There is enough evidence to show that delivering the fetus by C-section [involves surgically opening the abdomen and uterus and taking the live fetus out] carries increased risk to the mother and the child when compared to normal vaginal delivery. It is also known that higher the economic status of the woman the higher is her chances of getting a C-section done. This is also true in urban set up rather than in a rural set up. The percentages vary but in urban India it is 42% and above [Madras study]
There are definite indications for this procedure. Some of them are small pelvis, abnormal fetal position, delayed labour, fetal distress, maternal distress, wrongly placed placenta etc. These constitute around 2 to 5% of the pregnancies and the procedure is life saving in these. But what about the rest? If it is medically unnecessary why is it being done?
Here are some sordid facts
Surgical delivery in contrast to normal vaginal delivery means use of operating theatre, anesthesia, and increased duration of hospital stay. All this mean more money to all the parties concerned.
The obstetrician can deliver the baby at his or her convenience instead of waiting for the natural child birth to occur which may happen at an inconvenient time [to the doctor]
It is easy to convince the mother to agree for the caesarian section.
One can thus come to the inevitable conclusion that these deliveries are done because of greed and convenience and not for valid reasons in a high percentage of cases.
Majority of obstetricians are women
Thursday, May 22, 2008
Sunday, May 18, 2008
Good, bad and the ugly
The dramatic entry of the twenty twenty cricket into the Indian cricket scene and the apparent success made me write this piece.
Many large cities of the country boast well built spacious stadia exclusively meant for playing cricket. The spectator capacity varies from 35000 to 100,000! Except for a few days in a year most of these facilities remain unutilized or underutilized. With the introduction of 20/20 cricket, most of these stadia have come alive with spectators jamming the stands. Imagine over 50 matches held over a three months time! It is a win win situation for the players, the corporate backers and the paying cricket crazy public. These matches have thrown open the doors of riches to many players who have had no hope of making it to the national squad and to many ex players who are past their prime and many players from other countries who for one reason or the other fine themselves free to take part in these matches, Needless to say that money plays a very important role in motivating these players to play in these matches, hereafter called as Indian premier league! India’s darling, M.S.Dhoni reportedly was bought by a corporate house for 6000,000 rupees! For those who want to know what it is in dollars, the going rate is 40 Rs per dollar. The glitz and glamour is provided by film stars and business tycoons who have made use of this opportunity to become more visible and sell their wares.
Now let me come to the bad part of the show
Test cricket as we know now, played over five days with bowlers and batsmen trying to excel in the traditional manner of play, seem to be on its way out. The days of the square cut, the drive are over. The spectacle of a fast bowler running up to bowl with three slips and a gully waiting for the edged catch, may not be available for the next gen of cricket lovers. In 20/20 there is no place for the slip, he is needed to guard the boundary to catch the lofted pull or punch. The days of Tedulkars, Dravids and Gangulys will give way to others who will master the art of innovating new array of strokes and the batsmen will rule the game. Money bags and not the discerning cricket lover will dictate how this game is going to be played and who plays it. Genuine lovers of the game will find it tough to understand the new and changed rules of how the game is played. This shorter version which is over in 120 minutes with guaranteed result and short lived excitement is prime time viewing and going by the ratings, all other channels have taken a beating. Why watch the important news channel when the 20/20 match is on?
The ugly part
The spectacle of batsman trying to scoop the ball over the wicket keeper’s head and getting applauded in the bargain! The sight of a batsman rising on his toes and coming down on a ball like hitting a golf ball with a pitching wedge! Such an ugly sight but effective stroke in getting runs! The sight of the ball disappearing over the square leg boundary from a ball pitched ouside the off stump! Blasphemy. Then there is less than acceptable sight of men and women behaving like demented dervishes, in the stands and of players spitting allover in the playing area in the full glare of the TV cameras. But then, these are changing times and who will listen to the lamentation of an old fool like me!
Many large cities of the country boast well built spacious stadia exclusively meant for playing cricket. The spectator capacity varies from 35000 to 100,000! Except for a few days in a year most of these facilities remain unutilized or underutilized. With the introduction of 20/20 cricket, most of these stadia have come alive with spectators jamming the stands. Imagine over 50 matches held over a three months time! It is a win win situation for the players, the corporate backers and the paying cricket crazy public. These matches have thrown open the doors of riches to many players who have had no hope of making it to the national squad and to many ex players who are past their prime and many players from other countries who for one reason or the other fine themselves free to take part in these matches, Needless to say that money plays a very important role in motivating these players to play in these matches, hereafter called as Indian premier league! India’s darling, M.S.Dhoni reportedly was bought by a corporate house for 6000,000 rupees! For those who want to know what it is in dollars, the going rate is 40 Rs per dollar. The glitz and glamour is provided by film stars and business tycoons who have made use of this opportunity to become more visible and sell their wares.
Now let me come to the bad part of the show
Test cricket as we know now, played over five days with bowlers and batsmen trying to excel in the traditional manner of play, seem to be on its way out. The days of the square cut, the drive are over. The spectacle of a fast bowler running up to bowl with three slips and a gully waiting for the edged catch, may not be available for the next gen of cricket lovers. In 20/20 there is no place for the slip, he is needed to guard the boundary to catch the lofted pull or punch. The days of Tedulkars, Dravids and Gangulys will give way to others who will master the art of innovating new array of strokes and the batsmen will rule the game. Money bags and not the discerning cricket lover will dictate how this game is going to be played and who plays it. Genuine lovers of the game will find it tough to understand the new and changed rules of how the game is played. This shorter version which is over in 120 minutes with guaranteed result and short lived excitement is prime time viewing and going by the ratings, all other channels have taken a beating. Why watch the important news channel when the 20/20 match is on?
The ugly part
The spectacle of batsman trying to scoop the ball over the wicket keeper’s head and getting applauded in the bargain! The sight of a batsman rising on his toes and coming down on a ball like hitting a golf ball with a pitching wedge! Such an ugly sight but effective stroke in getting runs! The sight of the ball disappearing over the square leg boundary from a ball pitched ouside the off stump! Blasphemy. Then there is less than acceptable sight of men and women behaving like demented dervishes, in the stands and of players spitting allover in the playing area in the full glare of the TV cameras. But then, these are changing times and who will listen to the lamentation of an old fool like me!
Thursday, May 1, 2008
Milky Way
I have known Fatima since her school days. Never a bright one, she struggled through school and it was no surprise to me that she couldn’t finish school. I felt she was very relieved when the marriage proposal came, not because of the forthcoming bliss of married life but at the prospect of relief from the tedium of school. I was fond of her because of her sunny nature and whenever she came, I was assured of a laugh one way or the other. Either she laughed at me or I laughed at her. She went away to distant Coimbatore and I saw less of her then on. But each year she returned to her father’s house either to a deliver a baby or to spend the school holidays. Her husband, I saw little of but the father who is also my friend a great deal, during the days when she and her children were here with him.
Not quick on the uptake [she], I used to have a hard time explaining why and what of her illness whenever she fell ill in the years before her marriage. But she was not a difficult patient and she followed instructions to the letter whether she understood the advice or not. Inevitably, during her time spent in Bangalore, she would see me, now more for her children’s sake that for herself. As to her own health she cared a damn and was becoming fatter by the month. That seemed bother no one except me. Whenever I pointed this out to her, she would retort ‘it is not healthy to be like you, thin and skinny [those days, twenty years ago, I was much thinner than I am now]!’ I had no answer to this because this misconception of health that being fat is healthy was also shared by her father and her husband and against this trio I was helpless.
Let me get back to the incident I was trying to recall. It was a worried looking Fatima Begum [Now she is respectfully married and a mother to add] who came with her two year old toddler. He looked fine to me as the boy wasted no time in attacking the strewn odds and ends that usually can be found on my table which are a child’s delight. The nakko, nakko [no, no] cries of the mother went unheeded as the boy proceeded to throw these on to the floor. Hearing the commotion, the grandpa, my friend, rushed inside only to see the grandson at his usual best [I forget his name now]. The boy became quiet as he had my knee hammer with him and he was giving it a close look.
The mother told me the reason why she was here to see me. ‘Look doctor, my son is bringing milk out of his ear since three days. This is despite my stopping milk for the last three days’ I was a bit taken aback. Without asking her any further questions, I tried having a good look at the ear. Like mother like son. I couldn’t believe a child of that age being so cooperative. Embodiment of docility. The only interest he showed was in trying to inspect my autoscope. The ear was full of whitish pus which my friend, his mother thought was milk. I was curious to know how a reasonably educated girl could believe that the milk given orally can find its way to the ear. I made enquiries and true to form, Dr Seshachalam, her Coimbatore doctor, by the way of explanation had told her that. In a way he is a better doctor than I. Dr Seshachalam did not waste time trying to explain the intricacies of chronic ear infection to a person like Fatima. She needed a simple, easy to understand explanation and he had given her one. This was not the first time he had done one better on me and I have accepted defeat quite gracefully, as his treatment[unlike his explanations] for any given ailment was always correct.
Now the difficult question, what should I do? If I agree with Doc Seshachalam’s advice, this simple woman will starve the boy each time he has an ear discharge. I asked her, ‘did Dr Seshachalam ever ask you to stop giving him milk?’ She said no. ‘He did not say that, he said only little goes to the ear and the rest goes to the stomach, it is only I who took this precaution’. I saw a silver lining and caught on to it. Told her to restart milk feeds and despite the knowledge that she will not believe me, spent some time explaining why and how of ear infection.
Out of respect and for old time’s sake, she listened to me patiently, took the prescription and snatched the knee hammer from the wailing child’s reluctant grip, placed it back on the table, thanked me and went away.
I was sure she would return again to provide me with some other form of entertainment.
Not quick on the uptake [she], I used to have a hard time explaining why and what of her illness whenever she fell ill in the years before her marriage. But she was not a difficult patient and she followed instructions to the letter whether she understood the advice or not. Inevitably, during her time spent in Bangalore, she would see me, now more for her children’s sake that for herself. As to her own health she cared a damn and was becoming fatter by the month. That seemed bother no one except me. Whenever I pointed this out to her, she would retort ‘it is not healthy to be like you, thin and skinny [those days, twenty years ago, I was much thinner than I am now]!’ I had no answer to this because this misconception of health that being fat is healthy was also shared by her father and her husband and against this trio I was helpless.
Let me get back to the incident I was trying to recall. It was a worried looking Fatima Begum [Now she is respectfully married and a mother to add] who came with her two year old toddler. He looked fine to me as the boy wasted no time in attacking the strewn odds and ends that usually can be found on my table which are a child’s delight. The nakko, nakko [no, no] cries of the mother went unheeded as the boy proceeded to throw these on to the floor. Hearing the commotion, the grandpa, my friend, rushed inside only to see the grandson at his usual best [I forget his name now]. The boy became quiet as he had my knee hammer with him and he was giving it a close look.
The mother told me the reason why she was here to see me. ‘Look doctor, my son is bringing milk out of his ear since three days. This is despite my stopping milk for the last three days’ I was a bit taken aback. Without asking her any further questions, I tried having a good look at the ear. Like mother like son. I couldn’t believe a child of that age being so cooperative. Embodiment of docility. The only interest he showed was in trying to inspect my autoscope. The ear was full of whitish pus which my friend, his mother thought was milk. I was curious to know how a reasonably educated girl could believe that the milk given orally can find its way to the ear. I made enquiries and true to form, Dr Seshachalam, her Coimbatore doctor, by the way of explanation had told her that. In a way he is a better doctor than I. Dr Seshachalam did not waste time trying to explain the intricacies of chronic ear infection to a person like Fatima. She needed a simple, easy to understand explanation and he had given her one. This was not the first time he had done one better on me and I have accepted defeat quite gracefully, as his treatment[unlike his explanations] for any given ailment was always correct.
Now the difficult question, what should I do? If I agree with Doc Seshachalam’s advice, this simple woman will starve the boy each time he has an ear discharge. I asked her, ‘did Dr Seshachalam ever ask you to stop giving him milk?’ She said no. ‘He did not say that, he said only little goes to the ear and the rest goes to the stomach, it is only I who took this precaution’. I saw a silver lining and caught on to it. Told her to restart milk feeds and despite the knowledge that she will not believe me, spent some time explaining why and how of ear infection.
Out of respect and for old time’s sake, she listened to me patiently, took the prescription and snatched the knee hammer from the wailing child’s reluctant grip, placed it back on the table, thanked me and went away.
I was sure she would return again to provide me with some other form of entertainment.
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