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Scope and Limitations of
Homeopathy
Dr Uma GoyalObstetrician & Gynecologist (MS, FICOG, FIAMS, FICMCH,
FNAMS)Former Head, LHMC & S.S.K. Hospital
Senior Visiting Consultant, Holy Family HospitalNew Delhi
[email protected], Mobile-9810583950
24th September 2009
Status of Healthcare in India
India ranks 171 out of 175 in publichealth 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
Public Healthcare Infrastructure in India
Source: Asian Health Services, World Bank, CBHI Statistics, ESIC, Harvard School of Public Health
1500 Urban Health Posts
Urban
Rural
229 Tertiary Medical Colleges and Hospitals
1,290 ESI and PSU Hospitals
6,298 District and Taluk Hospitals
2,400 Community Health Centers
23,458 Primary Health Centers and1,46,036 Sub-Centres
TertiaryCare
SecondaryCare
PrimaryCare
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
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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 Icondense my talk only to where I
stronglyfeel that Case should be handled byObstetrician
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< 4’10” 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
24th September 2009
…….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
24th September 2009
….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
