Today, I highlight the recent news about the significant drop in teenaged births in the US, including some interesting trends. Then on Thursday, we will continue our “Welcoming All Families’” series with “Working with Teen Parents” and take a look at childbirth classes for teenage mothers. Some ideas and suggestions for working with pregnant teens, in a specialized class designed to meet their needs or integrated within your regular childbirth class offerings. – SM
Number of babies born to US teen mothers 2011
The National Center for Health Statistics, part of the Center for Disease Control and Prevention recently released the most up to date data for teen birth rates in the United States. The good news is that teen birth rates dropped by 25% from 2007-2011. Since 1991, teen birth rates have been on a decline, with the exception of 2006-2007, but this drop has picked up steam in most recent years. In 2011, a total of 329,797 babies were born to women aged 15–19 years, for a live birth rate of 31.3 per 1,000 women in this age group. (Hamilton, 2012.) In 2007, the teen birth rate had been 41.5/1,000 teenagers aged 15-19. The rate dropped by 8% just between 2010 and 2011. Just two states, North Dakota and West Virginia did not experience significant changes.
This is particularly good news, as babies born to teenaged mothers are more likely to be born prematurely, have low birth weights and have a higher rate of infant mortality, when compared with mothers aged 20 or older. All of these consequences carry significant financial costs for families. These consequences cost the US government 10.9 billion dollars annually.
High school drop out rates are increased amongst teen mothers, and many may not go back and receive a high school diploma or GED. This has a major financial impact for these young families for years to come. Only 50% of teenage mothers receive a diploma by the age of 22. (Perper, 2010.)
The decline in teen birth rates may be linked to economic and attitudinal factors, according to the Pew Research Center. Overall, birth rates amongst all age groups go down during rough economic times, as the United States has been experiencing since the recession began in 2007-2008. Currently, teens seem to be less sexually active and the teenagers that are choosing to have sex are more likely to use birth control then ever before. (Martinez, 2011.)
Declines in rates were steepest for Hispanic teenagers, averaging 34% for the United States, followed by declines of 24% for non-Hispanic black teenagers and 20% for non-Hispanic white teenagers. Interestingly, the difference in long-term birth rates for non-Hispanic black and Hispanic teenagers has essentially disappeared by 2010. Even though the USA has seen these large drops in teenage birth rates, the US teen birth rate is one of the highest amongst Western countries.
DeSilver, D. (2013, May 28). What’s behind the falling teen birth rates?. Retrieved from http://www.pewresearch.org/fact-tank/2013/05/28/whats-behind-the-falling-teen-birth-rates/
Hamilton BE, Mathews TJ, Ventura SJ. Declines in state teen birth rates by race and Hispanic origin. NCHS data brief, no 123. Hyattsville, MD: National Center for Health Statistics. 2013.
Martinez G, Copen CE, Abma JC. Teenagers in the United States: Sexual activity, contraceptive use, and childbearing, 2006–2010. National Survey of Family Growth. National Center for Health Statistics. National Vital Health Stat. 2011;23(31).
With Father’s Day being celebrated this Sunday, Certified Doula David Goldman shares his experiences as both a birth doula and expecting father, as he ponders the role birth professionals and health care providers have in welcoming or marginalizing the partner during pregnancy, birth and early parenting. The role of men at births has been questioned, mocked and celebrated over the years. Read and hear how David has been able to experience it from both sides. – Sharon Muza, Community Manager
My head was spinning with joy, fear and uncertainty as I walked into the birth room for the first time as a doula. I squatted to the side as I acclimated to the calm energy and slowly made my way toward the laboring mother. A nurse walked in and with unexpected excitement shook my hand and smiled deep into my eyes as she walked passed me. My doula mentor stepped in to explain that I was not the dad but was the doula. I laughed to myself, having once again forgotten the rarity of men, especially those in non-medical roles, in the birth room. Since then, I carry a shirt in my birth bag that reads, “Nope, I’m not the Daddy, I’m the Doula” to avoid the confusion and the awkward and misplaced, but well intentioned congratulations. I also wear the shirt because once the staff knows I’m a birth professional, I’m often accepted as part of the ‘real team’ rather than just a ‘bystander’ who might get in the way and needs to be looked out for.
As we are likely well aware, the history of childbirth in North America has included discrimination, sexism, misogyny and other forms of oppression against women. Birth communities have become a source of strength and have collectively fought and won major battles including public breastfeeding, rights to options and evidence-based care in childbirth and so much more. But as with all forms of oppression and marginalization, we can’t bring one person up by bringing another down. As one of a very small handful of certified male birth doulas in North America and a birth professional who has completed a Lamaze International approved childbirth educator workshop on the path to obtaining LCCE status, I feel honored to work among thousands of strong women who are pushing the boundaries every day to make childbirth and parenting less traumatic and more empowering for all birthing women.
As a birth professional, I have worked with many amazing dads who glowed at least as bright as their pregnant partners. At most of the births that I have attended, the tears coming from the eyes of men overwhelmed with joy and relief at the birth of their baby have been just as wet as those of the mothers. I am not trying to equate the experiences of becoming a father with becoming a mother. However, I do hope to shed light on how birth professionals’ communication with fathers can influence the pregnancy and childbirth experience not just for fathers but also for mothers and babies. Like many birth professionals, I have worked hard to support the whole “client family” and honor the role of each person involved. However, now that I find myself in the role of the client family for the first time, I am quite surprised by my experience.
The presence of a father, birth partner or family member can help to improve women’s birth experience by providing emotional support and reassurance during labour and delivery. While unexpected emergencies may arise, for many couples, birth can be a very positive experience. Royal College of Obstetricians and Gynecologists
Currently, my partner and I are halfway through a pregnancy and, as you can imagine, I now have the opportunity to see things from a whole new perspective. As a birth professional who has taken many courses, attended conferences, read piles of books, shared dialogue via various internet forums and participated as an active and founding member of the local birth professional group in my community, I feel relatively empowered and knowledgeable on the topic of pregnancy, labor, birth and postpartum.
I’m surprised, however, by how marginalized I feel being the partner in the pregnancy and that I feel less and less central in the birth of our baby as we include and add professionals to our team. Providers make little eye contact with me and ask for decisions almost exclusively from my partner. People frequently ask where she will be birthing and whom she has chosen to attend. I’m finding that images in advertising and instructional materials with partners in primary support roles are not as common as those with birth professionals at the center. Many online birth communities are specific to “Mommas” and a large group that had once made an exception (not at my request) to include me as a birth professional recently removed me from the group now that I am a “Dad-to-be” reducing my access to the very support that I had previously offered to many new families. Overall, while we often intend to honor the role of partners, I’m seeing that we are missing the mark throughout the field.
If a well-trained and experienced birth doula and an active part of the local birthing community is feeling disempowered, how must partners who are brand new to birth feel? After all, we may hold knowledge and experience but as we have all seen, a sweet smile or a kiss from a partner can be an amazingly effective medicine for a birthing mother. We already know that the experience of women and babies is improved by continuous care during childbirth. (Hodnet, 2012). What can we do as birth professionals to better support partners in being fully present and connected?
One of the most significant things that birth professionals and health care providers can do is to welcome partners with mutual respect and honoring their challenging and important roles. By doing so, we can likely improve the experience overall and help foster attachment between the parents and with the partner and the baby even before the birth. The bonds, attachment and successes fostered in childbirth are likely to be a great springboard into future parenting experiences.
In order to improve the likelihood that partners will feel central in the birth team, we as birth professionals must include them from the beginning. We can frequently make eye contact, ask for their opinions and check in to see how they are feeling about decisions. In our prenatal discussions, we can help partners address any barriers they may feel to fully supporting the birth. We can create communities that include partners to seek advice, support and dialogue. Just as we reassure birthing women throughout the process, we might provide acknowledgement for the hard work and endurance of partners. Discussions that promote collaborative dialogue between partners can be encouraged when decisions are needed. Childbirth educators can offer suggestions on how to ask care providers to include the partner more substantially and role-play scenarios with couples in class.
Birth professionals should stop applying the standard stereotypes that have been around for ages, and are continually propagated through the media, assuming fathers are bumbling fools who are being dragged to childbirth classes, panic at the first contraction, don’t know their way around a newborn, just might “pass out” at the birth and who are easily excited and unable to contribute anything positive to the experience. This is just not the truth. Today’s father is often researching right along with the mother for best practices, exploring choices and celebrating each milestone in the pregnancy. During labor and birth, many fathers want to be the main support and fully share the experience with their partners.
We want the professionals we have chosen to participate with us on this journey to recognize the unique roles and needs that each parent has. Their very actions and choice of words can help fathers to feel more involved and respected or can marginalize the father to a spot on the edge of the process. Welcome us as an equal player, celebrate what we bring to the table, share resources and information sources that are specific to our needs as fathers and partners in creating this life. Have office and classroom spaces filled with diverse images celebrating the amazing role that we are honored to play as partners. Use posters, films and activities that highlight and honor the special place we hold. Allow us to grow into the role of father, feeling secure, supported and respected by the professionals who are helping us to birth our baby.
As childbirth educators, do you often make light of the lack of information and experience that fathers bring to the birth experience. Do you make assumptions about the dads in your classes? Have you perpetuated any of the longstanding stereotypes by the media you use, activities you conduct or your choice of words? Can you share what you are doing in your class to be as inclusive as possible and to help the couple to moving into parenting by setting them up for a labor and birth filled with connection and support? Let us know in the comments. – Sharon Muza
Hodnett ED, Gates S, Hofmeyr GJ, Sakala C. Continuous support for women during childbirth. Cochrane Database of Systematic Reviews 2012, Issue 10. Art. No.: CD003766. DOI: 10.1002/14651858.CD003766.pub4.
About David Goldman, MAEd, CD(DONA, PALS)
David P. Goldman, MAEd. CD(DONA, PALS), was trained as a birth doula six years ago at the Simkin Center, Bastyr University and has become one of the very few male certified birth doulas in North America. He has been an educator working with students of all ages for over fifteen years and has completed a Lamaze International approved childbirth educator workshop on the path to obtaining LCCE status. David works with the WISE Birth Doula Collective in Bellingham, WA as well as Open Arms Perinatal Services in Seattle, WA. David can be reached at email@example.com
“Do women really eat their placentas?” I am asked this question in every Lamaze class I teach. This question is often accompanied by a raised eyebrow and a giggle. Many times, at least one mother will sheepishly avert her eyes and mention that she’s thinking about doing it because she’s heard of the amazing benefits that can be achieved by consuming her placenta. Our class discussion commences with differing opinions, theories, vague and distorted facts and many grunts of “ugh, gross!” It then becomes my job as the childbirth educator to sort this out and offer my students evidence based information with regards to placentophagy.
Hollywood seems to have picked up on the trend. Locally, in Pittsburgh, were I practice, there are at least three placenta encapsulation specialists and a few others who dabble in it. Talking to one recently, she mentioned that she was busy enough that she needed to bring in a partner to help her. It would appear that the trend is indeed on the rise.
Let’s take an in-depth look into the modern practice of placentophagy and the evidence behind it.
Most modern mothers will choose to encapsulate their placenta. Taking it in a pill form seems to be most palatable for many women interested in consuming their placenta. The placenta is washed, steamed (sometime with other ingredients such as jalapeño, ginger and lemon), sliced, dehydrated, pulverized and encapsulated. Within 24-48 hours after birth, the mother has her placenta back in pill form and will ingest a certain number of pills each day.
Why would a woman want to take placenta capsules?
There are many claims made about the benefits of consuming placenta. The list below is from Placenta Benefits.info
The baby’s placenta, contained in capsule form, is believed to:
contain the mother’s own natural hormones
be perfectly made for that mother
balance the mother’s system
replenish depleted iron
give the mother more energy
lessen bleeding postnatally
been shown to increase milk production
help the mother to have a happier postpartum period
hasten return of uterus to pre-pregnancy state
be helpful during menopause
This is a rather amazing list. It would appear that consuming placenta postpartum is a bit of a magic bullet. This, in and of itself, makes me wary of the claims. There are a number of oft cited studies to back these claims up. However, my research turns up only studies in animals, anthropological studies and a recent survey of mothers who consume placenta.
Animal studies are good preliminary research and may provide indication for further study in humans. In and of themselves, they provide insufficient information to recommend placentophagy in human mothers.
Anthropological studies are a fascinating peek into human evolution, history and practice. They may provide clues as to why humans, as a rule, do not consume placenta. Or for those limited cultures that did/do consume it, the rationale behind doing so may be revealed. However, as with animal studies, anthropology alone does not give us cause to say that we should or should not be participating in placentophagy.
There is ongoing research out of Buffalo, NY by Mark Kristal, as well as from the University of Nevada, Las Vegas by Daniel Benyshek and Sharon Young on placentophagy. I look forward to their further contributions and hope their work provides impetus for additional hard science.
To date, there is not one double-blind placebo controlled study on human placentophagy.
Although advocates claim that these nutrients and hormones assumed to be present in both the prepared and unprepared forms of placenta are responsible for many benefits to postpartum mothers, exceedingly little research has been conducted to assess these claims and no systematic analysis has been performed to evaluate the experiences of women who engage in this behavior. (Selander et al. 2013)
A note on Selander, et al: Jodi Selander is the owner of Placenta Benefits LTD. Her financial conflict of interest is noted in the survey.
What we have is anecdotal evidence from mothers who have consumed placenta (Selander 2013). Care providers who witness the effects of placentophagy in the mothers have been noted as well. There are a number of studies in animals, both with regards to behavioral and, chemical and nutritional benefits. There are a number of anthropological studies, as well as a recent survey (Selander 2013).
What we truly lack is a double-blind, placebo controlled human study of the affects of placentophagy.
“While women in our sample reported various effects which were attributed to placentophagy, the basis of those subjective experiences and the mechanisms by which those reported effects occur are currently unknown. Future research focusing on the analysis of placental tissue is needed in order to identify and quantify any potentially harmful or beneficial substances contained in human placenta… ultimately, a more comprehensive understanding of maternal physiological responses to placentophagy and its effects on maternal mood must await studies employing a placebo-controlled double blind clinical trial research design.” (Selander 2013)
This leaves us with a few unanswered questions.
Is the benefit we see in the human mother after consuming placenta because she has consumed it, or is this placebo effect?
Are their benefits or risks to consuming amniotic fluid after birth?
If there is no biological imperative for human mothers to consume placenta, is there a reason for that? Is this a reason suggesting harm from eating placenta, a social norm, or something larger with regards to our need for bonding with our community of women during and after birth?
“This need for greater sociality during delivery then, in combination with the consequent pressure to conform to cultural norms, led to a strengthening of socials bonds and a reduction in the likelihood of placentophagia.” (Kristal 2012)
Coming full circle; how do we approach the topic of placentophagy in our Lamaze classes? Keep it simple. As of today, consuming placenta is not an evidence-based practice. Therefore, we cannot directly recommend it to our students.
However, to support our students’ autonomny, I believe a mother should be able to take her placenta home and do with it as she will. If your students wish to engage in this practice, I’d encourage them to speak to their care providers prenatally, to ensure safe handling of the placenta and to set appropriate expectations at birth.
Kristal, M. B. (1980). Placentophagia: A biobehavioral enigma (or< i> De gustibus non disputandum est</i>). Neuroscience & Biobehavioral Reviews,4(2), 141-150.
Kristal, M. B., DiPirro, J. M., & Thompson, A. C. (2012). Placentophagia in humans and nonhuman mammals: Causes and consequences. Ecology of Food and Nutrition, 51(3), 177-197.
Selander, J. (2013), Placenta Benefits, placentabenefits.info. Retrieved June 09, 2013, from http://placentabenefits.info/index.asp.
Selander, J., Cantor, A., Young, S. M., & Benyshek, D. C. (2013). Human Maternal Placentophagy: A Survey of Self-Reported Motivations and Experiences Associated with Placenta Consumption. Ecology of food and nutrition, 52(2), 93-115.
Soykova-Pachnerova E, et. al. (1954) “Placenta as Lactagagen” Gynaecologia 138(6):617-627
Young, S. M., Benyshek, D. C., & Lienard, P. (2012). The conspicuous absence of placenta consumption in human postpartum females: The fire hypothesis. Ecology of Food and Nutrition, 51(3), 198-217.
May 2013 saw the first-ever Monthly Meet-Up for LCCE Educators throughout the globe and by all measures it was a success! New and experienced LCCE educators, as well as Lamaze International staff, participated in the inaugural meeting. Educators shared their thoughts and ideas on topics ranging from smartphone birth and parenting apps to liability insurance for childbirth educators. Those who attended plan on attending once again in June and hope to have more LCCE Educators join in on the conversation!
The Monthly Meet-Up is a live, online gathering of Lamaze Certified Childbirth Educators. Free to members of Lamaze International, the casual online chat lasts 45 – 60 minutes and provides a chance for LCCE Educators to share their thoughts, ideas, questions, and concerns on specific topics. The Monthly Meet-Up occurs on the fourth Wednesday of each month at 11:00 EST. A maximum of 20 members will be able to attend each session, so sign-up early by visiting the Monthly Meet-Up page on Lamaze International website.
Topics discussed are based entirely on input from the LCCE population. If you have a specific idea or question you would like to explore during a Meet-Up, please share your thoughts on the Monthly Meet-Up discussion board. The discussion board is also the go-to place to catch up on any conversations you may have missed.
The June Monthly Meet-Up will include an idea-generation and resource-sharing session on the topic of role-play scenarios for childbirth class. If you have any ideas or if you use a scenario in your class to teach positive and assertive communication skills to parents, please mark your calendar for June 26 and plan to attend the next Monthly Meet-Up.
I first became interested in childbirth-related psychological trauma in 1990. Twenty-three years ago, it was not something researchers were interested in studying. I found only one study, and it reported that there was no relation between women’s birth experiences and their emotional health. Those results never rang true for me. There were just too many stories floating around with women describing their harrowing births. I was convinced that the researchers got it wrong,
To really understand this issue, I decided to immerse myself in the literature on posttraumatic stress disorder (PTSD). During the 1980s and 1990s, most trauma researchers were interested in the effects of combat, the Holocaust, or sexual assault. Not birth. But in Charles Figley’s classic book, Trauma and Its Wake, Vol. 2 (1986), I stumbled upon something that was quite helpful in understanding the possible impact of birth. In summarizing the state of trauma research in the mid-1980s, Charles stated that an event will be troubling to the extent that it is “sudden, dangerous, and overwhelming.” That was a perfect framework for me to begin to understand women’s experiences of birth. It focused on women’s subjective reactions, and I used it to describe birth trauma in my first book, Postpartum depression (1992, Sage).
Since writing Postpartum Depression, there has been an explosion of excellent research on the subject of birth trauma. The bad news is that what these researchers are finding is quite distressing: high numbers of American women, as well as women in other countries, have posttraumatic stress symptoms (PTS) after birth. Some even meet full criteria for posttraumatic stress disorder. For example, Childbirth Connection’s Listening to Mothers’ Survey II included a nationally representative sample of 1,573 mothers. They found that 9% met full-criteria for posttraumatic stress disorder following their births, and an additional 18% had posttraumatic symptoms (Beck, Gable, Sakala, & Declercq, 2011). These findings also varied by ethnic group: a whopping 26% of non-Hispanic black mothers had PTS. The authors noted that “the high percentage of mothers with elevated posttraumatic stress symptoms is a sobering statistic” (Beck, et al., 2011).
If the number of women meeting full-criteria does not seem very high to you, I invite you to compare it to another number. In the weeks following September 11th, 7.5% of residents of lower Manhattan met full criteria for PTSD (Galea et al., 2003).
Take a minute to absorb these statistics. In at least one large study, the rates of full-criteria PTSD in the U.S. following childbirth are now higher than those following a major terrorist attack.
In a meta-ethnography of 10 studies, women with PTSD were more likely to describe their births negatively if they felt “invisible and out of control” (Elmir, Schmied, Wilkes, & Jackson, 2010). The women used phrases, such as “barbaric,” “inhumane,” “intrusive,” “horrific,” and “degrading” to describe the mistreatment they received from healthcare professionals.
“Isn’t that just birth?,” you might ask. “Birth is hard.” Yes, it certainly can be.
But see what happens to these rates in countries where birth is treated as a normal event, where there are fewer interventions, and where women have continuous labor support. For example, in a prospective study from Sweden (N=1,224), 1.3% of mothers had PTSD and 9% described their births as traumatic (Soderquist, Wijma, Thorbert, & Wijma, 2009). Similarly, a study of 907 women in the Netherlands found that 1.2% had PTSD and 9% identified their births as traumatic (Stramrood et al., 2011). Both of the countries reported considerably lower rates of PTS and PTSD than those found in the U.S.
How Does this Influence Breastfeeding?
Breastfeeding can be adversely impacted by traumatic birth experiences, as these mothers in Beck and Watson’s study (Beck & Watson, 2008) describe:
I hated breastfeeding because it hurt to try and sit to do it. I couldn’t seem to manage lying down. I was cheated out of breastfeeding. I feel that I have been cheated out of something exceptional.
The first five months of my baby’s life (before I got help) are a virtual blank. I dutifully nursed him every two to three hours on demand, but I rarely made eye contact with him and dumped him in his crib as soon as I was done. I thought that if it were not for breastfeeding, I could go the whole day without interacting with him at all.
Breastfeeding can also be enormously healing, and with gentle assistance can work even after the most difficult births.
Breastfeeding became my focus for overcoming the birth and proving to everyone else, and mostly to me, that there was something that I could do right. It was part of my crusade, so to speak, to prove myself as a mother.
My body’s ability to produce milk, and so the sustenance to keep my baby alive, also helped to restore my faith in my body, which at some core level, I felt had really let me down, due to a terrible pregnancy, labor, and birth. It helped build my confidence in my body and as a mother. It helped me heal and feel connected to my baby.
What You Can Do to Help
There are many things that nurses, doulas, childbirth educators, and lactation consultants can do to help mothers heal and have positive breastfeeding experiences in the wake of traumatic births. You really can make a difference for these mothers.
Although it is not within many of our scope of practice to diagnose PTSD, you can listen to a mother’s story. That, by itself, can be healing. If you believe she has PTS or PTSD, or other sequelae of trauma, such as depression or anxiety, you can refer her to specialists or provide information about resources that are available (see below). Trauma survivors often believe that they are going “crazy.” Knowing that posttraumatic symptoms are both predictable and quite treatable can reassure them.
Refer her to resources for diagnosis and treatment.
The site HelpGuide.org also has many great resources including a summary of available treatments, lists of symptoms, and possible risk factors.
Anticipate possible breastfeeding problems mothers might encounter.
Severe stress during labor can delay lactogenesis II by as much as several days (Grajeda & Perez-Escamilla, 2002). Recognize that this can happen, and work with the mother to develop a plan to counter it. Some strategies for this include increasing skin-to-skin contact if she can tolerate it, and/or possibly beginning a pumping regimen until lactogenesis II has begun. She may also need to briefly supplement, but that will not be necessary in all cases.
Recognize that breastfeeding can be quite healing for trauma survivors, but also respect the mothers’ boundaries.
Some mothers may be too overwhelmed to initiate or continue breastfeeding. Sometimes, with gentle encouragement, a mother may be able handle it. But if she can’t, we must respect that. Even if a mother decides not to breastfeed, we must gently encourage her to connect with her baby in other ways, such as skin to skin, babywearing or infant massage.
Partner with other groups and organizations who want to reform birth in the U.S.
Our rates of PTS and PTSD following birth are scandalously high. Organizations, such as Childbirth Connection, are working to reform birth in the U.S.
2013 may be a banner year for recognizing and responding to childbirth-related trauma. The new PTSD diagnostic criteria were released in May in the DSM-5, and more mothers may be identified as having PTS and PTSD.
There has also been a large upswing in U.S. in the number of hospitals starting the process to become Baby Friendly, which will encourage better birthing practices.
There is also a major push to among organizations, such as March of Dimes, to discourage high-intervention procedures, such as elective inductions.
And hospitals with high cesarean rates are under scrutiny. This could be the year when mothers are care providers stand together, and say that the high rate of traumatic birth is not acceptable, and it’s time that we do something about it. Amy Romano describes it this way.
As we begin 2013, it is clear from my vantage point at the Transforming Maternity Care Partnership that the transformation is underway. In Childbirth Connection’s nearly century-long history, we’ve never seen so much political will from leaders, so much passion from grassroots advocates, and so much collaboration among clinicians and other stakeholders. This new landscape presents many new opportunities for educators and advocates.
There is much you can do to help mothers who have experienced birth-related trauma. Whether you join the effort to advocate for all mothers, or simply help one traumatized mother at a time, you are making a difference. Thank you for all you do for babies and new mothers.
This article originally appeared as an editorial in the journal Clinical Lactation: Kendall-Tackett, K.A. (2013). Childbirth-related psychological trauma: An issue whose time has come. Clinical Lactation, 4(1), 9-11
Beck, C. T., Gable, R. K., Sakala, C., & Declercq, E. R. (2011). Posttraumatic stress disorder in new mothers: Results from a two-stage U.S. national survey. Birth, 38(3), 216-227.
Beck, C. T., & Watson, S. (2008). Impact of birth trauma on breast-feeding. Nursing Research, 57(4), 228-236.
Elmir, R., Schmied, V., Wilkes, L., & Jackson, D. (2010). Women’s perceptions and experiences of a traumatic birth: A meta-ethnography. Journal of Advanced Nursing, 66(10), 2142-2153.
Galea, S., Vlahov, D., Resnick, H., Ahern, J., Susser, E., Gold, J., . . . Kilpatrick, D. (2003). Trends of probable post-traumatic stress disorder in New York City after the September 11 terrorist attacks. American Journal of Epidemiology, 158, 514-524.
Grajeda, R., & Perez-Escamilla, R. (2002). Stress during labor and delivery is associated with delayed onset of lactation among urban Guatemalan women. Journal of Nutrition, 132, 3055-3060.
Soderquist, I., Wijma, B., Thorbert, G., & Wijma, K. (2009). Risk factors in pregnancy for post-traumatic stress and depression after childbirth. British Journal of Obstetrics & Gynecology, 116, 672-680.
Stramrood, C. A., Paarlberg, K. M., Huis in ‘T Veld, E. M., Berger, L. W. A. R., Vingerhoets, A. J. J. M., Schultz, W. C. M. W., & Van Pampus, M. G. (2011). Posttraumatic stress following childbirth in homelike- and hospital settings. Journal of Psychosomatic Obstetrics & Gynecology, 32(2), 88-97.
About Kathleen Kendall-Tackett, Ph.D., IBCLC, RLC, FAPA
Kathleen Kendall-Tackett is a health psychologist and an International Board Certified Lactation Consultant. She is the Owner and Editor-in-Chief of Praeclarus Press, a small press specializing in women’s health. Dr. Kendall-Tackett is a Fellow of the American Psychological Association in both the Divisions of Health and Trauma Psychology, Editor-in-Chief of U.S. Lactation Consultant Association’s journal, Clinical Lactation, and is President-Elect of the American Psychological Association’s Division of Trauma Psychology. Dr. Kendall-Tackett is author of more than 320 journal articles, book chapters and other publications, and author or editor of 22 books in the fields of trauma, women’s health, depression, and breastfeeding, including Treating the Lifetime Health Effects of Childhood Victimization, 2nd Edition (2013, Civic Research Institute), Depression in New Mothers, 2nd Edition (2010, Routledge), and Breastfeeding Made Simple, 2nd Edition (co-authored with Nancy Mohrbacher, 2010).