Neurons to Networks–An Excellent Video

Twelve years ago it was the book “From Neurons to Neighborhoods” and a wonderful conference in Los Angeles that brought together people who understood the importance of the links between healthy brain development and safe, supportive neighborhoods for families.

Now even more research supports the concept that safe, loving early relationships have phenomenal power over the trajectory of childhood brain development. Such research also serves to underline some of the reasons for the high aggression and poor learning ability (among other symptoms) shown by many of the young children I see in therapy–the powerful effects of early childhood trauma: abuse and neglect (sometimes even before birth–such as exposure to street drugs or alcohol).

There are regrettably few individuals around the world who know how to restructure brain development gone awry, and they can only do so much and only up to a certain point. We need to be able to get it right the first time, and to help people understand why this is so important, and what it will take to make it possible for more babies and their parents.

Anyway, this was meant to be a brief introduction to the video: which the makers are willing to tailor to the needs of individual organizations that wish to use it. Please enjoy it (it lasts under 11 minutes) and feel free to share it wherever it might be useful.

My personal hope is that it will help us to provide what is necessary to give infants and young children a better start in life–with safer, more loving families, more time with the folks who care for them, paid parental leave, and simpler births more supportive of mothers’ and babies’ mutual dance of love.

The Relationship between Artificial Oxytocin (Pitocin) Use at Birth for Labor Induction or Augmentation and the Psychosocial Functioning of Three-year-olds

SUMMARY OF FINDINGS OF THE STUDY

Claire L. Winstone, Ph.D. 

 

The focus of my dissertation research study was, as you can see by the above title, an exploration of whether there is any relationship between the use of Pitocin (artificial oxytocin) to start or speed up labor, and the way children born with its use function individually and in their relationships when they are three years old. I was interested in Pitocin use because what I read suggested that around two-thirds of inductions are now for non-medical reasons, but there wasn’t a lot of research to tell us whether there were any specific consequences to the child of this use.

 

Before starting this research I first interviewed six therapists who work with babies, children, and adults to resolve issues arising fromchallenging prenatal or birth experiences. All the therapists had worked with clients who had been born with the use of Pitocin. The therapists told me what they had observed and learned about their clients and the role they thought Pitocin played in their functioning. I performed a content analysis on the interview transcripts, and about two years later, had a long list of “items” that eventually became the raw material for a survey to be conducted with mothers of three-year-old children. I sent this list to the six therapists with a voting form, and they helped me select which items best represented the various areas of functioning about which I planned to ask the mothers.

 

Eventually, this list became the survey that participants were invited to complete. Ultimately, I had 498 completed surveys that could be analyzed to see if Pitocin use appeared to be related to a difference in how three-year-olds functioned.  The following is a summary of the findings that were statistically significant.

  

1.      Receiving Pitocin resulted in more negative recollections of labor and delivery, suggesting that mothers who received it had a more challenging experience than those who didn’t. However, there was a similar finding for the use of epidural anesthesia and for pain medication, both of which tend either to precede or follow the use of Pitocin.

 

2.      Mothers who received Pitocin spent less time with their babies in the first hour after delivery, and were less likely to feed their babies exclusively at the breast in the first six months. In other words, babies who were born without Pitocin were more likely to be fed exclusively at the breast in the first six months than those born with Pitocin

  

3.      Two factors distinguished children born with Pitocin from those born without Pitocin.

 

The first was called “Assertiveness”, which describes a socially appropriate way that babies and children communicate their need for help and comfort when they are feeling uncomfortable or unsafe. Typically, crying, using facial expressions and physical gestures, and later, verbalizing their thoughts and feelings, elicits helpful responses from parents, who try to identify and meet the need the baby or child is expressing. However, babies born with Pitocin, whose mothers reported having had a more challenging time during labor and delivery, appear to have a higher need to be assertive because they seem to experience more discomfort, but are apparently less effective in asserting their needs and getting them met when they feel unsafe or uncomfortable.

  

The second factor was called “Need to Control Environment” and this summarizes what seems to be a higher level of discomfort or insecurity, particularly in response to “outside-in” influences (e.g., reacting to food with digestive problems or being picky eaters; problems coping with other people’s timing and structure, refusing help from others) and increased or exaggerated efforts to control their environment, resulting in behaviors that may be more challenging to their mothers/family. There appears to be some continuity of effects between infancy and age three: for example, children who were described as picky eaters, or as having digestive problems at three, were likely to have been colicky, fussy babies. Interestingly, the hormone oxytocin is very involved in the digestive process: it plays a role in the production of digestive enzymes and as we enjoy our meal, in a positive feedback loop, we produce more oxytocin.

  

It may be that a process described as “hormonal imprinting”, identified in a considerable number of animal studies since the 1970s, is the mechanism that accounts for these differences between children exposed to Pitocin and those who were not. Using Pitocin to initiate labor may “flood” the available oxytocin receptors in mother and baby, apparently affecting children’s internal comfort levels and how they interact with others, although how this takes place in the babies has not yet been studied. Since both mother and baby receive Pitocin during labor and delivery, it is as yet unclear to what degree each contributes to challenges in their mutual relationship.  

Santa Barbara Graduate Institute

July 2008 

 Use these links to download a .pdf of the Powerpoint presentation of this material:

Microsoft PowerPoint – APPPAH 2010 Handout Format

 Microsoft PowerPoint – 6 slides per page

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“Pit to Distress”

There is currently a lively discussion going on about the order given to nurses to “Pit to distress”, apparently with the intention of causing fetal distress that can then result in an emergency cesarean.  Two days following the original post it went viral with well over 11,000 hits.  I do encourage you to read this discussion, since the trend is alarming and another very clear example of a health care system in crisis putting the safety and needs of mothers and babies last.  I feel no need to add to what has already been said by The Unnecesarean, Keyboard Revolutionary , and others, so I will only make a brief comment here about the perinatal psychological implications of this:

What astonishes me over and over again is that no-one ever, ever seems to consider (well, actually Sarah Buckley does) what it may mean to motherbaby to have a massive overdose of Pitocin binding with oxytocin receptors at a time when oxytocin is supposed to be surging ready for post-birth bonding, not to mention all the consequences of distressed babies, crash sections and traumatized mothers and babies. Michel Odent said somewhere: “When human beings release adrenaline, they cannot release oxytocin.” Why do we settle for so little? The “at least you have a healthy baby” offered as the consolation following a cesarean is questionable itself, unless “is breathing and has a pulse” is all you need to meet the criteria for “healthy”.

What does it mean to begin life with life-threatening trauma entirely as a result of someone who is too impatient to allow nature to take its course? Assuming that the cesarean ensuing from “Pit to Distress” is successful and there are no lasting physical problems for mother or baby (which, of course, we can’t assume in all cases!), what is it like to have adrenaline and cortisol flooding your system, likely an overnight stay in the nursery, a mother in recovery from major surgery, and delayed or failed breastfeeding, instead of basking in abundant endorphins and oxytocin, nursing and falling in love?

Animal studies have suggested that interfering with the oxytocin system at birth may have enduring consequences: for digestion (in which oxytocin is involved) and social functioning.  We also know that the oxytocin system is implicated in autism spectrum disorders and schizophrenia.  Now that is not to imply a causal relationship between the two–I’d be the last to suggest this, but I do wonder about social functioning when birth becomes disruptive to the hormones involved in the primary attachment relationship.  Rixa Freeze, in her own discussion of this issue, Pitocin Protocol and emergency cesareans, cited a recent study, Hospital’s Oxytocin Protocol Change Sharply Reduces Emergency C-Section Deliveries which noted that “As oxytocin utilization declined from 93.3% to 78.9%, emergency cesarean deliveries decreased from 10.9% to 5.7%”. I know I’m not the only person shocked that a hospital would consider 78.9% oxytocin use a good percentage!!  That means more than 3/4 of women birthing at that hospital are being given Pitocin! Does this mean that 3/4 of American women are incapable of giving birth without chemical help? Are their bodies “broken”?  Or is it the health care system?

What will it mean for all these babies/children/people to have started life rushed into the world with the wrong chemicals flooding their newborn bodies? What will it mean for their mothers: oxytocin receptors flooded with a synthetic  that, while a perfect chemical copy of oxytocin, cannot replicate its multiple functions at birth, in our bodies, and in our daily relationships.  And what will it mean for society?

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Here is a link to flow-chart of typical consequences of Pitocin use:

http://www.birthinternational.com/parents/obstetric/diagram.html

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Michael Jackson: The Power of Early Trauma

What is tragic about Michael Jackson’s death, by whatever physical cause is ultimately determined by the Coroner, is how it was the perhaps inevitable outcome of a perfect recapitulation of his traumatic childhood. He said that he never had a childhood, and was “terrified” of his father. He said that he felt safe onstage, where he could shine and feel loved by thousands of people at a time, and unsafe just about everywhere else. Behind the scenes, he faced a father who was abusive and experienced tremendous pressure to perform perfectly. He spent a lifetime trying to make himself over to please those he loved, and those who he believed loved him, and clearly found himself flawed.

At the end of his life, looking less than robust and possibly continuing a long-standing addiction to narcotics, once again he was under tremendous pressure to perform—in 50 concerts, for heaven’s sake! And again, by powerful, intimidating father figures in the form of his financial backers who expected him to sing and dance his way out of monstrous debt while making them a handsome profit. Whether these individuals were truly intimidating or not doesn’t matter: Michael would have experienced them that way—that’s part of the recapitulation. Terror induces trauma and similar situations may trigger trauma memories on a physiological level. The expectation was essentially to equal or surpass his performances at his prime—and make no mistake, Michael Jackson at 50 was no Mick Jagger at 64—the robust Jagger’s life story is a very different one. While he clearly longed to be back on stage and adored, and was working hard to prepare for it, perhaps Michael knew there was no way he could meet those expectations and struggled with the anxiety of attempting to do so, or perhaps he just “lost heart” for such a crazy endeavor and felt as trapped and helpless as the little boy he was when all this began. What fascinates me is how he managed to manifest such a sadly similar experience at the end of his life as he had experienced as a child. What a brilliant, shining star he was, and what a truly tragic life he lived! I really hope he is at peace now.

Here is a link to a related article describing Jackson’s life: http://www.cnn.com/2009/SHOWBIZ/06/26/michael.jackson.spotlight/index.html