Hey Prepper Nation,

We get quite a few excellent emails discussing various preparedness issues and scenarios, but occasionally one is so compelling that it could stand on its own as an article.  Here are a few thoughts and questions by Patty Prepper, and my responses on the topics she touches upon.

To Dr. Bones and Nurse Amy:

First, I’d like to thank you for the information on fish antibiotics, it has made that aspect of prepping *much* easier.   🙂

(Dr. Bones says: Aw shucks, you’re very welcome!)

And, so you’ll begin to know that I am not given to rashly following whatever I might happen to read somewhere – your argument passed the logic test (not likely that there is enough demand, for there to be separate non-human manufacturing); then I called the company to verify their source of supply, which is USA (not China or Indonesia, etc – better quality controls…); then I’ve run each type that I’ve ordered so far, through an online pill identifier, which has checked out.  And there doesn’t seem like there would be enough profit in it, to counterfeit or otherwise tamper with them – we’re not talking about chemo meds at 1000’s of dollars per dose…  Given all that, I’m content that, if needed, they will do their job.

I do want to ask you for a specific bit of advice, but before I do – I think it would help to put it into perspective, if I mentioned my primary focus in prepping…

I grew up in South Florida, so hurricane prepping was normal to me.  Actually, it seems like it was normal to more people then, than now – I’ve been amazed at the people I’ve seen in the supermarket, under a hurricane warning, stocking up on nothing more than “hurricane party” supplies, and a token gallon of water…

Anyway, until quite recently, hurricane-type prep was the extent of my prepping – to be able to be reasonably self-sufficent for several weeks.  And beginning to read some of the massive volume of “prepper” info online, has certainly broadened my horizons about what people worry about, but I don’t share most of it.

Yellowstone erupting, something the size of the dinosaur killer falling out of the sky, those types of scenarios – yes, devastating – yes, will eventually happen (given a large enough time scale!) – but the odds of them happening in my own tiny lifetime are infinitesimal, so I’m not going to lose any sleep over them.

Many others are not immediately critical – global warming, another Great Depression, massive inflation, dwindling oil, etc, etc, etc.  We’re are nothing if not an adaptable species, and we will have time to adapt to new realities in those types of cases.  Yes, some will not survive, but most will – during the Depression, doctors existed; some people couldn’t pay for their services, and some could only pay in barter, but they were still there in the community…

The disturbing reading I’ve been doing lately regards the sudden destruction of the power grid.  Not so much in the context of an EMP weapon (though that’s certainly possible), because those who could do it, have too much to lose (Mutually Assured Destruction) and those who want to do it, and don’t have much of anything to lose, can’t do it.  At least not yet.  Or so we hope and want to believe… But what is within the realm of reasonable concern (in my opinion), is a massive CME (Coronal Mass Ejection or EMP event caused by nature).

We buy flood insurance and build levies for a 100 year storm (and look how well that worked for Katrina), yet we have a history of a massive CME barely more than 150 years old (the Carrington Event), and several smaller ones since, and we have virtually no preparations to either defend against them, nor recover from them.  A recovery that could take a number of years, even by government estimates…

So, a total infrastructure collapse, with the associated death rates.  The survivors would eventually adapt, but that would have to happen within the context of the development level of a third world country. Which brings me (yes, “finally!” {grin}) to the topic of the moment: Pregnancy and childbirth in a third world context…

It’s well enough to say that women have been having babies with little to no assistance since before we were human, and that nature/evolution will take care of those who aren’t fit enough to survive, but while I agree with that broad focus – no one, myself included, is happy with the narrow focus.  When it comes down to yourself or those you love becoming a negative statistic.

WHO has maternal death rates exceeding 1 in 100 in a number of countries, and approaching and exceeding 3 in 100, if you look at the high end of the range, in what are presumably severe conditions and high risk pregnancies.

I’ve taken some first steps on the subject (condoms, a few doses of “Plan B” morning-after pills, a very basic book intended for midwives in a third world setting from Hesperian.org), etc), but I have run into a brick wall on one item.

In a crisis setting, as seen around the world, and throughout history, rape will be an issue.  Regardless of attractiveness, or age, from small children to elderly women – and occasionally men and boys, though that’s not the topic here. Setting aside the physical and emotional damage, and the disease factors, we come back to pregnancy…   And even assuming that there is access immediately afterward to Plan B, it isn’t always successful.

I have a twelve year old niece, who (in a full collapse situation) I would probably “inherit” before very long (her mother is a Type 1 diabetic). I’m working on the possibility of insulin (I’ve found the original archived notebooks online) but, as you said in your article on the subject, the chemicals may be hard to come by.

Anyway, in her case, an attempt to carry a rape-induced pregnancy to term at her age and size, in a collapse setting, would (I believe) be a higher risk than a careful MVA (Manual Vacuum Aspiration).I’m obviously not asking you to stick your neck out too far for a stranger online that you’ve never even met, but any advice you might think useful would be much appreciated!

Patty Prepper

Dr. Bones says:  Well, Patty, you share much of my perspective regarding TEOTWAWKI scenarios, although I believe that we are currently in the midst of an economic collapse.  I believe it will be fitful, with many ups and downs before an event occurs that causes a more rapid downward spiral.

I appreciate your research regarding aquarium antibiotics; you are doing what every prepper should be doing when they read articles online (even mine):  look into it for yourself, and come to your own conclusions.  You’ll figure out what make sense to you, and what doesn’t.

Your last issue is more complex, with medical, philosophical, religious, and practical considerations to deal with.  The following information does not necessarily reflect my personal viewpoint, but addresses the question I am asked.

Regardless of your political stance towards ending a pregnancy, it stands to reason that you may be faced with the question if there are females in your family or survival group.  Patty, you have done all you can by stocking up on the available methods, such as condoms and the “morning-after” pill. Pregnancy caused by rape can be dealt with by this pill, which goes by the name “Plan B”.  It is over the counter and generally effective if used within 72 hours, and would be the least invasive method of achieving your desired result.

Despite this, skill with uterine evacuation would be helpful to deal with miscarriage (10% of all pregnancies end this way). Manual vacuum aspirators or any instruments used internally are items that require some experience to use, so as to avoid complications like uterine perforation and intestinal damage.  I would think that few will be given the opportunity to obtain that experience before a collapse; as such, we will lose some of our women to complications from either the pregnancy itself (untreated miscarriage causing hemorrhage or infection from retained dead tissue) or from attempted procedures (uterine perforation, bleeding, infection, etc.).

These risks exist regardless of the reason for either intervention or non-intervention.  It is only our knowledge of sanitation/hygiene that keeps us from the third world maternal death rates you quoted; these rates would surely rise in times of trouble.

As such, even the most prepared may be placed where many will be when the SHTF:  Between a rock and a hard place.  Difficult decisions may have to be made; the path you take as an individual, family or group will depend on many factors.  Have a thoughtful discussion with all involved before things go South, and you will know the direction you’ll take.

Thank you, Patty Prepper, for your time and effort in putting together a thought-provoking email.

Dr. Bones