Article on Respectful Obstetric Care

My article on respectful obstetric care is now online on Perspectivo Mag!!

Comments and suggestions are welcome!

Memorable Encounters- I

I used to read James Herriot many years ago. He had expressed a thought frequently in his many books, the truth of which I am realizing in my own life now. He said that he would have seen many, many patients, but a few always stay in the mind, who stand out clearly in the nebulous seas of memory.

Among the people I recall are two ladies: a daughter and her mother.
The daughter had just given birth and was suffering from engorgement of breasts, which was why she had been referred to me. This patient was in her mid-twenties; the baby who was born was a "precious baby". Of course all babies are precious, but this phrase is used to describe any baby who is born after many trials, miscarriages and so on. This lady had had a stillborn some years previously, multiple miscarriages, abortions etc and who was thrilled to finally have a live, healthy baby in her hands. Her mother had been making her drink garlic milk for a few weeks before the childbirth to increase her milk production. She felt that that was the reason why her breasts were so hard and painful.

So we chatted, I told her all the usual steps to decrease the engorgement, such as warm compresses on the breasts, frequent hand expression of milk, frozen cabbage leaves (!) and paracetemol for the pain. Just as I was about to leave, her mom said, "Doctor, can we try jasmine?"

I blinked and said, "Okay, why?"

She said, "Why, to decrease the milk flow, of course"

I frankly admitted that I had never heard of jasmine having an effect on breast milk and then she said,

"It's a very common thing in our tradition. Every time the mother needs to decrease her milk, especially in case she no longer has to feed the baby, we tie a garland of jasmine flowers around her breasts and by next day, her breasts will be empty"

"Really?" I ask. "What if she wants to get the milk again?"

"Then she just has to start breastfeeding and drink a lot of garlic milk", said the mother.

Later that evening, I googled this up and sure enough, there were a couple of papers that talked about jasmine flowers affecting prolactin, the hormone that stimulates milk flow. I also spoke to a very experienced pediatrician who agreed that this really worked. What is unclear to me, however, is how long-lasting the effects are and if they can truly be reversed with substances like garlic, which are known to stimulate milk, and how long the reversal process takes. 

Weeks later, someone else told me that jasmine flowers are never given to a new mother, for this same fear. Jasmines are not even kept in the same room, apparently.

Interesting, right?

A Muslim family told me that they feed the mother the udder of a mother-goat. Apparently it looks a bit like paneer inside and one chops it up, roasts it and makes it into soup. And a couple of days later, milk starts leaking out of the breasts like water from a tap!

The things you don't learn from a text book.... :)

A Picture Worth Your Time

What a stunningly powerful picture.

I saw it on the Washington Post. Copyright belongs to Johnathan Bachman/Reuters

The caption is pretty brief: A demonstrator protesting the shooting death of Alton Sterling is detained by law enforcement near the headquarters of the Baton Rouge Police Department in Baton Rouge, La.