health and wellness

Let’s talk Abortion…

So today, what would I like to
expound on. My mind takes me to a case I was handling just two days ago. A spontaneous abortion. Yes abortion.
I said it.

You see, people have associated that word with the ethical issue of whether we are justified to kill and whether women have a choice in whether to keep a child or not and whether a man has a say in it and all that… And today I am not here about that. There’s a lot of talk about it outside there. 

What of a lady who did not intend for it to happen? I am a medical student, a fourth year, and funny enough I prefer learning at night. Perhaps night shifts would do me good.

All the same, on a Tuesday evening, after a day of reading, I grew tired of looking at the books and headed to the wards. From the corner of my eyes, I saw someone on a carrier being wheeled by a potter, she/he was all  bloody…and I just watched and walked on. Hoping they’ll be fine.

Three hours later, and the thrill and excitement of being in a ward at night having kicked in, I see another person in a carrier, a transfer from a different ward, steadily heading to gyn ward. I had to step in a bit closer to realise it’s a woman and the trail of blood made me wonder what was happening to this day. The doctor I was shadowing came in, glanced at her and was like

“oh my, isn’t this the lady who had passed out on the road at 6pm? ”

A cold shiver just ran down my spine as it also dawned on me that it’s the very same lady I had seen at 9pm. Hospital regulations were that she had to pass through casualty and from then have a transfer and easy as that sounds, sometimes the process is wanting as evidenced by this case.

All the same, we rushed her to the ward, placed her in one of the isolation rooms and inspected her (safety measures all ensured of course). Therein, suspended on her blood soaked clothes was a fetus, well developed, looking close to 24weeks Gestational age. It was ghastly to say the least and blood just continued flowing. 

We asked her what had happened and a weak, blank, unattached response followed;

” Ni mtoto ametoka ” ( the child came out) na ninafuja damu (and I’m still bleeding)

There are sights one should never see and that of your fetus lying suspended in a blood soaked dress from your womb, devoid of life, is one of them. It does something to you. Something unexplained.

She told us she was 6months into her pregnancy and was approaching 7months and had had no trauma whatsoever, just lower abdominal pains and then the bleeding started.

A case of incomplete abortion.

In the medical world, abortion is the loss of a fetus before it attains a viable age, which in my setup is 28 weeks. WHO talks of 20 weeks.

It can be spontaneous or induced and of the induced it can be criminal, therapeutic, legal or clandestine.

Spontaneous Abortion basically means, the mother wished to keep her child and there was no external interference with pregnancy yet it just aborted.

The induced ones

a) therapeutic: if the mother’s life was in danger.  For example in eclampsia(abnormally high blood pressure in pregnancy that can lead into heart failure and convulsions )

b) Criminal: done by a medical practitioner, in a country that has criminalized law and has no medical use other than the mother had an unplanned pregnancy.

c) legal: Same as criminal, only that it is legal in these countries, hence providing comprehensive abortion care and counseling.

d) clandestine: done by unprofessional hence crude methods used and tends to really complicate.

Whichever path one uses, no woman wants to truly abort her child. It is a difficult choice and has repercussions that one has to live with for the rest of their lives. There are the brave who keep their children and perharps give them up for adoption, there are those who raise them and there are those who take the easier option. We love you all. And understand you. There are those who, like this lady, genuinely longed for their children, had little conversations with them while in the womb, and then the womb opened and the child was no more. We truly grieve with you for your tremendous loss.

It is in the light of this that I write today,
to give warning of impeding danger, before a spontaneous abortion or after any abortion to all the women out there to try save the life of many mothers and if acted upon really early: your unborn child :

If you are pregnant and you feel any Lower abdominal pain that is increasing in intensity and frequency, kindly rush to a hospital, it may be sign of an impending abortion or delivery.

Any hotness of body/fever over 39℃ for a period of time, and pain while urinating should also be treated promptly as maternal infections can cause fetal demise.

Avoid radiation at all points If possible as this is also a predisposing factor.

Any bleeding from the vagina at this period of time is ominous, especially fresh blood that is not clotting. Do rush to a hospital.

If you find any clots or clumps with persistent bleeding and lower abdominal pain then that could mean incomplete abortion and can become septic which worsens the situation further.

Therefore it is key to go to hospital and have it verified that all parts have been removed.

Incomplete abortion carries with it the complication of severe bleeding as the placenta is still receiving blood from the maternal vessles and therefore it drains the rest of the body as it flows down the vagina. 

The lady whose story began this post lost close to 3litres of blood and had to have an immediate transfusion. She was already getting into shock with cold hands and feet and temperature gradient, and dizziness when we began our intervention. Luckily she survived and her clean up was pretty good. But not so many people get to tell of such a story and 3litres of blood is no joke!

If however you have had an abortion and you have any signs of

Bleeding that’s continous and more than expected as had been informed by your practitioner

Any hotness of body, foul smelling discharge, general body weakness, painful urination,  lower abdominal pain, it could mean you are getting post abortion sepsis and you need to rush to a hospital.

There are the psychological repurcussions of abortion and one needs to find a way to let go, mourn and grieve the death of your child (whether aborted willingly or unwillingly ), give it a name even, bury it descently in your mind as it is still a loss and failure to do so will mean lifelong mental and emotional anguish.

There are many books out there though that deal with such and I am here too, if you need to talk.

But find a way to let go.

So in a nutshell,

Abortion is not just the termination of an unwanted pregnancy. Some are wanted but for various reasons the womb cant sustain them.

There are many signs of a threatened abortion or an incomplete abortion. Don’t bleed to death or have an infection send you or your loved one to the grave when you can pick them out and seek help.

There are many post abortal complications and one needs to learn to pick them out as well.

Abortion is not easy for any woman, let go, allow yourself to moan and watch yourself heal.

For the society, many women die every year because of abortion and its consequences. Most times because it is done in clandestine places as many countries still have this practice as illegal. Let us be watchful for the plight of the unborn and the carriers(mothers) as well. 

Let not our judgemental eyes and sneers force our women into some of this things.

After all, for any child and mother, not alive today, through this practice, we either through our eyes, our words, our stares, or our ignorance, we played a part. It’s all our responsibility.


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