Showing posts with label low-risk. Show all posts
Showing posts with label low-risk. Show all posts

Wednesday, April 7, 2010

Preeclampsia And Toximia Preventable With Good Nutrition


Many doctors will tell you they don't know what causes Pregnancy-Induced Hypertension, Preeclampsia or Toximia. While in some cases this is true, many times these potentially serious pregnancy complications can be prevented simply by getting proper nutrition during pregnancy.

Ina May Gaskin, in her book, "Ina May's Guide to Childbirth", explains it well:

"In telling you that toxemia can be prevented, I have given you the good news. The not-so-good news is that the techno-medical model of birth does not recognize any connection between toxemia and poor nutrition. The assumption about toxemia underlying this model of birth is that it doesn't matter what a pregnant woman eats or drinks, because her baby is somehow able to extract what it needs from her, regardless of how poorly she eats. One of the most important reasons for this missed connection between good nutrition and good health is that obstetricians receive virtually no training in nutrition during their medical and clinical education. Instead, they continue to be taught that the cause of toxemia is unknown and that it cannot be prevented.

"...Within the techno-medical model of care, the favorite ways of dealing with toxemia today include "treatment" by early delivery, whether by induction of labor or planned cesarean section, and the prescription of magnesium sulfate, Valium (diazepam), or calcium.

"Tom Brewer, author of "Metabolic Toxemia of Late Pregnancy," is a U.S. family practice physician who has devoted his life and career to understanding the cause of toxemia and to educating women and caregivers about how to prevent it. Between 1963 and 1976, he ran a prenatal-care project in Contra Costa County, California, for a population of over seven thousand mothers from the lowest income group in the San Francisco Bay Area. By all odds, most of the women in this population would have been considered likely candidates for developing toxemia and having low-birth-weight babies. In similar populations during the same period, the incidence of toxemia ranged between twenty and thirty-five percent. That is not what happened in the Contra Costa County project, where because of Brewer's intensive work, the women received extensive nutritive counseling during pregnancy. There, the incidence of toxemia was only 0.5 percent, with no cases of convulsive toxemia. The published results of this study convinced many midwives but few physicians or researchers, ostensibly because Brewer's work was not based upon randomized controlled trials. This research method (in which women are assigned by chance to groups receiving different treatments, whose outcomes are then compared by researchers unaware of the group to which each woman belongs) is often called the 'gold standard' of research because it is designed to eliminate bias. However, the problem with applying it to the thesis that good nutrition can prevent most cases of toxemia is that IT REQUIRES THE DELIBERATE MALNUTRITION OR STARVATION OF A GROUP OF WOMEN to be compared with a group of well-nourished women [emphasis mine]. Unfortunately, in the modern world of techno-medicine, cures and treatments involving drugs and surgery are often more researched and quickly accepted by most obstetricians than are preventative measures.

"Gardeners know that you must nourish the soil if you want healthy plants. You must water plants adequately, especially when seeds are germinating and sprouting, and they should be planted in a nutrient-rich soil. Why should nutrition matter less in the creation of young humans than it does in young plants? I'm sure that it doesn't. Farmers, ranchers, and veterinarians know that pregnant animals must be well-fed and given enough water and salt to give the best chance of survival to their young. It doesn't make sense that the human species could be the only one whose newborns have the power to extract from their mothers nutrients that their mothers aren't eating themselves.

"I know of no zookeeper who would feed pregnant animals in zoos junk food and expect optimally healthy young to be born. Common sense says that eating well is a good idea."

For more information, please see the following blog posts and site:

Monday, February 8, 2010

The Midwifery Model of Care

"The doctor of the future will give no medicine, but will instruct his patient in the care of the human frame, in diet and in the cause and prevention of disease."
- Thomas Alva Edison

For me, this statement embodies the midwifery model of care.

Midwives generally approach birth from the perspective that if it's not broken, don't fix it. Midwives help women approach pregnancy in a holistic fashion: taking into account diet, lifestyle, personal and emotional well-being, and more in helping a pregnant woman stay healthy and low-risk and
avoid complications rather than expect them and react to them.


This isn't to say that midwives are ill-equipped to handle problems. They are trained to know what to watch for, and when transfer of care may be needed if something is beyond their scope of practice. Even home birth midwives come to a birth equipped with knowledge as well as tools in case there is a need for it. I was a little surprised when I was in labor with my planned home birth and my midwife showed up with an oxygen tank along with her other tools. She set it aside and never needed to use it, but it was there just in case.

Birth is a natural process, not inherently dangerous

Yes, there are complications that can come up in birth, and there are times when medical intervention is definitely needed. The majority of the time, however, no such intervention is warranted.

According to Grantly Dick-Read in his book "Childbirth Without Fear" 95% of all births are low-risk and require no medical intervention whatsoever.

The Midwives Model of Care™ is based on the fact that pregnancy and birth are normal life events.

The Midwives Model of Care includes:

  • monitoring the physical, psychological and social well-being of the mother throughout the childbearing cycle
  • providing the mother with individualized education, counseling, and prenatal care, continuous hands-on assistance during labor and delivery, and postpartum support
  • minimizing technological interventions and;
  • identifying and referring women who require obstetrical attention

The application of this model has been proven to reduce the incidence of birth injury, trauma, and cesarean section.

The Midwives Model of Care definition above is Copyright © 1996-2001, Midwifery Task Force, All Rights Reserved.

I've written many times before about midwives. Here is an older blog post that might be of interest:
Differences Between Physician and Midwife - My Personal Reflections

In the coming weeks I will be posting a series of blog posts about midwives, along with some personal experiences and advice from some of my friends. If you have any questions or comments, or would like to share your own experience, please feel free to post a comment below.

Wednesday, April 8, 2009

Preeclampsia, Toximia, HELLP Syndrome & Pregnancy-Induced Hypertension

Pregnancy-Induced Hypertension or PIH is a diagnosis which includes the complications of: toximia, preeclampsia, eclampsia (which indicates that a seizure has occured) and the HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome, which indicates blood and liver complications. The term PIH can be used to refer to any or all of the above complications.

Sustained high blood pressure or Hypertension can increase an expectant woman's risk of reduced placental blood flow to the baby, placental abruption, and possible internal organ damage to the mother. Blood pressure can vary according to activity level, emotional state and body position. If you are at rest and free of emotional stress, your blood pressure is more likely to be low, whereas if you are active and/or stressed your blood pressure is more likely to be elevated. Blood pressure readings can vary depending on the instrumentation used and the skill of the person taking the reading, so it's a good idea to request that the same person with the same equipment take your blood pressure reading each time you have it checked.

PIH can be prevented and/or reversed through a healthy diet. 80 to 100 milligrams of protein daily can reverse the symptoms of PIH. Good sources of protein include:
  • Meat, poultry and fish
  • Eggs
  • Dried beans and peas
  • Cheese (cottage cheese is especially high in protein)
  • Milk
  • Whole grains
  • Peanut butter
  • Nuts
For more information about a health pregnancy diet, please see my post about Staying Healthy and Low-Risk

Mild PIH consists of the following symptoms:
  • Blood pressure over 140/90
  • Edema (fluid retention and swelling)
  • Protein in the urine
Mild PIH is generally treated with bed rest (the best position to rest is on your side), regular blood pressure checks, and close medical supervision to watch for signs of a more serious problem.

Severe PIH is characterized by any or all of the following symptoms:
  • Blood pressure over 160/110
  • Headaches
  • Blurred vision
  • Spots before the eyes
  • Pain in the upper abdomen
  • Decreased urine output
  • Increased knee and ankle reflexes
  • Changes in blood chemistry that indicate problems with the liver, kidney and blood platelet levels
  • In the most severe cases, seizures or coma or death of the mother and baby can occur, which is why PIH is treated very aggressively
Severe PIH may be treated with hospitalization and medication such as magnesium sulfate to decrease the risk of seizures.

If signs of severe PIH persist after treatment, an induction of labor or cesarean section may be planned. Blood pressure generally normalizes within days or weeks after birth, and with early diagnosis and treatment, complications from PIH are usually minimal and a healthy outcome is achieved.

The causes of PIH are unknown, but it has been found to be more common in first time mothers, those pregnant with twins, teenagers, women over the age of 35, obese women, those with poor diets, and women in high stressful living conditions. Expectant mothers with a personal or family history of chronic hypertension, kidney or liver disease, diabetes mellitus, or a past pregnancy with PIH are also more likely to develop PIH.

Information paraphrased from Pregnancy, Childbirth and the Newborn by Simkin, Whalley & Keppler.