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Views on Mother and Child Care Booklet

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Dr Prathima Reddy, Director & Senior Consultant, Obstetrics & Gynaecology, Fortis La Femme shares her iews on the Ministry of AYUSH’s newly launched booklet that provides tips to would-be mothers for having healthy baby

Abhimanyu the son of Arjuna and Subhadra, a valiant and brave warrior, was a mere sixteen year old when he was killed by the Kauravas because he did not know how to exit the Chakravyuha formation. The story reveals that Lord Krishna was narrating to Subhadra how to enter, exit and destroy various formations in a battle. But Subhadra fell asleep after hearing how to get into the Chakravyuha formation and so Lord Krishna stopped narrating how to exit and destroy the formation. This became Abhimanyu’s nemesis.

In recent times, the controversial booklet entitled Mother and Child Care published by the Central Council for Research in Yoga and Naturopathy has raised concern in the scientific world over some of the advice published.

It advises that the mothers ‘should have spiritual thoughts and keep themselves at peace and that they ‘should detach themselves from anger and haterednes (sic)’.

So is it true that the unborn baby can hear and feel when in the mother’s womb.

Is there any evidence that babies respond to the moods of the mothers and are affected by them? Some studies suggest that in response to music, babies’ show a change in heart rate as well as movements. (Kiselevsky BS et al , Maturation of fetal responses to music: 2004, Developmental Science). Studies have found that babies responded to certain types of music both inside and outside the womb and tended to become calm when that particular music piece was played even after they were born. Apparently, they changed moods according to different genres of movies, silent while a sad one was played and more active while they were shown a happy clip.

Common sense suggests that feelings of anger and hate are not good in the long term, for any human being, let alone a pregnant woman. Pregnant women are more prone to mood changes and depression due the variation of hormones in their body. So it is important that this aspect is addressed early on in the pregnancy and measures should be taken to ensure that she has an emotionally balanced pregnancy. Advice such as (in the booklet), “have spiritual thoughts, be detached from anger, and be with the good people in stable and peaceful condition” is not wrong advice. While this may not prevent antenatal or postnatal depression it is still important to “think happy thoughts” and remain as far as possible positive throughout the pregnancy and beyond.

The incidence of depression in pregnancy in India is about 10 – 31 per cent and is prevalent across all age groups. Both the antenatal and postnatal period are at risk for depression with the antenatal period being at a higher risk. Therefore mental well-being in pregnancy is especially important to lessen this incidence. Open ended questions regarding anxiety and depression must be asked and answers documented. Problems should be identified early and medical help must be offered when required.

The incidence of ante-natal and post-natal depression is increasing and various reasons are cited for this. The multiple roles a woman plays, increase in nuclear families with not much help from the extended family or friends, intimate partner/ domestic violence, feelings of inadequacy in the mother exacerbated by the environment at home, the birth of a female child (when a male child was desired), low self-esteem, poverty and non-supportive in laws.

Long term exposure to stress has been proved to affect the baby adversely by causing premature delivery and low birth weight. Exercise, yoga, meditation and breathing exercises are advised for the physical and emotional well-being of the mother. In addition to this, a stable and happy relationship with her partner and close family adds to her mental well-being.

The booklet advises against consuming “non vegetarian food, masala and spicy food”.

Most Indian women are undernourished and anaemic. In fact the leading cause of maternal mortality in the developing world, is post-partum haemorrhage. Anaemia is a major contributing factor. Women who have low haemoglobin levels at delivery are unable to withstand the normal blood loss of 500 – 1000 ml of blood as well as their more healthy counterparts. Hence they are at a higher risk of maternal morbidity and mortality. Inclusion of meat, poultry, eggs and fish in the diet is advised for women who are not vegetarians, as they are good sources of iron and protein.

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