Cats, cesareans and epidurals - All About Epidural
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Cats, natural births, cesareans and epidurals

Date: July 13th, 2013

While the never-ending debate on natural birth continues, the incidence of obstetric interventions, including epidurals and cesareans, is on the increase. There may be a good reason for it. Cats support it…


There is a lot of anguish among natural birth advocates in regards to the current state of obstetric practices. There are too many cesareans, too many epidurals, too many doctors and not enough home births. I tend not to get involved in the natural birth debate. If you’re a male the argument is pretty much lost before you have a chance to talk, unless you’re joining the “natural” side. The number of obstetric interventions, however, has indeed increased in the last decade. Reasons often quoted are increasing age of first time mothers, increased litigation, higher expectations of the public from healthcare, more liberal attitudes to invasive interventions among medical practitioners and improvement in clinical care. However, there is another reason for increased need for interventions: increase in the incidence of difficult childbirth which, in turn, is caused by changes in human physiology over the last several decades brought about by changes in our lifestyle. The first link in the chain of evidence that this is likely to be true comes from… cats.

Francis Pottenger and his cats

Between 1932 and 1942 Dr Francis Marion Pottenger, Jr, was conducting experiments on cats. The main purpose of his work was to produce a standardized adrenal extract. At that time of the experiments the technology to measure the actual level of adrenal hormones was not yet available, and the only way to determine the strength of the extract was to test it on animals. If the cat’s adrenal glands are removed the animal dies within short time, unless receiving adrenal extract obtained from other sources. The dose of extract that kept the cats alive was used to calibrate its potency.

In order to keep the cats healthy Dr Pottenger was feeding them milk, cod liver oil and cooked scraps of meat that included the liver, tripe, sweetbreads, brains, heart and muscle. In spite of the fact that this diet was considered rich in nutrients, to Pottenger’s surprise mortality after surgery was fairly high. In seeking the explanation for high death rate among cats he noticed that many animals had signs of nutritional deficiency, and many kittens born in the laboratory had various skeletal abnormalities and organ malfunction.

As more and more cats were donated to the laboratory, the demand for cooked scraps exceeded its supply, and Pottenger started buying some raw meat scraps – organs, muscle and bone – from the local meat packing plant. This was fed to a different group of cats. After a month Pottenger noticed that these cats were much more vigorous and appeared in considerable better health than those fed cooked meat. This occasional observation prompted him to conduct the series of experiments that lasted a decade.

For the first series of experiments Pottenger divided the cats into two groups. The diet of the first group consisted of two thirds of raw meat and one third of raw milk. The cats in the second group were fed two thirds of cooked meat and one third of raw milk. Both were also getting cod liver oil. The differences in the diet between the groups produced dramatic results.

The kittens in the first group were strikingly similar in their size and development. In Pottenger’s words “from generation to generation they maintain a regular, broad face with prominent molar and orbital arches, adequate nasal cavities, broad dental arches and regular dentition. The membranes [mucosal linings – E.S.] are firm and of good, pink color with no evidence of infection or degenerative change. Tissue tone is excellent and the fur of good quality with very little shedding noted… The calcium and phosphorus content of their femurs remains consistent and their internal organs show full development and function… These cats reproduce one homogenous generation after another with the average weight of the kittens at birth being 119 grams. Miscarriages are rare and the litters average five kittens with the mother cat nursing her young without difficulty”.

The cats of the second group were different. In Pottenger’s words, they “reproduce a heterogeneous strain of kittens, each kitten in a litter being different in size and skeletal pattern. When comparing the changes in configuration found in their X-rays, there are as many variations in the facial and dental structures of the second and third generation cooked meat fed animals as there are animals. Evidence of deficiencies is written so plainly on their faces that with a little training, any observer can be almost certain that a given cat had been subjected to a deficient diet or that it comes from a line of cats that has suffered from deficient nutrition”.

There are detailed descriptions of every organ system of these cats. But the following couple of paragraphs are of particular interest to our discussion of childbirth.

“The long bones of cooked meat cats tend to increase in length and decrease in diameter with the hind legs commonly increasing in length over the forelegs. The trabeculation [the internal structural mesh of the bones – E.S.] becomes coarser and shows evidence of less calcium. In the third generation, some of the bones become as soft as rubber and a true condition of osteogenesis imperfecta is present…

What does it have to do with epidural?

From the protocols of Dr Pottenger: “At autopsy, cooked meat fed females frequently present ovarian atrophy and uterine congestion, and the males often show failure in the development of active spermatogenesis. Abortion in pregnant females is common, running about 25 percent in the first deficient generation to about 70 percent in the second generation. Deliveries are generally difficult with many females dying in labor… Other cats show increasing difficulties with their pregnancies and in many instances fail to become pregnant. The average weight of kittens born of cooked meat fed mothers is 100 grams, 19 grams less than the raw meat nurtured kittens.” [Emphasis mine, E.S]. In other words, cats on experimental diet frequently had problems with reproduction, including difficult labor.

Nutrition is important

The effect of food on the body is well known, and frank shortage of nutrients leads to deficiency diseases. Examples of such diseases include scurvy as the result of lack of vitamin C in the diet, or night blindness as the result of low intake of vitamin A. Such disease, however, are rare in the modern Western world. In the recent decades the attention has also been drawn to evolutionary aspects of nutrition. It is hard to deny the fact that digestive system of different animal species is geared for different foods. Digestive system of cows is designed to process grass, birds do their best when fed seed, and lions have to eat meat. I am not aware of experiments where lions were fed porridge or tomatoes, but I suspect this kind of diet is not going to be terribly good for them.

Humans are very adaptable when it comes to nutrition and can survive on various foods for long periods of time. However it is obvious that from evolutionary point of view some food types are more beneficial for us than others. What exactly we are designed to eat is the topic of debate between paleontologists, nutritionists and fitness experts. When you consider what was available to humans one hundred thousand years ago it makes sense to suggest that the choices were limited to freshly killed meat and collected plant food: greens and berries. Later, invention of agriculture led to the introduction of large amount of grains into the human diet.

The most drastic change in human nutrition occurred during the twentieth century, with the variety of food literally exploding in the last several decades. This was also accompanied by the increasing availability of food. As the result, the diet of modern human is very different from that of Homo sapiens thousands of years ago. There is no denying that we now consume highly processed food.

Dr Weston Price

There is some evidence that the change in the diet – deviation from the Nature-given – may lead to health problems. Enter the work of Dr.Weston A.Price, a retired dentist who decided to travel the world and study nutritional habits and its effects on health of native peoples.

In 1935 he visited Africa, which at that time was fairly isolated, and the traditional tribal diets well preserved. There was also reasonably large population of white settlers, so that it was possible to compare their diet and health with that of the natives. Price was continuously struck by the contrast between these two groups. Africans had strong physiques and were generally tall. Dental decay among Africans was rare, usually less than 0.5%. In fact, six tribes were completely free of dental decay, and all members of these tribes had straight, uncrowded teeth. The selection of foods among the natives varied: some were predominantly meat eaters; some consumed mostly grains and vegetables. Many tribes also consumed milk and even insects. However, one thing was in common: their food was minimally processed.

Strikingly, the health of natives who adopted Western life style and, as its part, Western diets declined, starting with the first generation. The incidence of dental decay was much higher, and children displayed the signs of degeneration of facial bones. Their jaws were narrower and their teeth were crowded. The “civilized” natives also began displaying the signs and symptoms of diseases typical for Western lifestyle: heart problems, cancer, appendicitis, gall and kidney stones. Their resistance to infections also declined.

Dr Price was a dentist, not an obstetrician, and his observations were focused mostly on dental health. When I was reading his work for the first time it struck me that I actually observed such changes in dental skeleton during my lifetime. I spent my childhood during seventies and hardly new anyone who had dental braces. Thirty years later when my daughters were growing up orthodontics became the attribute of the majority; the question was not if you need it but when you are going to get them. I believe it is the result of changes in the dietary composition during these decades: more processed food, refined sugar and less protein.

The Times They Are a-Changin’

Even though I haven’t come across studies directly addressing changes in other parts of skeleton as the result of changes in food composition, it is unlikely that such changes only affect the anatomy of the scull and facial bones. Bones involved in the process of childbirth – the pelvis, lumbar and sacral spine – are likely to undergo similar unfavorable changes. Moreover, the incidence of overweight and obesity increased significantly in the recent decades, and these conditions affect postural biomechanics, including that of the pelvis and the spine.

The point of this discussion is not to try and convince the reader to return to the natural ways of eating. I don’t believe this is either possible or feasible. Human evolution brings with it the inseparable good and bad. Invention of a motor car moving around has become much easier, and the distance that took a week to cover one hundred years ago now can take less than a day. On the other hand, with the development of cars came car accidents leading to death or disability. Developments in modern medicine save lives, however they also brought medical mistakes. The progress in food technology resulted in abundance of tasty, convenient and cheap fast food; unfortunately, this food is also highly processed and calorie dense, which together with other factors may contribute to obesity and various medical conditions. Overall, the progress has been beneficial for the humans as species: in the developed world the quality of life is better than it has ever been, and life expectancy in the modern day is at its highest ever.

That is why I find arguments about natural birth useless. Sure, the nature has designed humans with the ability to reproduce, and we did it successfully for millennia. However we changed during this time. We don’t hunt our food, we do not move around (spending two hours in the gym three times a week is not the same), our lifestyles are different. We pursue different goals and enjoy different things. The very standards of beauty have changed: for one, large hips that are very handy for smoother childbirth are out of fashion. We don’t even get off the couch to change the TV channels! Typical modern woman has a full time job and has her plate full with daily worries. Is it reasonable to expect this woman to give birth like a primate when her time comes? I don’t think so.

Because of changes in human body that necessarily accompany evolution of our civilization the need for interventions in obstetric practice is not likely to decrease. There are more cesareans to come in the next decades. Instead of worrying about cesarean numbers we should think of ways to make surgery safer and reduce its undesirable effects. Changes in lifestyle and diet will inevitably lead to higher incidence of complicated childbirth and the need for more epidurals. I wish the advocates of the “natural” stopped fighting the progress and started figuring out how to get most benefit from it while minimizing its negative side-effects.

References:

1. FM Pottenger. Pottenger’s Cats. A Study in Nutrition. Price Pottenger Nutrition; 2nd edition. 1995.

2. Weston A. Price. Nutrition and Physical Degeneration. Price Pottenger Nutrition; 8th edition. 2008.

Image from: http://www.freedigitalphotos.net/images/view_photog.php?photogid=879

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Dr. Eugene Smetannikov is a practicing anesthesiologist with the interest in obstetric anesthesia. He is the author of the most comprehensive book on the subject, The Truth About Labor Epidural

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