Volume 14, Issue 3/4

Publication Date: 
03/2000
Volume #: 
14
Volume Page Numbers: 
193
352
Price: $20.00

The Sufis, the mystical offspring, some say predecessors, of Islam, have preserved sacred lineages called Silsilah. In these nominal lists are not only inventories of the various leaders of these orders but an unwritten and more mystical linkage, a transmission of learning and feeling which unites not only the history but the intentionality of these groups.

In the West, we often make such connections through the experiences of individuals whose names are marked by their deeds. As a young man, Lord John Russell, later Prime Minister of England,1 visited the former French Emperor, Napoleon at his place of exile on the island of Elba. The English politician's grandson, Lord Bertrand Russell constructed the Principle, Mathematica (1910-1913) with Alfred North Whitehead and later won a Nobel prize for literature. Bertrand Russell was alive and still actively supporting the cause of pacifism when I was a college student in the 1960's.

As humans, I believe that we preserve these connections as a tangible proof of the universal correlation. Or as I often say to my students, "We all already know each other. We just don't realize it yet." This double issue of the Journal is an acknowledgment of these ideas and of the multivarient talents of the contributors.

I hope that this issue will become part of an archival record of the history and purpose, not only of APPPAH, but also of two of the architects of pre- and perinatal psychology, Dr. Gustav Hans Graber and Dr. Frank Lake. The Rev. Simon House discusses the groundbreaking work of Frank Lake, with whom House and also APPPAH Board member Dr. William Emerson were associated. Dr. Sepp Schindler, long time colleague of Dr. David Chamberlain, describes the legacy of Hans Graber, the founder and first president of the International Studysociety in Prenatal Psychology (ISPP). David Chamberlain, himself, shares his remembrance of the history of APPPAH, adapted from his address, in accepting the Thomas Verny Award.

This issue also introduces the preliminary findings of the first research sponsored by APPPAH. In 1999 the Van Strum Foundation provided a $5,000 grant which allowed the Board of APPPAH to offer partial sponsorship to one clinical experiment in prenatal and perinatal psychology and health. The Board, after considering a variety of projects, accepted a proposal by Russian River Counselors of Monte Rio, California, a non-profit group directed by psychologist Antonio Madrid, Ph.D.

Dr. Madrid and his associates had previously conducted a series of studies using short-term hypnotherapy to correct failures of maternalinfant bonding. This initial work was reported in an inaugural edition of the association's Journal during the Spring of 1985. From 1988 to 1991 doctoral research by three of Dr. Madrid's colleagues, clarified the role of non-bonding problems in birth complications and in the development of asthma in children. The resultant Maternal-Infant Bonding Survey (MIBS) made it possible to identify the key factors which inhibit bonding.

The current research has been conducted with mothers of children who have pediatric asthma. The study is designed to aid the parent in resolving the causes of non-bonding. The therapeutic process delineated in this work has had a remarkable effect on the health of the children.

To the members of the APPPAH Board this line of inquiry is of unusual importance because it illuminates the consciousness of both baby and mother and the reversibility of a major childhood disease. We present the theoretical foundation of this consequential research, with the hope that it is the first of many significant studies to be sponsored by this organization. The entire study by Dr. Madrid and his colleagues will be published in a subsequent Journal.

This issue is also enriched by a significant study by Laura M. Glynn, Ph.D., Pathik D. Wadhwa, M.D., Ph.D., and Curt A. Sandman, Ph.D. on the influence of corticotropin-releasing hormone on human fetal development and parturition. As the results of the study indicate: "It appears that premature elevation of placental CRH during pregnancy may contribute to shorter gestational lengths. Also, CRH may affect fetal development."

Lewis E. Mehl-Madrona, M.D., Ph.D., in Psychosocial Prenatal Intervention to Reduce Alcohol, Smoking and Stress and Improve Birth Outcome among Minority Women, describes the methodology and the outcome of his work with a group of Native American women and their health care providers in reducing the use of toxic substances during pregnancy.

Recently I was rereading a biography, by Antonia Fraser, about Charles II and the English Restoration. Charles' mother, Henrietta Maria had earlier lost a prematurely delivered son. When she was pregnant with Charles, her own mother, Marie de Medeci, sent over from France not only a noted midwife and a special birthing chair but also, "a charm against miscarriage in the shape of a heart: Henrietta Maria wore the charm constantly, worrying when she forgot to put it on."2 Many years later, in one of the last letters of his life, Charles I addressed his son, the future Charles II, in a moving phrase: "You are the son of our love. . . ."3

Thomas Armstrong, Ph.D. explores similar cross-cultural "images of protection and guardianship of a fetus before, during and after birth," in his article, The Genius Within Us: Psychospiritual Guidance during Pre- and Perinatal Development and its Connection to Human Potential After Birth. He concludes that "further research into these images can help shed light on specific aspects of human development." Certainly the ideas Dr. Armstrong discusses seem to be true of King Charles II, who was conceived and born in love and protected in utero by images cherished by his grandmother and his mother. Charles II remained his entire life, despite the vicissitudes he endured as a result of the English Civil War, "by nature affectionate and affable." A contemporary wrote: "There was a softness and a gentleness in him, both in his air and his expression."4

It is through the efforts of Jane English, Ph.D. that the set of papers on cesarean birth have been assembled for this issue. Jane English has spent twenty years as she explains, in "research, self-exploration and collecting anecdotal material" that led to various article and presentations and to her book, Different Doorway, about her own cesarean birth. To her comments are added the thoughts of Robert Oliver, M.D. on The Ideal Cesarean Birth, Robert Leverant, M.A., M.F.T., who examines his own labor cesarean birth in the context of Wilhelm Reich's concept oforgonomy, and a dialogue between Joanne Steele, B.A. and Jane English on parenting a cesarean born child.

I have always maintained, due to my later propensity for journeys into "the back of the beyond," that mine was a cesarean birth, "because I was born with my bags packed." However, underlying the joke was an experience so traumatic that it produced both blessings and bereavements, which I am even yet unraveling. So I nodded my head, yes, as I often do, when reading things Jane has written or when I listen to her speak. I spoke for an hour on the phone with Robert Leverant, finding an old friend in our shared encounter of a labor cesarean birth.

I longed for the enlightened mothering that Joanne Steele, with whom I also shared a wonderful conversation, was able to give her daughter and I wept over the loving and caring experience that being born cesarean would be in the hands of Bob Oliver.

Perhaps the most famous "cesarean born" of the twentieth century is the present Queen of England, Elizabeth II. So respectful was the press, at that time, about the British Royal family that the initial announcement of the future Queen's birth simply said that, "a certain line of treatment was followed." One of the Queen's more forthright and modern biographers wrote, "{T}he Duchess of York (now the Queen Mother Elizabeth) went through long, difficult hours of labour before the baby was born."

It was a difficult birth at a difficult time. Elizabeth was a breech baby, her mother tiny and small-boned; the birth was a Caesarean, performed at 2:40 a.m. on April 21st, 1926, just twelve days before the country was engulfed by the General Strike, which many observers saw as the onset of class struggle and even revolution.6 Uncommon in the era of Queen Elizabeth's birth, the cesarean section has been utilized in the United States in the last two decades in proportions varying from 16% to nearly 24% of live births. According to Dr. M.K. Menard in an article entitled Cesarean Delivery Rates in the United States in the 1990's, "Focused efforts" to reduce cesarean sections have resulted in a modest decrease in their rate. He adds that: "A common theme in these reports of successful strategies to decrease the c-section rates safely is the importance of physician motivation to make the change." Other recent studies seem to indicate that the decline in the rate of cesarean section deliveries in the United States seems now to have stalled.6

The controversy over the cesarean section has attracted world-wide attention and various aspects of the issue have been widely investigated. The focus of these investigations has been the upsurge of cesarean sections both in the developed and developing world and the realization that the operation may not always contribute positively to the health of the mother and the baby. Indeed, several studies have demonstrated both the short and long term negative effects. Research has also revealed that factors other than medical necessity play an important role in the decision to perform a caesarean section. For example, "Turkey, although reliable data does not exist, can be classified among the countries experiencing the cesarean epidemic, at least among highly educated and wealthy mothers."7

Brazil, although for different reasons, also has one of the highest rates of caesarean sections in the world. In one study of 5960 mothers, 27.9% were delivered by Caesarean section-30% for nulliparae, 80% for second deliveries when the first was by caesarean, and over 99% for third births when the first two were by caesarean.

Socioeeonomic status and requests for sterilization by tubal ligation were important underlying factors. "9.4% of the women were sterilized during a caesarean section (3.7% in the lowest income group and 20.2% in the highest). 31% of women who had their first child by a caesarean section and who were having a second operative delivery were sterilized." The high rates of caesarean sections and accompanying sterilizations reflect the lack of appropriate reproductive and contraceptive policies in the country.8

An article in the National Medical Journal of India also revealed a very high rate of cesarean section deliveries in the selected metropolitan population in Chennai, Tamil Nadu, India. The authors maintain: "On purely scientific grounds, a rate of 40% to 50% is extremely difficult to justify." The article also states that the data also suggested that a cesarean delivery "may be adversely affecting some aspects of breast-feeding."9

Natural child birth is obviously preferable to intrusive intervention and I deplore the excessive and sometimes unnecessary use of the cesarean delivery. Yet, despite the trauma, the cesarean when utilized correctly, does alter "the outcome favorably for a significant percentage of women and babies." A brochure published by the National Library of Medicine offers this rational:

In our society now women may be afraid of the pain of childbirth, but they do not expect it to kill them. Such could not be said of many women as late as the nineteenth century. Moreover, most women now expect their babies to survive birth. These are modern assumptions and ones that cesarean section has helped to promulgate. An operation that virtually always resulted in a dead woman and dead fetus now almost always results in a living mother and baby-a transformation as significant to the women and families involved as to the medical profession.10

Although my mother and I both nearly died at the hands of a well meaning and frantic physician desperate to save the wife and child of a fellow doctor-we did survive. Years later, despite more harmonious and well planned circumstances and with a team of highly qualified obstetricians in attendance, my mother and my younger brother, who was delivered in a non labor cesarean birth, each still came close to death. Nevertheless my mother lived an additional eighteen years and my brother is now in his fourth decade. As my late father used to say, jokingly to us, concerning his patients who complained about the unavoidable side effects of certain uncomfortable treatments, "They've never considered the alternative."

References

1. Lord John Russell, later Earl Russell was elected to the House of Commons in 1813. He served as Prime Minister under Queen Victoria from 1846-52 and from 1865-66.

2. Antonia Fraser, Royal Charles: Charles II and the Restoration (New York: Alfred A. Knopf, 1979), p. 12.

3. Ibid., p. 12.

4. Ibid., p. 15.

5. Sarah Bradford, Elizabeth: A Biography of Britain's Queen (New York: Riverhead Books, 1996), p. 27.

6. M.K. Menard, M.D., "Cesarean Delivery Rates in the United States in the 1990s" Obstet Gynecol Clin North Am (June 1999); 26(2):275-86.

7. M. Tatar, S. Gunalp, S. Somunoglu, A. Demirol, "Women's Perceptions of Cesarean Section: Reflections from a Turkish Teaching Hospital", Soc Sci Med (May 2000); 50(9):1227-33.

8. F.C. Barros, J.P.Vaughan, C.G.Victora, S.R. Huttly, "Epidemic of Cesarean Sections in Brazil", Lancet (July 20, 1991); 338 (8760): 167-9.

9. M. Pai, P. Sundaram, K.K. Radhakrishnan, K. Thomas, J.P. Muliyil, "A High Rate of Cesarean sections in an Affluent Section of Chennai: Is it Cause for Concern?" Natl Med J India (Jul-Aug 1999);12(4):156-8.

10. Jane Eliot Sewell, Ph.D., Cesarean Section: A Brief History. (A Brochure to Accompany an Exhibition on the History of Cesarean Section at the National Library of Medicine), April 30-August 31, 1993.

Ruth Johnson Carter

Editor-in-Chief

Georgia College & State University

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