Homeopathy in Childbirth - objections from hospital midwife

[Rolf]

I have booked a doula for my (hopefully) imminent labour. We have been to see a homeopath together and plan for her to throw remedies in my mouth whilst I'm in labour.

I was told yesterday by a very reliable source (my hairdresser!!) that a friend of his recently delivered at the same hospital and when her doula started giving her homeopathic remedies, the midwife got very worked up and asked her to stop. I'm not sure whether or not she did, but the hospital is now undertaking an internal inquiry (whether generally or into this particular case, I'm not sure). The patient apparently was perfectly happy with her care from both the hospital and the doula so I think it's for the purposes of clarification rather than a big witch-hunt.

I'm slightly concerned that because of this there will be generally twitchy atmosphere about someone not employed by the trust giving a patient any sort of medication. I've added to my birth plan "I would like to use homeopathic remedies in labour and am happy for my doula to administer them". Do you think that's adequate or should I go further? Should I write out a list of the remedies I'm taking in with me, the name of the homeopath who dispensed them and a more sweeping waiver? Or is that the litigator in me speaking?

I have quick labours so won't be able to waste time debating with them. My doula is well-known at the hospital and I think will be very good at this sort of advocacy. And I have a good relationship with the hospital although as it's a big teaching hospital there's every chance that in labour I won't be looked after by anyone I know.

Any thoughts would be v welcome.

There will of course be no such problem in court, because homeopathy demonstrably has no effect, positive or negative.

"but if a doctor has prescribed medication for a medical condition I would trust him/her and take it"

You might be interested in this report from the Independent newspaper.

Special report: Prescription medicines

Each year, Britons are dying in their thousands because of the side effects of prescription and over-the-counter medicines. Reported deaths are up 155 per cent in a decade ? and experts are seeking new safeguards. Nina Lakhani reports

Sunday, 21 October 2007

Thousands of patients are dying each year as a result of side effects from pills prescribed by GPs and hospital doctors.

And while the number of deaths from suspected adverse reactions to prescription drugs has more than doubled in the past 10 years to 973 last year, medical experts warn that as few as one in 10 deaths and other serious complications are being reported.

Doctors' poor prescribing skills and repeated failures to recognise accurately adverse drug reactions in patients have seen deaths multiply by about two and half times since 1996.

Experts are calling for a revamp of the current warning systems designed to alert doctors to potentially lethal prescription drug treatments.

They believe tens of thousands of patients suffer life-threatening, disabling or other serious reactions that need hospital treatment because of a failure to spot and report many dangerous side effects and drug interactions quickly enough.

One study estimated that the equivalent of all the beds from seven general hospitals ? 5,600 places ? are occupied with patients suffering from drug reactions at any one time, costing the NHS more than £450m each year. Researchers believe around 70 per cent of adverse reactions could be avoided through better training, computerised prescribing systems and staff spending more time talking and listening to patients.

The latest revelations follow The Independent on Sunday's exclusive report two months ago highlighting the dramatic rise in the number of drugs that doctors are now prescribing.

The report in August showed that the NHS faced an £8.2bn bill for prescription medicines in England in 2006, as doctors issued 51 per cent more drugs than they did 10 years earlier.

But today's revelations highlight a 155 per cent rise in reported deaths from adverse reactions to prescribed and over-the-counter drugs ? a far steeper increase that will shock the both medical profession and patient groups.

An international conference on drug safety which convenes in Bournemouth tomorrow will hear that "too little progress" has been made in the past 15 years in training doctors to use medications more safely.

Professor Saad Shakir, director of the Drug Safety Research Unit at Southampton University, said: "Doctors need to know how to use medications ? this is the most important ethical responsibility for us. Surgeons wouldn't conduct an operation they haven't studied and trained for, and these same standards should apply to medications.

"The competence of doctors in understanding medicines, knowing when and how to use them and how to recognise problems is as essential as training a surgeon in how to perform an operation. Using medicine should be a part of medical training and the ongoing monitoring and evaluation of doctors."

The British Medical Association said last night that the figures amounted to a "wake-up call" and is calling for better training in the medical profession. Dr Peter Maguire, deputy chairman of the BMA Board of Science, said: "This big rise in fatal and serious adverse drug reactions should be a wake-up call to all doctors. We have a large number of new medications, but there are also fake drugs coming into the market, and more and more people are using herbal and over-the-counter drugs, as well as all the existing prescription drugs. On top of that, people are living longer and we have the situation of polypharmacy, where we treat people with several medications.

"In recent years, there has been less pharmacology taught in medical schools, but if you consider the growing number of drugs available and the trend towards combination therapies, then this does seem to go against the grain."

But some experts argue that the task of knowing all potentially harmful drug reactions is beyond doctors, and that computerised prescription systems must be used.

Professor Lucian Leape, patient safety expert from the Harvard School of Public Health in the US, said: "The trouble with education is that it is never 100 per cent effective. The best way is to use a computer system that doesn't forget which medication the patient is allergic to, or that they have impaired kidneys, whereas the doctor may be considering 30 different things.

"By using a correctly programmed computer, we believe you can reduce prescribing errors by 90 per cent."

Many of the reported deaths are linked to older common medications such as aspirin, rather than newer drugs. Doctors and patient groups believe the danger lies with interactions between new and old drugs, which are increasingly combined to treat older patients with multiple diseases. Age Concern warns that elderly patients are more likely to suffer from side effects and are less likely to tolerate a combination of medications.

A failure by doctors to make the difficult distinction between adverse reactions and disease symptoms can prove potentially fatal, as patients may be given drugs that are more harmful than helpful. According to patient groups, doctors and other health professionals do not always take the suspicions of patients and relatives sufficiently seriously.

Penny Bunn was prescribed anti-depressants by a psychiatrist in 1998 when she was a slim 30-year-old broadcast assistant at the BBC. Five years later, she was in hospital with kidney and liver damage, weighing 20 stone. Eventually she was diagnosed as suffering adverse reactions to her prescribed drugs.

As well as serious weight gain, she experienced blurred vision, vomiting, jaundice, irregular periods, agitation and difficulty passing urine. But because none of these symptoms was recognised as adverse drug reactions, Ms Bunn was prescribed more and more medication, eventually leaving her close to death.

She said: "We now know that I am allergic to all anti-depressants. However, rather than even consider this as an option at the time, the consultant psychiatrist continued to blunder blindly on, misdiagnosing all the reactions I was having as being evidence of further psychiatric disorders.

"No medical personnel ever mentioned anything about side effects or interactions, yet I now know some of the medications I was given are not meant to be used together. How the psychiatrist managed to sit there, as I changed before his eyes, and never cotton on to the fact that there was something horribly wrong with what he was doing, I do not know."

Munir Pirmohamed, professor of clinical pharmacology at Liverpool University, said doctors' failure to spot adverse drug reactions was the most important reason for the under-reporting of the problem.

He said the Yellow Card scheme ? as the warning system is known ? had improved public safety by encouraging more reporting, but that this alone was not good enough: "The Yellow Card scheme needs to be complemented by other methodologies so that we can detect adverse drug reactions sooner rather than later."

Drug trials include relatively few tests on healthy individuals over a short period of time and may not pick up any number of adverse reactions. And interactions between new and older drugs are not tested during clinical trials, so these dangers can only be identified after a drug is licensed and in effect "tested" in the real world.

Professor Shakir said that the current drug safety systems were "... about firefighting and damage limitation, whereas it needs to be more proactive, and though this is starting to take place we don't know the impact of this yet."

Doctors and patient groups stress that people should not stop taking their prescribed medications, but that there is a need for them to be more alert and assertive with their doctors, especially as demand grows for quicker access to new drugs.

Professor Pirmohamed said: "If people are going to get earlier access to new drugs, then an increase in serious adverse drug reaction is a worry, but this is a debate for everyone, including patients, who are often willing to take the risk in order to get access to new drugs more quickly."

Some experts are calling for the pharmaceutical industry to be given more responsibility in this post-marketing surveillance and a more pro-active approach than the Yellow Card scheme, which has been underused since it began over 40 years ago. Drug companies are not currently responsible for monitoring a new product once it is licensed for use, nor do doctors and other professionals have to report any side effects in their patients.

But Professor Shakir said: "I believe identifying, responding to and reporting adverse drug reactions should be included in NHS targets, so that doctors see it as part of their job."

Deadly side effects

The drugs most often reported to have produced fatal reactions in patients (1996-2006)

Clozapine: an anti-psychotic

Infliximab: an anti-inflamma-tory

Diclofenac: an anti-inflammatory

Warfarin: prevents blood clots

Olanzapine: an anti-psychotic

Venlafaxine: an anti-depressant

Aspirin: prevents blood clots

Methotrexate: treats cancer and rheumatoid arthritis

Paroxetine: an anti-depressant

Rofecoxib (Vioxx): an anti-inflammatory

Source: MHRA

The risks

'Dad had a right to know about the side effects'

Retired RAF Squadron Leader Charlie Bootle (right) died in 2001 from an adverse reaction to Methotrexate.

Sqn Ldr Bootle had been taking the well-known medication for rheumatoid arthritis for three months. His daughter, Amanda, describes the events leading up to his untimely death.

"My dad was a fit 72-year-old and a keen sailor who suffered from rheumatoid arthritis. He started to feel breathless out of the blue and when it got worse after a couple of days he and my mum worked out it could be the medication, so they went straight to his GP, who sent him to hospital.

"He kept telling the doctors what he thought but they wouldn't listen because he was just the patient. In the meantime his condition deteriorated so quickly he was dead within days. The hospital told us they didn't warn patients about all the risks of the drug in case people didn't take it, but this is a doctor playing God. My dad had a right to know.

"He should have been allowed to make an informed choice and know what side effects to look out for. That could have saved his life. The National Patient Safety Agency has since issued safety alerts but it scares me that while this drug saves lives, many patients still don't know all the risks. Doctors have to tell their patients: everyone has a right to know." NL

'How can patients take in complex information?'

Chris Steele is a GP and resident doctor on ITV's 'This Morning'.

"I had to miss my slot on 'This Morning' last week as on Tuesday I developed a problem with my heart. It was beating slower than usual and started skipping beats. I went to my local A&E, where I was given an ECG and other tests, and then diagnosed with an adverse reaction to Atenolol, a common medication for high blood pressure, which I've taken for 10 years.

"The medication hadn't changed but my heart has got weaker with age so I am more susceptible to side effects. What worries me is that I'm not sure a normal patient would have noticed or acted on the symptoms so quickly. I'm a doctor so I knew I needed help and that my condition could have developed into cardiac failure. The whole area of medication side effects, interactions between drugs, herbal remedies and foods is a nightmare.

"Doctors don't have the time to keep up to date with all the information out there or to extract all the relevant information from patients in a 10-minute consultation. It's just not possible.

"And how can we expect patients to comprehend the complicated information in the medication leaflets provided? Many elderly patients cannot even read the small print. This is such a complex issue and I really don't know what the answer is." NL

The Pill Epidemic
Deaths from adverse reactions to prescription drugs have doubled in ten years. What should be done about this? Are pills handed out too easily? Should doctors receive more training in how to spot adverse reactions? Or should patients be educated to better detect these in themselves?

tittybangbang
Some people do take rat poison. The drug warfarin is a rat poison.

fair enough I was a little sweeping in my statement that if something is prescribed you should just take it - doctors do get things wrong. However in the case of an asthmatic child, which was what I was referring to, I think it would very unwise to stop taking the prescribed medication without asking your doctor and instead self-medicate with homeopathy (if this is indeed what is happening in this case)

To clarify above - my son doesn't need his asthma medication since he started homeopathy. If he needed conventional medicine, I would give it, just as I gave it when he was ill before he started homeopathy, and that's what his homeopath (and any homeopath) would support too. I have a salamol inhaler handy at all times, one in my handbag, one in the flat, one in his changing bag, and there's one at the nursery he attends. So if he was wheezing he would have it straight away. He has been seen by doctors with follow up appointments at hospital and GP surgery who have all said to give salamol immediately whenever he wheezes, but nothing otherwise. Conventional medicine doesn't have anything else to offer besides steroids which he has had in the past, but which no doctor would prescribe high doses to a baby except in extremis - and now that we aren't in extremis since taking the homeopathy, that means no steroids. Which is very good news.

In the meantime he takes homeopathic remedies morning and night and hasn't needed anything else for a month. We're off to homeopath this afternoon, I think she'll be very pleased with him

I'm glad he doesn't need the strong drugs any more although I'd give it if he had the slightest wheeze and I'd take him to hospital as before. But I'd call his homeopath on the way and she'd meet us there - she arranged this when first treating him but hasn't needed to do it since he's improved so drastically on the remedies so we aren't going to the hospital all the time any more.

He finished the course of steroid tablets prescribed by the dr, hence am not giving those any more. They had horrible side effects - he only slept for 10 hours in 48 when he had the first dose (injected at hospital) - and each was just a one hour burst of sleep then he'd wake up screaming and biting himself, punching us etc. But of course we gave them to him, even though it was heartrending to give him something that was plainly doing him so much harm, but was necessary at the time.

We're just glad that we're not doing midnight rushes to the hospital any more.

Btw I didn't just have PCOS, I also had damage from when my appendix burst as a child. I won't go into the anatomical details as I find it a bit upsetting, but DS really is a miracle and if my belief in my homeopath (different homeopath to DS) was what did it I still bless her for it.

"He has been seen by doctors with follow up appointments at hospital and GP surgery who have all said to give salamol immediately whenever he wheezes, but nothing otherwise." "He finished the course of steroid tablets prescribed by the dr, hence am not giving those any more." Could you contemplate it was those that made him better for the time being? Oh no, that would be just so...conventional.

Side-effects are distressing, esp. in such a little child.

Can I just point out that homeopathy properly prescribed NEVER treats a disease / condition as labelled by allopathic medicine (conventional)but treats the WHOLE person and ideally the causation of the illness. So, no wonder the trials never work, after all we ARE all different and if I get a cold I will have certain symptoms whereas anyone else who picks up the same cold will probably have different symptoms (temperature, sore throat etc) I'm sure you all realise that you can have for example a sore throat that hurts every time you swallow or it stings or it's swollen or it's inflamed or red or or or...and as homeopaths we take ALL these symptoms into consideration, so patient A gets one remedy, patient B a different one as they are presenting individual symptoms, therefore double blind trials are useless....

Also, what do you do when your little one bumps their haed? That's right you rub it better/put your hand over the bump, maybe even applying light pressure - that is homeopathic treatment, curing like with like! In a sense you are re-applying the force of the impact, of course much gentler, but still...I also recommend you look up this
www.life-enthusiast.com/twilight/research_emoto.htm...

Sarahmsqt - my goodness you're talking some bollocks on there. And you're not even being paid for it. I can't imagine when you're in full flow.

Dear Cristina you astonishing person, thank you for the use of such beautiful language , do you get paid for that? Enjoy your life & all the best for the future (sincerely) x

Sarah

Are you really unaware that you sound insane?

I had a water birth and the only thing I used throughout my 14 hour labout was Clary Sage and it was the best experience of my life. You don't take in internally, but with a good breathing technique and applying it to a towell (or some such) it can really help calm you down. But with all things, what works for one doesn't work for all - and for all I know, I could have done the whole thing without it, but I rather liked the smell.
Go with what feels right for you - you could take in 100 tinctures and hate them all, but don't listen to negativity on any subject before childbirth as it just adds to your angst. Be positive and love what you're doing and you'll breaze through.

There is no reason why you should not use homoeopathy during your labour, and no reason why, with simple instructions, that your doula should not give you the remedies. I am a trained midwife and used homoeopathy throughout my labour (it is SO excellent for making labour efficient and dealing with any fear or shock or exhaustion, and great for Mum and baby afterwards). Many homoeopaths, my sister included, will provide women with a "labour kit" of remedies, plus simple, clear instructions. You do not need a trained homoeopath to be there. There is no legal requirement or anything like that.

The important point is that this midwife's reaction came from fear and ignorance. You need to discuss the issue with the hospital/midwives and say that this is what you are going to do (This is YOUR labour after all, your body, your baby) and that you will need a midwife who is happy with the situation. In actual fact midwives are not supposed to refuse to treat women just because they don't like something. They are supposed to be an advocate for the woman. The hospital can contact the ARH (Association for Registered Homoeopaths) if they need any reassurance. Homoeopathy of course is so great because it has NO side effects and does not interact badly with conventional medicines.

Thanks for your kind wishes, dear Sarah. Thanks for loving my username too. As with all usernames, mine is a true depiction of my wonderful self.

If double-blind trials involve qualified homeopaths dispensing what even they don't know are real/placebo pills, I can't see why those trials aren't valid. I also find it rather telling that nobody's ever been able to nab that million - quite an incentive, I'd have thought. BUT - given labour seems to be so affected by state of mind, does it really matter if it's the placebo effect that helps? I mean, isn't the placebo effect a proven physiological response to a psychological stimulus, so very real? Whatever helps sounds wonderful, frankly. Personally I'd rather restrict my alternative therapies to head massages for tension headaches, which I believe has medical evidence in favour, because I am an innate sceptic so wouldn't benefit from any placebo element, but if people want to use a totally harmless system of belief to aid their health alongside conventional treatments, well, so what? Who suffers?

I really hate it when people disbelieve the (very strong) evidence on vaccination safety, purely because it's innocent kids that potentially suffer, and not the person making the decisions on treatment. It's not akin to refusing a treatment that exclusively affects you, or even your own children; it's making decisions that fly in the face of the overwhelming bulk of the evidence, on a public and not a private health issue. Homeopathy, though, can't harm anyone and will help some, due to feelgood/placebo - sure, I think some of those in the treatment business are cranks, but they're well-meaning cranks, who genuinely care for their patients and believe in what they're doing; as has been mentioned, it's not a route to riches. As long as conventional medicine is practised alongside when necessary, it does no harm, and may do some psychological good. So why the anger?

Rolf, is it possible that the midwife didn't know what was being administered? Some herbal remedies are contraindicated alongside some conventional, I think, and if I were a midwife and someone suddenly started giving unprescribed drugs to a woman in labour without that being agreed prior, I'd be a bit - hold up - too. So if she knows at the start that, during transition, your doula will be administering your treatments and why, yours will probably be okay, maybe? Anyway, I hope so and that you have a good labour.

"I really hate it when people disbelieve the (very strong) evidence on vaccination safety"

Which very strong evidence would that be? I'd love to see it. Cochrane found that MMR safety trials were completely inadequate. Adverse reactions are known to be hugely under-reported. And if vaccinations are so effective then I don't see why innocent kids would suffer. Mumps vaccination may well have increased the number of adults catching mumps (when it's potentially more dangerous). It remains to be seen whether Hib will do the same (the vaccination that was meant to last for life has been found to not last to the end of 2 years). And so on and so forth.

I be more prepared to see it as a public issue if there was back up for when it goes wrong. But when it does you're on your own Jack.

This is a direct quote from the Cochrane report on MMR:

"The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate."

Hardly very strong evidence of safety.

As another 'innate sceptic', I'm with Qally on most of what she said, but I'm with jimjams on the vaccine issue.

MMR is safe for the vast majority of infants, but a small percentage does regress following this vaccine. As long as the proper studies aimed at finding which children are at risk, it is unreasonable to expect parents to roll the dice and put their babies at risk of permanent damage 'for common good'.

Seems to me that there are the believers and the non-believers and never the twain shall meet. That is fine tho, everyone to their own. In my experience having a non harmful remedy to believe in certainly helped me. In short, I was diagnosed with MS 11 years ago & took a homeopathic remedy after consultation at Glasgow Homeopathic Hospital instead of the beta interferon that could have been prescribed to me by my consultant. I had nothing to lose, try it and see... I have not had any further attacks. Whether it is a case of mind over matter or not I really don't care. I'd much rather have taken it than have to inject myself with Beta Interferon that has not been extensively tested on women of child bearing age, isn't guaranteed to have an affect and also costs £10k to prescribe.

In my first pregnancy I took Arnica for the extensive bruising and it cleared up in a few days. Also my DS lost the forceps bruising across his face in a day or 2 as I bfed him. I fully intend to have homeopathic remedies to hand this time around too & would support anyone else in this decision.

Yes I would agree entirely with that cote.

And ditto the baby jabs too really. I'm not anti vaccination. But i am anit mass vaccination with no attempt to screen for infants at higher risk who need a modified schedule. That could be done now fairly cheaply.

"The design and reporting of safety outcomes in MMR vaccine studies, both pre- and post-marketing, are largely inadequate." You'll think I'm nit-picking here but the fact that the design and reporting of safety are inadequate doesn't mean the safety itself is inadequate.

Qally - "but if people want to use a totally harmless system of belief to aid their health alongside conventional treatments, well, so what? Who suffers?" There's an interesting point made in Goldacre's artcile referred to earlier. It's about medicalising an otherwise non-existent condition, which may not be such a good thing. Homeopaths jump in when medicine ends its job. As in the asthma example above. Or even the MS one. Why not allow yourself some breathing space and consider yourself "cured"?

It's worrying how women ask for evidence and information in decisions such as childbirth (tell me, tell me, how many operations have you done? I'm so clever the exact numbers will make total sense to me) but put on blinkers when it comes to homeopathy (often having bugger all idea what they are prescribed or even the difference between homeopathy and herbal medicine).

I'm still reeling from "what do you do when your little one bumps their haed? you rub it better/put your hand over the bump - that is homeopathic treatment, curing like with like!"

To think that there are people on this planet who expect help from this woman and others like her.

I shudder to think what she offers a burn victim - hot air from a hair dryer? Like cures like, right?

CoteDAzur - I liked that post too. Patronizing isn't limited to the medical profession. But it's alright if it comes from someone else, isn't it?

No of course it doesn't mean it's not safe. It does mean there isn't very strong evidence for vaccine safety - the post I was replying to- and the knowledge that we have about its safety has come after it's been rolled out on general release and given to millions rather than before.

And combinations are rarely tested. This was conclusion from the first international symposium on vaccine safety (very pro vaccination). Most of the safety data is drawn from analysing the components in isolation. This (imo) is not really good enough.

The MMR brand that caused the most problems has been withdrawn. (For causing too many cases of aseptic meningitis- although it's also the brand that has been linked to the worst cases in the whole MMR/autism thing as well). With better safety testing perhaps it wouldn't have been out there in the first place.

A direct quote from my neurologist "If you believe in it, it will be stronger than anything I could ever give you". 11 years on, I DO consider myself cured and can breathe freely thanks Cristina. Funnily enough conventional medicine offers no cure for MS. I agree with Energyhealermum it is your labour & your body & your baby and everyone is different. Labour is all about being relaxed as possible whether that be thru the conventional or the alternative route or a mix of the two.