TOI, Patna April 4, 2008
Tomb In The Womb
Working women are increasingly at miscarriage risk.
One in five loses her baby.
One in three reaches a condition when delivery becomes a hazard
One in five loses her baby.
One in three reaches a condition when delivery becomes a hazard
Madhuri Kumar
One in every five urban working women suffers a miscarriage! This is no doomsday prophecy. It’s happening here and now. The ratio may appear outrageous but gynecologists confirm it is true. In fact, some even peg the miscarriage count higher. "The actual percentage of miscarriages is estimated to be as high as 40% of pregnancies since many occur without the woman ever getting to know she had been pregnant. Of those miscarriages that occur before the eighth week, 30% have no foetus associated with the sac or placenta," says Dr. SL Srivastava, a gynecologist with a private nursing home.
Representatives of non-government organization (NGO) Sakhi that works on family welfare and reproductive health acknowledge that working women, particularly those in towns and cities, are particularly vulnerable to miscarriage. "The more the number of working women, the higher the miscarriage figure," said an NGO worker.
According to the administrator of Kurji Holy Family Hospital, sister Julie. Among married women, miscarriage occurs in 15-20% of all pregnancies.
So what’s causing pregnancies among urban working women to terminate? Doctors point to a combination of factors work pressure, stress, commuting long distances in poor public transport, conception at a late age, lack of rest and nutrition and environmental pollution. Together, they form a killer concoction that smothers the foetus.
Another major factor is lack of adequate sleep among working mothers. With many unable to get an eight-hour sleep during pregnancy, the consequences are often disastrous. It adds to stress, causing severe hormonal imbalance that triggers other complications like hypertension, severe headache, hyperacidity, fluid retention and breathing trouble.
"Hormonal imbalance is responsible for at least 30% of recurrent pregnancy losses. Many women suffer from disorders such as PCOS (polycystic ovarian syndrome) which disturbs the natural balance of hormones needed to ensure a healthy pregnancy." Dr. Srivastava added. Former state IMA chief and BC Roy award winner, Dr. Manju Gita Mishra, also pointed out that hospitals and nursing homes had witnessed a sharp rise in miscarriage cases.
"The reasons are not far to seek. Apart from factors like stress and strain, age also plays havoc. With Bihar urbanizing at a hectic pace, most working women in cities prefer to marry late and delay pregnancy. The risk of miscarriage increases with advancing age from about 9% at 20 years to 80% at 35 years. This risk is irrespective of a woman’s reproductive history," Dr. Mishra explained.
What’s required for an active would-be mother is a balance between work and rest. "Like too much of stress, complete bed rest in normal cases can also lead to severe complications. It is the imbalance that accentuates a crisis," said Dr. Manju Mala, director at state Institute of Health & Family Welfare.
Challenges at work also impact them. Too much pressure at work or sarcastic remarks from bosses and colleagues have adverse effects on all of us. But in case of a woman who is in a family way, the damage is even greater," says gyanaecologist Dr. Jyoti Agrawal.
Citing a recent incident, she narrated how Sakshi, a reporter of a private television channel, started bleeding on her way back from work during the seventh month of pregnancy. A colleague rushed her to hospital.
"Though Sakshi survived, the baby could not be saved. It was a case of intra-uterine death. We found the umbilical chord of the mother wrapped around the baby’s neck, strangulating it."
Gynecologist Dr. Amrita Saxena recalled another case. "I saved a patient in the nick of time. Employed in a private bank, she experienced a loss of fluid while traveling in an advanced stage of pregnancy. When she was wheeled into the nursing home, a lot of fluid had already been lost. Both she and the baby were at risk," the doctor said.
With such cases on the rise, gynecologists are worried about the frequent complications that working women face during pregnancy. Three factors have been cited as reasons for miscarriages: lack of adequate rest, mental and physical stress, anxiety and environmental pollution.
According to gynecologists, whether a woman can work during pregnancy depends on her health, the condition of the foetus and the nature of her job. Traveling apart, even long hours of sitting and standing constitute great risks to pregnant mothers.
Women, who have hypertension, thyroid malfunction and obesity during pregnancy need to be particularly careful as they carry a great risk during all trimester. In fact, 35% working women reach a stage when delivery becomes risky.
"Working women need to follow a regulated life during pregnancy to avoid complications which can arise from irregular dietary habits, long hours of strenuous work and anxiety," said De Saxena, pointing to the higher risk for women working in BPOs, banks and other service sectors where one sits for long hours, leading to fluid retention, back problems and swollen feet.
Finally, it is all about one’s personal choice. Many simply don’t want to make a compromise. "Why can’t we have both?" It is a question that echoes the quintessential crisis of the modern woman.
One in every five urban working women suffers a miscarriage! This is no doomsday prophecy. It’s happening here and now. The ratio may appear outrageous but gynecologists confirm it is true. In fact, some even peg the miscarriage count higher. "The actual percentage of miscarriages is estimated to be as high as 40% of pregnancies since many occur without the woman ever getting to know she had been pregnant. Of those miscarriages that occur before the eighth week, 30% have no foetus associated with the sac or placenta," says Dr. SL Srivastava, a gynecologist with a private nursing home.
Representatives of non-government organization (NGO) Sakhi that works on family welfare and reproductive health acknowledge that working women, particularly those in towns and cities, are particularly vulnerable to miscarriage. "The more the number of working women, the higher the miscarriage figure," said an NGO worker.
According to the administrator of Kurji Holy Family Hospital, sister Julie. Among married women, miscarriage occurs in 15-20% of all pregnancies.
So what’s causing pregnancies among urban working women to terminate? Doctors point to a combination of factors work pressure, stress, commuting long distances in poor public transport, conception at a late age, lack of rest and nutrition and environmental pollution. Together, they form a killer concoction that smothers the foetus.
Another major factor is lack of adequate sleep among working mothers. With many unable to get an eight-hour sleep during pregnancy, the consequences are often disastrous. It adds to stress, causing severe hormonal imbalance that triggers other complications like hypertension, severe headache, hyperacidity, fluid retention and breathing trouble.
"Hormonal imbalance is responsible for at least 30% of recurrent pregnancy losses. Many women suffer from disorders such as PCOS (polycystic ovarian syndrome) which disturbs the natural balance of hormones needed to ensure a healthy pregnancy." Dr. Srivastava added. Former state IMA chief and BC Roy award winner, Dr. Manju Gita Mishra, also pointed out that hospitals and nursing homes had witnessed a sharp rise in miscarriage cases.
"The reasons are not far to seek. Apart from factors like stress and strain, age also plays havoc. With Bihar urbanizing at a hectic pace, most working women in cities prefer to marry late and delay pregnancy. The risk of miscarriage increases with advancing age from about 9% at 20 years to 80% at 35 years. This risk is irrespective of a woman’s reproductive history," Dr. Mishra explained.
What’s required for an active would-be mother is a balance between work and rest. "Like too much of stress, complete bed rest in normal cases can also lead to severe complications. It is the imbalance that accentuates a crisis," said Dr. Manju Mala, director at state Institute of Health & Family Welfare.
Challenges at work also impact them. Too much pressure at work or sarcastic remarks from bosses and colleagues have adverse effects on all of us. But in case of a woman who is in a family way, the damage is even greater," says gyanaecologist Dr. Jyoti Agrawal.
Citing a recent incident, she narrated how Sakshi, a reporter of a private television channel, started bleeding on her way back from work during the seventh month of pregnancy. A colleague rushed her to hospital.
"Though Sakshi survived, the baby could not be saved. It was a case of intra-uterine death. We found the umbilical chord of the mother wrapped around the baby’s neck, strangulating it."
Gynecologist Dr. Amrita Saxena recalled another case. "I saved a patient in the nick of time. Employed in a private bank, she experienced a loss of fluid while traveling in an advanced stage of pregnancy. When she was wheeled into the nursing home, a lot of fluid had already been lost. Both she and the baby were at risk," the doctor said.
With such cases on the rise, gynecologists are worried about the frequent complications that working women face during pregnancy. Three factors have been cited as reasons for miscarriages: lack of adequate rest, mental and physical stress, anxiety and environmental pollution.
According to gynecologists, whether a woman can work during pregnancy depends on her health, the condition of the foetus and the nature of her job. Traveling apart, even long hours of sitting and standing constitute great risks to pregnant mothers.
Women, who have hypertension, thyroid malfunction and obesity during pregnancy need to be particularly careful as they carry a great risk during all trimester. In fact, 35% working women reach a stage when delivery becomes risky.
"Working women need to follow a regulated life during pregnancy to avoid complications which can arise from irregular dietary habits, long hours of strenuous work and anxiety," said De Saxena, pointing to the higher risk for women working in BPOs, banks and other service sectors where one sits for long hours, leading to fluid retention, back problems and swollen feet.
Finally, it is all about one’s personal choice. Many simply don’t want to make a compromise. "Why can’t we have both?" It is a question that echoes the quintessential crisis of the modern woman.
Travel Tips
Take doctor’s advice before traveling.
Avoid traveling on rough and bumpy roads.
For air-travel, ask the doctor and then inform the airline about your pregnancy and stage.
Carry your own food and water.
Drink plenty of water during travel.
Use seats with adjustable arm rests, firm seat, back cushions and lower back support.
Put your feet on a footrest, box or even a small bag.
If you have to stand for a long period, keep one foot on a footstool or box. Switch feet and take frequent breaks.
Avoid heavy, repetitive lifting.
Avoid the sun, Heat reduces stamina and increases the risk of dehydration.
Controlling Work-Related Stress
Make a daily to-do list. Don’t try what you can’t do and don’t fret.
Be positive. Talk to people who have a positive outlook.
Share your problems with colleagues, friends or spouse.
Learn to relax. Go for pre-natal yoga if advised by the doctor.
Do not take any medication unless advised by the doctor. Even over-the-counter pills are a strict no-no.
Miscarriages are a real curse. It shatters a woman, both physically and emotionally. A little caution will help society and save precious lives.
Piyush Upadhaya -- Practising Psychiatrist
Take doctor’s advice before traveling.
Avoid traveling on rough and bumpy roads.
For air-travel, ask the doctor and then inform the airline about your pregnancy and stage.
Carry your own food and water.
Drink plenty of water during travel.
Use seats with adjustable arm rests, firm seat, back cushions and lower back support.
Put your feet on a footrest, box or even a small bag.
If you have to stand for a long period, keep one foot on a footstool or box. Switch feet and take frequent breaks.
Avoid heavy, repetitive lifting.
Avoid the sun, Heat reduces stamina and increases the risk of dehydration.
Controlling Work-Related Stress
Make a daily to-do list. Don’t try what you can’t do and don’t fret.
Be positive. Talk to people who have a positive outlook.
Share your problems with colleagues, friends or spouse.
Learn to relax. Go for pre-natal yoga if advised by the doctor.
Do not take any medication unless advised by the doctor. Even over-the-counter pills are a strict no-no.
Miscarriages are a real curse. It shatters a woman, both physically and emotionally. A little caution will help society and save precious lives.
Piyush Upadhaya -- Practising Psychiatrist
Obstetricians aims to deliver a healthy baby, but there’re times when we feel helpless. Only good ante-natal care helps deliver a healthy child.
Dr Manju Mala -- Director, Institute of Health And family Welfare
Dr Manju Mala -- Director, Institute of Health And family Welfare
I had a miscarriage about two years ago, when only a fortnight was left to deliver my second baby. I feel guilty, because it happened due to heavy workload.
Minoti Chaklanobis -- Assistant Registrar, Chanakya Law University
Minoti Chaklanobis -- Assistant Registrar, Chanakya Law University
