Preventing eclampsia : an interview with Tom Brewer, MD

Townsend Letter for Doctors and Patients, Nov, 2004 by CJ Puotinen

Q: Are pregnancy problems increasing in the United States?

Dr. Brewer: They are. Pregnant women in our country have become less healthy than pregnant women in other countries. Increasing numbers of premature or "low birth weight" babies are being born. The US is starting to resemble Third World countries that have extreme poverty and famine. That is because our doctors don't know anything about nutrition.

Instead of focusing on food, they focus on drugs. They keep looking for a remedy that will cure toxemia. They prescribe diuretics for edema, hypertensives for high blood pressure, and drugs that suppress the appetite for weight loss. Those do nothing to prevent or reverse Metabolic Toxemia of Late Pregnancy, they just make it worse.

People have been recommending supplements, too, like calcium, fish oil, and an aspirin a day, all of which are supposed to prevent toxemia. But research published in the medical journals show that these aren't effective, either. (76-79,81) Calcium, aspirin, essential fatty acids, and other supplements can't take the place of good food.

Meanwhile, doctors are doing what they've been taught, and it isn't working. I think this is why so many obstetricians have been sued for malpractice. If they were delivering full-term healthy babies with no complications, no one would be suing them. But the premature birth rate just keeps increasing, and so do all the other problems that result from inadequate nutrition.

Improving the diet is the most effective and least expensive way to prevent toxemia and insure the delivery of full-term, healthy babies. The dietary guidelines I developed in the early years of my medical practice are still working well. When I went to Richmond, California, and ran the prenatal clinics of Contra Costa County from 1963 to 1976, over 25,000 women followed these guidelines with success. (51)

These clinics had never offered any kind of nutritional counseling. The women would be weighted, they'd have their blood pressure checked, and they'd have a urine test, but no one ever asked them what they ate. I always asked. That's the thing I did that was different. The reason I could do that was because I was the only OB doctor at the time. My methods were unconventional, but I was the person in charge, so we did it my way.

I was taught in medical school that if a pregnant woman gains over two pounds a week, she's about to die. That's how intense the fear of weight gain was. But I never told a single woman that she was gaining too much weight. The only reason I discussed weight with them at all was to be sure they were gaining enough, that they weren't too thin. Winslow Tompkins (8,18) studied this in the 1940s and '50s both in West Virginia and Philadelphia, and he discovered that the patient who does not gain weight is at high risk for toxemia. His work had a profound effect on me as I studied this problem. He worked for the government as head of the MIC (Maternal Infant Care) program, which was a forerunner of the WIC (Women, Infants and Children) program. The MIC program didn't work because so many doctors who worked in it ignored Tompkins' good advice and did what they were taught in medical school instead, so they got poor results. He had the right ideas, he articulated them and got the programs set up, but the program's doctors, who were scattered around the country, followed the advice of pharmaceutical companies and ignored nutrition. They prescribed diuretics and other drugs, and their patients suffered.