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A Death, And A ‘Changed Life’: Traumatic Births Take Toll On Health Workers Too

Sarah Jagger and midwife Stephanie Avila were together when Jagger's son suffered a brain injury during labor that led to his death. Here, about a year later, in 2013, Jagger and Avila share a moment of gratitude after the safe arrival of a healthy baby girl. (Courtesy of Orchard Cove Photography)

Sarah Jagger and midwife Stephanie Avila were together when Jagger’s son suffered a brain injury during labor that led to his death. Here, about a year later, in 2013, Jagger and Avila share a moment of gratitude after the safe arrival of a healthy baby girl. (Courtesy of Orchard Cove Photography)

Everything seemed fine until the little boy was born.

He wasn’t breathing, but his heart was strong, recalled Stephanie Avila, the midwife attending the baby’s birth at a Rhode Island hospital back in 2012. But it soon became clear that the boy had suffered a brain injury during labor.

Eleven days later, after an MRI confirmed the severity of the injury and the family withdrew life-support, the child died. His official diagnosis: hypoxic ischemic encephalopathy, a brain injury caused by oxygen deprivation.

“I was prepared to stand by the family through this trauma,” Avila said in an interview. “But I fully expected I’d get sued — and it was going to get ugly, or uglier.”

Of course, the little boy’s family was devastated. “I just went into my own world,” said his mother, Sarah Jagger, speaking about the loss of her son.

But Avila suffered too. “I was a wreck,” she said.

Immediately after the birth, Avila said, she remained on call overnight at the hospital, Women & Infants, in Providence. “I retreated to the call room and curled up in the fetal position and prayed that no other people in labor would show up. I cried, had the worst headache I’ve ever had in my life, and felt like I’d vomit. For days I felt emotionally and physically terrible. I’d be walking down the street and suddenly could no longer move.”

At the time, Avila had two small children of her own. “And whenever my 2-year-old would do this cute thing, I’d think, their baby will never walk around in his mother’s high-heeled shoes. I’d get these terrible thoughts and I’d never know when it would strike.”

The Psychological Toll

After a traumatic birth — or any traumatic medical event — attention, rightly, turns to the grieving family. But research has been mounting in recent years that health care providers, sometimes called “the second victims,” also sustain long-lasting emotional damage following such a trauma.

A new study published by Danish researchers underscores the phenomena: Midwives and obstetricians who experienced a traumatic birth — one involving severe injuries or death — report that the psychological toll of such an event is deep and long-lasting.

More than one third of those surveyed said that they always would feel some sort of guilt when reflecting on the event, researchers report. Nearly 50 percent agreed that the traumatic birth had made them think more about the meaning of life. “This tells us that health care professionals are affected, not only professionally, but also at a personal and even existential level,” said Katja Schrøder, the study’s first author and a Ph.D. fellow at the University of Southern Denmark.

‘Changed My Life Forever’

This was indeed the case for Avila. “I feel as though that day — even to this day — changed my life forever in many ways,” she said. And while the “acute” nature of the trauma has passed, she said, the enormity of it continued to grip her, sometimes unexpectedly and at random times.

In the Danish study, published in Acta Obstetricia et Gynecologica Scandinavica, a journal of the Nordic Federation of Societies of Obstetrics and Gynecology, more than 1,200 Danish obstetricians and midwives responded to a survey on the aftermath of a traumatic birth. Of those respondents, 14 were selected for a followup interview.

Many of the providers spoke of not being able to shake the trauma, whether they were blamed for the bad outcome or not. “Although blame from patients, peers or official authorities was feared (and sometimes experienced), the inner struggles with guilt and existential considerations were dominant,” researchers report.

From the paper:

One mid-wife explained that even now, 12 years after the event, she would still think about that particular mother and child when passing through their town…

Most participants described having spent many hours agonizing and wondering whether they could have prevented the adverse outcome. One midwife said that her sense of guilt would never disappear because she knew that the parents would have to live with the consequences of her handling of the delivery.

Still, the researchers found that for many providers, “the traumatic childbirth had given rise to personal development opportunities of an emotional and/or spiritual character …for instance by achieving a more humble and profound understanding of both professional roles and of life as a whole.”

A Meaningful Meal

About a month after her infant son’s death, Jagger did something unusual: She asked Avila to meet for lunch. Up until then, the two women had been in touch — Avila had called to check in often, offering to help out and attend followup medical appointments with Jagger.

But the lunch date marked a turning point, the women agreed. First, it became clear that Jagger didn’t blame Avila for the boy’s death, and did not want to focus on the tragedy going forward.

“We had this little boy who had a such a short life,” Jagger said. “I didn’t want his life to be clouded in anger. I wanted his life to be about love…and not focus on the horrible part.”

But the meeting also underscored the growing bond between the women. When it was over, they walked outside and Jagger posed a question: “I said to her, ‘If I have another baby, would you deliver it?’ And I think she was horrified. But I think because I trusted her so completely, through the birth, and his death, and her calls and the followup, I felt like she was there with me, like this was our loss, it wasn’t just my loss.”

The Danish research paper quotes Donald Berwick, a pediatrician who served in the Obama administration and is also a patient safety guru of sorts. In a 2009 interview published in the Journal of Patient Safety, Berwick speaks about those “second victims”:

Health care workers’ egos can be big. But believe me, their superegos are a lot bigger. You carry into work — as a nurse, or doctor, or a technician or pharmacist– the intent to do well. And when something goes wrong, almost always you feel guilty, terribly guilty. The very thing you didn’t want to happen is exactly what happened. And if you don’t understand how things work, you feel like you caused it. That creates a victim. My heart goes out to the injured patient and family, of course. That’s the first and most important victim. But health care workers who get wrapped up in error and injury, as almost all someday will, get seriously hurt too. And if we’re really healers, then we have a job of healing them too. That’s part of the job. It’s not an elective issue, it’s an ethical issue.

In the past decade or so, various institutions and nonprofits have emerged with tools and systems to better support medical professionals who have endured a traumatic event.

One of those groups, MITSS, or Medically Induced Trauma Support Services, based in Massachusetts, provides trauma tool kits used around the country.

Linda Kenney, the founder of MITSS, was herself the victim of an anesthesia error that nearly killed her. She said that for her, connecting with the anesthesiologist who caused her injury (he called her afterwards to express his regrets) and creating the nonprofit to help others, helped her heal.

But for health care providers, sometimes talking to peers at a hospital, or others in the institution, isn’t enough and can actually feel isolating, Avila, the Rhode Island midwife, said. Because of the omnipresent fear of lawsuits, and also due to patient privacy laws, she said, “there are very few environments where we can freely discuss what happened.”

A Second Chance

In 2013, a few days shy of what would have been her son’s first birthday, Jagger went into labor with her second child, and she called on Avila to attend the birth. By that time, Avila was no longer working for the same midwifery group, but the practice arranged for her to have insurance during the birth, and Avila left a family gathering on Block Island to get to Providence on time.

Jagger’s little girl is now a healthy 2-and-a-half-year-old who considers Avlia her “auntie.”

“It was this amazingly cathartic experience for all of us,” Jagger said.

Avila is now a family nurse practitioner and attends births less frequently as part of her work. These days, she and Jagger are extremely close: They’ve vacationed together, bake each other birthday cakes and talk almost daily.

“I never would have expected our relationship to evolve to this point,” Avila said. “But despite how close we are now, I would sacrifice it in a moment if I could change the outcome of that first birth.”

Related:

Narrating Medicine: The Long Lasting Impact Of Child Abuse

One day when we were in first grade and sitting on a rickety wooden bench under a large oak tree in her backyard, my best friend’s mother called her to come inside.

A few minutes later, I heard wailing like an animal being gutted. Squinting my eyes and looking perplexed, I turned to my friend’s younger sister who was sitting beside me. She whispered, “She’s just getting beat.” Beat? What’s that, I wondered. She explained. Depending on the severity of their perceived wrongdoings, they were administered one of three levels of physical punishment: a stick, a belt or a big slab of wood. Their parents had moved from Ireland to our small suburb in New Jersey.

The Catholic schools the parents had attended as children in Ireland were very strict and the nuns reportedly beat them until their knuckles bled. Here, as parents in New Jersey, they told their daughters to strip naked and mercilessly receive corporal punishment. (I learned this from her sister, and over the years, from my friend.)

This was not a onetime event. These were repeated, deliberate acts. Continue reading

How Unconscious Fear Of Death May Skew Your Judgment — In Life And 2016 Politics

(Simeon Muller/Unsplash.com)

(Simeon Muller/Unsplash.com)

It’s “the worm at the core” of your life: the knowledge that you will die. And who can blame you if you assiduously push the worm to the back of your mind, right?

But then along come three experimental psychologists who cook up all kinds of crafty tests to analyze exactly what the worm is doing to you. They take Ernest Becker’s 1973 classic, “The Denial of Death,” and go all empirical with it, gathering actual data on how fear of death seems to affect people, from romance and shopping to war and, yes, 2016 politics.

So even though you may not want to look death in the face, you might want to peek at what the psychologists found in their research spanning hundreds of studies over 25 years. Because really, even though you may need your denial to get through the day, it’s arguably insane to spend a life pretending away its central fact. At the very least, you can try to understand what all that denial is doing to you.

Skidmore College professor Sheldon Solomon, co-author of the team’s new book, “The Worm At The Core: On The Role of Death In Life,” spoke recently at Boston’s Museum of Science, and I damped down my own denial and asked him about mortality.

A taste of what he said: “Whenever people are reminded of death, they love people who share their beliefs and they hate people who are different. They sit closer to people who share their beliefs and they sit further away from anyone who looks different. And if we give people in a laboratory setting an opportunity to physically harm someone who’s different, after people are reminded of their mortality they become much more hostile and vicious.”

Here’s our conversation, lightly edited:

How would you summarize your central idea?

What we would say, in a proverbial nutshell, is that one way of thinking about what makes human beings unique is the fact that while we share with all forms of life a basic inclination toward self-preservation, we are arguably unique because of our big forebrain, which gives us the capacity to think abstractly and symbolically, to dwell on the past and anticipate the future.

“We wouldn’t be able to stand up in the morning. We’d just be quivering blobs of biological protoplasm cowering under our beds.”

– Sheldon Solomon

And because of that we’re smart enough to realize that like all living things, we will someday die; that we could die at any time, for reasons we cannot anticipate or control; and that like it or not, we’re animals, breathing pieces of defecating meat, no more significant or enduring than lizards or potatoes.

And our claim is — and this is based on Ernest Becker, who won a Pulitzer Prize for his book, “The Denial of Death” — that if that’s all we thought about, ‘I’m gonna die! I could walk outside and get hit by a comet! I’m a cold cut with an attitude!’ then we wouldn’t be able to stand up in the morning. We’d just be quivering blobs of biological protoplasm cowering under our beds.

And what we believe, following Becker, is that the way that human beings come to terms with the potentially debilitating existential terror that’s engendered by the awareness of death is to embed ourselves in culturally constructed beliefs about the nature of reality — what the anthropologists call culture.

Prof. Sheldon Solomon speaks at Boston's Museum of Science. (Courtesy of David Rabkin/Museum of Science)

Prof. Sheldon Solomon speaks at Boston’s Museum of Science. (Courtesy of David Rabkin/Museum of Science)

What culture does is to give us a sense that life is meaningful and that we’re valuable. It tells us where we came from, it tells us what we’re supposed to do while we’re alive. It gives us some hope of immortality in the hereafter, either literally — through the heavens, the afterlives and souls of all the world’s great religions — or symbolically: We may know we’re not going to be here forever but we’re still comforted by the fact that some vestige of of our existence will persist nevertheless — perhaps by having children, or by amassing great fortunes, or by doing something noteworthy in the arts or sciences.

And so the argument is that what makes us unique is that we know that we will someday die, and this gives rise to potentially paralyzing terror that we reduce by believing that we’re people of value in a world of meaning. And whether we’re aware of it or not — and most of the times we’re not — everything that we do, for the most part, is in the service of maintaining a sense that life has meaning and that we have value in order to reduce death anxiety.

So that fear of death is insidiously affecting our behavior all the time…

Absolutely. Because otherwise this might be right but trite. If it were obvious, then maybe we would all know this and be talking about it. But I think what makes these ideas both subtle as well as potentially profound — and profoundly interesting — is that the argument is that most of us don’t think about death all that much. And the reason is that we’re comfortably ensconced in a cultural worldview that is sufficient to allow us to stand up every day.

But your team’s work picks apart what those effects are experimentally.

That’s correct. Ernest Becker won a Pulitzer Prize for “The Denial of Death” and these are all his ideas. And people just said, ‘Well, this is shocking nonsense.’ Or, ‘This is interesting but speculative and can’t be tested.’ So 35 years ago, right out of graduate school — we’re experimental social psychologists, my buddies Jeff Greenberg, Tom Pyszczynski and I — we said, ‘Well, why can’t we try and test these ideas?’

The very first study we did was with municipal court judges in Tucson, Arizona. We divided them randomly into two groups. And we just told the judges we wanted them to look at a typical court case and assign bond for an alleged prostitute. What we did was to randomly divide the judges into two groups, where one of them was reminded of their mortality by answering two open-ended questions: Just describe your thoughts and feelings about your own death. And: Jot down what you think will happen to you physically when you die. Continue reading

Opinion: Parents Can — And Must — Talk About Ugly 2016 Politics With Kids

Donald Trump gestures Thursday as Sen. Marco Rubio, R-Fla., listens to Trump's response during a Republican presidential primary debate in Detroit. (Paul Sancya/AP)

Donald Trump gestures Thursday as Sen. Marco Rubio, R-Fla., listens to Trump’s response during a Republican presidential primary debate in Detroit. (Paul Sancya/AP)

By Dr. Steve Schlozman

I’m not that old, but I’m old enough to remember when it was routine to hear in grade school that if you worked hard, you might get to be president of the United States someday.

Never once did I hear any of my teachers tell me what kind of hard work I’d have to do as a parent when, about 40 seconds into a presidential debate, one party’s leading candidate references the size of his…um….hands.

Are you kidding me?

How did we get to a place where you have to explain to your 10-year-old daughter that the Republican front-runner is bragging on national television about the size of his penis? Seriously. Tell me how we make that sound OK in any arena?

That was my task Friday morning when my 10-year-old daughter saw me watching clips of the debate. You might say that a 10-year-old is too young to watch the presidential debates, because it can include references to things like wars and lives lost. I think there are ways we can talk about those unfortunate aspects of a complex world to children of all ages.

But I (and I’m a child shrink) don’t have a great template to help my daughter understand the reasons a presidential candidate might refer to his penis. Not just anyone said this, mind you. It was the front-runner! What a mess. And it’s not like the debate got more admirable after all that.

People are, of course, allowed to argue for their beliefs. We even encourage these kinds of arguments. In fact, the entire fabric of our society is based on our ability to engage in these kinds of arguments in a thoughtful and civilized manner.

We’ll have to admit to our children that, developmentally, our politicians just can’t play nice in their sandboxes.

The problem, therefore, is how we reconcile the basic human desire to disagree with the values of civility and truth that we all pretty much agree save us from anarchy. It feels to me like right now, we’re only really accomplishing half of our goals. We have no problems disagreeing. We do, however, have all sorts of problems disagreeing in ways that we can later be proud of.

This is when we parents need to step in. Even if you don’t agree with the government, think the country is heading nowhere good, and really dislike the current leadership’s platform, you must (and I’m begging you) make the case to your kids for a reasoned and thoughtful process of objections.

As parents, we have an obligation, an absolute duty, to be crystal clear with our kids right now. When someone running for office says that certain religions are unquestionably and across the board more dangerous than others; that he should “rough someone up” because he doesn’t like the way that person behaved, or what he believes in; that he tends to respect the soldiers who don’t get caught and become POWs — you can’t just shake your head, chuckle, and explain that politics is a contact sport.

Let’s do a little thought experiment. Say little Timmy, age 10, gets a paper back from his teacher, and the teacher’s written comments make him very unhappy. Let’s say he wads up his paper, and with a dramatic and disgusted flourish, throws it into the trash in front of his teacher and peers. Continue reading

Irving’s: How Death Changes The Meaning Of A Miniature Magical Candy Store

Since being closed in December, Irving's Toy Shop is beginning to look decrepit as the awning is damaged and is tied up with twine after a couple of winter storms. (Jesse Costa/WBUR)

Irving’s Toy and Card Shop in Brookline, Mass. closed in December after its owner, 101-year-old Ethel Weiss, died. For weeks, the window was plastered with post-it tributes.  (Jesse Costa/WBUR)

For more than 10 years, I’ve passed Irving’s Toy and Card Shop just about every day. Until recently, the famously tiny store never failed to give me a lift: The happy candy-cane stripes of the awning; the sugary contents; the widely beloved centenarian, Ethel Weiss, who held court inside, dispensing bits of wisdom along with Chuckles and comic books.

Irving’s meant “treat.”

But now, the red-and-white awning is crumpled by the winter winds, and the sight of the dark storefront stabs my heart, a merciless reminder of mortality.

Now, to me, Irving’s means “nothing lasts.”

Irving’s is one of those places you know won’t last forever but you still hope it does.

Ethel Weiss died on Dec. 10 at age 101, after running Irving’s for an astonishing 77 years.

For weeks, the front window was covered with a blizzard of post-it notes, post-mortem tributes from children and former children from the nearby elementary school, all grateful for her kindness and her candy.

In the careful letters of a new writer, one read simply, “I love your candy shop,” signed Markus. Alexa wrote: “To Ethel, I loved your toys.”

markus

In the more controlled writing of older children were more complex messages: “You brought so much joy to me and my friends. Thank you for your generosity. You are missed. ♥ Lara.”

And then there were the much older writers: “Made elementary school much better for me! 1980-1988!” And “We will really miss you! Thought you’d make it to 120! Dr. Jack Porter.”

On our neighborhood Facebook group, we school parents shared our sorrow and talked about ways to memorialize Ethel. A mom posted, “My father, my daughter, and I all bought our very first purchases with our own money as little kids at Irving’s.” A dad wrote: “Irving’s is one of those places you know won’t last forever but you still hope it does.” Later, he added, “I’m so glad she had a chance to do what she loved until she passed. I would hate to see that shop go away.”

magical

I felt the same, but I also had the grim feeling of a spell broken.

WBUR’s Bruce Gellerman wrote a feature about Irving’s in 2013 — he even measured the store’s 15-by-40-foot dimensions — and analyzed my sense of magic lost: “The magic was the connection between your childhood and your children’s childhood — the continuity,” he said.”It was a portal back to your own childhood. It was timeless. It was tangible — not just a symbol — it was tangible evidence of your perpetual youth. The feeling that you walked in there and you were special. You knew Ethel was going to be there, and she was. For almost 102 years. How much better does it get?”

And, he said, everybody needs a penny candy store.

I found myself telling Bruce about the masses of post-it notes on the Irving’s window, and how the grown-up approach is surely to accept that after a certain point, life is no longer just about us getting treats. The outpouring of love prompted by Ethel’s death shows that what matters is not raking in the good stuff but rather giving it to others, leaving a positive mark on the world.

Right, he said. “The essence of life is what you leave in others. You don’t die as long as other people remember you.”

Or even if they don’t remember you. I imagine Ethel Weiss sitting in that 15-by-40-foot box for year after year — what to many of us would have been an oppressive prison — but turning it into a dispenser of good feelings. Irving’s was her purpose in life, and all her customers knew that she loved being there for them. (Hard to miss, when she wore a little sign saying “I love my customers.”)

Ethel Weiss, 100, dances with her daughter Anita Jamieson at the “Party Of The Century” at the Brookline Senior Center. (Jesse Costa/WBUR)

Ethel Weiss, then 100, danced with her daughter Anita Jamieson at the “Party Of The Century” at the Brookline Senior Center in 2015. (Jesse Costa/WBUR)

Not to get too woo-woo, but her positive energy emanated out into the world. Whether she’s remembered or not, those ripples continue outward, carried by all the people she affected.

She left a mark; she left the world better. We can all hope to do that.

She also created an institution, and these days, it’s unclear what will become of it. There’s talk in the neighborhood of finding a way to keep Irving’s running, perhaps as a non-profit managed by a nearby senior center, but the store belongs to Ethel’s daughters and they are selling it together with the apartment building next door.

Ethel’s daughter Anita Jamieson emailed me that she doesn’t have an answer yet to the question of what will become of Irving’s: “Of course, a dream would be to sell the property to someone who would continue the store on some level. Wouldn’t it be wonderful if the senior center could organize people to staff it?! The trouble is, dreams and reality often conflict.”

She added: “I do expect that we will sell the property in the next few months. No answer for you yet. Only dreams.”

I can’t help but hope that the dream of resurrecting Irving’s as a beloved neighborhood institution can be fulfilled, even with Ethel gone. As Bruce says, everybody needs a penny candy store.

And I think if the store were lit again, its awning straightened, for me it would come to mean, “Yes, we all die. But we can do a lot of good before we go — and some of it may even last a long, long time.”

[Also posted on WBUR’s Cognoscenti blog]

Further reading: Happy 100 To You, And You — Centenarians Multiply, At Forefront Of Age Wave

As Stores Open Early For Black Friday, Irving’s Toy And Card Shop Remains Unchanged

Irving's in 2013 (Bruce Gellerman/WBUR)

Irving’s in 2013 (Bruce Gellerman/WBUR)

SharingClinic, To Help Patients Tell Their Stories, Opens At Mass. General Hospital

Four years ago, Dr. Annie Brewster had a vision.

Brewster, a Boston internist, who was diagnosed with multiple sclerosis in 2001, had become frustrated that a crucial element of medicine — the human connection between patients and doctors — seemed to be lost in the modern era of 15-minute appointments and overly burdensome record-keeping. As a patient and a doctor, Brewster yearned for a therapeutic arena in which patients could tell their full health stories and feel they were actually heard, not rushed out the door; and where doctors, as well, could share a little more with patients.

Now, with the launch this week of the SharingClinic, an interactive “listening booth” stocked with audio stories from patients facing a range of illnesses, Brewster is a little closer to realizing her vision. Housed at the Paul S. Russell Museum of Medical History and Innovation at Massachusetts General Hospital, Brewster expects SharingClinic will continue to grow over time as more stories are collected and added to the kiosk. Eventually, she says, trained staff will begin to facilitate the storytelling in regularly scheduled “clinics” in a way that research suggests might offer an actual health boostContinue reading

Earlier:

Analysis: Can Mindful Eating Really Help You Lose Weight Or Stop Binging?

(t-mizo/Flickr)

(t-mizo/Flickr)

Updated 1/23

By Jean Fain
Guest Contributor

Mindfulness is all the rage. But does mindful eating — paying very close attention to your food and to your body’s signs of true hunger and satiety — really help you lose weight or stop binging?

On the one hand, paying closer attention to how you eat and why seems like a no-brainer for improved health. But in fact, mindful eating is steeped in controversy — pitting doctors against nutritionists, parents against children, therapists against clients, even colleagues against one another.

Proponents of mindful eating (also known as intuitive eating) like nutrition researcher Linda Bacon and other advocates of “Health at Every Size” — a self-described political movement promoting healthy habits and self-acceptance, rather than diets — recite a lengthy list of benefits related to mindful eating.

Critics of mindful eating offer a number of negatives: some say such navel-gazing about food makes it unappetizing, while others say mindful eating is superficial and ineffective, even irresponsible when it supplants traditional treatments for life-threatening eating issues.

Still others, like many who posted comments on my recent NPR interview with Jean Kristeller, author of the book, “The Joy of Half a Cookie,” dismiss mindful eating as a joke. One example: “Yes, let’s add more dietary neurosis to the babel of nutritional advice. How about this: eat the whole cookie. Have two, even. Just eat cookies less often, and eat nutritious food as the rule rather than the exception.”

According to Dr. James Greenblatt, an eating disorder expert, chief medical officer of Walden Behavioral Care and the author of “Answers to Binge Eating,” mindful eating is not only pointless in some cases, it’s potentially dangerous.

“Mindful eating clearly has a place in our treatment plans,” Greenblatt explained in a recent email exchange. “But, as a sole intervention for some of our patients, it is like asking opiate abusers to utilize mindful heroin detox. Many eating disorders reflect a severe neurochemical abnormality that needs to be addressed with biological interventions first, before adding other psychotherapeutic strategies and mindfulness.”
Continue reading

Commentary: When Sexual Violence Survivors Give Birth, Here’s What You Should Know

By Sarah Beaulieu
Guest Contributor

Sarah Beaulieu (Courtesy of the author)

Sarah Beaulieu (Courtesy of the author)

It shouldn’t have been a surprise that childbirth would leave me traumatized.

In retrospect, it seems obvious that when a survivor of sexual violence feels pain in her vagina caused by a strange being inside of her, the experience might trigger memories of an earlier trauma. But what wasn’t so obvious were the many ways that the childbirth and medical professionals didn’t prepare me for these unexpected and painful emotions related to giving birth.

With 20 years of therapy under my belt, I consider myself to be a fairly confident survivor with many tools in my resilience box. None of these tools prepared me for what happened during the birth of my son. After 12 hours of relatively peaceful labor in the hands of midwives, I dozed off, preparing for a long night. I woke up with at least two sets of hands inside of me, alarms ringing and a sense of panic in the room. My son’s heart rate had dropped dangerously low, and I needed an immediate C-section.

This experience — traumatic for even the healthiest woman — wrecked me, surfacing old post-traumatic stress disorder symptoms and pulling me into depression and anxiety. With the help of a hospital social worker, I emerged from my emotional dark place a few months later, and immersed myself in learning more about birthing as a sexual assault survivor. My experience was scary, but it couldn’t be that uncommon, I thought. After all, 1 out of 4 women share a sexual abuse history like mine, and U.S. women gave birth to nearly 4 million babies last year.

My research led me to Penny Simkin and Phyllis Klaus, two legendary birth educators who compiled much of the existing research into a single manual, “When Survivors Give Birth.”

I learned that, in fact, there were approaches to childbirth that were especially helpful to survivors of sexual violence. Not only that, but it was fairly common for pregnancy and birth to re-trigger memories and emotions related to past sexual violence. Yet despite this, the topic of sexual violence wasn’t typically covered by my midwifery practice, recommended childbirth literature or my natural childbirth class.

First and foremost, health care providers can adopt a trauma-informed approach to care for laboring mothers. Knowing that 25 percent of patients in labor and delivery will have a history of sexual violence, there is a benefit for all staff to be educated about sexual violence and its impact on birth. There are medical reasons too: Childhood trauma, including child sexual abuse, is a documented risk factor of postpartum depression and anxiety, which impacts 10 to 15 percent of new mothers — and their babies and families — each year.

Knowledge starts with screening for a history of sexual violence on standard intake forms and first visits. It also means creating a health care environment where survivors feel comfortable disclosing such histories. In my midwife’s office, there were pamphlets for every possible pregnancy complication, from gestational diabetes to heartburn to exercise during pregnancy. So, why not a pamphlet on giving birth as an abuse survivor?

Cat Fribley, an Iowa-based sexual assault advocate and doula whose practice focuses specifically on sexual violence survivors, describes trauma-informed care as “supporting the whole person with collaboration, choice and control, cultural relevance, empowerment and safety — both physical and emotional. This requires making certain adjustments to the way they work with survivors, acknowledging both the challenges that arise from sexual trauma, as well as unique coping skills — such as dissociation — that may help the survivor through the process of childbirth.”

Here’s an example: At one birth Fribley attended, “the birthing mother became visibly upset when new and unknown staff would enter the room while she was laboring. A simple sign on the door asking people to knock and announce themselves before entering helped make the birthing mom feel more in control of her environment — and the exposure of her body.” Continue reading

When It Comes To Happiness, Time Trumps Money, Study Suggests

(Amanda/Flickr)

(Amanda/Flickr)

By Joshua Eibelman
CommonHealth Intern

What do you value more: your money or your time?

A new study by researchers at the University of British Columbia suggests that those who place a greater value on their time, rather than their money, are happier.

Among the study’s 4,600 participants, there was an almost even split between those who prefer money and those who put a higher value on their time.

While the participants’ median age ranged from 20-45, older people tended to value time over money, possibly because over the years, their priorities shifted, and they feel greater satisfaction from quality time with friends and family, researchers found.

The study, published in the journal Social Psychological and Personality Science, looked at what kinds of trade-offs people were willing to make to achieve “happiness.” For instance, participants were asked whether they would prefer a higher paying job farther from home or a lower paying job closer to home.

College students surveyed at the University of British Columbia were asked various questions about what fields of study and jobs they’d choose and how they would prioritize time commitments versus potential salaries.

Participants were told that they’d been admitted to two graduate programs and had to decide between a higher starting salary with more more work hours, or a lower salary with fewer hours, the study said.

Those who are willing to make trade-offs in favor of time, the study found, tend to be happier. Interestingly, researchers report, “These findings could not be explained by materialism, material striving, current feelings of time or material affluence, or demographic characteristics such as income or marital status.”

Happiness was measured though a number of self-reporting tools and questions about the number of positive emotions people feel in a day, said lead researcher Ashley Whillans, a doctoral student in social psychology at the University of British Columbia.

Whillans likened preferences for either time or money as “personality characteristics.” Continue reading

Deep? Or Pseudo-Profound B.S.? Psychologists Explore Why Some Can’t Tell

(Anynobody/Wikimedia Commons)

(Anynobody/Wikimedia Commons)

What do you think of the following sentences?

“The universe is the wisdom of objective external reality.”

“Experiential truth embraces the expansion of actions.”

“Death is only possible in intrinsic possibilities.”

Are they profound wisdom? Or are they bull?

If you thought they were profound, you might need your BS detector checked.

Created from the website wisdomofchopra.com, this “wisdom” was generated by randomly putting together words found in the tweets of Deepak Chopra, the physician and author.

Who is more likely to see such bull as profound? And why? These are the questions that motivated Gordon Pennycook, a psychology PhD student at the University of Waterloo in Ontario, Canada, and his colleagues to publish a paper this week called “On the reception and detection of pseudo-profound bulls—.” (They spelled out the full word, which academic psychology allows but the AP Stylebook we use does not.)

The researchers took quotes like those above and tested whether people could see pseudo-profound statements for what they were — bulls—. Their findings suggest that people with higher intelligence and better critical-thinking skills are likeliest to detect BS. And more than one-quarter of the population they studied were particularly prone to buying in to it — and to holding, shall we say, “alternative” beliefs on topics from medicine to magic.

At first, this may seem like — you know — bull, but Gordon Pennycook is a real person. (Yes, Pennycook is his real name, despite its similarity to “poppycock.”) And if you wonder whether studying susceptibility to BS is important, just consider the possible effects on everything from votes in next year’s election to purchases of purported cure-all supplements.

The paper, published in the journal Judgment and Decision Making, is a remarkable study, not only in profane language — using the word bulls— about 200 times — but also in finally applying empirical analysis to the study of bull. Much has been written about it previously, but mostly just musings on the topic: “bulls— about bulls—,” Pennycook joked. Continue reading