Monday, November 15, 2010

Psychoprophylaxis: Not Just For Dads or Partners with Tocophobia!

New research, presented in a doctoral thesis from the Swedish Medical University Karolinska Institutet, shows that psychoprophylaxis can help men with tocophobia (fear of childbirth). The thesis, which is to be presented on Nov. 12, also shows that although psychoprophylaxis generally has no effect on the experience of childbirth for women or men, its actual use during delivery seems to reduce the risk of emergency C-section.


If this is a true translation of the thesis, then in my humble opinion, it is contradictory on so many levels.  


The psychoprophylactic method or PPM was an integral part of the Lamaze Techniques from early on, especially as it was a part of the original name of Lamaze.  Lamaze was previously known as ASPO or ASPO Lamaze, with ASPO being short for the American Society of Psychoprophylaxis in Obstetrics.  And while the article/thesis goes on to point out that the psychoprophylactic method generally has no effect on the experience of childbirth, all one has to do is research Lamaze or the psychoprophylactic method to find a myriad of research to substantiate its effectiveness.


But let's break it down.  Psycho means mind and prophylaxis means prevention.  Thus the psychoprophylactic method prevents the mind from dwelling on the intensity of the contractions my giving the mind something else to do (breathing, effleurage, focusing, guided imagery etc).  Additionally, learned techniques of the psychoprophylactic method are also comfort measures that documentable medical research has shown to be highly beneficial in reducing the sensation of pain during labor and birth.


In today's society, the element of fear, as discussed in this thesis is one of the overriding factors in women allowing interventions during labor and birth: fear of the unknown, fear of pain, fear of unpleasant outcomes.  While NO ONE can promise a lack of unpleasant outcomes, the use of psychoprophylactic methods can assist in the woman remaining in control ~ which research has shown to be important to a woman's perception of her childbirth experience.  Again and again, evidence exists that demonstrates that women who were active participants in their birth process were much more satisfied with the experience than women who expected to rely on their physicians and on interventions including medications.


The doctoral student, Malin Bergstrom, also stated "This is important, as these men are easily neglected, and if they don't receive help the chances are that they won't tell anyone about their fears. Apart from the personal effect this has, it is also possible that this affects their relationship with the mother and child."


My question is why are not the MOTHERS the focus of this study?  


Yes, it is vital that partners of childbearing women become prepared for birth and their fears and anxiety alleviated.  


However, with only less than 33% of expectant mothers OR partners attending childbirth education classes, it seems only right to include the mothers who will be in labor.  


What about the studies that show that fear, stress and anxiety in the laboring mother has a profound effect on the labor and health of the baby?


Childbirth is a safe and normal life event.  Childbirth is NOT a health crisis.  Neglecting to address birth in both educational and informative ways is a sin of which too many are guilty.



1 comment:

Arp said...

Where is the 33% figure from? I'm disappointed it's so low - something has to be done to improve it!