"I have suffered something": traumatic childbirth in 19th-century Britain.

IF 1.2 3区 社会学 0 HUMANITIES, MULTIDISCIPLINARY
Jessica Cox
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Abstract

In 1994, the American Psychiatric Association revised its definition of trauma in relation to post-traumatic stress disorder (PTSD), enabling the recognition of childbirth as a potentially traumatic event leading to the development of symptoms of PTSD. This article considers clinical definitions of postpartum PTSD in relation to 19th-century case histories of difficult childbirth, and posits that the circumstances of some of these births-particularly in the context of higher infant and maternal mortality-mean they were likely to have been experienced as highly traumatic events, which may have led to the onset of symptoms today associated with postpartum PTSD. While resisting problematic retrospective diagnoses of postpartum PTSD, the article highlights the presence of the now widely recognised risk factors for the disorder in the experiences of these women, and demonstrates that birth in 19th-century Britain had significant potential to be experienced as a traumatic event for mothers. In doing so, it seeks to contribute to a wider conversation around-and expand our understanding of-women's (physical and emotional) experiences of childbirth at this time, as well as some of the medical practices commonly employed in the birthing room, and the ethical questions which emerge from some of these. The article begins by outlining the risk factors now associated with postpartum PTSD, before exploring these in relation to 19th-century birth narratives. It draws on medical case notes (primarily the case studies of Dr Robert Lee) and women's own accounts of childbirth, as well as advice literature for women on the subject of childbirth. The discussion focuses in particular on three issues: women's knowledge around childbirth and agency within the birthing room (including issues of consent); the use of interventions in childbirth; and infant loss. The final part of the article briefly considers 19th-century discourses around puerperal insanity, and notes an association between difficult deliveries and the onset of puerperal insanity in some cases.

“我遭受了一些痛苦”:19世纪英国的创伤性分娩。
1994年,美国精神病学协会修订了与创伤后应激障碍(PTSD)相关的创伤定义,承认分娩是一种可能导致PTSD症状发展的创伤性事件。本文将产后PTSD的临床定义与19世纪难产的病例史联系起来,并假设其中一些分娩的情况——特别是在婴儿和产妇死亡率较高的背景下——意味着它们很可能经历了高度创伤性事件,这可能导致了今天与产后PTSD相关的症状的发作。在拒绝对产后创伤后应激障碍进行有问题的回顾性诊断的同时,这篇文章强调了这些女性经历中现在被广泛认可的疾病风险因素的存在,并证明了19世纪英国的出生对母亲来说有很大的创伤事件的可能性。在这样做的过程中,它试图促进更广泛的对话,并扩大我们对女性在这个时候分娩(身体和情感)经历的理解,以及在产房中常用的一些医疗实践,以及其中一些出现的伦理问题。文章首先概述了与产后创伤后应激障碍相关的风险因素,然后探讨了与19世纪分娩叙事的关系。它借鉴了医学案例记录(主要是Robert Lee医生的案例研究)和妇女自己对分娩的叙述,以及关于分娩主题的妇女咨询文献。讨论特别集中在三个问题上:妇女对分娩的了解和产房内的代理(包括同意问题);在分娩中使用干预措施;还有婴儿夭折。文章的最后一部分简要地考虑了19世纪关于产褥期精神错乱的论述,并注意到在某些情况下分娩困难和产褥期精神错乱之间的联系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Medical Humanities
Medical Humanities HUMANITIES, MULTIDISCIPLINARY-
CiteScore
2.60
自引率
8.30%
发文量
59
期刊介绍: Occupational and Environmental Medicine (OEM) is an international peer reviewed journal concerned with areas of current importance in occupational medicine and environmental health issues throughout the world. Original contributions include epidemiological, physiological and psychological studies of occupational and environmental health hazards as well as toxicological studies of materials posing human health risks. A CPD/CME series aims to help visitors in continuing their professional development. A World at Work series describes workplace hazards and protetctive measures in different workplaces worldwide. A correspondence section provides a forum for debate and notification of preliminary findings.
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