Thursday I listened to National Public Radio's Morning Edition. The topic was about using meditation to lower blood pressure. Dr. Randy Zusman, director of the hypertension program at Massachesetts General Hospital, recommends relaxation response training for high blood pressure unresponsive to medications. Forty out of 60 patients trained in the relaxation response were able to reduce the dosage of their medications. The downside was that the patients had to persevere in their practice of meditation.
It is refreshing to see the practice of medicine acknowledge the impact of the mind-body connection. Surgery and medications are often the sole focus of medical care in the eyes of both physicians and patients. But the mind and the body are intertwined and treating one without the other is bound to be less successful than treating both.
The field of obstetrics is no different from the rest of medicine. Here too, the mind-body connection is often forgotten. But there are reports in obstetrics that demonstrate how acknowledging this connection can have positive results.
Instead of measuring blood pressure, we can look at how many cesarean sections are done or how long labors last. Oxytocin (Pitocin) and early amniotomy are commonly used to lower cesarean section rates and shorten the duration of labors. Another approach is to use doulas. Doulas are trained birth attendants who provide physical and emotional support to the laboring woman. Doulas have been shown to decrease the cesarean section rate, the use of pain medications, and the duration of labor. In fact, the approach originally published in Dublin shown to reduce the cesarean section rate and shorten labor, now called active management of labor, included strict criteria for admission for labor, early amniotomy, oxytocin, and continuous labor companions.
In the story about meditation lowering blood pressure, I wondered if other outcomes were also affected. Did lowering blood pressure with meditation reduce the risk of heart attack or stroke? Maybe, maybe not. Does decreasing the cesarean section rate and the use of pain medications reduce the risk of mothers and babies dying or being ill beyond the immediate postpartum period? Maybe, maybe not.
Certainly doulas contribute to the care of laboring women in a way that medicines and procedures can not. Consider this blog by a family practice physician about a woman who becomes unresponsive to her birth team and either can't or won't push the baby out. Treatment included oxytocin and a doula. This family practice physician recognized that some things are not explained by physiology alone.
It can be baffling in our society to imagine that a person without a medical or nursing degree can have something valuable to add to such a medical event as a birth. But it shows that birth is more than just a medical event. Few life experiences are as emotionally and spiritually intense as birth and death. By recognizing this, we can improve maternity care in a way that medications and procedures can not.
