maryannewaweru

A Kenyan Journalist Writing About Health

Archive for the tag “pregnancy”

Lilian Madonye: When Infertility Leads to a Life of Reckless Abandon

By Maryanne Waweru-Wanyama

When 37-year-old Lilian Madonye took her marriage vows 14 years ago, she looked forward to the exciting life that lay ahead of her. In her early twenties, she was marrying the man of her dreams, an athlete whom she had courted for two years.

The wedding marked the beginning of her new life, a life that would be filled with untold happiness from both her husband and the beautiful babies they would raise together.

Lillian, a second born in a family of three, had been raised in a relatively comfortable upbringing in Eldoret town. Her father, a banker, and her nurse mother had provided them with a stable home and good education.

Nurtured in a Christian environment, Lilian was a role model in her school, neighbourhood and church where she served as a worship leader. And her marriage did not disappoint.

Lilian Madonye

Photo: Lillian Madonye during the interview

The first year was full on love, warmth and laughter. However, in the second year, the couple became worried when they were unable to conceive.

After trying for a baby for three years in vain, Lilian decided to seek professional help and saw a doctor who put her on fertility drugs and supplements. However, the desire for a baby became a dominant, crippling thought which consumed her whole being.

“Sex became a laborious task that was no longer enjoyable because of the pressure to conceive. Family, friends, neighbours and church members were already spreading rumours about my barrenness,” she remembers.

Meanwhile, Lilian kept hopping from one doctor to another seeking a miracle treatment, but none helped her conceive.

“The day I would receive my period each month would send me to a very dark place where I would spend the duration of the menses in tears. Helpless, I wondered what worth I was as a woman if I could not bear a child. What justification did I have to call myself a woman if I could not have a child?” she asked herself.

Frustrated and at her wits end, she one day asked her husband to take a fertility test if only to encourage him to be part of their quest for a baby.

“Even though I knew I was the one with the problem because I believed that infertility was a condition only for women, I asked him to get tested anyway.” But the results of the semen analysis test on her husband shocked her.

“My husband had a low sperm count, hence my difficulty in conceiving! The news took me aback because all along I thought I was the one with the problem,” Lilian says.

A low sperm count decreases the odds of a sperm fertilising an egg which results in pregnancy. Lilian’s husband was then put on fertility treatment aimed at boosting his sperm count.

At the same time, out of curiosity, Lilian decided to take a fertility test as well, and whose results showed that she was perfectly capable of conceiving and bearing a child.

“I stopped all the drugs I was taking. I wished we had both done the tests earlier as it would have saved me all the medicines I had taken for three years!”

For the next two years, the couple continued trying for a baby, but were unsuccessful. During this time, their marriage began undergoing turmoil.

“We would constantly engage in verbal confrontations about anything and everything. We were both frustrated and very desperate about wanting a baby. At some point, the fights became physical. Our marriage became filled with extreme tension and anger. We both became very unhappy in our marriage. There were infidelity issues and I was constantly rebuking women with whom my husband was having dalliances with. We stopped talking and even slept in separate rooms. I felt there was nothing left to hold on to and I eventually walked out of my marriage,” she remembers.

Lilian then moved to Nairobi where she landed a job as a sales representative in a bank. Older, wiser and with her newfound freedom — her faith in God long gone, Lilian took to alcohol and drugs. A short while later, she got a transfer to Mombasa.

“As soon as I landed in the beautiful Coastal city, I met up with people who introduced me to a wide variety of hard drugs which were easily accessible unlike in Nairobi. Soon, I began engaging in prostitution to finance my new lifestyle as my salary could obviously not cater for my needs. I would have multiple affairs with married men who would take care of my different financial needs.

Lilian Madonye

Despite being aware of the dangers, I would have unprotected sex with my partners. I didn’t care about HIV, venereal diseases or drug overdoses because I had nothing to live for. With no husband and no children, my life had no meaning,” she confesses.

Lilian says she was on a constant high because when sober, the reality of her empty life would hit her, something she did not want to face. One morning after a night out, she began feeling sick.

“I knew that Aids had finally caught up with me,” she remembers. Lilian went to the hospital, but the doctor’s diagnosis shocked her. She recalls his words:

“Lilian, your HIV test is negative. But there is another test that has yielded positive results. Congratulations, you are pregnant!” She did not believe it.

“I was living a very evil life, engaging in all the abominable acts mentioned in the Bible, but yet God remembered me? I wondered why, yet when I was a good Christian, faithful in my marriage and with enviable morals, he ignored me. But now, when I was fully immersed in sin, he remembered me?”

Shocked to the bone, Lilian decided to sober up for the sake of her unborn baby. She packed all her belongings and moved back to Nairobi to start a new life.

She got back her old sales job at the bank, and began piecing her life together, which was not easy. “I was used to men taking care of all my bills, but now I had to support myself and my unborn baby. It became very difficult to make ends meet, but I did not despair. My baby motivated me and kept me going,” she says.

One day, in her seventh month of pregnancy, she noticed some blood stains. She rushed to hospital, and by the time she got there, her clothes were soaked in blood and she was writhing in pain.

An ultrasound done on the foetus revealed that Lilian’s baby was already dead. Lilian had faced high blood pressure issues during the pregnancy, which led to her having pre-eclampsia, a condition characterised by a high level of protein the urine and which can be fatal.

But she had to deliver the baby anyway, and after six agonising days, she finally gave birth. “It was a baby girl. Even though I wanted to see her and hold her in my arms, the doctors refused and only showed me her legs. They said that because she had been dead for more than a week, she was already decomposed and in a bad state. I called her Zawadi, because she was my special gift,” she says, struggling to contain the tears welling up in her eyes.

As she walked out of the hospital on that day in May 2012, Lilian left with a new resolve. To completely turn her life around and find her purpose in life again.

“I don’t blame anyone for the path I took in life. I am responsible for all the decisions I made. I could have made better choices, but I did not. I have forgiven myself and I am embracing my new life.”

In January this year, Lilian formed a group for women struggling with infertility. The group is called Diamonds Women Ministry, and it brings together women struggling with infertility, and teaches them to focus on other areas of their lives even as they try for a baby.

“The reality is that not all women struggling with infertility will have a happy ending where they will get pregnant and have babies. I encourage women not to be consumed by the search for a baby to the extent that other areas of their life suffers. They should also not peg their worth as women solely on the basis of motherhood. I talk to women during bridal showers and talk to newlyweds about marriage expectations. I always use my personal experiences because I know I contributed to the loss of my marriage and advice them not to make the mistakes I made. I am a strong believer in marriage and just because mine did not work, it does not mean that it will not work for another couple,” she concludes.

Article courtesy: The Star

Warning Sins in Pregnancy: When to Call Your Doctor

During pregnancy, many women have lots of questions and queries. Some of them we ask our moms, our aunts, our friends, our colleagues, and some of us go to Facebook to seek answers :) . But, when does it become obvious that you need to call your doctor or midwife, or visit the health center immediately?

Dr. Stephen Mutiso, a consultant obstetrician/gynaecologist at KNH is our guest writer today and he lets us in on the warning signs –when a pregnant woman should seek a medic’s opinion as soon as possible.

*Antenatal care entails monthly visits to the clinic till 28 weeks gestation, then visits every two weekstill 36 weeks, and thereafter weekly visits till delivery –for those progressing well. However, sometimes there is variation from this schedule, and this depends on the needs of the expectant mother.

However there are certain situations when it becomes necessary to get in touch with your gynaecologist on an urgent basis before the next visit. This is especially when certain complications develop.

Complications during pregnancy and childbirth are common. Infact, approximately two out of every five pregnant women experience some complication during pregnancy, childbirth and postpartum period. 15 percent of pregnant women develop life-threatening complications. Most complications cannot be predicted and can happen at any point during the antenatal period, during delivery or post-delivery. Therefore, all pregnant women should be prepared to respond appropriately when complications arise by contacting their care givers immediately.

There are certain symptoms which if present denote that they could be serious complications hence need to act immediately. These symptoms are referred as danger signs. Knowledge of danger signs of pregnancy emergencies and appreciation of the need for rapid and appropriate response when they occur is important to avert fatal outcomes. At times, getting medical help early  makes the difference between survival and death.

The danger signs in pregnancy are: vaginal bleeding, severe headache, severe vomiting, swelling of hands and face, difficulty in breathing, fits, fever, reduction or absent fetal movements, gush of fluid, intense abdominal pain and contractions before 37 weeks. Danger signs indicate a woman needs immediate medical care.

Bleeding is a very serious complication. It causes most of the maternal and foetal deaths in Kenya. Any bleeding in pregnancy –irrespective of the amount is abnormal. When bleeding is present during pregnancy it may indicate that the placenta position is on the lower aspect of the womb (placenta praevia). Bleeding may also occur when there is premature separation of the placenta. This premature separation cuts off delivery of oxygen and other nutrients to the baby, and this could lead to the baby’s death. Other causes of bleeding in pregnancy include: rupture of the uterus and bleeding from the baby (though this is rare). Heavy bleeding after delivery may arise from different causes such as relaxation of the uterus (atony), injuries in the birth canal, incomplete expulsion of placenta and sometimes bleeding disorders.

Severe headache, swelling of hands and face, blurred vision, fits and difficulty in breathing indicate high blood pressure and need urgent attention. This complication is referred to as severe preeclampsia, and when fits are present it is called eclampsia. This disease is also deadly and delivery is the way out regardless of whether the baby is mature or not. Seekng immediate care from your gynaecologist is important.

Hotness of the body with or without vomiting may indicate presence of serious infection or malaria. Prompt treatment does save life.

When waters break it is important to call your doctor immediately, because there is a possibility that the baby’s cord can come out and get compressed by the baby’s head, thereby stopping blood supply to the baby. This can cause death of the baby. It is also very easy for infection in the uterus to set in once the waters break. This infection is life threatening. Urgent care is therefore crucial.

Pregnant mothers should be keen on foetal movements (kicks) throughout their pregnancy. Any decrease in baby’s movement may indicate that all may not be well with the baby, and so it is important for the woman to report this observation to her gynaecologist as soon as possible.

Intense abdominal pains require urgent evaluation by your doctor. Causes of severe abdominal pain include ectopic pregnancy; rupture of uterus, premature separation, infection of the kidney. At times, abdominal pain may be due to surgical diseases such as appendicitis, intestinal obstruction etc.

Contractions which occur before 37 weeks indicate premature labour. Babies born at this time could develop breathing difficulties which sometimes could prove fatal. Its advisable for expectant women to seek assistance when they start getting regular uterine contractions especially if there are more frequently than 10 minutes apart.

In conclusion, knowledge of danger signs is important because it improves complication recognition and ensures timely decision to seek care hence handling complications in good time and consequently saving lives and avoiding serious disabilities.*


Dr. Stephen Mutiso is based at the KNH Doctor’s Plaza, Suite 26/27. He provides a  wide range of  gynaecological services including: antenatal care, delivery (normal and caesarean),  infertility  treatment, fibroids, fistula surgery, screening for reproductive tract cancers and various  gynaecological operations.

Tel: 0722 678 002 or 0788 306 674

Website: drmutiso.com Email: mutisoh@yahoo.com

What Happens to a Kenyan Woman’s Family After She Dies While Giving Birth?

Every two hours in Kenya, a woman dies during pregnancy or childbirth. Quite unfortunate.

A new report on maternal health in Kenya has further amplified the devastating impact of a mother’s death on her family and in her community. The study, titled: ‘Price Too High to Bear’, reveals that that the unfortunate deaths of these women (mostly preventable), gravely affect her immediate family, the survival of her newborn, the health and opportunities of her surviving children, as well as the economic productivity of her family and her community.

The report by Family Care International (FCI), the International Center for Research on Women (ICRW), and the KEMRI/CDC Research and Public Health Collaboration in cooperation with Kenya’s Ministry of Health highlights the financial costs of the deaths of mothers in poor remote communities on their households, as well as the impact of these costs on family well-being.

The study was done in three sub-counties in Western Kenya (Rarieda, Gem and Siaya town -all in Siaya County) between 2011 and 2013. These were the following key findings:

The loss of a mother harms her surviving family members, her children’s health, education, and future opportunities.

The report states that of the 59 maternal deaths in the study, 14 women died during the last three months of pregnancy, one died during labour, and 44 died post-delivery. It is also important to note that over 70% of the maternal deaths occurred in the course of a normal delivery, while the remaining ones who died had experienced a caesarean section, use of forceps, or other intervention during delivery.

The link between maternal death and high neonatal mortality was also demonstrated:

Of the 59 women who died, 31 infants survived delivery. Of these, 8 died in the first week of life, with another 8 dying in the next several weeks. This left a total of only 15 surviving babies from 59 pregnancies.

In most of the households, the women who died used to carry out various tasks in their homes. These women used to contribute an average of 61 hours of household work each week, with tasks including; childcare, cooking, laundry, and fetching water and firewood. Following their deaths, the women’s husbands, mothers-in-law, older children, or other surviving family members had to pick up the slack, with 88% of families reporting that this had reduced these members’ ability to contribute earnings to household income.

Some of the deceased women were also involved in farming. For these, their deaths in some cases forced the household to allow land to lie fallow, or to cultivate fewer crops. Some families indicated that they had lost crops after the death of the woman, because surviving household members were not able to allocate to farming the time they had when the woman was alive.

A mother carries her son on a farm in rural Kenya.

For the surviving school-going children, they were in some cases withdrawn from or forced to miss school, because economic disruptions made it difficult to afford school fees. The household could no longer afford to pay the school fees, because the mother’s income was not available any more. Even when there was some money, it was used to hire casual farm labour.

Where children continued their schooling, often their grief and new household responsibilities negatively affected their schoolwork. In a number of cases, families reported that children withdrew from school altogether. Others who remained in school often had less time for schoolwork — and less time to actually attend school due to the additional household chores and because they had to take care of their younger siblings.

Social, emotional and other non-­economic consequences

In many parts of Western Kenya –where the study took place, a ‘household’ is made up of all those who eat under the same roof. Before the mother’s death, majority of individuals in the household ate in the woman’s home. But after she died, only about a quarter of individuals from her household continued eating in her house. Of those who changed where they had their meals (most of them children aged below 18 years), they said they did so because of the death of the mother. In most cases, children began taking meals in the home of their grandmother. Other children were removed from household and given out to relatives for foster care.

When a woman dies, her funeral costs are a crippling hardship for her family.

Funerals are a big deal in Africa, and Kenya is no exception. Many communities strive to give their departed relatives a ‘grand, respectable’ send off which could see them spend huge amounts of money. Across all wealth levels of households interviewed, families’ funeral costs exceeded their total annual expenditure on food, housing, and all other household consumption. On average, economically active members took a month off from work during the funeral period. Given the already high costs of the funeral, this lack of economic activity is an additional burden for the household.

A mother selling potatoes by the roadside in rural Kenya.

Those are just some of the key findings of the study. Indeed, it only goes to show that Kenya continues to have a high maternal mortality rate, despite commitment from the government to address the issue. It only means that the country needs to pull up its socks in reducing maternal mortality rates. Meanwhile, 2015 is just around the corner, and I wonder if my country will be able to achieve MDG5, that of reducing maternal mortality.

I can only hope for the best.

A Difficult Pregnancy and Premature Twins Inspired A New Venture

Her twins were due on 20th July 2013, but they came early -on 29 April 2013. It had been a difficult pregnancy right from the beginning, as she experienced heavy bleeding, severe cramps, had an open cervix…until doctors recommended that she undertakes a cervical stitch if she wanted to save her babies. She is Maryanne Kariuki, and it is this experience that led her to begin her own personal initiative, the A & J Initiative. Read more….

Maryanne_Kariuki with her twins Avie and Jamie.

Maryanne_Kariuki with her twins Avie and Jamie.

My Pregnancy Was Filled With Feelings of Depression

Pregnancy is supposed to be a time when the woman is happy, glowing and celebrating every moment of the pregnancy journey, right? Well, somewhat.The first trimester for many pregnant ladies is usually a difficult one. Thankfully, the nausea, vomiting and lack of appetite usually subside after the thirteenth week, and for many, this is when they begin enjoying their pregnancy.

But not for all women.

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Take Wanjiku Wanderi for example who experienced a bad case of nausea and vomiting right until the end of her pregnancy. She was always in a bad mood, angry and just generally filled with alot of negative energy. Then there is Dorcas Ratemo who never quite felt happy during her pregnancy, was always sad, gloomy and miserable and she was someone to completely avoid. So, were they just building up pity-parties, or were their ‘bad energies’ justified?

Well, I spoke to them, and here are their stories, which I originally published in the Daily Nation.

Pregnancy Forum for Expectant Moms

Pregnant women love talking and sharing about their pregnancy journey. One woman in Nairobi, Lucy Muchiri, who is a consultant midwife has found a way to bring them all together, where they can not only share their experiences, but also learn about the different physical, emotional and hormonal changes they are going through as they prepare for the arrivals of their little bundles of joy.

Here is a review of one such session.

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