Trauma Following Termination of Pregnancy for Fetal Abnormality: Is This the Path From Guilt to Grief?

Termination of pregnancy for fetal abnormality (TOPFA) is a potentially traumatic event that may lead to intense grief symptomatology. The present study included 41 couples who were assessed 1–6 months after TOPFA. No gender differences were found regarding the intensity of trauma symptomatology or the prevalence of clinically relevant trauma symptomatology, present in about a third of the sample. Most couples were congruent regarding trauma symptomatology. Women experienced guilt with significantly more frequency than men. For both genders, guilt influenced both trauma and grief symptomatology. For women only, guilt influenced grief symptomatology indirectly, through trauma symptomatology. Clinical implications are discussed.     

Women's experiences of the therapeutic value of writing about pregnancy sickness

Background

There is evidence of the beneficial effects of writing therapy in relation to a range of disorders. This is the first study to evaluate those effects in the field of pregnancy sickness.

Aim

To analyse the experiences of women using writing therapy to address issues associated with pregnancy sickness.

Method

Ten women with an age range of 32–48 years participated in this research study. All had been hospitalised at least once with severe pregnancy sickness symptoms in the form of hyperemesis gravidarum. Participants were invited to write reflectively about their former pregnancy sickness, at home, and then take part in a qualitative, semi‐structured telephone interview of approximately one hour to talk about how they experienced this writing process.

Findings

Thematic analysis identified several themes relating to the beneficial effects and uses of writing therapy and women's relational need to be heard and supported.

Discussion

This study supports previous findings about the beneficial effects of writing therapy and contributes new knowledge to the field of pregnancy sickness vis‐à‐vis the importance of emotional expression, emotional care and emotional recovery. The findings have important implications for healthcare professional practice.     

PREGNANT WOMEN'S RECOLLECTIONS OF EARLY MATERNAL BONDING: ASSOCIATIONS WITH MATERNAL–FETAL ATTACHMENT AND BIRTH CHOICES

Recollections of own maternal care measured by parental bonding were found to be important in the pregnant woman's construction of herself as a mother. Although these recollections were studied with regard to various variables, there is a dearth of studies associated with pregnancy and childbirth. In this cross‐sectional study, 341 pregnant women were recruited. Measures included a Sociodemographics–Obstetric History Questionnaire; the Childbirth Choices Questionnaire (H. Preis, M. Gozlan, U. Dan, & Y. Benyamini, 2018); the Parental Bonding Instrument (G. Parker, H. Tupling, & L.B. Brown, 1979); a question regarding the planned presence of the woman's mother at delivery; and the Maternal‐Fetal Attachment Scale (M.S. Cranley, 1981). Parental recollections of Care were associated with fewer natural birth choices (hence, a more “medicalized” delivery), lower maternal–fetal attachment, and a wish for the mother's mother to be present at the birth. Parental recollections of Encouragement of Behavioral Freedom in childhood were associated with more natural choices regarding childbirth. In addition, women with higher scores on the parental bonding Denial of Autonomy factor reported stronger maternal–fetal attachment. Thus, early recollections of experiences with caregivers as manifested in parental bonding may be a possible influence on the transition to motherhood, and working through possible difficulties associated with these recollections may improve adjustment to motherhood.     

重复异位妊娠的临床处理策略

为了探讨重复异位妊娠适宜的临床治疗方案,对2006年1月至2006年12月我科收治的251例异位妊娠中42例重复异位妊娠患者的资料进行回顾性分析,资料显示:重复异位妊娠的发病率为16.7%(42/251),平均发病年龄30.7岁,42例患者中异位妊娠部位与上次发生在同侧输卵管12例,对侧输卵管30例,两次异位妊娠发生间隔的时间最短为2个月,最长为9年,平均3.2年。其中10例为第3次异位妊娠。此次患病手术治疗25例,包括切除输卵管13例,保守性手术12例。因盆腔炎症和保守性手术是重复异位妊娠的危险因素,预防和彻底治疗盆腔炎症是降低重复异位妊娠发生的重要手段,采取保守性治疗或保守性手术时应慎重考虑其对患者将来生育和心理的影响。     

异位妊娠临床诊疗中的策略与决策

通过异位妊娠的发病率,诊断及治疗中的注意事项,治疗方法的选择的分析,探讨异位妊娠的临床诊断及治疗的策略与决策。为了提高异位妊娠的诊断率、减少误诊率,需要建立合理的临床思维方法和科学的处理程序,为异位妊娠的临床诊断及治疗,提供科学的临床决策方法。     

Associations between prenatal substance exposure,prenatal violence victimization,unintended pregnancy,and trauma exposure in childhood in a clinical setting

Given the importance of early prevention and intervention strategies for children exposed to trauma, detection of early risk factors for exposure to traumatic events in childhood is critical. The present study examined associations between three known prenatal risk factors that characterize environmental instability in utero—prenatal substance exposure, prenatal violence victimization, and unintended pregnancy—and child exposure to interparental violence and other adverse experiences in a sample of 198 mother–child dyads (M child age = 44.48 months) referred to a hospital clinic for treatment following exposure to trauma. Prenatal substance and violence exposure were associated with child trauma exposure, and prenatal violence victimization was also associated with maternal severity ratings of traumatic exposures. Unintended pregnancy was not associated with child trauma exposure or severity. These findings expand our understanding of prenatal risk factors for trauma exposure in childhood and, specifically, highlight prenatal substance exposure and violence victimization as risk factors for subsequent exposure to trauma in early childhood. Results suggest that prenatal prevention and intervention programs should target reducing maternal substance use and in-utero exposure to violence.     

Plenary address – A year of living ‘dangerously’: Reflections on risk,trust, trauma and change

This paper examines the role of emotions in the construction and performance of mis/trustful relations; with medical professionals, their technologies, and ultimately, with oneself. Using personal experience of two common conditions as illustrative examples, it questions what it means and feels like to trust, and how, where and by whom such feelings can be enhanced or undermined. It explores some of the ways in which discourses of risk are mobilized and embodied to create a crisis of trust, asking; what kind of selves and emotionalities surface, and what are the health outcomes, when bodies are viewed as ‘at risk’? Visualizing technologies that probe the interior for data play an increasingly prominent role in healthcare, and are typically considered more trustworthy sources of knowledge about the body than anything that might be produced by the tech-free sensing self. However, not all (even ‘physical’) trauma can be seen or quantified, and not all information is equal. The paper reflects on the emotional dissonance that ensues when one's own perceptions and representations are at odds with those of medical experts for whom one is supposed to perform trust. It examines the feeling rules that are broken when we fail to appreciate our treatment at their hands, and asks: What happens when we resist expert author-ity by telling different stories about our embodied selves, ones that make space for emotions in contexts where they are rarely seen to count, and where only what can be measured matters?     

Prenatal Paranoia: An Analysis of the Bumpy Landscape for the Pregnant Athlete

ABSTRACT

I analyze the case of pregnant athletes, and argue that sexism surrounds pregnant athlete’s participation in sport. I claim that we stigmatize the pregnant body in action. Participating in sport while pregnant is often considered socially irresponsible behaviour because of unfounded fear of harming the fetus. Many believe that elite sport is in conflict with reproductive ability. However, this belief is not rooted in scientific findings, and rather is reinforced by traditional sexist views of the woman’s athletic body and its capabilities. Analyzing the various degrees of sexism like sexual objectification and unjust discrimination that surround the pregnant athlete is a relevant and necessary exercise in order to challenge traditional sexist views and increase agency for the pregnant athlete.