AUTISM - THE BIG SKELETON IN THE OBSTETRICS CLOSET

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.

The post dated scheduled labor induction

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.

The failure to progress diagnosis - the ceiling to brain damage.

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 factor in increasing Autism numbers

 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.