The legal landscape.
Autism, being the result of legal malaise sounds like a tall order. But the concept is not really that outlandish, considering that human birth has now become a medical event involving complex interventions in most of the developed world. When any of these complex interventions is not performed correctly, it has potential to cause severe injury to the baby, the mother or both. Injuries to the baby in this case are more significant as they can have life altering consequences from brain damage. Hence there exists a long history of malpractice litigation from deliveries gone wrong resulting in badly brain damaged babies. Consequently obstetrics payouts are the among the largest malpractice payouts and rightfully so, due to enormity of the lifetime of suffering caused.
Lately however, things have quieted down significantly on the litigation front, perhaps eerily quiet, not because the problems have gone away, but because they're supressed by years of tort reform that malpractice insurance companies have silently gotten passed through state legislatures, in the years following the initial decades of patient activism in the 1980's through 90's. They have managed to cap jury payouts all under the guise of making access to medical treatment more affordable by making the medical system less litigious. But the opposite has been true. It has ended litigation at the expense of patient safety and ability to hold even the worst physicians accountable for their misdeeds.
With medical malpractice becoming so much harder to prosecute and get results, the feedback loop about dangerous drugs, bad doctors and adverse outcomes that these legal cases provided has almost ceased to exist. The pendulum has swung so far to the other side, malpractice lawyers have moved on to other greener pastures. Its easier to go after a trucking company involved in a bodily injury accident, than to go after an incompetent doctor that caused grave harm to a patient. Anything short of death of a young healthy patient has become a long shot to prove in court. However, there is no dearth of such medical malpractice. In the US for example, malpractice is the 3rd leading cause of death after heart disease and cancer. And existing birth injury lawyers have given up on risking their time and effort on new possibilities and try to focus on only the proven tracks that have been successful in the past.

Abusive labor induction
Given this backdrop, lets shift focus to the malpractice of our interest that has been totally impacted by this changed legal landscape. This is the problem of abusive induced labor that pervades the maternity wards of most western nations, which is causing the autism epidemic. The pitocin label clearly indicates it is capable of causing "Permanent CNS or brain damage" due to uterine motility. The fact that it is a result of uterine motility clearly points to traumatic brain injury from contractions. However the entire fetal monitoring apparatus is geared towards detecting hypoxia, while detection of traumatic injury is left to the discretion and interpretation of the obstetrician. The contra-indication #5 on the Pitocin label states further administration of Pitocin is contra-indicated - "Where adequate uterine activity fails to achieve satisfactory progress". This is the failure to progress diagnosis which is defined by the American College of Obstetricians & Gynecologists(ACOG) as 72 induced contractions of labor spread over 4-6 hours. Pursuing labor beyond this contraindication point causes traumatic brain damage and it is an established fact. However, obstetricians routinely cross this point of "failure to progress" diagnosis without forcing a C-section like the ACOG recommends.

Doctors protect Doctors
As much as the case for traumatic injury is based on facts established by the Pitocin labeling and the ACOG induction protocols, courts expect lawyers to interpret complex medical procedures using interpretations of expert witnesses who are doctors considered experts in their field, willing to testify that the obstetrician was wrong to allow induction to proceed for over 4-6 hours. Courts require such expert testimony to prove causation in any malpractice suit. Unfortunately most doctors who do the rounds as expert witnesses in courts, do not come forward to defend these established facts. The probable reason is because this fight is against insurance companies with deep pockets and these witnesses have mostly been compromised by taking the other side alongside malpractice insurance companies in past cases testifying against the possibility of traumatic injury. If such folks come forward to suport the case of traumatic injury they will end up perjuring themselves vs their previous cases. Herein lies the catch-22 situation that is resulting in the continuing indiscriminate abuse of Pitocin or other prostaglandin based labor induction, causing the autism epidemic, thanks to the lack of consequences to Obstetricians that continue to believe they're doing good by avoiding the C-section in these cases. And the malpractice continues to this day.

Thus the responsibility of finding a solution falls squarely in the hands of parent activism to organize a solution. That is the objective of the Autism Parents intiative, to engage in collecting evidence that would be sufficient to establish the role of abusive labor induction in causing the autism epidemic. Join this retrospective autism data collection here if you havent already.

 ​Parents impacted by autism in their children are often faced with one question that runs deeper than anything else -  "Why Me?". We are told autism is genetic or the causes of autism are this far unknown. It's almost become fashionable for people to state  "nobody knows what causes autism". Thanks to the espousal of genetics as the cause of autism by media, the medical community and autism researchers, governments and private institutions continue funneling valuable research dollars into genetic research, although researchers have come up empty handed inspite of decades of research. And thats not the researchers fault either, since they're essentially barking up the wrong tree.  Unfortunately genetics is also the easiest to blame. Countering the genetics argument is hard as it is still a complex science with enough unknowns and the easier story to sell parents on. Surprisingly, even the most educated parents who received the "all clear" from genetic testing are convinced there could be something in the genes, some environmentally caused de-novo mutation that caused their kids affliction.
The genetic perception is so ingrained that even the social stigma around autism stems from the belief that autism is genetic. Haters consider autistic folks as freak genetic accidents that need to be wiped out to cleanse the genetic pool. Some parents’ stoic acceptance of their kids’ autism, is simply because there is this firmly entrenched belief in their minds that autism is genetic and genetic mistakes are an act of God. Then there's clueless misdiagnosed folks on social media taking pride in the fact that Autism runs in their family, when factually they couldnt and wouldnt be on social media if they really suffered from autism, which by definition makes sufferers non verbal and incapable of any significant social interactions. These people potentially have other afflictions along the lines of conditions like dyslexia which is known to run in families, has known genetic roots and too often gets mixed up with autism.

What if I told you more than 50% of autism out there is caused by traumatic brain injury caused by a dangerous labor and delivery drug that was abused beyond prescribed limits by your obstetrician? Would you embrace it as something you have always suspected, or would you dismiss it as some silly rant coming from an unqualified idiot? What if I showed you proof, elusive proof that has been hiding from parents, hidden by quirks of fate and the complexities of the birth process.
As a parent of 2 boys on the autism spectrum, both brain damaged exactly the same way, by the same Obstetrician, by the same prolonged induced labor process, I understand this etiology of autism better than most others in the non-obstetrics realm. This same pattern of Pitocin abuse has been responsible for more than 50% of the cases of Autism in the US and other western countries. Thanks to the adoption of labor induction around the world, autism occurence is fast catching up in the rest of the world.
I share with you below, this proof of malpractice that caused me to write a book and launch a campaign to end the malpractice by legal process. Every qualified person that has looked at this report below so far has always responded with “ Wow, this looks like you got to sue someone, this is traumatic brain injury”. I am abstracting the personal details in this report and showing you only the key content.

Notice the terms “remote white matter insult” and the terms “nonspecific gliosis in the front peripheral and parietal white matter”. Gliosis is the equivalent of scar tissue in the brain and as per the report it is in the white matter. White matter is situated deeper in the brain and represents the neuron fibers that carry neuron signals to the many functional areas of the brain. Such widespread traumatic damage to areas deep within the brain could have been caused only at one point in a person’s life. That is when they were born, emerging head first, from their mother enduring the trauma force of artificially induced contractions.
This is unfortunately something that happens all too often in maternity wards across the developed world. It is often very rare for anything this drastic to show up on MRI scans. This happened only because this was our second child and was born without pushing. As explained in detail in my book, pushing mostly hides any injuries that happen in the previous stage. Now that you have seen the proof would you now believe Autism could be Traumatic Brain Injury from induced birth. Perhaps I ought to sue someone about my kids’ autism ? Perhaps that will bring more attention to the subject. I even dream it might help change the ways of many obstetrics. Will say more in my next post.

Nobody knows what causes Autism... And they want you to believe it !
Its been over 40 years since the Autism rate really started taking off, in the western world, since around the year 1980. Researchers have looked long and hard at data collected over all those years, looking for possible causes and mostly come up empty handed. In that time vaccines as the cause of autism has been rejected in U.S. courts. There has been research directed at genetics, a whole host of environmental factors and yet, nothing conclusive has ever come out. In rare occasions studies have pointed at the possibility of birth interventions being responsible for the increase, but they constantly get swept under the rug, as if there is an effort to keep something hidden. Obstetricians dont like to speak openly about it but the tell tale signs are all over. Autism is more prevalent in western countries. People try to write that off as the result of environmental toxins, the burden of technological advancement and others blame the lower numbers in developing countries on the lack of services and ability to identify autism in the undeveloped world.
But when it comes to true non-verbal autism, there is really not a need to put in any effort to identify it. And children not developing speech when they should, is the main criterion in the latest DSM-5 definition of autism. And the autism count by this definition is still higher in the west. Inspite of the ability to identify genetic abnormalities very efficiently in the West, its proven to be one of the most perplexing challenges for geneticists. To people in the know, the reasons are obvious. Autism in the west is a result of brain damage at birth caused by modern birth interventions. 

​The two most significant causes of brain damage at birth are 
1)  Hypoxic damage from cord compression, nuchal cords, placenta issues during birth.
2)  Traumatic brain damage from abuse of Pitocin used to induce labor.

Fortunately modern science has the ability to identify and distinguish these various kinds of injury and deficits using Magentic Resonance Imaging (MRI) scans. The MRI scan is the most powerful imaging tool available for looking at minor variations in the tissues of the brain and other organs. It can detect various congenital deficits, genetic conditions, hypoxic injury and traumatic injury. Congenital and genetic conditions tend to present themselves as groups of brain structural deficits and volumetric changes in an MRI. Hypoxic injury if significant, tends to show up in MRI scans as areas of dead tissue (infarcts) in the deep grey matter of the brain. It might also be seen as other resulting conditions such as periventricular leukomalacia. The time since injury is also a factor in how certain artifacts show up. Traumatic injury usually is associated with white matter damage, where the forces of induced labor cause physical trauma which might show up as gliosis in the brain. Induced labor contraction force related trauma can cause axonal shearing of the fundamental neuron tracts, which unfortunately may not show up in an MRI. Additionally the molding / squeezing of the head in the pushing stage of birth, ends up erasing some of the scarring and disperses out the damage at the cellular level mostly beyond resolution of an MRI scan.
A good radiologist would be able to interpret and distinguish the causes of these various conditions. Unfortunately, radiologists do not consult directly with patients which is again one more problem with the structural set up of the medical system, which keeps patients from identifying the true causes of their condition and works to shield obstetricians in this case from potential malpractice suits. And when it comes to obstetric malpractice causing brain damage, nothing comes close in terms of numbers amd impact, to the malpractice I am about to describe below.

When a mother is postdated, i.e. shows no signs of labor, no cervical dilation at the determined due date, obstetricians resort to labor induction seemingly to avoid other complications like cord ripening, meconium passage, bigger baby necessitating a c-section, some of which can cause death of the baby if left undetected. However, in the case of healthy first pregnancies a mother can and should be allowed to go 42 weeks, and I have heard of cases where the mother's pregnancy lasted 46 weeks and resulted in a healthy normal delivery and a healthy baby. But many obstetricians resort to labor induction right on the due date and they do it, even when the maternal cervix is zero dilated. But for labor induction to be successful, cervical preparation is very important. Some techniques suggested to prepare the cervix to dilate include enemas, mechanical dilations, membrane striping, foley balloon catheters, nipple stimulation, even sex, and some of the best obstetricians follow/suggest these preparatory procedures. But the vast majority of obstetricians in the world of production line style optimized delivery systems have resorted to strapping up the mother to a pitocin drip with zero cervix preparation resulting in failed induction. Whats worse is they fail to understand/recognize or just plain ignore this point of failure of labor induction.

When labor induction is pursued, there is a fixed time limit for how long it can be attempted. This is the time required to reach 72 contractions, which is typically managed at 2-3 contractions every 10 minutes amounting to 4 - 6 hours allowed for induction. Inducing beyond this time limit causes brain damage by the force trauma of contractions. Remember every contraction of the uterus, hammers a baby's head against the un-dilated cervix wall at the other end of the uterus and it is literally a matter of time beyond which the fine tissues of the brain, i.e. the neuronal wiring connections that run through the white matter start getting sheared. This is a point of contraindication(#5) defined in the Pitocin label, beyond which induction is to be discontinued and C-section is to be performed. If the cervix has not dilated to 10cm by this time, labor induction needs to be abandoned and C-section is the only recourse. Lack of delivery within this time limit constitutes the "failure to progress" diagnosis.
Unfortunately, this diagnosis, is completely dependent on the nurses and obstetricians to call out. It is dictated by protocols established by hospitals on the recommendation of the American college of Obstetricians and Gynecologists. It is also dictated by the contra-indication #5 on the Pitocin label. But then, the entire labor monitoring set up is geared towards detecting hypoxic injury and there is no externally seen symptoms of traumatic brain injury. No fetal distress, no major indications in the Fetal monitor. So, its squarely on the shoulders of an Obstetrician aided by the nurses to make the call and force the C-section. And this being traumatic injury, it happens in every case and is not subjective, ie not dependent on how an individual mother responds to the medication, brain damage just happens to every baby whose mother is induced beyond this time limit.
These days there's off-label use of prostaglandins (misoprostol) to induce labor, which is why the contra-indication limit is set at the number of contractions of 72 and the same brain damage limit applies to these other drugs that are used to induced labor.

 The biggest contribution to Autism numbers in the west comes from obstetricians inducing mothers beyond the "failure to progress" diagnosis point causing irreversible brain damage in their newborns. This is the reason autism numbers have risen continuously since 1980 when Pitocin was approved for elective inductionof labor. Unfortunately this birth injury goes undetected, simply because nobody is looking for them. The fetal monitors dont show fetal distress, the obstetricians hand off the damaged kid to the pedeatricians and the parents are blissfully unaware of the birth injury suffered by their precious baby.  Obstetricians in the know wont talk loudly enough about it, lest they expose their bethren to malpractice lawsuits, allowing the malpractice to continue to this day, contributing to ever inceasing autism numbers.
So what would you do, if you were subjected to induced labor and your child is diagnosed with Autism? You may want to sue, but as you will soon find out, others have tried before and with obstetricians protecting other obstetricians, cases have been defeated in court, creating precedents in these cases where the only proof is expert witness testimony. More about this in a subsequent post. For now, the one thing you could do is join the Autism Parents Intiative's restrospective data collection initiative here and join the research and evidence collection with other parents.