The health ministry today permitted retail private pharmacies to sell synthetic Oxytocin drug from September 1. However, it has strictly regulated its sale. Oxytocin is a life-saving drug for pregnant women as it helps ease delivery of babies in various ways. It also helps reduce the Maternal Mortality Rate (MMR) which India struggles with on a regular basis.
On April 27 this year, the government had notified that it will ban sale of Oxytocin through private retail chemists from July 1. This was later changed to September 1. However, in a new circular on August 21, the Centre disregarded the April 27 notice, which said that, “Oxytocin in any form or name shall not be allowed to be sold through retail Chemist”. It also removed the provision which said that only government pharmacies can sell Oxytocin.
WHY OXYTOCIN SHOULDN’T BANNED?
- MMR drops with the use of Oxytocin in easing out childbirth.
- The drug is life-saving for women as it controls postpartum bleeding, induces labour pain and augments labour.
- It was banned because of misuse by the cattle industry, so government should instead regularize its use there.
- Alternative drugs are super expensive and could create complications in women’s health.
LIFTING BAN A GOOD STEP
Talking about lifting the ban on Oxytocin, Obstetrician and Gynaecologist, Dr Jyotsna Gupta told SheThePeople.TV, “It is definitely progressive to lift the ban. Initially, when it was banned, everyone was worried that Oxytocin will not be available, then how will we manage postpartum haemorrhage because we can’t give other drugs to women because they have side-effects and lead to complications. So now the government has permitted it and we can procure the drug easily.”
She said that the drug should be banned for all others except for pregnant women as it is highly misused in the dairy industry where people give this drug to cattle so they continue giving milk. “It should only be available in the government pharmacy and not at any other place so it is not easily accessible to everyone other than the pregnant women,” Gupta added.
WAYS IN WHICH OXYTOCIN HELPS WOMEN
According to Dr. Mira Shiva, founder and co-convener of All India Drug Action Network (AIDAN), synthetic Oxytocin is in the national list 2015 and 2011 of essential medicines and World Health Organization’s list as well. “It is the most effective in postpartum bleeding and it lowers maternal mortality rate by 38%. In some places it could be more as internal bleeding is the major cause for it and the fact that lots of our women are anaemic only reinforces it. We do not have a referral backup facility of blood bank or doing caesarean early enough, so for saving lives of women after pregnancy, it is crucial,” she said.
“For prevention of postpartum haemorrhage, there is both a government of India protocol and WHO protocol which recommends that the doctors give 10 International Units (IU) inter-muscularly when the baby is out. Oxytocin also helps in contraction of the uterus because when the placenta and baby come out, there is continuous bleeding so the doctors need to give more of the drug for treatment of postpartum haemorrhage. It is called active management of third stage of labour."
Even for induction of labour, doctors sometimes need to give Oxytocin when the due date is over. As the baby is still inside and the pains have not started, they induce labour to stimulate natural childbirth. "So for augmentation of labour also, women require Oxytocin. It is also used in cases when the baby is out but the placenta is yet to come out.”
GENDER BIAS IN MEDICAL CARE
Experts are of the view that instead of thinking of banning such a significant drug, authorities must think of scaling up. But also when it comes to women’s health, alternatives are not only extremely expensive but also very difficult to access. And it will exclude a very large number of women and India already has a high maternal mortality rate. “As usual, women are always at a collateral damage. No one is denying the fact that there is misuse of oxytocin, one needs to regulate the cattle industry and not the drug itself,” said Theacare founder, Swarnima Bhattacharya.
About the illegal use of Oxytocin and the concerns surrounding it, Shiva said, “People who buy it in bulk often buy the cheaper drug which comes from the clandestine and illegal sources, which needs curtailing of those sources. Not to mix up the cattle industry misuse of oxytocin and the use in maternity care. Veterinary doctors should deal with it and not risk mothers’ lives. Our concern about it as a public health issue is that women anyway face so many biases and if she gives birth to a baby girl, then it is anyway bad, so why make it worse for her by putting her life at risk?”
When it comes to women’s health, alternatives are not only extremely expensive but also very difficult to access. And it will exclude a very large number of women and India already has a high maternal mortality rate
WILL ENHANCED ACCESSIBILITY HELP?
Accessibility and affordability are two main factors that decide the higher consumption of the drug and that it reaches more women in principle. Bhattacharya said that the government’s policy of over-the-counter easy medication is a huge disaster in so many ways. "Even the normal medicines that we take require moderation but we take it so freely the moment we fall slightly ill. So people will misuse medication which requires only a random prescription. People today self-medicate their own abortion, so if there is no regulation on these things, then unaware and irresponsible people will use it.”
While it is a good step that the government is not going to ban the drug, far more steps to reduce its misuse by the cattle industry needs to come into existence.
Picture credit- Daily Mail