This section of the APPPAH Newsletter is intended to draw attention to items in the news that are pertinent to prenatal and perinatal psychology. APPPAH does not necessarily agree with, or vouch for, the scientific worthiness of any of the news items mentioned here. We mean merely to take note of what is going on, so that you may.
"AMERICAN WOMEN: BIRTHING BABIES AT HOME"
Time magazine ran an excellent, comprehensive article on the state of home birth in the U.S., including a discussion of the American Journal of Obstetrics and Gynecology's controversial meta-analysis from last summer.
Author Catherine Elton leads with a clever yet chilling prologue: "When Hillary McLaughlin found out she was pregnant, she was unable to legally obtain the service she needed. So she looked for an underground contact. She got a woman's name—just a first name—and a phone number from a friend who advised her to destroy the evidence as soon as she made the call. When McLaughlin reached the woman, however, the woman told her she no longer 'did that' and that she wasn't willing to risk going to jail for it anymore. Turned off by all the 'whisper, whisper, cloak-and-dagger stuff,' McLaughlin decided to 'jump state lines' from Illinois to Missouri to find a legal provider. Forty years ago, you might have assumed McLaughlin was looking for an unlawful abortion. Rather, what the small-business owner, 33, sought was a certified midwife who could deliver her baby at home in Edwardsville, Ill." [Read more at http://www.time.com/time/magazine/article/0,9171,2011940-1,00.html#ixzz1HWwPvO9X]
ROLE OF WOMEN'S CHOICE IN RISE OF C-SECTION RATES LIKELY SPURIOUS
A new analysis of data on nearly 20,000 women from around the globe suggests that the steadily rising Cesarean-section rates over three decades is not because "women are asking for them." The rise in the rate of cesarean deliveries, particularly in middle- and high-income countries, is frequently attributed to women's requests for the procedure. In the U.S. the C-section rate was 4.5 percent in 1965, and 32.9 percent in 2007, according to the CDC. But only sixteen percent of women included in the research review said they would prefer cesarean section to vaginal delivery. This is the first meta-analysis that's looked at women's preferences, and was published in BJOG. It searched the medical literature and identified 38 studies including 19,403 women from the Americas, Asia, Europe, Africa and Australia. [Reuters, Dec. 2010]
BED REST NOT SUPPORTED BY EVIDENCE
Bed rest may not be the best option for preventing preterm labor and may even cause harm to the mother and baby, according to an integrative literature review in a special issue on "Women's Health Across the Lifespan" in Biological Research for Nursing. Bed rest or activity restriction, prescribed for up to one million women in the U.S. annually to treat pregnancy complications, is based on the assumptions that it is (a) effective in preventing preterm birth, and (b) safe for both the mother and fetus. According to the study, however, research over more than two decades has failed to support these assumptions. All known research about bed rest, high-risk pregnancy, and preterm labor was reviewed, and how those relate to the side-effects of bone loss, thrombosis, depression, stress, and other symptoms. In addition to the impact of an overall negative pregnancy experience for the mother, which has largely been ignored by medical professionals, the researcher found a number of troubling issues with bed rest, including such concerns as: loss of muscle function, muscle atrophy, sore muscles; bone loss; maternal weight loss and lower fetal weight; fatigue, sleep cycle changes, and boredom; depression during pregnancy and postpartum; and nasal congestion, reflux, indigestion, back and muscle aches. [ScienceDaily, Oct. 2010]
EFFECTS OF PREGNANCY LOSS PERSISTS MANY YEARS
A study of 13,000 British women found that the 2,800 who had suffered a miscarriage or stillbirth were much more likely to be anxious or depressed during their next pregnancy, and after the birth. This state of mind persisted for nearly three years after they gave birth to a healthy baby, researchers found. Jean Golding, one of the authors of the report, published in the British Journal of Psychiatry, said, "This study is important to the families of women who have lost a baby, since it is so often assumed that they get over the event quickly, yet as shown here, many do not." Lead researcher Emma Robertson Blackmore, of Rochester University in the U.S., pointed out, "This finding is important because, when assessing if a women is at risk of antenatal or postnatal depression, previous pregnancy loss is usually not taken into account in the same way as other risk factors such as a family history of depression, stressful life events or a lack of social support." [The Telegraph, March 2011]
CHILDHOOD ABUSE AND FEAR OF CHILDBIRTH
A Norwegian population-based, cross-sectional study of over 2,300 women examined the association between a self-reported history of childhood abuse and fear of childbirth. The study, reported in the journal Birth, indeed found that a history of childhood abuse (physical, emotional, or sexual) significantly increased the risk of experiencing severe fear of childbirth among women giving birth for the first time (primaparas). For women giving birth for a subsequent time (multiparas), the fear of childbirth was most strongly associated with a negative birth experience. [Birth, 37(4), Dec. 2010]
BIRTH SIZE AND MENTAL HEALTH
Scientists have discovered the first evidence linking brain function variations between the left and right sides of the brain to size at birth and the relative weight of the placenta. The finding could shed new light on the causes of mental health problems in later life. The research, conducted at the University of Southampton and the Medical Research Council (MRC) Lifecourse Epidemiology Unit at Southampton General Hospital, reveals that children who were born small, with relatively large placentas, showed more activity on the right side of their brains than the left. It is this pattern of brain activity that has been linked with mood disorders such as depression. The study adds to a growing body of evidence showing that adverse environments experienced by fetuses during pregnancy (indicated by smaller birth size and larger placental size) can cause long-term changes in the function of the brain. "This is the first time we've been able to link growth before birth to brain activity many years later," explains epidemiologist Alexander Jones, who led the study. "We hope this research can begin to shed new light on why certain people are more prone to diseases such as depression." [Stonehearth online newsletter, Feb. 2011]
HINTS ABOUT THE FURTHER MYSTERIES OF THE FETAL BRAIN
New research finds that full-term babies are born with a key collection of networks fully formed in their brains. The findings, reported in Proceedings of the National Academy of Sciences, challenges some previous theories about the brain's activity and how the brain develops. Researchers using fMRI scans focused on "resting state" networks in the brains of 70 babies, born at between 29 and 43 weeks of development. Resting state networks are connected systems of neurons in the brain that are constantly active, even when a person is not focusing on a particular task, or during sleep. The researchers found that these networks were at an adult-equivalent level by the time the babies reached the normal time of birth. One network of particular interest identified in the babies is the "default mode" network, thought to be involved in introspection and daydreaming. Professor David Edwards, lead author of the study, said, "Some researchers have said that the default mode network is responsible for introspection—retrieving autobiographical memories and envisioning the future, etc. The fact that we found it in newborn babies suggests that either being a fetus is a lot more fun than any of us can remember—lying there happily introspecting and thinking about the future—or that this theory is mistaken." Indeed! [Imperial College London news release, Nov. 2010]
DEPRESSION IN NEW DADS
Postpartum depression affects new dads, too, and it can negatively affect parenting, according to a large observational study published in Pediatrics. The study of more than 1,700 fathers of one-year-olds found that depression occurred in 7% of those dads, and increased the odds of recent spankings nearly four-fold and more than halved the likelihood of the men reading with their child most days of the week. Pediatricians could be in a good position to help, suggest the study authors, as 77% of the depressed dads reported having talked to their child's doctor in the prior year: "Pediatric providers should consider screening fathers for depression, discussing specific parenting behaviors (e.g., reading to children and appropriate discipline), and referring for treatment if appropriate," the group recommended in their paper. [MedPage Today, March 2011]
IVF MAY NOT HAVE "DETRIMENTAL EFFECTS" ON CHILD'S INTELLIGENCE.
In the face of recently emerging research (much of it reported here in past issues) raising questions about the long-term health effects of IVF, a recent study of children's test scores suggests that IVF conception "does not have any detrimental effects on a child's intelligence or cognitive development." According to an article in Human Reproduction, researchers studied "academic test scores of 423 Iowa children ages eight to 17 who were conceived by IVF and...the test scores of 372 matched peers from the same schools." The IVF kids "scored higher than their peers in all grades on tests for reading, language, math, and vocabulary." [Los Angeles Times, Oct. 2010]