Wednesday, August 28, 2013

In the Waiting Room: My Journey to Motherhood

 (This was initially written for but a lot of 

people have asked me to put it here too. So there you have it.....)

By Dolapo Taiwo-Fajolu
In the beginning…
Getting married was high on my priority list once I survived the long and arduous journey to achieving academic qualification. By the time I was through with school and landed a plum job in the bank, there was nothing stopping me and my fiancé from taking the plunge. We were ready and believed in our dreams of starting a family immediately.
At 31, I couldn’t wait to start making babies. I didn’t feel anything could stop me from getting pregnant on the first try; I was healthy, and had a clock-work regular cycle. Also, no one in my family had to deal with infertility, so I felt it would be a breeze. Although, a few years prior, I had discovered milky-like discharges from my left breast and went for a check-up after I told my mum. The doctor said it was probably nothing to be worried about as there were no lumps. I had no idea that that “nothing” was actually a major sign of an abnormality that would delay my attempts at conceiving.
Getting worried
After Eight months of unprotected, deliberate sex and no pregnancy, I began to worry that something was wrong. My hubby didn’t see any problem and would jokingly ask me what the rush was for? I began to suspect the discharges from my breast were something more than nothing especially as it now leaked from both breasts. I googled it and what I discovered was frightening.
My diagnosis: Prolactin and Infertility
It was from medical journals and googled articles that I discovered a world of prolactin levels and infertility. I went to a specialist hospital armed with the information I already had about my condition and the blood work revealed a higher than normal level of prolactin. The doctor confirmed that my periods, though regular were just my uterus shedding its walls.
I was not ovulating at all!
The shock of the news, the fear of treatment and all the associated psychological issues were overwhelming.
Another term for high prolactin levels is hyperprolactinemia. Women who are not pregnant and are not breastfeeding should have low levels of prolactin. While Prolactin plays a vital role during lactation and breast development in pregnancy, If a non-pregnant woman has abnormally high levels of prolactin, it may cause her difficulty in becoming pregnant. The occurrence of a milky flow from the breast of a woman who has not recently been pregnant or nursing is called galactorrhea. This was the initial condition I experienced that the doctor I visited did not see as anything to worry about!  While galactorrhea can be caused by excessive local stimulation as well as hormonal imbalance, a full examination to rule out the cause, should have occurred.
Getting treated.
The doctor had to eliminate the causes of my galactorrhea. Some medications cause an increase in prolactin levels. One of such was a drug I was using for ulcer (Cimetidine).  Other drugs that could result in galactorrhea include some types of anti-depressants, sedatives, Estrogen, Oral contraceptives (birth control pills), blood pressure medications (methyldopa, verapamil), and medication for nausea (Reglan, metoclopramide). It can sometimes also be due to physical stress (i).
I was placed on a high course of Bromocriptine (Parlodel) and Six weeks into treatment, I conceived! Oh I thought if I only knew it was that simple!! And then I miscarried. This happened twice and then nothing again for months. The doctor placed me on a regime of weekly injections to boost my hormones and I got pregnant again. This 3rd time, the pregnancy went past the first trimester and into the 24th week and all of a sudden, I began to dilate and my cervix couldn’t hold up again! (ii)

Another clog in my wheel: Incompetent cervix
By the time I got to the hospital that fateful 1st Saturday in January 2009, I was 24 weeks into my pregnancy and 4cm dilated! The doctor told us the prognosis was bad, my baby’s lungs were immature and could risk grave infections if born at that age. He did an emergency cerclage. Cervical cerclage is a rarely used type of surgery that involves sewing shut the outlet of the uterus (cervix) to prevent it from opening before a pregnancy is carried to full term.
I was placed on full bed rest and we began to pray for a miracle. The doctor opined that if I could keep my son in for four - six more weeks, he would have a high chance of survival. I must add here that the cases of premature births in Nigeria are very high and most hospitals are not equipped for the care of such delicate children. Three days into my bed rest, my water broke and I had to deliver my son prematurely. He didn’t survive the delivery and died immediately after. The devastation I felt was indescribable. It was just 5 days into a new year and I could not believe I was starting the year on such a sour note.
The diagnosis was clear - my cervix gave up mid-way into my pregnancy. The doctor said the condition is not pre-determined and most times, it is diagnosed only when it has happened. Now apart from hyperprolactinemia, I had to contend with an incompetent cervix! I felt my world crashing on me and was depressed for a long time. Friends and family came around and in a few months I was ready to begin the journey again. Now this time, with the Parlodel, the injections and all I was finding it difficult to repeat the magic that made me conceive before. And how could I forget the crazy side effects of Parlodel! I was constantly feeling sorry for myself and sex with my husband was more of a reproductive research than an expression of love to each other.
I went through several procedures; Hsg (X-ray examination of the uterus, fallopian tubes and surrounding areas), laparoscopy, D&C to remove tissue in the uterus after the miscarriage, just name it. I felt violated, invaded and a lot of times, just sick of all the probing and needles.

Next steps: putting my faith to gear
I am a believer and both my hubby and I serve God as workers in our church. My husband and I began to pray to God to step in. We started taking communion together daily and around that time we listened to Pastor Poju Oyemade of Covenant Christian Center in Lagos talk about the power of confession. We wrote our confessions and consistently declared that we were parents of the kind of children we wanted. About that time too, we changed churches to a place that was instrumental in developing our faith beyond serving God to relating with God as a powerful and miracle-working Father.
I had peace that God would give me children, I just didn’t know when. I was still taking my drugs the entire time. I knew I had to get pregnant! Do you know what it feels like when all the women around you are either pregnant or have a baby? Apart from the emotional and physical issues, there is also the societal stigma that is prevalent in our Naija society. People ask how far? How many children do you have now? Those who know you are still waiting are careful not to upset you and at the same time, you really want to rejoice with your friends who are having children but deep down you feel sad about your condition.
The same society that places a high mark on fertility however lacks the moral and spiritual guidance and counseling backings needed to help people face these challenges.
Medical counseling is rare if not non-existent and most doctors are seeing the high infertility rate in the country solely from an entrepreneurial point of view rather than a balance of providing succor and solution to a prevalent problem.

Hope rising
Unexpectedly in June 2010 I realized I was late. I took a test and it was positive. I didn’t know how to react as elation was mixed with fear but I was determined to do all the right things for this child. So with prayers and the best medical care available, I proceeded with my pregnancy. I researched my condition and took note of all my symptoms. This pregnancy from the beginning was unlike any I had before. I was sick, and had bleedings at the 8th and 11 weeks. I had cervical cerclage when I was 13weeks.  Now all I had to do was take things easy, take my medications and lie low. The months moved slowly and every week that passed brought relief. I was constantly in pains, and sometimes felt like my pelvic would burst out from under me but prayers and faith in God’s words and my confession kept me going.
When I passed the 24-week mark, I celebrated quietly as my pregnancy had passed the point where I lost my last baby. However, at 30 weeks, I began to lose my mucous plug and then started having discharges of mucous and blood. By now I was on complete bed rest and the doctor was hoping I could carry my son beyond 32weeks.

Oh! The joys of motherhood!
That was not to be as my water broke early one beautiful Monday morning. The stitches were removed and I delivered my son weighing 1.6kg and we immediately began the Neonatal Intensive Care Unit (NICU) ordeal.
Prior to this, I had never met or spoken to anyone who had a preterm baby and all the experiences online were different from my Nigerian situation.

OT in NICU (Pictured L, R)
I was however consoled that my son and I received the best treatment a Nigerian hospital can offer and from a plummeting weight loss of 1.35kg, he gradually began to gain some weight. After four weeks in the NICU, at 1.7kg and having overcome apnea, and luckily escaping jaundice (A miracle I praise God for), I took my son home.
I learnt some valuable lessons while in the hospital, one of which is that you are your own counselor and encourager. Another lesson is that no matter how hard you worry, God is in control and he has your best interest at hand.
Five Months later

Moving forward
There are women who have fertility issues that have gone undiagnosed or been mis-diagnosed. Many, today, spend a lot of money on tests that are either too expensive or invasive or outrightly unnecessary.
So many women are hiding away because of the stigma ascribed to infertility in our society and many groan under the persecution and label of barrenness.  There are hardly counselors or teachers who are willing to show the way and where biology has failed, spiritual lessons are one-sided or insufficient. Even the bible says a barren womb is unsatisfied! As long as the woman is not with a child, there can never be fulfillment! How then can we help? How can knowledge empower us? How can we be sure our circumstances will not be exploited by entrepreneurs in our money-driven society? I advise women to arm themselves with knowledge, to be brave and face their illnesses or whatever is causing delay.
The first step towards healing is acceptance. Accept you have a problem, identify your symptoms if any, in case there is none (unexplained infertility), check your diets. Most delays can be from our partners as well so the test should include semen analysis. A good doctor will not start to treat you without first confirming the status of your spouse’s semen. Lifestyle changes too are key to finding healing. Apart from this there is the belief that external influence beyond the physical causes infertility. I would be fooling myself if I didn’t mention this as our African roots and society are riddled with such stories of people being cursed or placed under the influence of one juju or voodoo. While not glorifying the devil that is masterful in deceit, it is important to note that the Almighty God is sovereign and powerful than any influence. So I hold the belief that no voodoo, charm or juju is able to keep a woman barren. Once your faith is in gear, believe the word of God concerning your situation, learn all you can about it and keep believing. Once that is done other steps follow.
I also would like to candidly advice that as women we should not wait too late to begin child-bearing if interested in having children and the opportunity presents itself. As much as we can, and is possible, we should start early. Yes, I know the economic situation and relationship problems may cause delays but we must please encourage the young ones to start early, especially if motherhood is high on our priorities in life. It is a known fact that the older a woman is; the harder it is to get pregnant and there are associated complications/age-related defects that might arise with the pregnancy despite current technological advances.
Lastly don’t give up. If you don’t get that BFP (Big Fat Positive on a Pregnancy Test) this month, next month is there. Keep hope alive!
Further reading:
  • Fertility Problems – Treatment Overview
  • God’s Waiting Room 1 & 2 by Yewande Zaccheus: these books contain testimonies of women who overcame their infertility either by miracle babies, IVF, Adoption and others. It is a good read and I found it helpful in my journey. I recommend it to every woman in the waiting room.


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