Sober Notes on Pregnancy
In my job, I get to see the good and bad side of most everything in life. Pregnancy is so often a thing of excitement and hope. It has its darker side, as well. Here are a couple of stories that don’t exactly exemplify a positive perspective of pregnancy.
None of My pregnancies was Planned
I was helping a thirty-two year old woman who was having pain and bleeding in early pregnancy. It was her seventh time being pregnant. Knowing whether a woman wanted to be pregnant is helpful in making decisions about how to deal with what might turn out to be a miscarriage so I asked, “Is this a planned pregnancy?” In answer to my question, she said, “None of my pregnancies was planned.”
For some reason, that really hit me. One of the reasons the role of women in our society has changed so much is their ability to control their reproduction. It just seems crazy to me that a poor woman with no insurance and questionable ability to care for seven children would take the “None of my pregnancies was planned” approach to life. Where is the desire to be in control? Where is the drive to get your life to play out the way you want it to? Where is the feeling of responsibility? Such important decisions being left up to chance in this modern age makes no sense to me.
Of course, in these situations, all of this just goes on in my head. It is not my place to lecture someone like this nor do I think confronting would make any difference.
Something More than Pregnancy
The other pregnant patient was a fourteen-year-old girl. She was thirteen weeks pregnant and came to the emergency department with her mother when she started to have some spotting of blood from her vagina. Her mother was worried she might be having a miscarriage. She denied any other complaints.
She had never been pregnant before and never had a pelvic or vaginal exam before. I took a few minutes explaining why we needed to do the exam to make sure everything was OK with her baby. I also told her just what I was going to do so she would know what to expect.
The first part of the exam is the speculum exam. A speculum is gently introduced into the vagina then spread open inside. The goal is to see the cervix or opening into the uterus or womb. As I peer inside, I am looking to see if there is any blood and if the opening is closed or not. In this case, rather than see blood, I saw a nasty vaginal discharge. When I asked her if she had noticed it, she said she had but had not told her mother about it.
Usually, such a discharge in a young woman is caused by some sort of a sexually transmitted disease. There is a pretty long list of germs that people share when they have sex and we test for most of them. In this case, she hit the jackpot with two. The laboratory reported that she was infected with both trichomonas* and chlamydia.** So, whoever was responsible for her being pregnant also left behind a bonus for her to deal with.
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