Iatrogenic diseases, pregnancy

[Guest guest]

Iatrogenic diseases - pregnancy

 

Obstetric intervention caused diseases has become an important topic

for discussion on this group as seen by number of recent posts. Why

not? while ayurveda is considered the science of longevity, it must

also address the issue of birth, the starting of life. Everyone

wishes to live infinitely long leaving his off springs behind, so

that in a way, life is extended infinitely.

 

And the cry about C-sections is being heard from all across the

globe. The entire modern medical profession is under scrutiny.

Doctors should not take their high ethical standing for granted, the

Australian health minister has warned in a scathing address. Abbott said that doctors' groups should be as zealous about

protecting their profession's honour as they are about protecting

their incomes. He mooted the creation of a national watchdog to

oversee medical ethics and to guard the standing of the profession.

[sOURCE: BioEdge 161, Weekly Newsletter -- 31 May 2005

<http://www.australasianbioethics.org> ]

 

Let us go back and see the activity at our group first.

This author pointed out chances of difficult pregnancies multiply if

incompatible (in terms of Indian astrology) parents marry, in msg #

1656. The possibility of disturbance in metabolism as an after effect

of C-section resulting in obesity and back pains was hinted at in

Msg# 1680. The lack of correlation between obessity and obstetric

intervention was pointed out in Msg# 1709, arguing that obesity can

come basically due to Kapha unbalance. Since C-section does not

permit normal routine of massage, immediate breastfeed, special

foods, such a kapha unbalance may be generated, as conjectured in

Msg#1723. Details of hormone imbalances caused by intervention were

brought out with the help of published literature in this message.

The clear signal that the C-section situation may be caused by

intervention itself was missed here. This is brought about by recent

Msg# 3834. The usefulness of C-section were pointed out by Sharon and

Deana in Msg#2870,2874 taking her own case, but she did not mention

any sufferings thereafter. However Bharathi Ganpathi and Deana

together mention the hormone imbalance side effect of C-section in

Msg# 2911, 2912. It is not known whether they are still suffering.

 

The issue of brain and spinal damage to babies as a result of pre

term deliveries were pointed out in Msg#3131. The availability of

Calcium, Iron and folic acid ayurvedic herbs or tablets was also

pointed out here. Possibility of avoiding C-section by pelvic floor

muscle training through yoga was also hinted at, with reference to

published literature.

 

The situation which lead to C-section are often beyond the control of

a doctor. Excessive multivitamins give a large baby, and weak

muscles of mom may be causing C-sections. according to Dr Mankikar

(Msg# 3173). Despite being an anasthesiologist, he is an ayurvedist

also at heart. But there may be a large difference between the way

human mother is prepared for this great event by a Obgyn and midwife.

MIdwifves have good record of Vaginal births (VB) without tear since

they bring out the true nature of human mom, that is tenacity, as

advocated by Guru Khalsa (Msg#3183). However, whenever patient can

not bear the pain or fetus is in distress, the case is automatically

transferred to a OBgyn, which may be causing this impression

(Msg#3250). This issue requires further assessment, as to how many

such cases are transferred against those undergoing simple VB without

intervention.

 

The average size of babies being very high these days and connection

between vaginal tears/midline incision in episiotomy with future sex

life may be persuading women to opt for C-section as Dr Mankikar

suggests in Msg# 3188. The emphasis of antenatal care should be on

making healthy and not heavy babis as suggested in Msg# 3190. The C-

section rate is perhaps higher in India than US.

 

"Dietic factors and lack of exercise may be the main reason in higher

socio-economic group" as suggested by Todd (Msg#3202). The use of

SSRI anti-depresants and its effect on infants was pointed out in

Msg# 3207.

 

The issue of pre-partum and post-partum depression is discussed by Dr

Mankikar(Msg#3251) . The legal aspects and social aspects of this

dangerous profession where every decision is a tight ropwalk and

attracts criticism are also issues which doctors face. The recent

news that some child birth homes in New York are closing down due to

excessive premiums of "Mal-practice protection insurance" supports

his statement. The society is given rights to sue medical profession

if it suspects mal-practice. But what a professional can do when he

is handed over a dangerous drug, with inadequate data on its safe use

in humans. This point will be clear with an example. Cytotec is in

use for last six to seven years. Recenyly, on May 16, 2005, the FDA

issued an alert on the risk of Cytotec (Misoprostol) when used in

labor and delivery, which states: "This Patient Information Sheet is

for pregnant women who may receive Misoprostol to soften their cervix

or induce contractions to begin labor. Misoprostol is sometimes used

to decrease blood loss after delivery of a baby. The FDA does not

approve these uses. No company has sent the FDA scientific proof that

Misoprostol is safe and effective for these uses. There can be rare

but serious side effects, including a torn uterus (womb), when

Misoprostol is used for labor and delivery. A torn uterus may result

in severe bleeding, having the uterus removed (hysterectomy), and

death of the mother or baby. These side effects are more likely in

women who have had previous uterine surgery, a previous Cesarean

delivery (C-section), or several previous births.

 

So far we took a quick review of group archieves. Out of concern for

babies born with brain and spinal damage, author is researching

underlying causes. During the course of this, he encountered several

patients who had to undergo emergency C-section also.

 

The tour of the scientific literature reveals that Oxytocin hastens

the contraction dis-proportionate to cervical dilation and causes

pain increasing faster than the tolerance level, which epidural

anasthesia relieves by numbing the nerves. The hormone which builds

up pain tolerance does not build up so rapidly as nervous systems

autonomy is disturbed. Epidural ansthesia, if given in sufficient

quantity relives the pain but hampers the pushing ability of

prospective mother. Delay results in loss of amniotic fluid so fetus

goes in distress. The C-section situation is precipitated, not by

design, but by course of events to which mother herself has brought

by not being pain tolerant or by being in unfamiliar "home"

environment. Panic causes her B.P. to rise or fetal beats to rise, as

she passes on her fear and panic to baby possibly leading

to 'meconium'. There is intense bond between mother and baby right

from 20 weeks gestation, where baby can listen mothers voice, can

feel mothers tension, joy everything. This sounds like the situation

is brought in by "mother" herself. She is in such a situation that

even a question by doctor is adequate to her deciding in favor of

epidural analgesia or C-section. Intervention disturbs the body's

own natural physiology and the bonding process, to give

pharmacological oxytocin or cytotec, just when the body's own supply

of oxytocin is at its highest for the purposes of bonding and

hemorrhage control. Lets us say what others say bout the situation.

"We are mammals. Most mammals birth fine. So what happened to us? We

used to birth fine. Women in "primitive" cultures birth fine. What

happened to modern women?" says Jan Tritten, editor of Midwifery

Today, in recent issue 74.

 

In 1896, Alice B. Stockham said, "I know of no country, no tribe, no

class, where childbirth is attended with so much pain and trouble as

in this country." (Tokology. Chicago IL: Alice B. Stockham and Co.)

 

This statement holds true to this day. At birth we are unblessed with

a thinking mind. As adults, our minds become one of our biggest

obstacles in pregnancy and birth. We listen to others, watch "Baby

Story" on television, hear of cesarean rates and the ease of

epidurals and completely lose our ability to do the task for which

our bodies were supernaturally designed, according to Jane.

This system of fear has been exported on a grand scale on the wave of

medicalization throughout the whole world. Western childbirth ways

are literally a huge plague. In U.K. the practice of Midwives is

still continues on a large scale. In India, except in villages, it

is almost extinct. The women who complete courses in Nursing and

midwifery leave the country for working in other countries or assist

in hospitals, with no say in decision making. Maternity homes managed

by only midwives are rare. Hence the higher number of C-sections in

cities, driven by life-style caused factors.

 

How many complications are caused by the mind? If we were birthing in

past times and places, labor would be shorter and less complicated.

Complications go much deeper today than just those around birth. We

have increased autism, breast cancer and detachment of our culture to

children and babies. Most are related to the childbearing year.

Most complications are preventable with good nutrition and good care

prenatally and in birth. Midwives play a key role in combatting this

dominant birth culture. The fact that few mothers were born naturally

themselves must also have an effect. The change can only be obtained

by such trained mothers and midwives. It cannot be accomplished in 10-

minute visits to hospitals or maternity homes. The midwives' own

trust and knowledge of birth needs to be transmitted to the mom.

However, in maternity home practice, with drugs available and an

environment that interrupts labor, everything she has learned

disappears.

 

So how do we avoid iatrogenic complications? Stay home or in a birth

center. Have a well-trained midwife, who honors physiology, not

medicine. Keep out of the proximity of drugs, distractions and

unnecessary procedures. First, do no harm.

 

"Often in today's oppressive birth culture the battle is in the minds

of the "care" givers" according to Jan Tritten. Most doctors have

never seen a normal birth. Even when a woman has a good birth

attitude, she goes unsuspectingly into the hospital, thinking this is

the safest place to have her baby. She runs right into the trap of

modern medicine, which is bent on making a lot of money from her and

exerting power over her. She is subject to a cascade of interventions

done unceremoniously to her and her baby, still thinking she is in a

safe environment. Somehow her mind, though, has learned to believe

this place and these people caring for her are safe practitioners.

The hospital is a good back-up system for true emergencies, which are

the cases where hospitals become safety nets."

 

Thanks Jan for raising the issue in print. The tide is turning, dawn

is there. Surely, in few more years, golden sun will also rise.

The entire article is available at:

 

http://www.midwiferytoday.com/magazine/issue74.asp

 

The members who specialize in the ayurvedic or alternative approaches to

labor management are requested to discuss their views freely. Author would like

to state here that he is not conveying that Midwives are more competent than

MDs. Even today, there are MDs who have trained midwives in simple homebirths.

And there are hospitals and maternity homes where MDs are deliverying babies as

good as midwives. But there number is rapidly decreasing.

 

Dr Bhate

 

ayurveda, Darla Wells <lethe9@g...>

wrote:

> That is fascinating; I went through a C-section in 1988 for breech

> birth and had a tubal ligation at the same time and that is exactly

> when all my major health problems started. The perimenopause and hot

> flashes and everything is exactly as you described it.