It’s Distressing

Part of my “summer busy-ness” included going to the backside of nowhere, with no internet for nearly two weeks. You probably didn’t notice it much if at all, because I was able to set up enough posts to keep active (and I could get online at the library… as long as I could get to the library), but I sure noticed! I am so addicted to the internet! ūüôā In addition to a plethora of emails, I had a huge number of posts from blogs I subscribe to, to catch up on, since coming back. It’s really almost insane — I need to cut back… but I don’t want to miss out! ūüôā So, I missed out on the whole “Pit to Distress” viral blog posts.

I did read N is for Nurse‘s original post which seemed to start it all — in fact, her refusal to “pit to distress” was one of the things I was thinking of when I wrote the post about laboring women having and needing a patient advocate. The remainder are in no particular order, except perhaps the order in which I read them. A few of the links will be to blog posts that have multiple links in them, so I may end up linking to a single post more than once, while inadvertently leaving out another post, thinking I’d already linked to it. So, I’m human. If there is a good post you know about that is not included in these links, feel free to post it/them in the comments!

The first one I read was from Jill at The Unnecessarean, followed by part two (which also includes multiple links). Then, Keyboard Revolutionary has another set of links; with Rixa at Stand and Deliver having two posts — the first has an interesting set of comments after it, because Rixa has a graph of fetal heart-rate with a graph of maternal contractions, and asks L&D nurses who read her blog “what should you do in this instance?” — and gets a multitude of answers, which leaves one commenter saying, “Funny thing about the EFM commentary here. It *perfectly* illustrates how constant EFM is total crap–because nobody can agree on what they are seeing!!” [That may be what Pinky was referring to in this post. And fwiw, here is one post and another post on ACOG’s refining fetal heartrate monitoring guidelines.] The second post has multiple links as well. Jenn from Knitted in the Womb weighs in with her tales of being a doula at some Pitocin-induced/augmented births, as does Sheridan at Enjoy Birth. One of the contributors to our Independent Childbirth educators blog posted this.

From the nurse/midwife side of things: Ciarin at a Midwife’s Tale; Reality Rounds (NICU nurse), on nurses declining to follow a doctor’s order that they disagree with; a triad of posts from L&D nurse Melissa at Nursing Birth — Pit to Distress part 1, part 2, and understanding the pitocin dosage; former L&D nurse now new CNM Rebirth Nurse; and finally, Nicole at It’s Your Birth Right weighs in. In addition to the posts, I’ve read most if not all of the comments on them, which are also very interesting.

Then there is this article — not exactly on “Pit to distress,” but it does tangentially discuss the topic.

This is frustrating, because aggressive dosing of Pitocin, even if not given the term “Pit to distress” (even in jest), can harm mothers and babies. Obviously, contractions that are too strong and/or too close together can distress babies, since it reduces their oxygen supply. But it can also cause a mom’s uterus to rupture, even if she has an unscarred uterus — i.e., no history of C-section or other uterine surgery. Of course, this is not typical — but it can sometimes happen. As one of the posts said (I think it was “Nursing Birth”) — Pitocin, like many other drugs, can have different effects on different people — for some, a tiny amount of a drug will be enough to knock ’em out or make him loopy, while another person can take a bottle of it and barely get drowsy. A tiny amount of Pit may put some babies in distress or hyper-stimulate a uterus, while other women and babies will hardly have any effect from a maximum dose.

Does “Pit to distress” happen? Yes. How often? No clue. Anybody’s guess. It probably varies like every other statistic or factor, like epidural rate, induction rate, C-section rate, etc. In other words, some docs are going to be horrible, and others are not. I remember reading something somebody wrote about birth plans — this nurse or midwife basically said that it was nearly embarrassing to read some birth plans that specified “no pubic shave” or “no enema” or such like because these practices were nonexistent any more. Then several readers chimed in with their own personal stories of them being on the receiving end of these practices which were supposedly “not happening any more.” In my area, I could see stuff like this happening because of what I know of the nearest hospitals’ typical practices in certain things. [My mom was given routine general anesthesia, a pubic shave, and episiotomy — without her consent, and even specifically against her will — for all 4 of her births in the 70s, even though the “natural birth” movement really caught on in the middle of the decade, and many hospitals had modernized their services and practices by the time I was born. A friend of mine only barely escaped being given a routine enema when she gave birth at a different area hospital in 1996. The only way she avoided it was that she had an attack of diarrhea [as part of the normal birth process, not from actual illness] when she was being admitted.) So, some things may not happen in most hospitals — but if it’s even 1% of hospitals, that’s probably 30-60 hospitals where X is still occurring on a routine basis, even if the other 3000+ hospitals aren’t doing it any more. If these hospitals have only 1 birth average per day that’s still 11,000-22,000 women annually who are routinely submitted to these antiquated and archaic procedures. Or to overdosing on Pitocin. I’ve never personally known a woman whose uterus ruptured under any circumstances — but that certainly doesn’t mean it can’t and doesn’t happen! So, even if the majority of “birth people” and nurses say that they’ve never seen it happen at their hospital, doesn’t mean it doesn’t happen anywhere.

Of course, Pitocin, like every other drug, should not be used unless necessary or medically beneficial. If a doctor — or midwife! — is using Pitocin to speed up your labor simply so they can get done and get gone, that is *ahem* not a medical reason. Some doctors tend to have the idea that labor should never plateau, go slow, sputter, or even stop. That tends to be not allowed. “The labor curve must be followed, at all costs!” [Only slightly tongue-in-cheek.] Some doctors use Pitocin on all women — a few of the stories in either the blog posts themselves or the ensuing comments mentioned this — one doula said that her client was told sometime towards the end of her pregnancy, before labor even began, that she would be started on Pit when she got to the hospital; another L&D nurse expressed frustration that Pit orders were written up for a woman before she was even admitted and assessed (the doctor did it when s/he called to tell them the patient was on her way).

What can you do about it? First — trust your doctor. Seriously — pick a doctor or midwife you can trust. This will entail more than just picking a name out of the yellow pages, or from your insurance company’s “preferred provider” list, or asking your friends who they went with. You wouldn’t have agreed to marry your husband based solely on someone else’s recommendation, nor picking a name at random from a list of “available men”; you probably wouldn’t buy a car just from a description, without even test-driving it, so why on earth would you choose the birth attendant based on such little information? Ask questions, and look for red-flag answers, including such nebulous answers as “only when necessary.” As some of the posts have showed, some doctors apparently consider a 100% Pitocin rate to be “necessary.” Unfortunately, some care providers merely provide a bait-and-switch — appearing to be one thing during prenatal visits, and morphing into somebody completely unrecognizable during labor and birth. Not much you can do about that, except being aware that it can happen, and trying to make sure it doesn’t happen to you. Of course, another possibility is that your favorite care provider will be unable to attend your birth, leaving you with someone else who may not share his/her philosophy.

Second, make nice with your nurse. She will be the one actually managing your labor (or being hands-off), so having her on your side can make the difference between having your wishes followed and having them brushed aside as unimportant. You don’t have to call it “bribery,” but you’ll catch more flies with honey than with vinegar. Something like candy bars (perhaps Snickers, “packed with peanuts” or some other thing that has protein in it) is quick and easy for you to have in your room, to give to your nurse when she first meets you in your room — greasing the wheels and all that. Of course, if she’s on a diet, that might not be the best; but you could think of something else that might go over well that’s not just a carby, starchy, sweet thing to eat (mixed nuts? shrimp tray? — a little difficult to get if rushing to the hospital, but if you’ve got the time, you’ve got more options). If she’s going to advocate for you, you don’t want her weakening due to an empty stomach! ūüôā [Also, if you’ve got food in your room, it’s easier for you to eat it without appearing obvious, in case your hospital has rules against moms eating while in labor. Just note, that may be their rules, but not necessarily your rules.]

Third, educate yourself — know how Pitocin is administered and what you should be looking for when having it — not just the negative side effects like contractions too close together, but also the desired effect of contraction strength and/or pattern. Ideally, you shouldn’t have to do this, but it wouldn’t hurt to know. Know also that you can ask that Pitocin be stopped and/or turned down — it is not at all unusual for labor to continue on its own and in a good pattern after having been jump-started by Pitocin. If you are contracting at an adequate pace, and/or are dilating sufficiently (although I will stress that dilation is not the only way for labor to progress), but a nurse is continuing to up the Pit, you can ask why and/or request that she stop increasing the Pit and perhaps even reduce it or turn it off. Certainly you should know the symptoms of your uterus being overstimulated, so you can be more effective when requesting or demanding that the Pit be turned down. I’ve read several stories (including some comments on these posts I’ve linked to) of women who were hyperstimming, but didn’t know they could ask that the Pit be turned down — some even thought that their level of pain and/or contractions was normal, since “labor is supposed to hurt.” If your nurse won’t turn it down even though you are clinically contracting too frequently, request a new nurse or to speak to the nurse in charge. Of course, if you’re in labor and particularly if you’re having back-to-back contractions, this won’t be easy for you to do, so this is where a doula or other labor attendant (husband, etc.) comes in.

Hopefully, you will never need this information. But if you do, I want you to know it.

Births by the day of the week

On page 53 of the 2006 National Vital Statistics Report (released Jan. 7, 2009), there was an interesting little chart: number of births by the day of the week. Not surprisingly, there were the fewest births over the weekend. Monday through Friday there were about 12,000-13,000 births per day; but on Saturday and Sunday there were only 7,000-8,000.

Of course, it shouldn’t be that way — there should be an even distribution. But there’s not. Reason being, that doctors are trying to practice “daylight obstetrics”, so they will induce or section a woman who doesn’t go into labor or give birth on their time table. I’ve read somewhere (but don’t have a link) that the birth rates right before holidays, especially long holiday weekends, is much higher than normal — doctors want to have the time off, so will make sure all the women they think might go into labor while they’re playing golf, or relaxing around the pool, or spending time with family, have already given birth before they leave.

Women should only be given C-sections when there is a medical reason. Women should only be induced when there is a medical reason. Women should only have their labors augmented when there is a medical reason. Any of these interventions done for non-medical reasons introduces medical risks to mother or baby for no good reason.

Is there any medical reason for inductions to be started on Monday through Friday and not on Saturday or Sunday? I remember reading someone’s birth story, and she said that she “had to be induced” for some medical problem, so went in on Friday. She wasn’t ready for labor, so nothing happened. So she was instructed to go home and come back on Monday or Tuesday to try for a second induction. Hmmm. How “medical” was that problem? I’d really be curious to know. It was “so medical” that she “had to be induced” one day… but then apparently not medical enough for it to be a problem over the weekend. Seems to me that if it was a problem on Friday, it would be a greater problem on Saturday and Sunday. But that’s just me. What do I know? I’m sure every obstetrician in America knows that medical problems only present half as much over the weekend (yes, I’m being sarcastic).

I’ve read too many stories of women who have found out after the intervention that the intervention that they were scared or coerced into agreeing to was actually not medically necessary — it was just done for obstetrician convenience. Stories of women who were told their babies were in dire need of a C-section… only to find out that it was really their doctor in dire need of getting home to dinner — that sort of thing.

One factor in the Monday to Friday induction/C-section rates is that hospitals are better staffed during daylight hours on the week. But why should that be? Of course, everyone wants off on the weekend and at night. That’s understandable. But birth shouldn’t be made to fit within those confines. It is understandable that elective pre-labor C-sections would be done M-F during office hours. But everything else…? Shouldn’t hospitals arrange staff so that they have more even distribution at all hours? It seems to me a vicious cycle — doctors section or induce during daylight hours because they have the most staff on hand during those times; and then because there are so many women being induced or sectioned plus those who go into labor naturally, that hospitals have more staff on hand during the day; then since there is more staff on hand during the day… You get the picture.

What if hospitals had the same number of nurses on hand at all times, 24/7? or nearly the same number? Would it change the picture of obstetrics? There is a type of obstetrician called a “laborist” — s/he’s an obstetrician who works a set schedule at a hospital, ensuring that there is an obstetrician in the hospital at all times. At the end of the shift, the person goes home, and another person comes on shift. If a woman hasn’t given birth, I would assume that it would be no big deal — the incoming laborist would be briefed about her situation, and take over labor-watching. That’s the way it is now with nurses — at the end of a shift, the nurse’s duties are over (although paperwork may not be!), and she can hand off the woman to the next shift. The way it is now, doctors are inclined to “hurry things up” so that they can be sure of when the woman will give birth, to make sure that they aren’t interrupted in the middle of the night to come and catch a baby, to be able to plan, go out to dinner, go to a movie, etc. If a woman goes into labor in the middle of the night, and is progressing normally but slowly, do you think the doctor will allow her to go 24 hours before giving birth? or do you think he’ll be at least a little bit tempted to have nurses augment her contractions so that she gives birth well before dinnertime, so he can go home and have a relaxing evening at home? I’m guessing the latter.

I blogged about a month ago about an L&D nurse’s blog post in which she mentioned having a woman have a completely natural labor (i.e., no induction or augmentation). This woman had gone into labor over the Christmas or New Year’s holiday, and the doctor was in no hurry to speed up her labor, because the doctor didn’t want to come in early and attend the birth. He was more than willing to let labor take however long it was going to take. He didn’t care about clock-watching… because he was home and wanted to stay there. But if he was at the hospital and wanting to get home, I daresay the situation would be quite the reverse.

Risk of Uterine Rupture

Here is an interesting study from Canada, published in 2002, which discusses the risk of uterine rupture over the course of ten years. There were almost 115,000 births in this study, with about 10% after a prior C-section. Nearly 40% of these women attempted a C-section and 80% of them had a successful vaginal birth. Of the total number of births, there were 39 uterine ruptures.

When they say “uterine rupture”, that sounds really bad, and it can be, but they class “complete” uterine ruptures in with “incomplete” uterine ruptures, also called “dehiscence.” They said, “Uterine dehiscence was associated with minimal maternal and perinatal morbidity.” There were 18 complete ruptures and 21 incomplete. This is something to keep in mind while reading other studies — whether they differentiate between complete and incomplete ruptures, because the cases of dehiscence had much better outcomes than those of complete rupture.

Three of the¬†complete ruptures and none of the dehiscence¬†were in unscarred uteri — two were after a previous D&C for a miscarriage and one was in a woman with no previous uterine surgery. (Since the only examples I could find¬†of uterine ruptures in unscarred uteri were attributed to agents used to induce or augment labor, I will assume that that is what happened in these three cases. However, it says later that there was “no labor” in several cases of rupture and dehiscence, including¬†one with an unscarred uterus.¬†If anyone knows of an incident of uterine rupture or dehiscence in an unscarred uterus¬†with spontaneous labor, or with no labor at all¬†— no induction or augmentation¬†— please let me know. I’ve heard of being so “great with child” that you feel like you’re about to pop, but I’ve never actually heard of it happening.)

The remainder (36) were all in women who had had a previous C-section. There were 4¬†ruptures and 10 incidents of dehiscence among women who did not labor; and 11 ruptures and 11 incidents of dehiscence in women attempting a VBAC. Wait a second — I’m confused. As I’m typing this, I have a pretty bad cold, so perhaps that is interfering with my reading and comprehension, but when I look at this table of the incidence of uterine rupture, it shows 21 dehiscence among women with a previous C-section, but only 11 among a VBAC attempt. However, when I look at this table of the characteristics of labor, it shows the following rates of dehiscence among various types of labor: for spontaneous, 9; induction, 6; no labor, 6. So, how is it that “Ten women (four complete, six dehiscence) had no labor,” when according to the other chart, 11 of the dehiscence were in VBAC attempts? Eleven plus six equals seventeen, right? Yet there were 21 dehiscence? Perhaps the other 4 were in women who went into spontaneous labor prior to a scheduled C-section, so it was not properly a “VBAC attempt”? Obviously women who choose a repeat C-section would not be induced, so we must then assume that 4 of the 9 “spontaneous” were elective repeat C-sections. Yet it said they had no labor. If someone wants to shine a light into this, please feel free.

But this throws things off. Very frustrating! So it’s debatable whether these 4 dehiscence that were not in “no labor” nor in the “VBAC attempts” were due to spontaneous labor prior to a planned C-section, or if they happened prior to the onset of labor, like the other six. And if the complete uterine rupture in an unscarred uterus “with no labor” was not an induction of labor, I’d really like to know, because I’ve not heard of this happening before. It seems like it would be the subject of a case study or something if it happened, because it is so rare. Is it possible, then, that in this “no man’s land” between spontaneous labor and “no labor” there were inductions which were begun, and halted prior to the establishment of labor, perhaps due to fetal distress?

Moving on…

There were 103,348 births to women who had not had a previous C-section, with 3 uterine ruptures, all complete, for an incidence of 0.029/1000 ruptures. Of the remaining 15 complete ruptures among women who had had previous C-sections, 11 were during a VBAC attempt. Which sounds like 4 complete ruptures happened in a scarred uterus with no labor; yet as I’ve previously pointed out, of the 4 such ruptures, 1 was in an unscarred uterus, which means that there were 3 ruptures with no labor and 1 with some labor. Which is confusing because it sounds like they’re saying two different things about the same incident.

There was one stillbirth, which happened in one of the women with an unscarred uterus (previous D&C), with “spontaneous onset of labor” — whether that excludes augmentation of labor is not said. Again, this may be an indication of drugs used to augment labor causing uterine rupture even in an unscarred uterus. It’s also possible that the previous D&C damaged her uterus — perhaps even punctured it, although that is a rare occurrence — and then spontaneous labor broke the hole¬†wide open.

There were no neonatal deaths in the women who had dehiscence, and three in women who had complete ruptures. However, two neonatal deaths were due to lethal anomalies,¬†with only¬†one due to severe asphyxia in a woman with spontaneous labor. This chart compares outcomes between dehiscence and complete rupture, but doesn’t have outcomes of babies with women who¬†did not have uterine ruptures, whether¬†planned or unplanned C-sections nor successful vaginal births or VBACs. Obviously, the rate of adverse circumstances is higher with a complete uterine rupture than with an dehiscence. The study says,

Dehiscence of a previous cesarean scar is much less traumatic, and 52% of our patients were without symptoms and discovered en passant only at the time of repeat cesarean delivery. The perinatal outcome with dehiscence was almost universally good with no serious sequelae. However, with complete uterine rupture there was, excluding lethal anomalies, one perinatal death, one-third of neonates with severe asphyxia, but no infants with long-term postasphyctic sequelae in 4516 VBAC attempts.

So, according to the “Incidence of Uterine Rupture” chart, there were 4 ruptures that were not VBAC attempts (0.566/1000), and 11 that were (2.4/1000), with a total rupture rate post-C-section of 1.3/1000. Compared to a total rupture rate among women with non-scarred uteri of 3/103,348, or 0.029/1000.

The perinatal outcome with dehiscence was almost universally good with no serious sequelae. However, with complete uterine rupture there was, excluding lethal anomalies, one perinatal death, one-third of neonates with severe asphyxia, but no infants with long-term postasphyctic sequelae in 4516 VBAC attempts.

So, there was 1 death out of 4516 attempts. or a rate of 0.22/1000.

While the researchers noted whether the women had more than one C-section, or whether the scar was horizontal or vertical (all of the ruptures in the “vertical scar” group were complete — there were no cases of dehiscence; but I would like to know the failure rate of such scars, since not all vertical scars do give way), it didn’t note whether the uterus was closed in a single layer or a double layer. That may make a difference in the rate of future uterine rupture. Spacing of pregnancies may also make a difference, with close pregnancies increasing the risk of uterine rupture in a subsequent VBAC attempt.

Oxytocin induction was used in 2 complete ruptures and 4 dehiscence; oxytocin augmentation was used in 3 complete ruptures and 0 dehiscence. Prostin (a vaginal suppository with a prostaglandin) was used in 1 complete rupture and 2 dehiscence.

…the fact that oxytocic agents for induction or augmentation of labor were involved in 43% of complete and 40% of dehiscence highlights the potential risk.

Misoprostol (miso, cytotec), is not mentioned in this study, and one thing I read recently said that American OBs didn’t start using it until 1996; and since this study concluded in 1997, I assume it wasn’t used at all in this study.

Pregnancy, labor, birth, and autism

Autism rates have soared in the past generation or so. While some people say that we are just identifying more cases that would have been sub-clinical or missed in previous years, many people are concerned — and rightly so — about the high levels of autism in the U.S. population. I think the current rate of autism is 1 in 166 children, with it affecting more boys than girls.

It’s no surprise that it affects boys more frequently. Despite females being called “the weaker sex”, many (perhaps even most) diseases and conditions are recognized to affect boys more than girls; and males die at a faster rate at every age, from conception through old age. But the reasons behind autism are not well understood.

In a recent post, I posted a comment by a woman who wonders if her son’s autism was caused by lack of oxygen to his brain because the cord was wrapped around his neck four times. That’s a plausible theory. The brain is actually poorly understood, even among the most eminent of doctors, and we live in an exciting time of medical advancements and increasing understanding. But even if it’s true in this case, nuchal cords certainly do not necessarily cause autism. A friend of mine (who does not have the slightest hint of autism) was born blue with the cord wrapped around her neck three times and the doctor thought she was stillborn, but unwrapped the cord and resuscitated her. She has no learning disabilities or problems — in fact, she is an elementary school teacher.

But could anoxia or hypoxia lead some children to develop autism? That would be an interesting thing for researchers to study. If you’ll read that woman’s story, she said she felt her son thrashing around inside her as someone who was drowning or suffocating might; when she went to the doctor, the fetal heartrate was abnormally low. When they induced labor, the heartrate dropped dangerously low, and the baby was born by C-section. Although the baby’s Apgar scores were excellent (9/9), the mother wonders if the lack of oxygen contributed to his possibly having autism.

One huge problem that contributes to the speculation and confusion surrounding the question of the reasons behind autism. There has been much publicity about the potential link between autism and vaccines — with the majority of the discussion in popular media on celebrities Jenny McCarthy and Jim Carrey who certainly believe that vaccines gave her son autism. If you follow that link, you’ll see that she has cured her son’s autism by having him follow a strict diet. This diet has helped numerous people with autism, but not all. Just as there may be more than one “cure” or “help” for autism, so there may be more than one cause. The rate of vaccination — the number of different diseases for which vaccines exist, the number and frequency of the shots, as well as the number and percentage of children who are getting vaccinated — is much higher than it was a generation or two ago. However, this is post-hoc fallacy. It may be a correct conclusion, but the “logic” behind that conclusion is false.

There is a big difference in a lot of ways, between children born in the 40s or the 70s and those born today. The rate of vaccines is one; the rate of inductions and augmentations is another. If the above woman is correct that her son’s autism is at least partially due to oxygen deprivation from a nuchal cord, then it’s possible that other reasons behind oxygen deprivation (aging or inadequate placenta, contractions that are too strong or too close together, etc.) could also be the causes of some other cases of autism. I recently heard of a woman who has heard that some people are linking Pitocin and autism, and is so concerned about this potential connection that her current birth plan wishes is that if her doctor thinks her labor should be augmented or induced with Pitocin, then she’d rather just have a C-section. I think that’s overkill, but if she’s so worried about it, there may be some good reason for it in her case. After all, not everybody is allergic to peanuts or strawberries, but there are some who will die if they eat them. In the same way, not everyone who is exposed to Pitocin or who suffers from diminished fetal oxygen becomes autistic, but if this woman is so concerned, maybe there is some intuitive thing she’s picking up on. While I’d rather have a little bit of Pitocin than a C-section, it’s her call to make, because it’s her body that will be recovering from the surgery.

The only case of autism I know of personally is in a girl who also has a genetic defect — in some ways similar to Down Syndrome (but affecting a different chromosome), with mental retardation. Her particular defect is fairly rare (in fact, I think she is the only person in the United States with this precise defect — the particular arm of the chromosome and the amount of genetic material involved), so how much of the mental retardation and autism is strictly due to the genetic defect and how much could be contributed to other factors (such as the frequent seizures she had in her infancy — finally discovered to be primarily related to teething) is anybody’s guess. While I don’t think she had any nuchal cords, she did go “overdue”, was getting into post-dates territory, when her mother finally induced “naturally” and gave birth to her at home with a CNM. The midwife said the placenta showed signs of age, so it’s possible the baby could have had reduced oxygen during labor, even without the contractions being artificially stimulated by drugs like Pitocin.

This article questions a possible link between ultrasound and autism, among other conditions. This also is plausible. But like the above-mentioned possibilities of vaccines or hypoxia, this one also depends heavily on post-hoc reasoning.

I daresay that the cause of autism is more properly rendered the causes of autism, with more than one reason behind it. In Gary Null’s book No More Allergies, which I read a couple months ago, he identifies a lot of disease states or conditions (such as asthma and arthritis, among many others) as being more properly considered allergies. In the book, he mentions many people who suffered from debilitating diseases who were able to cure themselves by figuring out what they were allergic to and eliminating that from their lives. In many cases, this was food; in others, environmental toxins. One of the things that he said is that Western medicine is of the opinion that every disease has one and only one cause, and one and only one cure (probably a bit of an exaggeration). He obviously disagreed with this, for he personally knew many people who had the same problem (like asthma), which cleared up when they identified the various causes for it (for some people, it was a sensitivity to milk; for others, it was lawn chemicals). What if some people are sensitive to bodily “insults” like vaccines, ultrasounds, or pitocin, and it manifests as autism — just as some people are sensitive to peanuts and it manifests in recognized symptoms of allergies.

If the disease that we call autism is actually caused by different factors, or by many factors working together, and science is looking for the “Magic Bullet”, then this conundrum will never be solved. I don’t know what research has gone into autism, because it hasn’t affected my life personally, so some of what I have said may be in error or has already been studied. If so, forgive my ignorance and feel free to post links to better information — I’m mostly “just talking” right here, because it’s a subject which intrigues me and this post is something I’ve thought about for quite a while. Anyway, I know that there are researchers that look at babies who die from SIDS, and try to find common threads among them, as a way of reducing the death rate from this unknown cause. There should be something like this for kids with autism.

I know that giving kids a pacifier will reduce their risk of SIDS. My kids refused pacis. They didn’t die from SIDS. Putting kids to sleep on their stomachs increases the risk of SIDS. My kids constantly woke themselves up when put to sleep on their backs (their hands would wave or jerk in their sleep, and they’d wake up). They didn’t die from SIDS. Vaccines do not “cause autism” in one sense, because not every child who gets a vaccine or who is fully vaccinated gets autism. But could vaccines increase the risk of autism, just as putting kids to sleep on their stomachs increases the risk of SIDS? Ditto for ultrasound and hypoxia. We don’t know what SIDS is, nor what causes it — if we did, we’d give it a better, more descriptive name. SIDS is the name for “this baby died and we don’t know why — all other causes of death have been ruled out… the baby just… stopped.” Autism is a similar puzzle; and just as there may be many factors that increase or decrease the risk of SIDS in infants, there may be many factors that increase or decrease the risk of autism in children.

Jenny McCarthy is absolutely 100% convinced that her son’s autism was caused solely because of vaccines. I’ve heard her on Oprah (the first time — I know she was on recently again, but it was preempted by coverage of the financial problems), and she gives clear and compelling testimony that her son was developing normally until receiving his 18-month MMR shot, and then he regressed into the world of autism, where he stayed until she put him on his strict diet. I’m not going to argue with her, and in fact I rather agree with her that vaccines (at least at the rate at which they’re currently given) may be harmful… at least to some kids. But if autism is ever diagnosed in children who have not received the MMR shot, or who are not vaccinated at all, then there must be an alternate cause — at least for those children. Ditto for ultrasound, Pitocin, fetal hypoxia, and any other potential reason.

I remember her saying previously, in response to skepticism that vaccines cause autism — especially in light of certain scientific studies which purport to disprove that theory — “My son is my science.” For her, it doesn’t matter what scientists have concluded — she has to believe her own eyes. In the article I linked to, she says that instead of people beating down her door trying to find out how she cured her son’s autism (although she doesn’t use the word “cure”), she has people questioning the validity of the original diagnosis. She says that most people — doctors and scientists — don’t want to accept the possibility that autism is curable, nor that some cases are caused by vaccines. Without the “stamp of approval” from the scientific and medical establishment, it will just be outsiders — parents of these children — who will keep spreading the word and trying to find answers for themselves. It will never be accepted by the masses at large until doctors and scientists finally accept it.

A lesson from history — Ignatz Semmelweis was right all along about washing hands to prevent “childbed fever” — yet in response to his proof that it worked, he was incarcerated in a mental hospital. Not until thirty years (and probably millions of deaths) later, Louis Pasteur finally came to the same conclusion, and then childbirth was transformed. Up until that time, med students learned how to perform vaginal exams on corpses (many times women who had recently died from childbed fever themselves) and would go to laboring women and perform vaginal exams on them (without even washing their hands, much less sanitizing them and wearing sterile gloves). After Pasteur’s germ theory gained acceptance, this changed, and deaths due to “childbed fever” — which had previously been attributed to different things — every doctor had his own pet theory, none of which were right — declined dramatically. But Semmelweis had it right, though he was mocked. Even though the scientific and medical establishment laughed him to scorn, he was right.

What else are the Ignatz Semmelweises of today right about, though the established “experts” refuse to believe them?