Gynaecology calls were never my favourite as an intern, if anyone had said I’d be working mostly with women now I’d have rebuked the devil. True to my thoughts, I am not a gynaecologist but in my line of diagnostic medicine most of my patients are those with gynaecological problems such as infertility, pregnancy and some complications and the worst of them all, gynaecological cancers.
How did this all start?
My second call as a gynae intern and my 6th month as a doctor started as usual, about 6 patients already in the emergency ward, not the classic busy night, or so I can had thought while walking around to check my patients every 30 minutes. What can I say? I’m always restless when on call, people tell me that’s why I would never gain weight. Anyway, I had settled down to my normal routine when a group of rowdy folks supporting a ‘possessed looking young woman (if you are used to African magic yoruba) came in.
“Doctor, doctor”, the wailing reached me inside the ward, I still wonder why they hardly shout “nurse, nurse”.
I was thinking that as I walked to the small desk and couch we called the emergency stall.
“What’s happened to her?” I asked seeing she was obviously not in labour, no protuding abdomen.
“O se oyun ni o, ati gbayen nio gbadun.”
<“She had an abortion and has not been well since then”>.
I had never been one to judge so I didn’t bat a lid, I was more concerned about what masterpiece the quacks had dumped at my table again, so I started asking questions and this was what I found:
She was just 21 years, unmarried, had a 3 year old son and had had 5 abortions done by some quack who runs a patent medicine store. All 5 pregnancies were from different men.
Now, she lay almost unconscious, pulse feeble with a stench that overtook the whole room. I tried to examine the abdomen, it was tense and tender. She was running a high fever and so I immediately assumed an infection after her procedure (post abortal sepsis).
But something was not adding up, how bad could the infection be and then I remembered to ask the golden question, how long ago was it done? The answer was 3 weeks, so why was this happening now?
An abdominal scan and blood works, showed she had a collection in the abdomen and she was in a combination of septic and anaemic shock.
We needed to act fast, explore the abdomen surgically. I called my senior resident who called the consultant and everyone came rushing in but nothing prepared us for what we found and I will advise reader disgression.
Omagine an avocado with its stalked part representing the cervix of a womb, the fleshy bottom being the roof, while the sides represent the front, left, right and back walls of the womb leaving the seed to be the space that houses a baby. Now this avocado had no front wall and the normally muscular side wall was thin like paper, and the contents were a bucket load of pus.
What had happened you may wonder? The womb had been puctured by the quack, it had bled in and had become infected and over the days the infection festered eating up the walls of the womb. We had one half rotten avocado on our hands. After cleaning up the bucket load of pus, we were left with an impossible choice. With that degree of damage it was ideal to remove the rest of the womb, but considering her age, unmarried status and the fact she had only one child (in this part of the world where we spawn), we were actually considering conserving the womb, we ended up sewing the pieces together knowing fully well she had next to no chance to carry a pregnancy to term or even get one at all.
Twenty years later, the events of that night still plague me and has affected my outlook to unwanted pregnancy. I am not pro abortion niether am I anti, but I feel each person has a right to choose wisely and safely, and at every chance I’d counsel young women on all options, ranging from abstinence, contraception, safe abortion to post delivery foster homes.