Healthy You

Dr Aruna Kalra, Gynecologist and Obstetrics Surgeon on infertility and pregnancy myths…

We have the honour to interview Dr Aruna Kalra, the Director and Senior Gynaecologist Surgeon of CK Birla Hospital and MD of Mums Clinic, Gurugram. Through her expertise, the doctor has brought many smiles to those with complicated pregnancies. Her forte lies in invasive gynaecological surgeries, high-risk pregnancies, vaginal birth after caesarean (VBAC) and Scarless Laparoscopic Surgery. Here, the veteran sheds light on infertility, pregnancy myths, nutrition and a whole lot more…

After working with many high-profile hospitals like Kasturba Hospital, Batra Hospital, Paras Hospital, you are currently working with CK Birla Hospital, Gurugram as the Director and Senior Gynaecologist Surgeon. You are also the MD of Mums Clinic in Gurugram. What sparked your interest in this line of profession?

“To optimise non-heme iron absorption, women should include at least one source of vitamin C with their meals.”

It was my childhood dream to become a doctor. And I am grateful to Almighty God to help me fulfil my passion, my dream.

As a young girl, Florence Nightingale’s stories influenced my life deeply. Those were the times when this profession was much respected in the society and we trusted doctors next to God. During my journey through years of studies followed by many years of practice in both government and private sector, I have realised that somewhere, we are losing empathy, kindness and emotional support towards the person seeking our help. It might be the other way around too. Our patients might also be approaching us with many doubts about our integrity and honesty. We need to build the same age-old trustworthy relationship with people in need of our expertise.

“My selection letter from medical college was found in the litter while I was sweeping the veranda, on the last day,” Dr Aruna Kalra

I believe in goodness and purity of work. And I have been showered with the multitude of love and respect from my patients. The most treasured reward is their absolute belief in me. My patient’s confidence in me infuses the zest to endure my passion righteously and ethically.

Were there any struggles to get where you are today? If so, how did you overcome them?

There was a hopelessly desperate couple wanted to conceive after the death of two kids and tubectomy. Successful tuboplasty was followed by natural conception and delivery of a healthy child.

I was God’s favourite child. Born in a lower-middle-class family, eldest of three daughters, I was loved, valued and never ever felt anything lacking.

Our parents didn’t let us get the slightest hint that coaching fee was a load of burden on our monthly budget. My selection letter from the medical college was found in the litter while I was sweeping the veranda, on the last day. My father and I rushed to Lucknow immediately and that’s how my journey started, merely out of luck.

Your expertise lies in minimally invasive gynaecological surgeries, high-risk pregnancies and vaginal birth after caesarean (VBAC) and Scarless Laparoscopic Surgery. Are there any motivating case studies that you would like to share with us?

“During early pregnancy, she (a pregnant woman) does not require food for two. We need to ensure that she gets healthy balanced diet.”

There are a number of cases which can be discussed. There was a hopelessly desperate couple who wanted to conceive after the death of two kids and tubectomy. Successful tuboplasty was followed by natural conception and the delivery of a healthy child. More than anything in the world, this gives immense satisfaction and gratification to a doctor!

There was another case when multiple fibroids were removed laparoscopically and followed by reconstruction of the uterus. And natural conception followed. Many women delivered normally after 1st operative delivery which is again very, very rewarding.

What do you feel are the major causes of infertility?

“Proteins in the human diet are derived from two main sources, namely animal protein (eg eggs, milk and fish) and plant proteins (e.g. pluses, cereals, nuts, beans and soy products).”

Other than numerous pathological reasons. In today’s scenario, young couples have many lifestyle issues as well. For example:

  • Work stress, touring jobs, no time for each other.
  • Unhealthy lifestyle e.g. smoking, alcoholism, unhealthy eating habits, late marriages, late planning of conception.
  • Polycystic ovarian syndrome
  • Obesity
  • Anxiety disorder
  • Multiple sex partners leading to pelvic inflammatory diseases and tubal factor infertility.
  • Endometriosis, fibroids, etc.
  • Thyroid disorders

The percentage of infertility is increasing among couples owing to both male and female factors. We need to address this emerging epidemic strategically in a stepwise manner by educating the younger population about adult vaccination, safe contraception, safe sexual habits and warn strictly against over the counter morning after pills or abortifacient pills.

Which are the different treatments that you offer to patients suffering from infertility?

“Husbands should take an active part in handling the newborn and extend enough help to his partner during the early learning phase of parenthood.”

Management includes diagnosis and treatment.

  • Sexual habits irregularities
  • Unhealthy lifestyle
  • Autoimmune illness
  • Previous viral infection, any surgery or prolonged treatment
  • Menstrual cycles abnormalities
  • Semen factor abnormalities
  • Ovulation study
  • Tubal patency test, etc, are followed

These are followed by specific treatment for the particular diagnosis. Sometimes, it can be genetic or unexplained. Treatment options are tailor-made for individual cases.

What advice would you give to a pregnant woman for a healthy delivery? What are the main nutrients required for a pregnant woman during and after pregnancy?

“For natural birthing, pregnant woman should be physically active during pregnancy and should have a positive outlook towards natural birth.”

We encourage pregnant women to follow a healthy eating pattern and choose foods that are rich in nutrients to help them meet their requirement for iron, vitamin C and other nutrients.

  • To optimise non-heme iron absorption, women should include at least one source of vitamin C with their meals. Vitamin C is found in a variety of foods such as broccoli, citrus fruits and juices, kiwis, mangos, potatoes, strawberries, tomatoes, etc.
  • Pregnant women should drink tea or coffee 1 or 2 hours after the meals rather than with meals as these drinks can interfere with iron absorption.
  • Our advice to girls is not to take a calcium supplement or calcium containing antacids with meals. Too much calcium can reduce the amount of iron absorbed by the body. Proteins are the building blocks of our body.
  • Proteins in the human diet are derived from two main sources, namely animal protein (eg eggs, milk and fish) and plant proteins (e.g. pluses, cereals, nuts, beans and soy products).
  • Protein supplementation has been shown to result in a significantly higher increase in fetal/birth weight.

Post-delivery, how can a newbie mom regain her strength and energy? When can one start exercising post pregnancy? What advice would you give to family members (husband, in-laws, parents) when it comes to taking care of the newbie mom?

Family members should be supportive and encouraging towards new mom. Husbands should take an active part in handling the newborn and extend enough help to his partner during the early learning phase of parenthood.

In an Indian scenario, husbands are mostly not participating in rearing the newborn. It is mostly the family’s elder females who take over the responsibility of mother and baby. This leads to severe depression, feeling of deprivation of love and affection in new moms.

Is there any myth that you would like to bust regarding pregnancy and delivery?

Yes, In India everyone has their expert opinion about pregnancy and delivery.

The first myth is that pregnant women need a diet of two people. In early pregnancy, the woman is suffering from nausea, vomiting, lethargy and stretching aches and pains. She is not able to consume enough meals with altered taste and smell for many food items. Give her body the time to adapt to sudden hormonal changes. And she does not require food for two. We need to ensure that she gets healthy balanced diet.

The second myth is that pregnant women should eat lots of ghee for normal vaginal delivery. It helps in slipping the baby and provides strength and energy to pregnant female for natural birthing pains and process. This also does not hold any truth. For natural birthing, pregnant woman should be physically active during pregnancy and should have a positive outlook towards natural birth.

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