Tag Archives: Pregnancy

Pregnancy is a kind of miracle. Especially so in that it proves that a man and woman can conspire to force God to create a new soul. ~ Robert Anton Wilson

Why cesarean sections are rising in private practice in India?

In the recent time, particularly in private practice the toll of cesarean sections are quite high in various parts of India. This author tried to speculate why cesarean sections are rising in India and here are the understandings of this author (which are also enriched by some real life experiences).

First question is whom to blame for this rising trend of C- sections in the private practice, the doctors or the patients. The answer might seem like to both, but I feel doctors. Why? Some people might cite that the ladies today are too softie and want everything smoothly with out undergoing the labor pain. But I feel that it’s not wrong for a woman to avoid pain of all sort in life and even labor pain. Besides alleviating pain, since family sizes are shrinking these days and becoming restricted to 1 to 2 children a vaginal delivery might be perceived as risky health practice by some pregnant mothers and their families, who feel cesarean can be a safe alternative to achieve a complication free birth.

The point to understand in this regard is that patients can actually demand anything based on their understandings, but that shouldn’t be an alibi for doctors to incise a woman’s tummy. Ethically doctors are supposed to explain the pregnant lady and her family about the pros and cons of the cesarean section and also stating when such an operation is really indicated. Unfortunately, these ethical issues are only limited to legal papers and texts with not much real life utilisation. Therefore, in my opinion the doctor should explain clearly the issues of delivery with out any word game during conversation to bend the patient and her family members mind set towards an unnecessary cesarean section.

Next question is why doctors in private practice incline more towards a c-section. I feel ‘money making’ will be a partly correct answer, a better phrase would be ‘easy money making’. When a doctor opts to do a cesarean section he doesn’t need to monitor the patient for long hours (unlike normal vaginal delivery). For long hours of observation, more staff are needed and more time needs to be dedicated, which counts as a negative feature for private practitioners. Not only that for conducting normal vaginal delivery doctors need to be available 24×7 because a pregnant patient may go into labor anytime, and private practitioners wouldn’t probably prefer to compromise their nights sleep regulalrly for their entire life, unlike their days when they worked as a resident trainee doctors. Elective cesarean is just like regular outpatient practice, where the cesarean operation can be done at any time convenient to both the doctor and patient.

A third query can be why then women who want a normal delivery with no indication for cesarean section voluntarily go to the government run hospitals where normal delivery is generally offered for eligible cases. This is a complex issue to answer. Many people don’t find the state run hospitals clean and hygienic enough. These hospitals are often accused for baby missing complaints after delivery. Sometimes, cats and other non-human species can find their way inside the hospital wards, and this author witnessed such multiple times. Unlike private practice setup where a woman can get treated under a particular obstetrician of her choice, in state funded hospitals less likely all women will be delivered by senior experienced obstetricians  and things might worsen particularly in night time when the lonely unsupervised trainee doctors makes a mess of situations like when shoulder of a baby which gets stuck in birth canal or the mother starts bleeding uncontrollably. Statistics is always good on paper and presentation, but in real life the loss of life or permanent complication of a mother and/or her baby is cent percent for that individual and her family. Its not wrong for a pregnant female to get delivered under skilled confident doctors rather than unsupervised learners. And at this particular point a cesarean section in private is possibly justified unless the government can make any drastic change in the trend.

Lastly, what can be the solution to avoid the unwanted indication-less c-section problem. Bringing in strong laws is obviously an option to compel private practitioners to follow the conduct of medical ethics. Besides that the country should adopt better recruiting, training and licensing system for doctors from nations that are best in obstetrics care in the world. Also the patients and their family members should be made aware about the wrong doing of unnecessary cesarean sections, so that they can demand a normal delivery when there isn’t any indication for Caesarean section. Furthermore, patients should be given legal right to record their doctors counselling about what mode of delivery should they choose so that at a latter time they can take it to the court as a piece of evidence.

Let’s hope, some day the social media loving policy framers will start tweeting on this topic too to get fame (which seems too delicious to them, ‘the Narcissistic farts’), and bring in some fragments of happiness to their citizens.

 

P.S.: Views and opinions expressed in this post are author's individual, not meant to hurt anyone in any form. If such has happened unknowingly, please understand it as a mere accident and not intentional.
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Pregnancy vaccines

Vaccines that are recommended in pregnancy include hepatitis A, hepatitis B, inactivated influenza vaccine and Tdap.

Certain other vaccines are sometimes recommended depending on various health requirements of some individuals. 

Vaccines should not be used) in pregnancy are mostly the live vaccines like MMR vaccine , live attenuated influenza vaccine (used as nasal spray), varicella vaccine, zoster vaccine, BCG vaccine etc.

Recently another vaccine is making its place in the list of recommended vaccines for pregnant women, the whooping cough vaccine. (link)

English: This is CDC Clinic Chief Nurse Lee An...

Do you need to change asthma medications, during pregnancy?

Generally change of common asthma medications are not required, however, a consultation from your doctor in this regard is important. Most medications used in asthma are considered safe in pregnancy. Steroid based medications too are well tolerated. 

For all your health concerns please be guided by your health care provide and not this blog.

Vitamin D increases children’s muscle power

Today lets talk about the wonder vitamin, Vitamin D. This vitamin is known for improving bone health by increasing mineralisation of bone.

This vitamin utilizes calcium we ingest effectively to make it available for bones.

But where from do you get this vitamin? Broadly you can get this vitamin from 2 sources one is the sunlight (which provides the D2 variant of vitamin D), and food products gives you the D3 component of vitamin D). Food products like oily fishes are rich sources of vitamin D. Continue reading Vitamin D increases children’s muscle power

Pregnancy & weight control

In this era there are talks related to obesity of various types adult obesity, childhood obesity, teenage obesity etc. One interesting form is pregnancy related obesity. Obviously gaining some amount of weight during pregnancy months is natural but too much of it may not be good too. Excessive weight gain during pregnancy can cause various problems in to the mother and baby. Mother may get a complication called preeclampsia, in which blood pressure is higher than normal and also proteins get excreted via urine. Furthermore the mother may continue to be obese even after the pregnancy is over and may have to deal with its own consequences. On the other hand the baby will be more prone to develop childhood obesity. Therefore a good control on mothers weight during pregnancy is essential. For better control of body weight latest studies suggest to stay active throughout the day. In literate world today pregnancy is honored and overvalued and which probably leads to over-care. In common mans dictionary good care mostly equates a plenty of bed rest although that may not hold true every time.

Henceforth, trying to maintaining an active lifestyle throughout the pregnancy months may be the most wise step to have a good control over body weight. Finally check out with your health care provider how much activity is appropriate for you.

What scientists call "Overweight" ch...
What scientists call “Overweight” changes with our knowledge of human health

Please cross check information from other sources too. For all your health concerns please be guided by your healthcare provider. References: http://www.nlm.nih.gov/medlineplus/news/fullstory_140031.html

MRI in autism detection and prevention

The list of what causes autism is enlarging rapidly. Recently various environmental factors were blamed too, like pollution. Interestingly the new in this list are antibodies. Like various diseases autism too is suspected due to mother’s antibodies (auto-antibodies) which attack the brain proteins of fetus (when a baby is in mother’s womb its called fetus). Maybe tomorrow autism will be listed in the list of immunological diseases. This may help in future to develop a diagnostic test which can identify this antibodies early in the pregnancy to take appropriate preventive steps to protect a child before taking birth with the burden of autism .

There is another new addition in autism encyclopedia. According to a new study MRI (Magnetic resonance imaging) studies may also predict future chances of autism in infants by detecting the amount of extra fluid around their brains. However, as of now such MRI will only let us know at earlier time (but after birth) if the baby is going to acquire autism in future but not much probably can be done to prevent autism from occurring. Rather if the autoantibodies can be detected much earlier in pregnancy abortion like steps may become a future possibility towards an autism free world.

English: A boy with autism.

For all your health concerns please be guided by your healthcare provider.  Please cross check information from other sources too. Reference: link1 , link2

Breast milk decrease in prediabetes

After the pregnancy is over many mothers face a problem of decreased breast milk production and can’t feed their newborn fully. There are various myths associated to this too. Interestingly breast milk production seems to be connected to the mothers health directly. New findings suggest that female breast during lactation can produce such huge quantity of milk with the help of a hormone connected to diabetes, i.e. insulin. Insulin is a hormone made in our pancreas, which plays role in introducing protein, fat and carbohydrate in the breast milk since it has anabolic role (i.e. storage type role, insulin stores fat, protein and sugar instead of degrading them).

Therefore, if a women is prediabetic her insulin function will be abnormal hence the amount of breast milk produced might decrease too. So if the prediabetes is taken care of in time, nourishing the baby might not be a problem. Simple steps of diet and exercise may ease the situation a lot. Even if you have diabetes don’t self medicate yourself since diabetic drugs are harmful for the baby and only a specific one is used henceforth, approach to a doctor to seek expert help.
A baby having milk from a bottle.

Please cross check information from other sources too. For all your health concerns please be guided by your healthcare provider. References: http://www.nlm.nih.gov/medlineplus/news/fullstory_138459.html