THE SPACING OF PREGNANCIES

 The question of how long a woman should wait before becoming pregnant is something we encounter every day when we see pregnant women in our antenatal clinics. I always like to clarify family planning and pap smear on the first visit. These things may be forgotten after the baby is born and the mothers tend to neglect them. A lot of the patients often miss their six-week post-partum visits and we might not get a chance to counsel them on contraception and perform a pap smear.

The WHO advises women to wait at least 24 months between childbirth and a new pregnancy. This is more applicable if the mother has a complicated pregnancy or a caesarean delivery. According to a study published in the Lancet Regional Health using data from more than 4.7 live births in Brazil, there tend to be various cases.

in cases with shorter pregnancy intervals a lot of the time the mother’s body has not completely bounced back to its normal state and if the mother is breastfeeding there may be an element of iron deficiency. She may still have sleep deprivation looking after a toddler and more support is needed in the third trimester of the pregnancy. With a rise in maternal age in the first pregnancy a lot of the mothers tend to try for the second baby as soon as six months’ post-partum. We often see the trend of having two babies under two where the influencers promote having a smaller age gap between the kids to improve their bond and a lot of the facilities used for the firstborn is still around and can be used again.

In cases where women have more than 7 years between the pregnancies the body may behave as if it is the first pregnancy and the mother can have an increased risk of pre-eclampsia, becoming post-dates, and poor progress of labour. Longer pregnancy intervals do not increase the risk of small for gestational age fetuses.

We need more studies with many women to assess maternal and fetal outcomes in different pregnancy intervals. In the meantime, we need to assess every woman’s risks based on her age, circumstances, and the previous pregnancy outcome.

 

ME AND GRANDPA

 I had a happy childhood. There were many people around, a lot of love and support. If I had to look back into the house where I was born and raised, there would be many sweet memories. My grandparents, my uncle, my mom, and my dad were a great part of it. We had a three-story house. Grandparents were at the lower story and we were at the top part. When my brother was born I was about five years old and grandma and grandpa provided a lot of support as I was growing up. Grandma who was a teacher, would help me with my homework. I was quite clumsy and lost a lot of my stationary at school. They would ensure that we always had a storage full of pencils, coloured pencils, etc.  

Uncle was often busy with his things but we would watch TV together, I would watch him do his artistic sketching and Painting or him playing his ancient musical instrument. We would also go for a drive in the evenings and have some ice cream or nice street food. I had a brief 3-year stay in South Africa and when I got back to my grand parent’s house my uncle was married and he had moved out.

I loved spending time with my grandparents. I am sure they also enjoyed watching us grow in front of their eyes. Studies show that grandparents will have a longer and healthier life the more time they spend with their grandchildren.

Grandma was more talkative and vocal. She always had a sweet story to tell. I know almost everything. From the time she was a little girl to the time she met Grandpa. The birth of her kids and their childhood up to how my mom and dad met and got married. Grandpa was the quiet one. He was more active and worked for almost ten years after he retired from his government job. He was in charge of the shopping as well. He was of great help during the time I was in high school and needed different kinds of textbooks for the university entrance exams. I had to give him a name and he would be back with the textbook! He would also take me to different exam venues and come and fetch me after I was done. Back then I was not comfortable navigating my way in the big city.

He was very proud of me when I made it to medical school! He passed away in his 90s in August 2018 from the complications of a fall in the kitchen while making tea in the morning. I got into the registrar program the same year. I did not make it to his funeral but I flew home for the 40^th day ceremony. As we get closer to the anniversary of his passing in August I feel very emotional and being away from home makes it sadder. Grandpa will always have a special place in my heart no matter where I live!

 

 

WOMEN'S DAY IN SOUTH AFRICA

 Women’s Day in South Africa is celebrated on the 9^th of August every year. This day commemorates the 1956 march of approximately 20,000 women to the Union Buildings in Pretoria. This march was led by four women, Helen Joseph, Rahima Moosa, Sophie Williams, and Lilian Ngoyi. They were protesting against the Apartheid regime’s passbook laws. They were part of the Federation of South African Women (FEDSAW) and demanded equal rights and end discrimination against women. The March was a significant event in South Africa’s history, making it a turning point in the fight against apartheid and gender inequality.

We have come very far, but we still face many challenges concerning women's well-being and working conditions in society. According to the latest statistics about two-thirds of the global maternal mortality cases occur in Sub-Saharan Africa. This shows the lack of access to essential reproductive health services, antenatal care, safe childbirth, and contraception. The sad truth is that a lot of these women probably did not want to be pregnant in the first place. Good reproductive health ensures that women can make informed decisions about their bodies and participate in social and economic activities.

We want to ensure that the employers consider implementing policies and practices that support women’s needs such as breastfeeding areas or time off for antenatal care. Providing dedicated lactation rooms is crucial for working mothers because it enables them to breastfeed or express during their break time. employers should consider offering paid leave for prenatal visits allowing women to attend necessary medical appointments without fear of losing income or job security.

Investment in women’s education and healthcare is crucial. Governments, civil society, and private organizations must work together to ensure that girls have access to quality education and women have access to comprehensive healthcare services. We hope that better education will reduce the burden of HIV and its complications in young girls. And with a stronger generation, we can help build a prosperous society and pave the way for future generations of empowered women.

 

 

 

 

THE BEST THINGS ABOUT BEING A DOCOTR

 What was going through my mind when I decided to study medicine? I was a book warm, doing well in high school and getting good grades. I did not have any doctors in close family members to speak to and understand what lies in the future. I am enjoying what I do every day, besides compassion, developing skills, and unwavering dedication there are other wonderful things about what I do.

I appreciate having an opportunity to make a difference in people’s lives. I enjoy working with women and I try to care for the whole person and not just parts of a person’s health. The bond that is formed with patients and their trust in me is invaluable. Being an ob-gyn we often perform numerous caesarean sections and gynaecological surgeries. Witnessing the tangible results of the surgical intervention and rehabilitation of patients who had severe pain, abnormal bleeding or urinary symptoms is very rewarding. The evolution from postoperative pain to recovery and beyond, complemented by the gratitude expressed by my patients underscores the intrinsic value of the profession.

We do have patients who might experience a pregnancy loss, an adverse outcome, or a cancer diagnosis during the time they are under our care and this can be emotionally demanding for the healthcare provider. helping these women get through their health struggles is rewarding. We know that this is a calling and to be part of something greater than myself, every small victory feels like a triumph.

Medicine is not just applying science and clinical skills; it is an art that aims to improve the lives of patients. Medicine allows me to harness human ingenuity and cause people to feel better, have less pain, and do more in their lives.