I do believe that an acid test of the pre- and perinatal psychology will be the extent to which it influences actual OB/GYN practices. That these practices are in sore need of change seems beyond doubt.
I have seen two publications since our last issue went to bed that underscore the need for such changes in procedures. One of these publications is Dr. Robbie E. Davis-Floyd's recent book, Birth as an American Rite of Passage (University of California Press, 1992). In this remarkable study Dr. Davis-Floyd supports the idea that many American obstetrical practices are in fact rituals that perpetuate technocratic cultural values and are unsupportable on any scientific grounds.
In this regard, I also bring to your attention a recent study by Dr. Michael C. Klein and his associates ("Does Episiotomy Prevent Perineal Trauma and Pelvic Floor Relaxation?" Current Clinical Trials Vol. 1, Document 10, 1992). The study tests the efficacy of routine episiotomy in preventing perineal tears and pelvic floor relaxation. They found in fact that episiotomies tend to promote, rather than prevent perineal trauma. Their conclusion was that "liberal or routine use of episiotomy be abandoned."
What do you bet that obstetrics will not just drop the practice of episiotomy? Indeed, there has been evidence around for years that episiotomy in most instances causes more trouble than the practice is worth. But as Dr. Davis-Floyd discusses in her book (pp. 128-132), the episiotomy is just one of many ritual procedures in a total complex of activities that treat birth as pathology, and that place women under the control of the professional "healers."
So perhaps you might agree with me that a really tough acid test of pre- and perinatal psychology would be persuading the OB/GYNs to drop all those rituals that do not bear up under scientific scrutiny.
While we are waiting for our discipline to pass its acid test, Dr. Michel Odent discusses his aquatic theory of humanity. Dr. Mark Sossin examines the association between developmental disabilities and narcissism in later life. Dr. Jane English then describes the psychology of caesarean birth and the importance of birth for self-identity and world view. Marilyn Moran looks at the effects of love making upon the course and experience of labor. Finally, Dr. Lewis Mehl tracks the relationship between a mother's own birth and her experience of giving birth.