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Pregnancy Bliss | Reproductive Health Hub

Seeking pregnancy termination

Question:  My close friend got 5 months pregnancy but now its create big problems so now she doesn’t want her pregnancy. Now her life get spoil so tell solution for this problems but she don’t want operation. Please help to solve this problem to any tablets is there to abortion pls help her but she didn't have email id. Anon. (India)

Answer: As practising doctors, we fully understand the problem of unwanted or unplanned pregnancy that millions of women in the world have to deal with every year. We are therefore fully empathetic. However, we are mindful that the vexing and difficult issue of pregnancy termination (abortion) is governed by different rules in different countries. Regrettably therefore, we are not in a position to advise on this difficult issue for any single individual. I would wish to comment, however, that it is potentially quite dangerous for the said person at the stated gestation of 5 months (around 22 weeks) to try to procure a ‘do-it-yourself’ pregnancy termination. If the laws in your country allow termination in these conditions, my advice would be for her to go through the normal channels and seek appropriate advice and help. If it is not legal, my plea to the person is to seek other ways of dealing with the issue other than pursuing termination of the pregnancy.



Anxious about going over due dates

Question:  I am 40 weeks and 4 days pregnant old and yet no signs of labour. I am anxious and worried pls help. T. (Nigeria)


Answer: After 40 weeks of carrying a pregnancy, it is only natural that, practically every woman is impatient to get on with the delivery. However, it is important to always bear in mind that, the calculated expected date of delivery (EDD) is only a guide. The vast majority of women will have the baby in the four weeks around that date rather than bang on the date itself. This is why it is stressed always that up to two weeks after the EDD, that is still regarded as term and not post-maturity as you may be tempted to believe. It is only when the pregnancy is threatening to go beyond 42 weeks that active intervention is called for. As long as you are well and your baby in the womb remains as active as before, try to be patient. Your doctors will, hopefully, have a plan to see you at around 10 -12 days after your due date to see if induction of labour should be planned for. My best wishes.



Any connection between autism and events in labour?

Question:  when my daughter was born thin stained meconium was present baby was cyanosed with minimal resp effort/grimace oropharynx was suctioned and no thick meconium was seen below cord.  Apgar score 5 for 1 minute and 10 after 5 minutes. I remember thinking at the time my baby had died because she didn’t cry for what seemed like ages and she was blue. Once my daughter did cry she never seemed to stop and she couldn't keep her milk down. i was told she had bruising on her scalp and was vomiting due to mucus. Every time my daughter fell asleep in my arms the minute i would lay her down she would cry being a first time mum and not much support from midwives. You wonder what's normal. This continued for a few months i even took baby to hospital when she was around 2 months old because of it. They couldn't find anything wrong and told me to change her formula which i did. Within a few weeks my baby did settle. At 2 years 9 months old my daughter was diagnosed with classic autism and severe learning difficulties. my daughter is 4 years old now and remains non-verbal. I do wonder now if my daughter should have been placed in special care after she was born or if i was left in labour too long and perhaps should have been given a c-section. i do not know if any of this contributed to my daughters condition but i do wonder every day if any different interventions had occurred would my daughter have been ok. J.G. (UK)


Answer: Looking through your quite detailed story, it is obvious you have had a very tough 4 years since the birth of your little girl. You have not given any details of labour but as you have mentioned, your daughter had good Apgar scores. As a new born she did not need assistance with breathing and that will be in keeping with absence of meconeum below the vocal cords. All that is reassuring about events at that time. The description of your experience in the weeks after the birth is really a fairly common one for many mothers and does not signify anything that might have gone wrong with the labour or delivery.  There is really nothing in what you have described that leads me to think you should have been delivered by caesarean section and there was clearly no indication for the baby to go to special care. This brings me to the issue of the diagnosis of autism. Having had the diagnosis for over a year now, I’m sure you have sought and obtained a lot of information about it.

You will therefore be aware that autism  is never caused by events in labour or at delivery. In other words, a difficult or traumatic labour does not lead to autism.

Trauma during delivery or conditions that cause prolonged oxygen starvation to the baby in the womb or at delivery can lead to brain damage. This will not manifest as autism. Rather, the child may present with what is known as cerebral palsy which is an entirely different condition. You will have had an opportunity to learn about  risk factors for autism. Problematic labour is not one of them. In any case, it does not appear that your labour was complicated. Unfortunately, with a diagnosis of autism, efforts to look for an explanation are almost always fruitless. My plea to you is to cease torturing yourself looking for a cause. Even though up to 6 in every 1000 children are diagnosed with autism, the causes remain unknown.


Heavy vaginal bleeding at 6 weeks pregnant

Question:  I am 6 weeks pregnant on thursday and have had heavy bleeding and pains almost like a period, i went into hospital yesterday (Saturday) as i passed a large clot that i thought was me miscarrying. The hospital checked this and said there was no sign of the egg sack or baby in this, they ran an an internal examination on me and said the neck of my womb is still closed which is a good sign. Although the bleeding and clots have got lighter they are still there. What could this be?? C. (UK)


Answer: You are just under 6 weeks pregnant and you have had a heavy vaginal bleed. That is a worrying development. I’m a little puzzled by the extent of examination and investigations that have been conducted to establish what is going on. A vaginal examination was certainly the right thing to do but the findings need to be interpreted with caution. A closed cervix can indicate that this is a threatened miscarriage but the pregnancy is intact. Likewise, it can mean you have had a complete miscarriage. The cervix is only open when you have an inevitable miscarriage (meaning miscarriage has not taken place but will definitely happen) or if you have an incomplete miscarriage (meaning, you have lost the pregnancy but not everything has come away already). Your situation is unclear. The bottom line is, you need to have an ultrasound scan arranged, ideally within the next week. Being so early in your pregnancy, this will have to be a vaginal scan. Alternatively, a blood test to check your pregnancy hormone (beta-hCG) level can be done on two separate occasions (two days apart) to check the trend of change. If this is rising normally, it will be particularly reassuring.