[Obstetric diagnosis and patterns of behavior in labor (author's transl)]

Obstetricians, so far mainly interested in mechanics, have lately understood that innervation and interplay of the propelling and retaining structures also depend on the affects and impulses acting during delivery. There is normal and pathologic obstetric behavior. The obstetric situations demanding action from the obstetrician are not rarely correlated or due to pathologic behavior at birth. This disturbed or disturbance-producing behavior at birth, however, is by no means always directly related to anxiety, in the sense of the generally accepted anxiety-tension-pain syndrome. Disturbed behavior at birth may also be related to many other affects which often, but not always, are secondary to anxiety or designed to defend against it: retentive, annoyed, perfectionistic, poor in contact, worried, inactive or confused behavior at birth. In practice knowledge of such affect-constellations aids the preventive efforts of the obstetrician. Theoretically the origin of this subgroup of functional disturbances of birth is interesting. Interpersonal psychiatry after Harry Stack Sulivan sees in the non-organic psychic disturbances and symptoms an interpersonal process and not any more characteristics of an isolated individual. Since the functional disturbances of obstetric physiology are in part related to, in part due to, affect-constellations and behavior, they confirm this concept of interpersonal psychiatry. Medicine likes to study physiologic processes as if they represented a closed system within the limits of an isolated organism. In fact, the course of many physiologic processes is determined by simultaneously active affects i.e. the concrete interpersonal situation. This view, increasingly accepted for the physiology of libido and functional sexual disturbances, also applies to part of the functional disturbances of birth.