News dated April 8, 2016, in Nong Han District, Udon Thani Province, a 14-year-old girl, 7 months pregnant, had a miscarriage. Out of shock, she threw the baby into a neighbor’s banana garden. Later, someone found the baby dead, and she was condemned by neighbors for killing her child… From the hospital’s history taking, the girl denied having an abortion, saying she had severe abdominal pain and a lump came out. The girl had to stay in the hospital because there were remnants of the placenta left in the uterus, and an infection was found…
According to Criminal Code Section 277
A girl under 15 years old who becomes pregnant, whether consensual or not, is considered to have become pregnant due to a criminal offense and must receive medical assistance to safely terminate the pregnancy but…this girl did not have access to abortion services. A miscarriage at 7 months of pregnancy poses a risk and may endanger her life
Uncle Doctor has 2 examples to learn and understand about women who are too far along in their pregnancy to fix it and those who are pregnant but solve the problem quickly. Let’s see how both cases are.
First example
A 26-year-old woman working as an assistant teacher in a private school came to check if she was pregnant. She said she broke up with her boyfriend since October, and her last period was in September. She used emergency contraceptive pills, monthly birth control pills, and sometimes took women’s herbal medicine. She met Uncle Doctor on April 8, and her period still hadn’t come, but she didn’t think she was pregnant because she thought she had taken emergency contraceptive pills and birth control pills, so she shouldn’t be pregnant. Moreover, she hadn’t had sex for a long time. She thought she might have another illness causing her period not to come. Uncle Doctor said emergency contraceptive pills reduce the risk of pregnancy by only 75% and the effectiveness decreases if used frequently. Therefore, if the next period is missed, she should immediately check if she is pregnant.
The reason for not taking a pregnancy test, she said, was that she had seen a friend test urine and found she wasn’t pregnant, but later tested again and found she was 4 months pregnant, so she thought urine tests weren’t very reliable!! But… this way of thinking might not be correct, right? Urine pregnancy tests are simple, effective, and reliable.
She continued that she had no symptoms like a pregnant person, nothing seemed abnormal, and she also thought her period not coming might be due to the emergency contraceptive pills. In the past, she had taken a lot and had missed her period for 2 months before it came. But in March, she started feeling like she had a belly, gained weight from 44 to 47 kilograms, and friends started commenting, “Why does someone so small have a belly?” “I thought I would try to get checked, but I was never free.” When her sister scolded her, she hurried to see the doctor.
Uncle Doctor examined her abdomen and found that the uterus was above the navel. An ultrasound showed a large fetus clearly. The conclusion was a 27-week or 7-month pregnancy. She asked, “Can I have it removed? I don’t know what to do.” In this case, it was an unplanned pregnancy that was too late to terminate. She had to continue the pregnancy.
Second example
A 27-year-old woman and her boyfriend were about to graduate and receive their degrees this year. Both worked and studied together, having been together for 4 years. They used condoms about 80% of the time to prevent pregnancy, and the rest of the time used withdrawal. Her last period was on November 22, and generally, it came every 4 months. In December and January, her period didn’t come, but she didn’t take a pregnancy test because she thought it was the same as before.
Later… around mid-February, she had to go to the hospital’s emergency room with abdominal pain, both dull and cramping, radiating to the back, with vomiting. The emergency room doctor performed an ultrasound and scheduled her to see an obstetrician again in two days. The transvaginal and abdominal ultrasound found she was almost 2 months pregnant. The doctor scheduled her for prenatal care and a blood test a week later.
She asked for advice, saying she wasn’t ready. The obstetrician said the doctor wasn’t there to consult on her life problems and walked out. The nurse in the examination room looked at her and said, “You’re 27 years old, why haven’t you graduated yet?” She said that the 3 nurses and 2 doctors she met all looked at her and whispered among themselves after she said she wasn’t ready for this pregnancy and asked for a solution the hospital could help with… The nurse said that the medical and nursing ethics do not allow for abortion, it’s a sin!
After that, she came to consult Uncle Doctor, even though she was afraid of being scolded. But Uncle Doctor told her to relax. She relaxed and expressed that she and her boyfriend wanted to have a child but wanted everything to be ready first. Now she still had the burden of paying off her parents’ house. “I think I’ve thought it through the best I can, looking at the problem ahead, there will be more.” “If I were to have an abortion, I want it to be safe, not dangerous for me, and I want it to be a consultation for me too.” She received abortion services, which she chose to use medication for an 8-week pregnancy. Although there were side effects like chills, diarrhea, and some vomiting, she eventually had a complete abortion, with bleeding for only 3 days. After the problem was resolved, that evening she was very hungry, even though she hadn’t felt like eating before…
The first woman lacked awareness of the changes, even though her period was missing, and needed to take a simple urine test. The second woman had to struggle and take responsibility for her future and her parents, wanting to have a child when she was truly ready. Both cases are older than the girl in the news, who is only 14 years old. Therefore, young ones facing unplanned pregnancy problems should seek consultation services as soon as they know their period is missing.
With love and care
Dr. Rueangkit Sirikanjanakul, RSA Network Coordinator
Source: www.lovecarestation.com