Scope and Limitations of Homeopathy

Dr Uma Goyal Obstetrician & Gynecologist (MS, FICOG, FIAMS, FICMCH, FNAMS) Former Head, LHMC & S.S.K. Hospital Senior Visiting Consultant, Holy Family Hospital New Delhi Email-drumag@hotmail.com, Mobile-9810583950

Status of Healthcare in India

India ranks 171 out of 175 in public health spending

Source: WHO Study 2008

24th September 2009

Affordability of Healthcare
With the cost of healthcare rising & mechanism for financial protection missing, personal expenditure on health will push 2% of our population below the poverty line each year

Source: WHO Study 2008

24th September 2009

Public Healthcare Infrastructure in India

229 Tertiary Medical Colleges and Hospitals
Tertiary Care

1,290 ESI and PSU Hospitals 6,298 District and Taluk Hospitals

Secondary Care

2,400 Community Health Centers 23,458 Primary Health Centers and1,46,036 Sub-Centres

Primary Care

1500 Urban Health Posts

Urban

Source: Asian Health Services, World Bank, CBHI Statistics, ESIC, Harvard School of Public Health

Rural

24th September 2009

Indian Healthcare status

15000 Hospitals (68% in the Private Sector) Total of 8,70,200 Beds (60% in Private Sector) Total of 229 Medical Colleges and 143 Pharmacy Colleges 503,900 Doctors - Registered Medical Practitioners: (80% in Private Sector) 200 Homeopathic Medical Colleges and 2,00,000 Homeopathic Physicians
24th September 2009

Population to be covered

In India, women of child bearing age (15-45 years) constitute 22% Children under age of 15 years constitute 35% of total population Total population to be covered is 57%

24th September 2009

Health status of women in India

5,85,000 women die of pregnancy related causes annually Of these 99% occur in developing countries including India

24th September 2009

Health status of women in India

450/ 1,00,000 women die of pregnancy related complications in India This means 1,12,000-1,15,000 deaths per year Or 359 deaths per day Or one woman dies every five minutes somewhere in India. 70% of these deaths are caused by factors arising out of Obstetrical emergencies
24th September 2009

Integration of various medical sciences

India has the opportunity to provide the mix of the western and eastern healthcare systems
A- Aryuveda Y- Yoga U- Unani S- Sidha H- Homeopathy

24th September 2009

Scope and limitations of Homeopathy in Obstetrics

As I understand, students are taught about Obstetrics and Gynecology. This has been incorporated in their curriculum. Place of practical training to be decided

24th September 2009

Scope of Homeopathy in Adolescent Girls

Girls from 15-19 years are: Mainly not covered by any system of medicine unless they have some specific problem But incidence of teenage pregnancy varies from 3-10%

24th September 2009

Problems

Too early Too many Anemia Malnutrition As teenage girls are not mature to bear the stress of pregnancy and labour Anemia and malnutrition are very very common
24th September 2009

.Problems

>80% of these girls anemic Hb< 11 gms And this results in high maternal morbidity and maternal deaths This is totally preventable and treatable

24th September 2009

Scope of Homeopathy

Homeopathy can play bigger and better role here by finding out details in history regarding diet etc and treat. Anemia and malnutrition are preventable Counseling for timing of pregnancy Correction of anemia and malnutrition before pregnancy
24th September 2009

Specific - All obstetrical emergencies

All obstetric emergencies like ectopic pregnancies, vesicular mole, inevitable abortion, ante partum haemorrhage, severe diabetes, hypertension, eclampsia, abnormal lie, obstetrical labour or ruptured uterus first to be treated by an obstetrician only BUT There is a lot of scope of homeopathy treatment before or after the emergency is over
24th September 2009

Antenatal Care

75-80% pregnant women are not in optimal state of health. Malnutrition and anemia is most common Objective of ANC

Healthy mother

Healthy child

24th September 2009

High risk factors in History

Age < 19 years > 35 years Parity Primi and more than5 Poor Diet Medical disorders like Diabetes, Hypertension, thyroid disorders H/o congenital malformation in early pregnancy H/o recurrent pregnancy H/o acute pain
24th September 2009

On Examination

Weight < 45 kg H/o P/V bleeding Anemia Oedema BP H/L Breasts State of pregnancy
24th September 2009

Pelvic examination in first trimester is important

Examples

Abortion Ectopic pregnancy Vesicular mole

24th September 2009

In abortion- especially

Inevitable abortion Incomplete abortion Missed abortion Septic induced abortion Vesicular Mole- Degeneration of Ch Villi Acute ectopic pregnancy

24th September 2009

In theory part

In theory part, all these conditions may have been covered in lectures but these constitute obstetric emergencies and here treatment should be in consultation with Obstetrician as it requires surgical intervention Role of Homeopathy is limited
24th September 2009

Emphasis

Is to give them practical training so as these conditions are correctly diagnosed. Going through training manual, it has covered extensively all the problems in first trimester Question is how the practical training will be imparted??
24th September 2009

For Second Trimester

Important Points in H/o Recurrent pregnancy loss H/o bleeding P/V Here apart from routine examination rule out Incomplete Int Os by examination Low lying placenta is diagnosed by ultrasound
24th September 2009

Incompetent Cervical Int Os

Etiology Previous D&C Operation on cervix Congenital Others Treatment of this condition is surgical by passing the purstring suture No role of homeopathy treatment Homeopathy can play a role in cases where no etiological factor is found
24th September 2009

Assessment of foetal growth

If foetal growth is poor or lagging behind more than two weeks Cause must be investigated and treated ( Refer to Obstetrician) Homeopathy can play a role if no cause is found

24th September 2009

Third Trimester

Danger signs when the woman should report immediately Vaginal bleeding-Ante partum haemorrhage Swelling over feet, face and abdomen Severe headache Epigastric pain Convulsions High grade fever
24th September 2009

.Third Trimester

Breathlessness Sudden severe pain in abdomen All these conditions require immediate attention as obstetric emergency, hence to be referred to Obstetrician No scope for Homeopathy treatment but can be used after surgical intervention
24th September 2009

Antenatal Care
Going through the manual, I find that it has covered minute details of ANC, hence I condense my talk only to where I strongly feel that Case should be handled by Obstetrician

24th September 2009

What gives me a pleasant surprise is that treatment recommended in Manual is the same as we recommend like

Iron Calcium Folic Acid

Supplementation throughout pregnancy and lactation

Immunization Inj TT- against tetanus 2 doses Anti D- In Rh ve patient

24th September 2009

Total Antenatal Visits

Minimum- Three If the progress is satisfactory then at the end of 36 weeks, plan for place of delivery

24th September 2009

Place of Delivery

Aim- Every normal delivery should be supervised because any time absolutely normal case may turn into emergency. Example- DTA, PPH PLACE

Primary Health Centre District Hospital Tertiary Care Centre

24th September 2009

Certain conditions where delivery should be conducted at tertiary level

Unstable lie Big baby Multiple pregnancy Short stature< 410 Previous Lscs Placenta previa Accidental haemorrhage
24th September 2009

.Certain conditions where

delivery should be conducted at tertiary level

Eclampsia Severe heart disease Severe anemia H/o Post partum haemorrhage No scope for Homeopathy treatment, obstetrical intervention is required
24th September 2009

All Primary Health Centres

Normal pregnancy can be delivered (in which no complication) But- facilities for Instrumental delivery Anesthesia Blood transfusion Pediatrician should be available
24th September 2009

And in case of Emergency

Ambulance should be ready and attending Physician should know where to refer And at referred level- patient should be attended immediately

24th September 2009

Conclusion

By adding Homeopathic Physician in Maternal and Child Healthcare, we cover considerably major population where no medical facilities exist By covering adolescent age group, certain problems of that age can be corrected, before she gets pregnant. Thus she is in better physical and mental health It will certainly bring down maternal morbidity and will definitely make a dent in maternal mortality 24 September 2009
th

.At the end

I can only suggest that a team should be formed at national level which includes Obstetricians, Homeopaths and Paramedics Select a village, do a survey of that area Find out the total population including female population from 15-45 years and children below 15 years Identify health service facilities available Health services should be provided by this team along with the existing health services
24th September 2009

At the end

This study should be continued for 12-18 months The results should be statistically analyzed Only such type of studies, will be a living document to show the effectiveness of the services provided

24th September 2009

 No country sends its soldiers to war to protect their country seeing to it that they will return safely, and yet mankind for centuries has been sending woman to battle to renew the human resources without protecting them Fred Sain, Former President, IPPF

24th September 2009

Regarding Delivery few unpleasant comments are always faced by Obstetrician

Delivery can be conducted by Dai, so what is the big deal Delivery can be conducted by untrained person, why worry Delivery can be conducted by elderly person in the family or by mother in law, why bother Delivery can take place in the fields, what is the harm ANSWER to all these questions are that even today, we have such a high maternal mortality 24 September 2009
th

.Regarding Delivery few unpleasant comments are always faced by Obstetrician

In developed countries like UK, delivery is conducted by a trained midwife Any maternal death in a developed country becomes national news and is audited by group of Obstetricians

24th September 2009

My Experience with Homeopathy

Cheers & Fears

24th September 2009

Thank You !!!

Email: drumag@hotmail.com Mobile: 9810583950

24th September 2009