Post-Traumatic Stress Disorder Linked to Premature Births

In 2012, nearly half a million premature births occurred in the United States. An infant born before 37 weeks gestation is considered premature. Risk factors include: race, smoking, alcohol use, having delivered a previous pre-term infant, carrying multiple infants (twins, triplets), problems with the uterus or cervix, and chronic illnesses such as diabetes, asthma and kidney disease.

If you don’t already know, post-traumatic stress disorder is also considered a risk factor for premature births. In the largest study ever conducted, researchers at Stanford University Medical Center followed more than 16,000 infants delivered by female veterans. More than 3,000 premature births were delivered by mothers diagnosed with PTSD. Those diagnosed with PTSD in the year prior to delivery were found to be at thirty-five percent greater risk. The researchers factored in other issues, such as race, age, medical conditions, and alcohol and drug use. It’s worth noting that fifty percent of the women studied never went into combat, proving that the link between PTSD and delivering a premature infant is not exclusive to veterans. Civilian women are affected too.

But how does PTSD contribute to premature births? Stress. Though the exact mechanism is not completely understood, higher than normal levels of stress hormones are released in those suffering from PTSD symptoms. The immune system then becomes suppressed, increasing the risk for infection, which increases the risk for premature birth.

The good news: those who do not experience PTSD symptoms in the year before delivery are at the same risk for giving birth to a premature infant as those who do not have PTSD. For those who do suffer symptoms in the year prior to delivery, treatment is available. The Veterans Administration is using the results of the study in the care of pregnant women with PTSD. For pregnant civilians with PTSD, the good news is that you now know you are at risk, and can inform your obstetrician. There are some risk factors you might not be able to control – age and race for instance – but you can gain control over your PTSD.

For a list of therapists, go to The National Board of Certified Counselors at:

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Celebrating Martin Luther King Jr.


This past weekend, in remembrance of Martin Luther King Jr, I attended a celebration in his honor at a local Unitarian church, where I was graced with the presence of Nontombi Naomi Tutu. In light of the recent deaths of Michael Brown in Ferguson, Eric Garner in New York City, and Tamir Rice in Cleveland, this event could not have come at a better time. People clapped and shouted “Right on!” as Tutu reminded us, in her mesmerizingly charismatic voice, “humanity is indivisible.”  She repeated this phrase again and again throughout her thirty-minute speech. She brought her own fears to the podium: because her son is seventeen, she said she doesn’t worry that he’ll go out and get into trouble; she worries what will happen to him because of the color of his skin. How many white parents worry that their sons will get shot because of the color of their skin?  Isn’t it correct to say that the black community is still not free, even though slavery ended one hundred fifty years ago in 1865?  They are not free in the sense that they must look both ways with extra caution when leaving the house. Unlike white people, especially white males, black people must work, often to no avail, toward privileged status. They earn less income than their white counterparts. Thirty- percent of black youth are unemployed ( Tutu cautioned us, “Privilege costs you your humanity.” I gathered that she meant unearned privilege, as it makes us less aware, less empathetic perhaps. If humanity is indivisible then, as Tutu says, “We can only be free if we are all free.”

Before I left, I had the opportunity to thank Tutu for traveling to Vermont on a drab January day, for leaving me with vital words to chew on: “Injustice oppresses the oppressor at the same time it oppresses the oppressed.”

By the way, I even had the opportunity to hug her. She hugged me back and said, “I like hugs.”

What did you do on Martin Luther King Day that speaks to the indivisibility of humanity? (Indulging in sales does not count).

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A “work of literature”

“Melissa’s memoir will be very well received as a true work of literature.” ~ Patrick Ross

Award-winning writer and author of Committed: A Memoir of the Artist’s Road.

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Driving after a Traumatic Brain Injury

For most of us, driving equates with independence and freedom. So when you are diagnosed with a traumatic brain injury and learn that you cannot drive at all, or need to limit your driving to daylight hours, you may feel the loss of independence you once enjoyed.

Even with a mild traumatic brain injury, changes in thinking, perception, vision, and motor skills can affect driving: the ability to stay in the correct lane, react quickly when another driver cuts in front of you, and seeing a green light change to red. With a TBI, individuals become easily fatigued and may have difficulty concentrating for long periods of time. They often have difficulty processing rapidly moving stimuli, such as passing cars and bicycles.

But the good news is that between thirty and sixty percent of individuals with a moderate to severe traumatic brain injury eventually return to driving. They do so with the help of driving rehabilitation professionals, who first evaluate cognitive functioning, judgment, and reasoning skills. They then conduct a road evaluation. Still, most TBI survivors are not adequately evaluated before getting behind the wheel again.

Family members can help too. If it’s your spouse, though, and you prefer to save your marriage, you may want to be evaluated by an objective party like a rehab professional. For me, though, my husband has been helpful (okay, so we’ve had a few spats). Since my TBI has presented with difficulty processing multiple stimuli and anticipating changes down the road, he has spent time with me driving – me behind the wheel and he the passenger – cueing me when to change lanes or to turn. He has also encouraged me not to engage in too much conversation while driving. Because I fatigue easily, I no longer drive long distances – either my husband drives or I take the bus. And he’s aware of what I call my “bad brain” days and initiates driving. More importantly, I’m aware of my “bad brain” days and either limit my driving, or do not drive at all.

Of course, making the change from limitless driving to limited driving has not been easy. I don’t see friends as much as I used to, and I spend more time indoors, especially during the winter. Thank goodness for social media!

How has your TBI limited your ability to drive? How have you learned to cope with the changes?


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Walking Toward Understanding: A Review of the Movie Wild


“I’m sorry you have to walk a thousand miles just to …” Cheryl Strayed’s ex-husband, Paul, tells her. But “just to” what? Early in Wild, Strayed finishes the sentence for her ex-husband: “Why do I have to walk a thousand miles?”

At mile one, Strayed is not sure why. She’s not even sure at mile eight, twenty-eight, or thirty-six. She lumbers around sharp curves and up and down rugged terrain in order to find the answer, or answers. Strayed’s father was an abusive alcoholic. Her mother, whom she calls “the love of my life,” died of cancer at forty-five. Strayed sought refuge in heroin, and sex with multiple partners, which is what led to the demise of her marriage. She finds the answers to the why part of her hike only at mile one thousand. Strayed hikes toward an understanding of her tumultuous life that seduced her into the woods. Much like how the memoir is structured, the movie depicts both her physical and emotional journeys, the present and past paralleling one another the entire one thousand miles. Of course, we can’t help but lumber along with her.

Wild is not only about Strayed’s yen to find the answers as to why she chose to venture into “wild” territory. It’s about identity, the body, forgiveness. Several tropes represent these themes: the heavy weight of her backpack on her shoulders and back calls to mind the burden of her guilt for past wrongs. The bruises she is left with remind us of the pain of her present, and past, life. Lifting herself up under the weight of the pack, then again when she slips in a river signifies perseverance. The pruning of the pack partway through her trek can be likened to the shedding of her guilt.

The sex scenes reveal Strayed’s confusion: she conflates sex, her body, with worthiness. When a reporter pulls his car over to the side of the road – Strayed is hoping to catch a ride – he interviews her for an article and calls her a hobo. Strayed is quick to clarify that she is not a hobo, that she’s simply hiking the PCT. But she has no place to call home, no anchor, no words to describe who she is. Strayed is not a mother or a wife, labels her mother once assigned to herself.

A series of metaphorical purges (guilt purges) take place: when strayed vomits after a night of drinking with other hikers, when she erases her ex-husband’s name from the sand, and when she finally breaks down sobbing, and says, “I miss you Mom.”

I could share more, but if you have yet to see Wild, or read the book, I don’t want to spoil the ninety-four day hike for you – the one hundred degree afternoons, the sweaty silences, the blue nights and sun-bleached mornings.

So, lace up your hiking boots, strap on your backpack, and join Cheryl Strayed at the head of the PCT.


Wild Director: Jean-Marc Vallee. Staring Reese Witherspoon, Laura Dern, and Gabby Hoffman.

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