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Pregnancy and the H1N1 Flu Virusby Jeramie Peacock© 2009 Midwifery Today, Inc. All rights reserved. Read also: The H1N1 Primer for Pregnant Women "First, midwife, heal thyself. Next, do no harm." As midwives consider the potential impact of the new H1N1 Flu virus on our clients, it serves us well to consider modalities and options for preventative treatment. Although the mainstream is pro-vaccination, there are many varied opinions on the matter to take into account. The issue of vaccination safety, specifically in regard to pregnant women, is a vast subject. A thorough discussion on the topic would contain volumes of information. Complete texts are dedicated to the subject, and to attempt to fully describe the many dimensions of this controversial subject in a single article would be impossible. There are, however, many resources available to interested and concerned parents and health professionals. In my opinion, vaccination in pregnant women is very similar to the issue of childhood immunization—both are deeply personal issues that require rigorous investigation and consideration. At the end of this article, I have included a list of references for further investigation into the swine flu vaccine and its safety in pregnant women. There are two important factors in considering vaccination. First, there are numerous additional ingredients contained in the vaccine, some known to cause cancer, of which most consumers are unaware. Second, there is a complete lack of clinical data on the vaccines, their effectiveness and their safety. Additional ingredients in the "Influenza A H1N1 Flu Vaccine" include but are not limited to formaldehyde, eggs, thimerasol, neomycin and polymyxin. Thimerasol, a mercury derivative, is being used as a preservative in the multiple-dose vials of the vaccine. All consumers have the right to request a thimerasol-free single-dose .5 ml shot. People who are allergic to eggs should know that egg and chicken protein are used in the H1N1 vaccine and that dosage needs to be adjusted based on a person's level of allergy. A person who has a severe allergy to eggs or to anything else in the vaccine should not get the shot, even if she is pregnant.(1) A complete list of ingredients contained in the H1N1 flu vaccine is available on the FDA Web site, and the link is contained in the resources list at the end of this article. The package insert from CSL Limited for its Influenza A (H1N1) Monovalent Vaccine states: "Animal reproduction studies have not been conducted with the Influenza A (H1N1) 2009 Monovalent Vaccine or AFLURIA. It is also not known whether these vaccines can cause fetal harm when administered to a pregnant woman, or can affect reproduction capacity. Influenza A (H1N1) vaccine should be given to a pregnant woman only if clearly needed." Dr. Bill Sears shares his thoughts about the vaccine on his Web site, "Here is where we are flying by the seat of our pants, so to speak. The product inserts make it VERY clear that the 'swine' flu versions of these vaccines have NOT undergone any testing to demonstrate whether or not they are safe and whether or not they even work. They are relying on the fact that they are so similar to the regular flu shots that they should work just as well."(2) Historically, alternative preventative treatment has been utilized successfully in times of epidemic flu outbreak. Although there is an option to vaccinate oneself with this new H1N1 vaccine, I would argue that the current global situation warrants a more serious search for safe, non-invasive alternatives. The inherent risks of vaccinations can serve as a reminder for midwives to return to the basics, creating and maintaining a healthy immune system. One alternative approach being considered in countries such as India and France is nationwide homeopathic vaccination.(3) Homeopathy as we know it today was founded by Samuel Hahnemann, although the principle dates back as far as Hippocrates. In essence, homeopathy is based on the concept that a disease can be cured by infinitesimal doses of a substance that in larger quantities mimics disease symptoms. It is governed by the principle that "like cures like"—if a substance can cause symptoms in a healthy person, then it can cure similar symptoms in a sick person. In sections 100 and 102 of his Organon, Hahnemann describes the use of homeopathics in relation to epidemic disease.(4) A Times of India article from August 2009 explores the link between homeopathy and epidemic outbreaks, historically and today. "Well-known Delhi-based homeopath Mukesh Batra cited the instance of the Spanish flu epidemic of 1918 in which more than 50 million people were killed worldwide. He said the mortality rate of people given allopathic treatment was 28.2 percent, while [in] those given homeopathic treatment [it] was 1.05 percent at that time." In the case of the 1918 flu, the most common homeopathic remedies were Gelsenium and Bryonia, both 30C.(5) Oscillococcinum was first studied in France during the 1987 flu epidemic caused by an H1N1 virus similar to the swine flu of today. This multi-center study examined the effect of Oscillococcinum (200C) on the early symptoms of flu. Results were published in the peer-reviewed British Journal of Clinical Pharmacology. More patients in the treatment group recovered completely in the first 48 hours than the control group (17% of patients with active treatment compared to 10% of controls). More patients in the treatment group also judged the treatment as better compared to the placebo, 61% versus 49%.(6) In 1990 German scientists replicated the French study of Oscillococcinum. They used the same criteria as the previous study. After 48 hours of treatment with Oscillococcinum, the treatment group had considerably milder symptoms than the control group, and the number of patients with no symptoms from day two onward was significantly greater in the treatment group (17.4%) compared to the control group (6.6%).(7) India has had first-hand experience with the effectiveness of homeopathy as a preventative treatment, as documented during an epidemic outbreak of Japanese encephalitis that threatened Andhra Pradesh ten years ago. At that time, the Indian government distributed one million doses of Belladonna to the children of Andhra Pradesh. "No child was affected by Japanese encephalitis after that," Batra said.(8) There is currently no single remedy recommended for H1N1. However, Dr. Anil Singhal, a well-regarded homeopath in India, is currently working with the Indian government to answer this very important question—what homeopathic remedy is relevant for today's flu virus? On his blog, he explains his investigation thus far: "Dr. Hahnemann used the prophylactic medicines during epidemics in his time. He evaluated the remedies based on his guidelines, and using those remedies proved [the] efficacy of homeopathic medicines in epidemics. His experiences [led] him to create guidelines to finding the curative remedy in such epidemics. Similarly we can apply this in our search of homeopathic medicine for H1N1 flu pandemic. "As per my analysis, in my opinion, Arsenic Album (or Ars. alb., or Arsenic alba) might be the right choice right now. Taking Ars. alb. 30[C] twice daily for 4–5 days might be helpful initially for a month or so. I chose 30 potency as it would be safer for kids, children, pregnant, and immune-compromised peoples."(9) So why is the WHO not considering homeopathics as a viable solution to the swine flu in 2009? "WHO relies on statistical data before advising governments on tackling a disease. And there is no study on the effectiveness of homeopathy to prevent or cure swine flu. Therefore it cannot recommend homeopathy," Bhatia (a Jaipur, India-based homeopath) explains.(10) As my mentor Carol Gautschi says to our clients, "It is all about your body's terrain." By empowering our clients to make choices that enable them to maintain healthy immune systems we help them take responsibility for themselves, while simultaneously lowering their risk of a serious encounter with the virus. There a few key adjustments everyone can take to improve and maintain a healthy immune system, beyond the standard recommendations such as Vitamin C and getting good quality sleep. These remedies are more than safe for our pregnant clients, their families and us. These include:
There are often times in midwifery practice when we use our intuitive sense, prayer, or unexplained knowing to address an issue that arises at any point in the childbearing year. As we strive to provide truly holistic care in an increasingly medicalized world, it makes sense for us to also consider other forms of "medicine" that have been available to women healers throughout history. By practicing traditionally and intuitively, and remaining open to incorporating new modalities into our repertoires, we will continue to move towards ever-higher standards of care. At the same time, we can remain grounded in our respect for the old ways and spend time in reflection on the midwife's role through times past. In that same vein of wisdom, we must also remember the ancient adage, "First, do no harm." By improving our clients' overall health and giving preventative recommendations, we allow them a safer space from which they can consider if vaccination truly is a "necessary" and safe choice for them. As more data emerges in regards to homeopathics and the H1N1 virus, I would encourage midwives to keep up to date with this non-invasive prophylactic approach. If we are to practice as traditional midwives we must hold our clients to a higher standard of care and responsibility for themselves. From this place of mutual respect and responsibility we can more clearly determine, in partnership, what is truly best for each individual woman. By first seeking prevention of the H1N1 flu, and then conducting a thorough consideration of each woman's individual body terrain, we empower ourselves as practitioners to make informed decisions from a place of holistic understanding. Jeramie Peacock is an apprentice midwife, living and working on the Olympic Peninsula in Washington State with her partner, Caleb, and son, Seamus. This is her first article for Midwifery Today. She can be reached via her Web site at www.newbornrevolution.com, or by e-mail at newbornrevolution@gmail.com. Further Resources:
References: Web sites accessed on 29 Sep 2009 and 5 Oct 2009.
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