Women who fear childbirth just got something else to worry about: a recent Norwegian study found that women who were scared of giving birth ended up spending more time in labor, about 8 hours versus 6.5 for women who weren’t afraid. According to the study’s authors, 5% to 20% of pregnant women fear giving birth. The reasons vary, from the mothers being young or never having given birth before to their having pre-existing psychological problems, a lack social support or a history of abuse or bad obstetric experiences. The study also found that mothers who feared childbirth were also more likely than unafraid women to need an emergency C-section (11% versus 7%) or assistance with instruments such as forceps for vaginal delivery (17.0% versus 11%). Overall, about a quarter of women who feared childbirth delivered without any obstetric interventions, compared with nearly 45% of women who were not afraid. “Fear of childbirth seems to be an increasingly important issue in obstetric care. Our finding of longer duration of labor in women who fear childbirth is a new piece in the puzzle within this intersection between psychology and obstetrics,” study author Samantha Salvesen Adams of Akershus University Hospital at the University of Oslo in Norway said in a statement. (MORE: Patience, Mom: More Hospitals Say No to Scheduled Delivery Before 39 Weeks) The researchers studied 2,206 women from pregnancy through childbirth. When the women were 32 weeks pregnant, the researchers assessed their fear of childbirth using a standard questionnaire. Women who scored higher than 85 were considered fearful; out of all the women, 165, or 7.5%, scored higher than 85. The researchers then analyzed the time they spent in childbirth. Women who were afraid labored for an hour and 32 minutes longer than did other moms. Even after adjusting for other factors that affect labor, such as epidural anesthesia, induction and instrument-assisted delivery, fearful women took 47 minutes longer to deliver than women who had less apprehension about giving birth. The authors note, however, that despite their fear, 89% scared mothers still succeeded in delivering vaginally, as they’d intended. That proportion was close to the 93% of women without fear who also succeeded. “Generally, longer labor duration increases the risk of instrumental vaginal delivery and emergency caesarean section,” said Adams. “However, it is important to note that a large proportion of women with a fear of childbirth successfully had a vaginal delivery.” Adams suggests that elective C-section shouldn’t be routinely recommended for fearful women, since, as the study’s findings show, they can still deliver vaginally if they wish. (MORE: Pregnant Women Who Control their Epidural Dosage Use Less Medication) The authors offer two theories for why women who are afraid of labor spend more time doing it. One is that they may psych themselves out. “Mental stress is associated with physiological arousal and release of stress hormones. During labor, high levels of stress hormones may weaken uterine contractility and thereby prolong labor in women with fear of childbirth,” says Adams. Another explanation is that fear of childbirth may interfere with clear communication between the mother in labor and the obstetric staff. “Poor communication with health personnel may delay obstetric interventions,” Adams says. “There are a number of reasons why women may develop a fear of childbirth,” said John Thorp, editor-in-chief of BJOG: An International Journal of Obstetrics and Gynaecology, the journal in which the new study is published, in a statement. “This research shows that women with fear of childbirth are more likely to need obstetric intervention and this needs to be explored further so that obstetricians and midwives can provide the appropriate support and advice.”
2012-07-09
Children who are pushed, grabbed, shoved, slapped or hit are more likely to be diagnosed with mental illness. Just one more reason to embrace alternative forms of discipline
By Bonnie Rochman | @brochman
What if we, as a society, could cut down on the incidence of mental illness by backing away from hitting, grabbing or pushing our children?
That’s a prospect raised by a new study in Pediatrics, which finds that harsh physical punishment increases the risk of mental disorders — even when the punishment doesn’t stoop to the level of actual abuse.
What qualifies as appropriate punishment is a hot-button topic among parents. The American Academy of Pediatrics opposes corporal punishment, but studies have shown that up to 80% of parents report that they rely on it to some extent. What constitutes physical punishment is also wide-ranging: everything from a light slap on the hand to an all-out whipping with a belt or a paddle.
“In the general population, there is a belief that physical punishment is O.K. as long as you’re not doing it in anger and you’re a warm and loving parent,” says Tracie Afifi, the study’s author and an assistant professor in the Department of Community Health Sciences at the University of Manitoba in Canada. “But there’s no data supporting that.”
(MORE: Why Spanking Doesn’t Work)
Afifi and colleagues decided to examine five forms of physical punishment — pushing, grabbing, shoving, slapping and hitting — that took place in the absence of even more severe acts of abuse or neglect such as punching, burning, physical neglect or sexual abuse. Other related research has not specifically included or excluded more severe types of abuse, meaning that the abuse — and not the grabbing or slapping — may be driving the relationship between physical punishment and mental disorders.
She did not examine spanking because it’s not easy to define: what’s considered spanking varies from parent to parent. But, she says, “a push is a push, and a grab is a grab.”
In the study, researchers analyzed more than 20,000 people in the U.S. who were age 20 or older: 1,258 who had experienced pushing, grabbing, shoving, slapping and hitting sometimes or very often, and 19,349 who reported they had experienced it rarely or never. They adjusted results for gender, race, marital status, education and a history of family dysfunction; if the person’s parents had drug problems or were hospitalized for mental illness, that could have affected their use of physical punishment.
Across the board, people who’d experienced physical punishment were more likely to experience nearly every type of mental illness examined. Their risk of mood disorders, including depression and mania, was 1.5 times greater than people who hadn’t been slapped or grabbed. The risk of depression alone was 1.4 times greater, which was the same rate for anxiety. People who’d been physically punished were 1.6 times more likely to abuse alcohol, and 1.5 times more likely to abuse drugs.
(MORE: How Child Maltreatment May Scar the Brain)
“There’s going to be lot of people that think that a parent absolutely needs to use physical force to raise a compliant child,” says Afifi. “It’s pretty well established that physical abuse has a negative impact on mental health, but this is showing the same effect even when you look at milder forms of physical force. This is saying that physical punishment should not be used on children of any age.”
George Holden, a professor of psychology at Southern Methodist University in Dallas who published research last year on the first real-time study of parents physically disciplining their kids, says Afifi’s findings fit into a “large constellation” of studies that show children whose parents use physical force are at greater risk for depression and anxiety. “This is yet another study documenting that this practice can result in unintended negative consequences,” says Holden. “Other studies have shown corporal punishment in childhood carries over to adulthood in terms of aggression, so there’s no reason why it wouldn’t in the area of mental health.”
Afifi hopes that “reasonable” parents will read about her research and decide to swear off physical punishment. Pediatricians can be part of the solution, talking to parents about alternative methods. “It’s never too late to stop,” she says, though she acknowledges a “cultural shift” needs to happen in order to turn the tide.
MORE: The New Science Behind Children’s Temper Tantrums
Rochman is a reporter at TIME. Find her on Twitter at @brochman. You can also continue the discussion on TIME’s Facebook page and on Twitter at @TIME.
Read more: http://healthland.time.com/2012/07/02/physical-punishment-increases-your-kids-risk-of-mental-illness/?iid=hl-article-editpicks#ixzz206BL2Na6