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    It’s a rare individual that doesn’t have a wife, girlfriend, mother, daughter or granddaughter that isn’t of childbearing age (say 13 to 50 year old).  Even if they aren’t related to you personally, they could be in your survival group.  Remember that, even if you have a little girl that’s 5 years old now, one day she will come of reproductive age.
    Preparedness is about knowledge. When the you-know-what hits the fan, society will be unstable and organized medical care will be spotty at best and nonexistent at worst.  When we reach the point that we are scrambling to survive, one of the least welcome events is one that, for many families, is ordinarily
    considered a blessing:  A pregnancy. 
    Why Pregnancy is a Problem in a Survival Situation
    Further down the road, when and if society re-establishes
    itself, we will have the responsibility to repopulate the world.  Until that time, however, a
    pregnancy and the possible complications that accompany it will be a burden.
    So why is it important to prevent pregnancies after a societal collapse?   Well, we know that the death rate among pregnant women (also known as the Maternal Mortality Rate) at the time of the American Revolution was about 2-4% per pregnancy.  Given that the average woman in the year 1800 could expect 6-10 pregnancies over the course of her reproductive life, the cumulative Maternal Mortality Rate easily approached 20 per cent.   That means that 1 out of 5 women might die due to complications of being pregnant, either early, during the childbirth, or even soon after a successful delivery!
    In a true disaster, we might be faced  with unacceptable levels of risk to our women because we won’t have either medicine or medical supplies in which treat pregnancy and childbirth complications.  There could be deaths simply because there are no IV  fluids or medications to stop bleeding or treat infection.  This would happen at a time that we will need every member of our survival group to be productive individuals. Growing food, managing livestock, perimeter defense and caring for children will take the energy of all involved.  When a pregnancy goes wrong, it takes away a valuable contributor from the survivor family (sometimes permanently) and places an additional strain on resources and manpower.
    Let’s discuss some of the reasons that women could cease to become productive group members (or even die) during pregnancy or childbirth:

    Medical Complications from Pregnancy

    Hyperemesis Gravidarum.  
    Simply put, this is medical-speak for excessive vomiting during pregnancy.  Almost every woman will experience nausea and vomiting in the early stages.  A small percentage of them, however, have an exaggerated response to the hormones of pregnancy that causes them to vomit so much that they become dehydrated.  Since they can’t maintain a reasonable fluid intake, they require intravenous hydration.  As a practicing obstetrician for 25 years, it seemed to me that I always had someone in the hospital with this condition.  Most pregnant women only have vomiting in the early stages.  A small percentage of them, have an exaggerated response to the hormones of pregnancy that causes them to vomit so much that they become dehydrated.  Since they can’t maintain a reasonable fluid intake, they require intravenous hydration.  As a practicing obstetrician for 25 years, it  seemed to me that I always had someone in the hospital with this condition.                                 
    How many survival groups will have access to IV equipment and the know-how to institute IV fluid therapy?   One of my hobbies is collecting old medical books, most of them from at least 100 years
    ago (in other words, where we will be medically if a collapse occurs).  When these books discuss Hyperemesis Gravidarum, they relate death rates in 10% to 40% in severe cases!
    Approximately 10% of all pregnancies end in miscarriage.  When a woman miscarries, many times she will not pass all of the dead tissue relating to the pregnancy.  On occasion, this tissue will become infected or cause excessive bleeding.  The treatment in this case would be something called a dilatation and curettage (D & C), which is a procedure that use curettes to scrape out the retained tissue.  This will stop the bleeding and prevent infection.  Again, how may survival groups have the ability and knowledge  to  perform this procedure or have access to the antibiotics necessary to treat possible infection?
    There is a condition known as Pregnancy-Induced Hypertension.  When a woman reaches the last month of a pregnancy (usually her first), she might begin to have elevated blood pressures that cause extreme swelling (called edema).  Normal pregnancy causes swollen ankles, but pregnancy-induced hypertension swells up the entire body, including the face. Left untreated, this condition leads to seizures and can be life-threatening.   If a collapse situation happens, the only treatment available would be bedrest, which at best takes away a productive member of your group, and at worst will fail to prevent a worsening of the condition.
    Childbirth Itself.    
    Let’s say the pregnancy itself was uncomplicated.  The birth process, while usually perfectly natural and routine, could also present some dangers.  Every childbirth, for example, involves some bleeding.  It could be a little; it could be a lot.  It could be caused by lacerations from the passage  of the infant through the vaginal canal or from a stubborn placenta (afterbirth) that does not expel itself spontaneously.  When a childbirth is associated with excessive bleeding, certain procedures and maneuvers are performed by trained midwives or obstetricians to stop the hemorrhage. When hemorrhage occurs and no trained individuals are present at the birth, the bleeding may not stop before major damage has been done to the mother.   Sometimes it’s necessary to actually reach into a woman’s uterus, grab the placenta and remove it, especially when part of the placenta is “retained”.  If a portion of the placenta is “stuck”, this tissue will prevent the uterus from contracting (which is the natural way that bleeding stops).  Of course, retained tissue could become infected, also.  Does your group have the knowledge, equipment and medications that might be needed to safely get your women through childbirth?
    After Childbirth
    Conditions in the delivery room after a societal collapse could be conducive to the development of infections, even if the delivery goes without a hitch. This was a major cause of maternal mortality before modern medical care and antibiotics became available.  As well, a woman who has a hemorrhage during childbirth could be so weakened by anemia that she is unable to return to normal activities for a very long time.
    Now, I don’t want everyone to think that I’m saying all women will die during their pregnancy.
    What I am saying is that not all survival groups have prepared to obtain the knowledge,
    resources, and ability to deal with the complications that could occur.  Every prepper
    should stop and think about the danger to which you could be exposing Mrs. Prepper, if you haven’t  prepared for every possibility.  Also, if people are rioting in the streets
    and your garden isn’t doing so well yet, do you really need to add a newborn baby to your list of responsibilities?
    So, what’s your plan?   Even long-time preparedness pros haven’t spent much time figuring out what birth control method they will use in a collapse situation.   Have you includedcondoms in your bug-out bag?  You should, but condoms can break;  even if they don’t, they won’t last forever.   With spermicide, condoms expire after 2 years; without spermicide, perhaps at most 5 years.   Birth control pills are useful, but try to get more than a year’s supply from your physician!  I know, for a fact, that insurance companies tightly control when women can get their next pack of pills!  Some offer 3 month’s supply at a time, but you still have to wait  until the end of those 3 months to get more.  Even if you could get them, they cost a bundle if purchased outside of insurance plans.  Like condoms, they, also  don’t last forever.
    As such, we will have to go back to a natural form of birth control: The Rhythm Method.
    Although not as effective in preventing pregnancy as the Pill, it is effective if implemented correctly.  The Rhythm Method involves trying to figure out your fertile period and avoiding unprotected intercourse during that time.  There are many online sources that can teach you this totally natural method of birth control.  Suffice it to say that, if you or your partner have 28 day menstrual cycles, you should avoid having unprotected sexual intercourse from about day 10 to day 18 (where Day 1 is counted as the first day of bleeding).  You can tell the  day that you or your partner is ovulating by taking your temperature with a thermometer daily for a cycle or two (there are actually special thermometers that are used for this purpose called Basal Body Temperature Thermometers).   When you ovulate, your basal body temperature goes up about half a degree and stays up until the next period.  Many women will notice some discomfort in the lower abdomen when they ovulate.  Once you’ve done  this for a few cycles, you are pretty sure when you or your partner are at risk for getting pregnant.  Correctly followed, the Rhythm Method is more than 80% effective.
    In the early going of any collapse scenario, it’s important to keep all the members of your
    survival group in top condition.  Before growing your family, you need to be growing your
    own food.  There’s going to be a lot to do to make sure you succeed when everything else
    fails.  So, in closing, my advice to you is:   “Be Fruitful, Don’t Multiply!”
    Dr. Bones

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    What If The You-Know-What DOESN'T Hit The Fan?
    You've got your preps, but do you have a plan?