Pre- and Peri-natal Psychology Journal 

About: Pre- and Peri-natal Psychology Journal is an academic journal. The journal publishes majorly in the area(s): Pregnancy & Feeling. Over the lifetime, 156 publications have been published receiving 1959 citations.

The Woman in the Body: A Cultural Analysis of Reproduction

Abstract: The Woman in the Body: A Cultural Analysis of Reproduction by Emily Martin Beacon Press, 1987 Paperback, 276 pp $1195 Winner of the 1988 Eileen Basker Memorial Prize As anthropology at its best can do, this book exposes hidden cultural assumptions about the nature of reality Martin has produced a powerful study of the dialectic between medical metaphors for women's reproductive processes and women's own views of those processes She and her associates interviewed 165 white and black women, seeking a balance between the three life stages of puberty, childbearing, and menopause 43% of her interviewees were working-class; 57% middleclass Early on Martin came up against one of the greatest dangers of studying one's own society Hearing women discuss uterine contractions as separate from the self and labor as something one "went through," and reading the same in medical texts, she at first thought that her interviews had turned up views of the body that simply reflected actual scientific fact It took her some time to realize that such scientific views are not "fact" but culturally grounded statements of an underlying ideology To get at this ideology Martin studied medical texts for the "grammar" that scientific medicine uses to describe female bodies In this medical grammar, she finds industrial society writ small The female reproductive tract is a machine designed to produce a baby; accordingly, menstruation represents failed production, connoting both a productive system that has failed to produce and one that produces only useless waste Such metaphors, disturbing to a society whose existence depends upon continued production, lead to menstruation's description in medical texts in highly negative terms: The fall in blood progesterone and estrogen, which results from regression of the corpus luteum, deprives the highly developed endometrial lining of its hormonal support Disintegration starts The endometrial arteries dilate, resulting in hemorrhage through the weakened capillary walls; the menstrual flow consists of this blood mixed with endometrial debris (quoted on p 48) (Martin contrasts this with a description of male reproductive physiology which speaks of the "remarkable" cellular transformation from spermatid to mature sperm, its "amazing" nature and "sheer magnitude") Confronting the argument that the above is not value-laden but simply a factual description of menstruation, Martin examines medical descriptions of the analogous regular shedding and replacement of the lining of the stomach, finding in a number of texts no references to degeneration, but instead a stress on the periodic "renewal" of the stomach lining Concluding that writers can choose to depict what happens to the lining of stomachs and uteruses either negatively as breakdown and decay or positively as continual production and replenishment, Martin suggests an alternative medical description of menstruation: A drop in the formerly high levels of progesterone and estrogen creates the appropriate environment for reducing the excess layers of endometrial tissue Constriction of capillary blood vessels causes a lower level of oxygen and nutrients and paves the way for a vigorous production of menstrual fluids Such a description would far more accurately reflect women's own more positive assessments of the menstrual fluid as the desired product Viewing pregnancy as the sole purpose of female reproductive organs and despising menstruation as a "waste" ignores the reality that most women do not intend to get pregnant most of the time (and so are often joyful when menstruation begins), and conceals "the true unity women have [Menstruation is] the one thing we all share" (p 112) In spite of ambivalence about the "disgusting mess," most interviewees felt that menstruation defines them as women and insisted that they wouldn't want to give it up Teens spoke of the joy of getting their periods so they could be part of the in-group that shared the women's "special secret," of mothers and sisters greeting their first menstruation with "You're a woman now! …

The Tentative Pregnancy: Prenatal Diagnosis and the Future of Motherhood/Reflections: On Hard Work

Abstract: Feel lonely? What about reading books? Book is one of the greatest friends to accompany while in your lonely time. When you have no friends and activities somewhere and sometimes, reading book can be a great choice. This is not only for spending the time, it will increase the knowledge. Of course the b=benefits to take will relate to what kind of book that you are reading. And now, we will concern you to try reading tentative pregnancy prenatal diagnosis and the future of motherhood as one of the reading material to finish quickly.

Pain and Its Effects in the Human Neonate and Fetus

Abstract: The evaluation of pain in the human fetus and neonate is difficult because pain is generally defined as a subjective phenomenon.1 Early studies of neurologic development concluded that neonatal responses to painful stimuli were decorticate in nature and that perception or localization of pain was not present.2 Furthermore, because neonates may not have memories of painful experiences, they were not thought capable of interpreting pain in a manner similar to that of adults.3"5 On a theoretical basis, it was also argued that a high threshold of painful stimuli may be adaptive in protecting infants from pain during birth.6 These traditional views have led to a widespread belief in the medical community that the human neonate or fetus may not be capable of perceiving pain.7,8 Strictly speaking, nociceptive activity, rather than pain, should be discussed with regard to the neonate, because pain is a sensation with strong emotional associations. The focus on pain perception in neonates and confusion over its differentiation from nociceptive activity and the accompanying physiologic responses have obscured the mounting evidence that nociception is important in the biology of the neonate. This is true regardless of any philosophical view on consciousness and "pain perception" in newborns. In the literature, terms relating to pain and nociception are used interchangeably; in this review, no further distinction between the two will generally be made. One result of the pervasive view of neonatal pain is that newborns are frequently not given analgesic or anesthetic agents during invasive procedures, including surgery.9-19 Despite recommendations to the contrary in textbooks on pediatric anesthesiology, the clinical practice of inducing minimal or no anesthesia in newborns, particularly if they are premature, is widespread.9-19 Unfortunately, recommendations on neonatal anesthesia are made without reference to recent data about the development of perceptual mechanisms of pain and the physiologic responses to nociceptive activity in preterm and full-term neonates. Even Robinson and Gregory's landmark paper demonstrating the safety of narcotic anesthesia in preterm neonates cites "philosophic objections" rather than any physiologic rationale as a basis for using this technique.20 Although methodologic and other issues related to the study of pain in neonates have been discussed,2123 the body of scientific evidence regarding the mechanisms and effects of nociceptive activity in newborn infants has not been addressed directly. ANATOMICAL AND FUNCTIONAL REQUIREMENTS FOR PAIN PERCEPTION The neural pathways for pain may be traced from sensory receptors in the skin to sensory areas in the cerebral cortex of newborn infants. The density of nociceptive nerve endings in the skin of newborns is similar to or greater than that in adult skin.24 Cutaneous sensory receptors appear in the perioral area of the human fetus in the 7th week of gestation; they spread to the rest of the face, the palms of the hands, and the soles of the feet by the 11th week, to the trunk and proximal parts of arms and legs by the 15th week, and to all cutaneous and mucous surfaces by the 20th week.25-26 The spread of cutaneous receptors is preceded by the development of synapses between sensory fibers and interneurons in the dorsal horn of the spinal cord, which first appear during the sixth week of gestation.27-28 Recent studies using electron microscopy and immunocytochemical methods show that the development of various types of cells in the dorsal horn (along with their laminar arrangement, synaptic interconnections, and specific neurotransmitter vesicles) begins before 13 to 14 weeks of gestation and is completed by 30 weeks.29 Lack of myelination has been proposed as an index of the lack of maturity in the neonatal nervous system30 and is used frequently to support the argument that premature or full-term neonates are not capable of pain perception. …

Massage with Oil Has More Positive Effects on Normal Infants

Abstract: Sixty one-month-old normal infants were randomly assigned to a massage group with oil and a massage group without oil. Massage had a soothing/calming influence on the infants, particularly when given with oil. The infants who received massage with oil were less active, showed fewer stress behaviors and head averting, and their saliva cortisol levels decreased more. In addition, vagal activity increased more following massage with oil versus massage without oil. The use of massage with infants is as old as the Qing dynasty (1644-1911) in China.1 Infant massage also has strong historical roots in Ayurvedic medicine in India around 1800 B.C.2 At least two volumes have been written on infant massage techniques and anecdotal accounts of its therapeutic benefits for various infant problems including colic and sleep problems.2,3 However, very little empirical research has been conducted to document the benefits of massage for infants except for research on infants at risk due to a variety of conditions. In preterm infants, for example, massage therapy facilitated weight gain and shortened the hospital stay by 6 days, yielding a cost savings of approximately $3,000 per infant.4-5 The infants, who were also more socially responsive following massage therapy, were continuing to show a weight advantage along with a mental and motor development advantage at the end of the first year.6 Other high-risk groups that have significantly benefitted from massage therapy include 1) preterm infants exposed to cocaine in utero, who gained more weight and showed better motor performance7; 2) preterm infants with HIV exposure whose weight and development were positively affected8; 3) infants of depressed mothers who also gained more weight and developed better sleeping patterns9; and 4) neglected and abused infants who became less touch aversive and more responsive to caregivers.10 Thus, different groups of high-risk infants have benefitted in several ways. The question of whether normal infants can also benefit from massage therapy was the focus of this study. Although therapists report that massage reduces irritability, enhances sleep and improves parent-infant relationships, no systematic studies have been conducted with normal infants. Another purpose of this study was to determine whether the use of oil enhanced the positive effects of massage. Therapists have anecdotally reported that massaging infants with oil is more effective than massaging without oil. However, this claim was also anecdotal. Our previous studies and those in the literature had provided massage therapy without oil. METHOD Subjects Sixty, one-month-old healthy, full-term infants (N = 30 females) were recruited from a university hospital approximately one day after they were delivered. Mothers of full-term, healthy infants were read the informed consent and, following their willingness to consent, were randomly assigned to one of two groups using a random numbers table. The two groups were a massage with oil group and a massage without oil group. The mothers averaged 25.3 years (R = 15-38), and their infants averaged 1.0 month (R = 3-6 weeks). Mothers were low income (M = 4.4 on the Hollingshead two factor index), and their ethnic distribution was 49% African-American, 49% Hispanic and 2% Asian-American. The two groups did not differ on these demographic factors. Procedures Massage Therapy. Each infant was massaged for 15 minutes between naptimes in a laboratory that is furnished like a living room. The mother, who was present during the massage procedure, was asked to remove the infant's clothing except the diaper. The infant was placed on a cotton blanket on top of an infant massage mat. The massage therapist (the same therapist for all infants) began by stroking the infant's face along both sides. Johnson and Johnson baby oil was applied (in the case of the oil massage) with long, gentle strokes from hip to foot, stroking the ankle with the hands wrapped around the lower leg, gently squeezing and twisting in a wringing motion. …

The Psychological Aspects of In-Vitro Fertilization

Abstract: Infertility is a life crisis that affects all aspects of a couple's life. When they enter an in-vitro fertilization program the trauma and emotional stress becomes intensified. The first section of this paper will review the psychological components of infertility. The second section shall focus on the psychological issues which apply specifically to in-vitro patients. In the last section, suggestions for primary care physicians who are directly involved in IVF programs will be made. INFERTILITY: A LIFE CRISIS A life crisis is a stressful event or situation that poses a problem that is insolvable in the immediate future. The problem over-taxes an individual's inner reserves because its resolution goes beyond traditional ways of solving problems. Infertility is a life crisis, not merely a transitory state of stress and anxiety. One's body has betrayed one, and throughout the diagnosis and treatment profound feelings of despair, hopelessness and self-hatred are experienced. One woman described it this way (Menning, 1977, p. 122): It is more than I can bear to think of myself as barren. It's like having leprosy. I feel . . . "unclean" and defective . . . empty, less than dead. Men often feel robbed of their masculinity and sexual identity. One husband described his feelings in these words (Menning, 1977, p. 120): I feel emasculated, I can make love to my wife 10 times a week, but she and I both know I'm only shooting blanks. I'm sterile and that makes me feel impotent. In addition to feelings of being damaged, infertility is viewed as a threat to one of life's most important goals, parenthood. Infertility profoundly affects a couple's relationship in the bedroom. Temperature charts, recording moments of intimacy for the doctor's scrutiny affects a couple's sexual spontaneity and pleasure. Even outside the bedroom a couple's ability to communicate is often severely impaired. Infertility affects them differently. Men are usually more optimistic about the outcome and cope with their pain by keeping it to themselves and focusing on practical, daily activities. Women, on the other hand, frequently cope with their anguish by constantly talking about it to their husbands. The men feel powerless to take away the pain and stop listening. The stress escalates and they retreat further from each other. Now in addition to their despondency over their inability to conceive they have lost their friendship and compassion for each other. Infertility affects a couple's peer relationships. In the initial stages, baby showers and birth announcements become painful reminders of their failures. Whether or not to go visit a friend who has just had a baby becomes a major trauma for an infertile couple. They must constantly juggle the loss of their social relationships vis a vis their anguish and jealousy. As the infertility progresses into years couples find themselves increasingly isolated from their friends who are busy with Little League games and Brownies. Infertility raises concerns about how their own families perceive them. One couple felt that their parents were angry because they robbed them of the privilege of becoming grandparents. They even felt their neighborhood was angry at them because their home was childless and didn't provide kids for the other children on the block to play with. Years of infertility places a couple's life on hold. Job security and advancements are affected by infertility treatments. Promotions are turned down because it might mean moving to another city and leaving their specialist. Women, in particular, experience stressful relations with their employers as they leave repeatedly for medical appointments. Financial burdens escalate as the costs for repeated appointments, inseminations, surgeries and medications soar. Future plans for trips and remodeling are put aside as couples save for further infertility work. …