Birth with two wombs
Last week there was an interesting program shown on SBS Television in Sydney. It was the story of a woman who was born with two wombs, two cervix and two vaginas, who conceived in each uterus at the same time.
Being born with two complete reproductive systems is extremely rare and is often associated with infertility. However, despite the odds, this mother became pregnant, with one baby a girl and the other a boy. The pregnancy was carefully monitored by her obstetrician (this was in the UK), because each uterus was about half the normal size and there was concern that this may hamper the baby’s growth and development.
The film followed the mother through her pregnancy, interviewing her and her husband, the obstetrician and her mother. There were several scares when ultrasound scans suggested there may be problems (once it was the shape of one baby’s head) but these proved to be false, and the babies grew well. The plan was to maintain the pregnancy as long as possible, with a caesarean birth scheduled around 36 weeks.
By 34 weeks, the scans were being done every two weeks to determine growth. At the 34 week visit, the obstetrician announced that the fluid surrounding one baby was reduced and he scheduled an immediate caesarean, for later that day. The poor mother was very upset, and not at all emotionally ready to give birth, however she agreed for the sake of her babies. Given that very few cases of a double pregnancy like this have ever been recorded, and none had produced two live babies, it is easy to see how everyone was trying to achieve a positive outcome in this case.
The scene after the caesarean was heartbreaking. The mother was shown in a bed, sobbing because she had not seen her babies. They had been whisked away in theatre to be cared for in intensive care as both had respiratory distress (a typical problem of premature births) and after two days, she had still not seen her children. She was bereft and clearly distressed by this separation, which had started suddenly, out of the blue on a day when she thought she was going to have a routine check-up.
Finally, after a long wait, she was taken in a wheelchair to the ICU where she was helped to cuddle her babies against her skin, while a midwife helped with all the tubes etc. The change in her was dramatic - at last she held her precious bundles and expressed the joy of holding her child and what it meant to her.
While this was an interesting story, and no doubt one of great historical interest, I felt it showed some glaring inadequacies in the system at the hospital in Exeter. Why was the mother left for two days without even seeing her babies? She was quite well and there was no apparent reason why she couldn’t have been taken immediately she left recovery, to at least see her babies. To deprive a mother, especially in her special circumstances, of the opportunity to affirm her babies were OK, after all the concern raised by this complex pregnancy, seems cruel and unusual punishment.
A caesarean birth is not one that most women anticipate, yet sometimes they are necessary. When a caesarean is indicated, especially in an emergency, why can’t basic humanity prevail and steps be taken to minimise the trauma that will accompany such an event? There are many things that can be done to ensure the emotional and psychological well being of the mother and her family at that time: holding the baby in theatre, having skin to skin contact while in the recovery area (and early breastfeeding), unrestricted access to the neonatal intensive care unit and help with expressing colostrum for the baby. The needs of the father must also be considered as he is often traumatised as well, and he needs unrestricted access to his partner and baby too.
On another note, I was surprised that the obstetrician made the snap decision for an immediate caesarean based on one reading of a scan that suggested some reduction in the amniotic fluid surrounding one baby. Surely the appropriate course would have been to monitor the situation, taking readings every two days to ensure that the fluid was decreasing. A single interpretation of a scan may have been incorrect, or it may have indicated reduced fluid that was stable and not a cause for concern. I couldn’t help wondering if his rushed decision had something to do with the theatre schedule, and the presence of the TV crew that day. The babies were as well as could be expected at 34 weeks and respiratory distress (the result of being born too soon) was reported as their only problem. Why couldn’t they have stay safely inside until both they and their mother were ready to take the next step into the world?