It was in August 2016 that one of Bengaluru’s best-known gynaecologists, sitting in one of the city’s swankiest maternity hospitals, dropped a bombshell: If I didn’t change my diet immediately, “this foetus will not be viable.”
I had to drop everything from my family’s staple diet: wheat rotis, meats, milk, cottage cheese, and even fruit juices.
While there was no reason to doubt the medical professional till then, the conversation suddenly took an uncomfortable turn. “You north Indians have all bad habits like eating roti. You need to eat rice and idli and sambar like it’s done in south India,” the doctor said.A racist doctor?
What followed made me all the more skeptical. “Haven’t you seen photos of bleeding cow udders just because humans try to extract more milk? If you drink that milk, your foetus will get negative vibes and be in distress. Drinking cow’s milk will increase your chances of a miscarriage. You have to immediately stop drinking milk and consuming any milk products if you want to have this baby.”
I was willing to go any distance for a smooth pregnancy and a healthy baby, but the doctor’s reasoning made no sense. I expected her to tell me about the latest scientific research determining why one food was better than another for pregnant women, and here she was shaming me for being a “north Indian” and warning me of “negative vibes.”
Of course, she handed me a list of scans and tests that I needed, along with a laboratory’s business card. “Give my reference, they’ll give you a 15% discount,” she said. “And make sure the tests are done only in this lab, you don’t want to take chances with your high-risk pregnancy.”
“High risk.” By just looking at me and talking to me for 15 minutes?
I knew I needed a second opinion.
But then, this was just the beginning of my nightmare with Indian doctors. Almost two years since I delivered a healthy baby girl at the end of as smooth a pregnancy as a woman could hope for, I’m still living it.
“I cannot point out one specific reason why doctors scare new parents or expecting mothers. To me, it looks like they’re either trying to make more money or projecting themselves as better than the others by making the issue seem more complex than what it is,” said a Bengaluru-based paediatrician whom I spoke to about the phenomenon.
And it wasn’t just me.
Doctor shopping
After that first encounter, I spoke to several friends, either pregnant or in their postpartum period, to find a doctor I could trust.
Neha Didwania, a friend of a friend in her sixth month of pregnancy, told me she, too, was yet to find one despite trying several of them—even consulting two at the same time.
“The first doctor I went to is the head of the gynaecology department at one of the biggest private hospitals in Mumbai,” said 33-year-old Didwania, a Mumbai-based fashion designer. “I asked several fellow pregnant women who were consulting her and spoke to some of her earlier patients, and not one of those women had had a normal delivery. That made me panic.”
In a list she prepared of several doctors, one was famous for ensuring normal vaginal deliveries—almost 95%. But then, his hospital was so unhygienic there was no way Didwania would have opted for him. ”There were also doctors who seemed greedy in the first visit itself. They would insist I do several tests, and I do it in their own labs, not anywhere else,” she said
Eventually, she settled for a not-so-popular one and delivered a baby girl normally.
Indeed, trying out several gynaecologists is a common practice among urban Indian women with access to books and research material on maternity-related issues. In mommy circles, it is called “doctor shopping.”
For until a couple of years ago, India had more medical colleges than any other country in the world. Yet, the quality of doctors is considered “very bad.” To make things worse, medical education here has hardly evolved for over two decades now.
The clueless experts
I have spent the past 18 months “shopping” for the right paediatrician for my daughter. Most of whom I have met so far have a problem with my decision to offer breast milk to my child beyond the first year.
“She will become clingy,” said a doctor who advised that I stop nursing her by the time she was seven months old. A couple of other paediatricians, including one who studied medicine in London, told me that breast milk loses all nutrition beyond the first year and the baby continues to suck just for comfort.
Their advice contradicts guidelines set by the World Health Organization (WHO), as well as the American Association of Pediatrics (AAP). ”Exclusive breastfeeding is recommended up to six months of age, with continued breastfeeding along with appropriate complementary foods up to two years of age or beyond,” the WHO guidelines state. AAP recommends breastfeeding for at least 12 months, continued “for as long as mutually desired by mother and baby.”
But the deliberate misleading by some doctors in India has led generations of mothers to believe otherwise. New mothers constantly face pressure from older women in their families to stop breastfeeding when the baby is just a few months old. Often, new mothers are shamed for choosing to feed their babies beyond the first few months, given the sexual properties that society assigns to breasts.
“It is not that they (the doctors) do not wish to work for the best interest of the baby. It is that they haven’t been updated with the latest evidence and recommendations about breastfeeding,” said Adhunika Prakash, a certified lactation educator and counselor.
Despite spending much of her first pregnancy in 2012 learning about the benefits of breastfeeding and preparing herself for nursing, Prakash’s son was fed formula milk at birth on the premise that he had hypoglycemia or low blood sugar. “I came to know later that his sugar level dropped because he was separated from me and I wasn’t allowed to breastfeed soon after birth,” she says.
According to Jack Newman, a Canadian physician specialising in breastfeeding support and advocacy, compared to separation, skin-to-skin contact with the mother maintains a higher blood sugar in the baby.
Finding solutions
Today, Prakash is the founder of Breastfeeding Support for Indian Mothers (BSIM), a closed Facebook community with over 87,000 members.
The support group allows mothers to ask questions related to breastfeeding, which are then answered by volunteers and by fellow mothers in the group. All replies must strictly be backed by scientific research. The group gets hundreds of queries every week, many of which are seeking to vet ill-informed bits of advice given by family, friends, or, yes, doctors.
“We have members who post photos of pamphlets made by formula companies on our Facebook group. These formula milk pamphlets can be found at the clinics of some paediatricians. These pamphlets intentionally have misinformation, which causes a mother to undermine her milk supply even when the baby is getting enough,” Prakash said.
I was introduced to BSIM by a friend right around the time I delivered. And I closely escaped the “formula trap.”
When I told a neo-natal doctor that my three-day-old baby seemed to want to feed every few minutes, she advised me to “top up” breast milk with some formula, even prescribing a specific brand.
Before following her advice, I read up on the problem on my own, discovering terms like “feeding on demand,” “cluster feeding,” and “growth spurt.” Over the past year-and-a-half, these concepts have helped me not just understand my baby’s needs but also keep calm myself.
If I may add, none of the doctors I’ve met so far even mentioned these terms.
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