What goes round indeed comes around. This is much the case in Gynecology where it is entirely possible to care for a generation of families.

A while back, a young lady came along to book for antenatal care with me.  She talked to me as if I had known her all along. I couldn’t really hide the fact that she didn’t look familiar. “Can’t blame your memory” she said, adding “after all, you delivered me prematurely and can’t expect you to remember that far back”. She was now carrying her own pregnancy.

I was at a loss, until her mother Tabitha walked in. Then it all came back. I was a young Gynecologist then, and was faced with Tabitha’s complicated pregnancy. She was only at 28 weeks of the pregnancy when complications set in. Continuing with the pregnancy put Tabitha at great risk. But this had to be balanced against delivering a premature baby. “We’ll buy more time and make decisions by the day” I remember cautiously trying to prolong the pregnancy. We only got to 32 weeks, and made the painful decision to deliver a very premature baby, and save Tabitha’s life. Against her desire, Tabitha had to desist from future pregnancies on medical grounds.

It was a baby girl named Baraka. She struggled with prematurity, but against all odds survived. She was not unscathed though, she suffered delayed development. My subsequent relocation meant that I didn’t keep tabs with Tabitha and her daughter.

“We got to know you had returned, and want you take care of Baraka’s pregnancy” Tabitha jolted me back to the present. “My pleasure” I said and hoped Baraka’s pregnancy was going to be smooth sailing. “Baraka’s baby will fill the gap of the second child I never had. I hope she gets many more” Tabitha expressed her wishes.

Indeed, Baraka’s pregnancy was uncomplicated. She delivered a baby boy, then all hell broke loose. She started bleeding profusely, all standard measures to control the bleeding did not have any effect. Removal of the uterus is life-saving when faced with uncontrollable bleeding after delivery. “That’s the only option to save her life” I said to her mother, knowing too well what it meant for the future. “So be it, better alive without a uterus than dead with one” Tabitha said tearfully.

And that’s how Baraka’s life was saved. Mother, daughter and grandson left the hospital weeks later. They were all healthy, but mother and daughter knew only too well there would be no more children in their household. That is until the Baraka’s son was old enough to father a child. “We’ll ensure his wife delivers under your care as well”, Tabitha pre-emptively predicted the future. That would be her third generation under my care, assuming I lived that long. I hoped the grandson would have better luck, and bear more children than both his mother and granny.
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