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 To
Whom It May Concern:
Public health authorities have identified an enormous
increase in the incidence of childhood autism.
In California, the number of kids receiving state
services for autistic disorders has nearly quadrupled
since 1987. (1) A recent news report on National
Public Radio noted 775 news cases, a 33% increase
over the previous quarter in which only 550 new
cases were identified. This brain development
disorder results in a lack of normal language
skills and inability to form human bonds of affection
with parents and other people. The majority of
its victims are boys. Many also suffer from epilepsy.
The physical, mental, emotional and social disabilities
combined are so sever that most autistic children
end up in institutions by the age of 13. This
is a tragedy for the child and its parents, a
loss to society and an economic burden of great
proportion. Autism is now thought to affect one
person in 500, making it more common than Downs
syndrome or childhood cancer. According to Dr
Marie Bristol Power from the National Institute
of Child Health and Human Development, it is a
not a rare disorder but a "pressing public-health
problem". (1)
Neither the cause of this disorder nor the reason
for its exponential increase is well understood
by researchers at this time. However there is
data associating autistic disorders with the use
of an artificial hormone (Pitocin) which is given
to pregnant women to induce or speed up labor
(1, 2). Pitocin is a synthetic exogenous source
of the natural hormone oxytocin which stimulates
the gravid uterus to contract. It was developed
as a drug by the Parke-Davis pharmaceutical company
in 1953 and put into general use in 1955. It comes
from the pituitary glands of cattle and includes
acetic acid for pH adjustment and .5 percent chloretone
as a preservative. The lead story in the July
31, 2000 issue Newsweek magazine was devoted to
exploring this growing health problem. The Newsweek
reporter, Geoffrey Cowley, interviewed Dr Eric
Hollander of New York's Mount Sinai School of
Medicine, a physician who specializes in treating
autistic kids. Dr Hollander reported that several
years ago he noticed that 60% of the autistic
patients in his clinic had been exposed to this
drug as a fetus. Material published by the World
Health Organization also notes an association
between the use of Pitocin and autistic disorders
(2).
In spontaneous labors the mother's pituitary gland
makes an endogenous (i.e. internal) oxytocin that
triggers the physiological onset and progress
of labor. The hormone oxytocin is also produced
during breastfeeding (causing the let-down of
breast milk) and it accompanies sexual orgasm.
For this reason it is referred to as the "love
hormone" by obstetrician Christianne Northrop,
MD as each of these biological events are associated
with experiences of great emotional bonding and
include meaningful social interaction between
the individuals involved. Since autistic disorders
produce an inability to make or maintain affectionate
bonds or have normal social relationships, one
cannot help but wonder if perhaps there is an
causal relationship between these disorders and
exogenous sources of an artificial form of oxytocin.
Perhaps flooding the immature body of the fetus
(especially boy babies) with this gender-specific
synthetic hormone from animals somehow interferes
with the eventual function of these psychological
systems. It is an intriguing question.
However, Pitocin is not the only drug received
by women whose labors are being induced or augmented.
The use of Pitocin requires that the mother also
be given IV fluids, have continuous electric fetal
monitoring in place and remain sedentary in her
hospital bed while connected to this equipment.
Pitocin-induced uterine contrations and enforced
maternal immobility makes labor more painful,
so much so that under these circumstances most
laboring women also receive narcotic pain relievers
and/or epidural anesthesia. The use of these drugs
and anesthetics is also associated with an increase
in operative deliveries (vacuum extraction or
forceps). It is possible that the causative agent
or trigger event for autism is a particular combination
of drugs or certain physical problems or propensity
for either the mother or baby, in combination
with certain drugs, rather than a simple direct
effect of Pitocin per se.
The use of Pitocin to induce or augment labors
and concomitant use of epidural anesthesia has
been steadily climbing for the last 20 years -
about the same period that the increase in autism
has been reported. Estimates of the use of Pitocin
in laboring women over the last 2 decades range
from 12% to 60%. However, a 1992 survey by a medical
anthropologist at the University of Texas found
that 81% of women in US hospital receive Pitocin
to either induce or augment labor. Epidural use
is as high as 95% in many urban hospitals. When
one factors in a Cesarean rate of 23% (acknowledging
some overlap), the proportions of these facts
is staggering as virtually 100% of medically-managed
births are subjected to a high level of pharmaceutical
interventions that have never been approved for
use in fetuses. It certainly seems prudent to
research the possible association with pharmaceutically-augmented
labors in an attempt to discover the cause of
the rising tide of autistic disorders. It may
be necessary to amend our current obstetrical
practices to prevent an epidemic of this expensive
and emotionally-crippling disorder.
Existing data on babies born at home under
the care of midwives as a control group in Autism
research
For research purposes it seems only logical to
utilize the subset of healthy childbearing women
who received physiological management of the intrapartum
and experienced no medical treatments during the
labor and birth (i.e. - no Pitocin or other labor-inducing
drugs, no narcotic pain medications, no general
or regional anesthetics and no operative deliveries,
etc) as a control to determine if intrapartum
medical treatments are causative or contributory
to the development or exacerbating of autism disorders.
In the early 1990s the Midwives Alliance of North
America (MANA) embarked on a retrospective statistical
study of domiciliary birth outcomes. More recently
they have been conducting a prospective study
by enrolling nationally certified professional
midwives as a requirement of their re-certification.
To date they have compiled statistics on about
15,000 births. This would provide the demographic
data for follow-up questionares to ascertain the
rate of autism within this substantial group of
babies who were unmedicated during the labor.
Also a recent change in the California birth registration
law authorizes for the first time since 1915 the
filing of birth certificates by professional midwives
providing community-based birth services (client
home and free-standing birth centers) so that
the gathering of statistical data in California
on this subset of births is now possible.
An informal survey among the dozen or so community
midwives practicing in our geographical area and
spanning the last 20 years, failed to identify
any babies born at home who have since been diagnosed
with autistic disorders. Every year I attend a
national midwifery conferences sponsored by MANA
which includes an exchange between midwives of
practice problems and unusual trends. Among the
400 or so community midwives (CNMs and direct-entry
midwives), no cases of autism have been reported.
Admittedly this is not a rigorous scientific study
but it does raise questions as to whether strict
adherence to physiological management of intrapartum
events, either alone or in combination with the
self-selection of healthy women choosing home-based
midwifery care, may confer some protective effect
relative to autistic disorders.
We are very much interested in facilitating this
form of research and would be happy to follow
your lead in helping to bring about interest in
it by scientists at US-Davis and elsewhere who
are involved in the study of autistic disorders.
(1) Newsweek Magazine, July 31, 2000
(2) Care in Normal Birth: A Practical Guide-W.H.O's
"Safe Motherhood" series
(3) Mothering Magazine, Spring Issue, 2001
cc: Ken Johnson, PhD, MANA Statistical Project
Robbie-Davis Floyd, PhD, University of Texas
Midwives Alliance of North America (MANA) http://www.mana.org/
American College of Domiciliary Midwives/California
College of Midwives http://www.goodnewsnet.org/
You may wish to review some of the ultrasound
safety info, especially when used before 12 weeks.
Labour
of Love - The The Web Magazine for Conscious Parenting
Safety References
http://www.ob-ultrasound.net/joewoo3x.html
Ultrasound scans may disrupt fetal brain development
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