Aparna Prakashan, Pune. 1995. 260 pages. Paperback. Rs. 100.00

This book, extolling the mother, has been written by an obstetrician with vast experience as a skilled clinician and as a popular post-graduate teacher. In addition to describing the scientific and technical aspects of obstetrics and gynaecology with wit, he enlightens us on the social, moral and philosophical aspects of his specialty. The brief essays on the prenatal determination of sex, education on matters sexual, abortions, family planning, normal and abnormal menstruation, cancer of the cervix and menopause are likely to prove useful to doctors and members of the public.

In the chapter on pregnancy he points out that nature does almost everything that is necessary for the welfare of the mother and baby. ‘It is amazing that in the process of delivery the foetus emerges from the aseptic cavity, the aseptic tract and then through the septic tract in its journey to the external world. Nature does not rest content with this. Before the birth of the baby, the bag of water in front of the baby ruptures so that organisms at the vulva and in the vagina are washed away. After the birth, the liquor comes out in a gush and finally the placenta mops up whatever organisms may have remained.

Fascinating narratives abound. We are told of how Prahlada listened to the Narayana Mantra whilst still in the womb, how Abhimanyu learnt chakravyuham and Kahoda corrected his father’s pronunciation of the Vedas. The process of learning whilst in utero is thus vividly highlighted.

‘Love’s labour lost’ deals with abortion. The plight of the mother is described with feeling. He awakens our sensibilities by describing occasions when relations enquire only after the condition of the neonate, ignoring that of the mother who has labored or, worse, when they bemoan the birth of a girl.

Carefully chosen subheadings provoke thought. That for ‘Onset of labour’ is entitled ‘still an enigma’. Is it not strange that in every species the foetus (weighing a few grams at the end of gestation over 21 days in the mouse or weighing several hundred pounds after 640 days in the elephant) undergoes a carefully synchronised process culminating in birth? Labour can neither be initiated nor stopped at will.

A colleague in the labor ward once exclaimed: ‘If I place one flower at the foot of the goddess in the temple, I shall place two at that of the mother in labour. ‘ In a similar spirit, the author calls the mother and foetus his gurus. He marvels at the manner in which the foetus adapts itself to the various contours of the birth canal, flexing at the appropriate place to effect birth with safety to itself and its mother.

He also thrills to the first breath inhaled by the newborn baby and asks why a baby cries whilst all around it are full of joy. He is reminded of Shakespeare’s lines: ‘When we are born we cry that we have come to this great stage of fools…’ (King Lear). He extolls breast-feeding, terming it a sanskara already provided by nature. Maternal milk is the baby’s birth right.

He pleads for appropriate and adequate care of the pregnant mother and counsels all prospective parents to be honest about diseases that they might pass on to their children. Since the sex of the unborn baby is beyond the control of the wife, obstetrician or those in charge of the hospital or nursing home, he counsels husband and family to accept it with equanimity and grace.

Induced abortion is discussed in some detail. He cautions against carrying out ‘medical termination of pregnancy’ in unmarried girls before studying ABO and Rh groups as even 0.1 ml blood can sensitise the mother and endanger her health during subsequent pregnancies. In a lighter vein he quotes Dr. M. K. K. Menon: ‘At one stage we asked students the indications for termination of pregnancy. I hope we do not reach the stage when we need to ask indications for the continuation of pregnancy.’

He warns against artificial insemination with semen obtained from professional donors of blood as this amounts to selling sexually transmitted disease, rendering the woman infertile for life and spreading AIDS.

It is sad that he has to plead that doctors carry out a visual screening for cancer of the cervix after inserting a speculum instead of relying on Pap smears alone. He also pleads against the sense of privacy that disallows women from declaring the presence of a lump in the breast, making his point by describing women doctors who have delayed seeking help till painful metastases made this inevitable. His comments on hysterectomy also rnake painful reading: ‘The uterus, more than any organ in the human body – except, perhaps, the vermiform appendix and the faucial tonsils – is susceptible to unjustifiable removal. In some parts of the country it is rare to encounter a woman over the age of thirty with an intact uterus.’