From the news in January 2017, a child was abandoned on January 20 in Chiang Mai. Municipal garbage collectors found a rice bag placed next to a trash can beside a gas station. Inside was the body of a fetus not more than 8 months old.
On January 22, in the Yan Nawa district of Bangkok, at a condominium, a housekeeper and building technician found a clogged toilet. They used equipment to suction the waste and found a baby’s leg emerging. The police found a suspect who confessed to having a miscarriage.
On January 27, in Warin Chamrap district, Ubon Ratchathani, a newborn baby was found crying loudly lying next to the kindergarten swimming pool near a trash can, with blood stains on its abdomen.
These three news stories indicate that there are still many obstacles in preventing and solving pregnancy issues in women. Society, including medical personnel, should open their hearts to give these women opportunities to receive help and solve problems at all times. Additionally, there is one piece of news that Uncle Doctor finds interesting:
On January 19, in Khlong Luang district, Pathum Thani, an 18-year-old girl gave birth in the bathroom. She was confused, not knowing when she was pregnant. The baby was healthy. The mother revealed that her daughter had a stomachache and went to the bathroom, hearing the baby crying. Previously, she did not have prenatal care because she did not know she was pregnant. After the incident, people did not believe that a woman could be pregnant and not know it.
Before that, Uncle Doctor encountered a similar incident. On January 6, a mother brought her 18-year-old daughter for prenatal care, saying she just found out today that her daughter was pregnant because she noticed unusual behavior: preferring to be alone and wearing oversized clothes like a pregnant person. The mother asked her daughter a week ago if her period had come, and the daughter replied that it came every month. Later, the mother felt the abdomen was hard and large, thinking it was true. The period had blood from December 8-12, 2016, using one sanitary pad per day, sometimes half a pad. There was more bleeding during the day and less at night. Normally, the period would require two pads a day for five days.
This girl broke up with her boyfriend in February 2016 and had no sexual relations with anyone. She remembered having a normal period in early April. On April 15, she attended a party in front of her room, celebrating Songkran with friends, drank until she passed out, and woke up in the room with two friends. She did not suspect sexual assault. During this time, she had no dizziness or nausea, no fatigue, ate normally, and urinated infrequently. She said she did not notice herself, did not see her belly grow, and gained 4 kilograms.
The ultrasound showed a gestational age of 36 weeks or 9 months. It is expected that she had sexual intercourse in April, and she is close to giving birth, even though she just started vocational school for only three months.
On January 26, a mother and daughter came for consultation. The mother said, “We are not ready to keep the child at all. We are raising a 10-month-old grandchild who is her child. Now the daughter is not working, and her boyfriend is irresponsible, with no stable job, and family problems, living separately.”
Uncle Doctor looked at the daughter and saw that the belly was visibly large, but the 30-year-old daughter said, “I think my period is not more than 2 months late. The last period was in November 2016, but it was light because I don’t have much blood. In October, the period was heavy, using four pads in five minutes, had to wear diapers for three days. I don’t believe the baby is moving because I know when my last period was.” She said confidently.
“I feel normal, no morning sickness, no special cravings, no loss of appetite, urinate infrequently because I drink very little water, but I’m irritable and angry all the time because of stress,” she continued. “The belly became bloated and hard quickly this month. I started feeling movement in the past two weeks. It’s the first month I’m worried and have a period, but why am I still pregnant?”
She told Uncle Doctor that she thought she came for consultation as soon as possible, but the ultrasound result showed she was 26 weeks pregnant. Uncle Doctor advised that even if the gestational age was less, like 20 weeks, abortion could not be performed because the first pregnancy was delivered by cesarean section. If abortion is done with medication, it risks uterine rupture and death. The gestational age should not exceed 3 months for it to be best and safest.
These two cases indicate unawareness of pregnancy.
There was news on January 22. Prof. Dr. Pisake Lumbiganon, President of the Royal Thai College of Obstetricians and Gynecologists, confirmed that unawareness of pregnancy can occur if one does not regularly observe bodily changes regarding menstruation, as it may be irregular. Morning sickness may not occur, and very few show severe symptoms. One might justify it as a gastrointestinal issue, intestinal problems, causing stomach upset, including obesity.
As in the two cases mentioned, the blood observed was not like the usual, either much more than before, less than before, or late. If this is the case, it is better to test urine for pregnancy. Early pregnancy symptoms include breast pain, nausea, vomiting, weight changes, constant fatigue, irritability, frequent urination. Later stages include breast enlargement, darker nipples, increased vaginal discharge, enlarged abdomen, and fetal movement. Unawareness of pregnancy can be addressed by paying attention to any symptoms. If you have had a cesarean section and do not want to be pregnant, you must use effective contraception or do not let the pregnancy exceed 3 months if you want to terminate the pregnancy safely.
With love and care,
Uncle Doctor Ruangkit Sirikanchanakul