Debunking Taboos in Obstetrics and Gynecology

The global image of India is that of an upcoming and progressive nation. True, India has leaped many boundaries in all sectors- commerce, technology and development etc. in the recent past. Yet many of us still tend to stay in the era of myths, traditions and superstitions, which are usually prejudices that became part of social culture and have no scientific evidence.

Just last morning there came to me this young lady smartly dressed and in her early weeks of pregnancy, with a horrified look on her face. She was accompanied by her mother, who looked equally scared. When I enquired, the mother said in a frightened voice- “Doctor, please save her pregnancy as she might abort anytime, she has had papaya this morning”. I was amused and at the same time disturbed.

So, does papaya really cause an abortion? The answer is NO; in fact, a ripened papaya is good for pregnancy as it has lower levels of papain, is a rich source of Vitamin A and is a rich antioxidant. One can avoid the unripe ones but ripe papaya is very healthy for pregnancy.

Pregnant women are bombarded with advice. With so many inputs from social media, web searches, family and friends, it can be difficult for women to navigate the myriad of conflicting recommendations regarding what they should and should not do when they are pregnant. This leads to confusion at best, and misinformation at worst, regarding nearly all facets of life – eating, drinking, sleeping, working and exercise, to name a few.

During pregnancy, the requirements of vitamins and mineral supplements increase, and thus a pregnant woman needs to take folic acid during the first 3 months of pregnancy, as this is very important for prevention of neural tube defects in the baby. From the 3rd month onwards, iron and calcium supplements must be included, as whatever nutrition one gets from the diet is not sufficient during pregnancy. Adequate iron quantities not only provide adequate nutrition to the growing fetus but also prevents anemia due to blood loss during delivery. All these supplements are completely safe during pregnancy.

Expecting women are often discouraged from climbing stairs and doing any exercise. But we encourage mothers to be to walk for 40-45 minutes every day or take up antenatal exercises to build their stamina to endure labour. This helps in keeping active during pregnancy and also in recovering faster after childbirth.

Pregnant women are often told that because they have a fetus growing in them, they must eat enough for 2. This is incorrect. When there is only one foetus, consuming 300 – 350 extra calories a day is during the first and second trimester is enough. In the third trimester, the extra consumption can be increased to 500 calories. Anything more than this and there is a risk of excessive weight gain which could place the expectant mother at risk of contracting diabetes or other medical complications and increase the risk of a C-section having to be performed. Be careful of your diet and do not overeat just because you are pregnant.

In our practice, we often come across pregnant women getting scared when asked to get an Ultrasound done, as they fear that this may harm the growing fetus. This is not true, ultrasound uses harmless high-frequency sound waves that reflect to give a graphic description of the body’s internal structures. Ultrasounds are totally safe whenever and however done and may be conducted any number of times and for any indication. In fact, an USG is usually able to detect most structural lethal abnormalities.

The taboos are not limited to the pregnant ones alone. There is this completely different set of women who, in spite of having some complaints, are too scared to visit a doctor, fearing they may be diagnosed with something fatal and thus they choose to stay back home. I have a question for all such women – would you prefer to consult a doctor earlier, get an examination done, spend a few bucks on a small diagnostic test and get done with it or would you rather prefer consulting late with an advanced disease, having to spend quite an amount for running a battery of investigations, imaging, advanced tests and so on, with less chances of a proper cure and keep suffering. Please think about it.

If you are postmenopausal and started bleeding again – No, it’s not due to stress.

Stress can be a cause of missed periods or irregular bleeding in premenopausal women, but bleeding among postmenopausal women is not normal and the cause must be determined. After a woman has gone through menopause, usually between the ages of 48 to 50, she should not bleed again – ever! There are numerous causes of postmenopausal bleeding, some of which are benign. However, it can also be an indication of cancer of the vagina, uterus or cervix. Getting the condition diagnosed and treated increases the chances of recovery and reduces the stress of uncertainty.

A casual visit to a doctor, and getting yourself a small pap smear test done, as a screening test for cervical cancer, which hardly takes a minute, is definitely worth your time. Our medical field has advanced to unimaginable extents and there is a cure for almost every disease now. So, please stop fearing. As it has been rightly said, “Happiness can be found even in the darkest of times, if one only remembers to turn on the light”.

And as I end my article, a small request to all the readers, please stop “googling” for your health problems. Not only can you end up freaking yourself out when you visit Dr. Google, you could also be unwittingly revealing personal information. Please stop treating the web like a doctor; after all, it is not the web that has taken the Hippocratic oath. Take care of your body; it’s the only place you have to live in.