Friday, April 2, 2010

What Triggered the Prequel

My post from last night, The Prequel of my Traumatic Birth Experience, was prompted by a friend posting this article on facebook. Though it is reporting a study saying that that anxiety in pregnancy can predict developmental delays in the baby once born, my attention was drawn to this paragraph:
"Contrary to old beliefs, however, research shows that ordinary day-to-day job and home stress isn't likely to cause low birth weight or other problems for most women. Traffic delays, work deadlines and other everyday hassles aren't likely to pose a threat to unborn babies, researchers say, and pregnant women who feel they are coping well tend to do just fine."
I disagree with this statement based on my experience (copied from the prequel):
When I was in week 34 of my pregnancy, I was working part-time at a preschool (9am-1:00 pm each day). I had a commute and prep time before class started so I was waking up at 7 am. I'm not a morning person (if you ever notice when most of my blog entries are posted you'll know that I'm a night owl). I was constantly tired in my pregnancy. I'd get home from work and have to take a long nap each afternoon just so I could function the next day. One day, I had to rush away from work for a prenatal appointment, but that day had already been a struggle. I was fighting nausea the whole day (strange for the third trimester) and had thrown up 3 times, once as I was getting into the car to head to the appointment. Already feeling tired and sick, I encountered unexpected traffic which was making me late to the appointment. I generally get very stressed when I am late to something so the combination of being impatient, stressed sick and tired was not boding well for that appointment. I then parked rather far away from the clinic and had to walk (more like jog since I was worried about being so late).
I also remember there was a journal article that linked maternal employment in late pregnancy to increased blood pressure. The researchers of the study being discussed in The Wall Street Journal either were unaware of this study published in American Family Physician in 2001 (Increased Blood Pressure and Working in Late Pregnancy. American Family Physician Oct 2001), not considering increased blood pressure as a "problem" for women, or had reviewed the findings of that study and disagreed with its findings.

To me, my experience leads me to support the findings of the 2001 study. Even though, I was incorrectly diagnosed with pregnancy induced hypertension at that appointment, it is true that my blood pressure was elevated from my baseline (diastolic at 88 after that stressful day, but its 60 when not pregnant, and at 70 when pregnant).

Reading the Wall Street Journal report last night brought that all back. Even at the time, my husband and I ascribed my working, the stressful commute and the brisk walk to the increase in blood pressure. I still do not understand why the midwife was not willing to accept that as a possibility. We felt it was lunacy to then think that rechecking my blood pressure later in the appointment, AFTER diagnosing me with gestational diabetes, putting my on bed rest and leading me to believe I was experiencing PIH, was going to result in a lower blood pressure reading, because I had time to "relax" during the appointment!?!

That was precisely the time when I stopped feeling like I could enjoy my pregnancy. Up until that point, I had felt very excited and happy as the birth approached. After that appointment, that happiness was clouded by the specter of the dead baby and dead mother card, as well as an induction that I knew made a cesarean more likely, which increases the chances of complications and death. All of this then caused greater confusion in my mind because at the beginning of my pregnancy, I was given a priesthood blessing by my husband and adopted father in the gospel which told me that I would give birth and go through the pregnancy without complications. Given what my husband and I knew, we believed the blessing was still true because the midwife was mistaken in her diagnosis. But how to handle a situation with a maternity care provider where our version of reality didn't mesh with hers? It all added up to a great deal of stress in our minds and just paved the way for the trauma I experienced as a result.

I often think that if the birth experience had happened in isolation of the prior stress, I wouldn't have experienced PTSD to the degree that I had. As it is, I felt there was so much manipulation and lies that I knew I wasn't safe going into labor so my stress response to what was happening in the hospital was amplified.


Jennifer said...

I'm sorry you were triggered by that article. I could not link to it, but I think the reason they are not including high blood pressure as a problem for the baby is that the study seems focused on mental outcomes for the baby, not physical outcomes. It seems they were specifically looking at what types of anxiety in the mother cause long term effects for the baby. So, anything that causes a physical issue for the mother would no really be applicable to what they were studying for. That is the way I am reading it any way, but maybe I'm missing something?

Jenne said...

I was really only referring to the quote I included from the article, specifically, "ordinary day-to-day job and home stress isn't likely to cause low birth weight or other problems for most women." Given all the hype about blood pressure in pregnancy, high blood pressure decidedly is a problem for women in pregnancy and in my case it was caused by ordinary day to day stress. I also find the 2001 article I cited more compelling than a journalist's summary of research.