RhoGAM

I’m so tired of being nauseated.  It’s not really pure nausea.  It’s more of a green feeling, an I-don’t-feel-like-doing-anything feeling.  And morning sickness is a dumb terminology.  It lasts all day.  It’s probably worse in the evenings than in the mornings.  A man must have dubbed that term.  Pretty much I just feel like ick.

Of course it would all be worth it…

if there was a heartbeat still.  

I don’t always share very personal things on our blog.  That’s usually for Olen.  

But he’s not here, and I have no one to complain to.  So I write to you.  

There’s not too many OB/GYN’s who would find themselves in my predicament.  But I live in Chad, enough said. 

I’m one of those OB’s that can’t seem to figure out how to follow their own advice, like birth control.  No just kidding.  I know how to use it.  Olen and I just really like kids and we are pretty much crazy.  

So we decided to try for 4!  The big announcement was soon to come out since we were soon to be 12 weeks.  I usually never tell before 12 weeks because I see so many miscarriages.  They are quite common.  It’s impossible to know how many go unnoticed, but at least one in five pregnancies will end in a miscarriage.  I don’t know how the world gets populated. 

But ours was not to be.  

Our ultrasound machine is not working properly.  Olen’s uncle, Scott, was visiting from Moundou, and he brought his nice portable machine to loan us.  (Thank you Scott!)  So Olen and I decided just to look on Friday night.  No irregular symptoms, just wanted to see our baby.  

He was taking his time looking, and then said, “Dear… I don’t see a heartbeat.”  

We had done an ultrasound 13 days earlier, and it measured 7 weeks and 6 days, with a heartbeat. The fetus was measuring right on with dates of 9 weeks and 5 days, so it must have just happened.

We were both sad at the news, but then came the real worry for me.  

“Uggh,” I groaned, “We don’t have any RhoGAM here!”  

RhoGAM is a special injectable medication that pregnant women with a blood type rhesus negative take to prevent their bodies from forming antibodies against a possible rhesus-positive fetus when there is bleeding in pregnancy.  I needed some to protect the next pregnancy from being unnecessarily complicated.  Normally you get it at 28 weeks if there is no bleeding.  We had planned to have Olen bring it back from the states with him on his upcoming trip to California. This is only necessary for rhesus-negative women with rhesus-positive baby daddies. I’m A negative and Olen’s O positive. I married poorly.

During the last 2 pregnancies I had RhoGAM brought over on ice in the checked baggage of someone who was visiting us.  

RhoGAM doesn’t exist here.  As far as I know.  I have never seen it.  We don’t practice first world medicine here!  

And I am here.  In Chad.  Practicing third-world medicine.  And receiving third-world medical care at the moment.  

No RhoGAM means we may not be able to have another kid.  I’m already 35!  That’s a high enough risk.  I don’t need more risks!  

But the present isn’t looking so inviting either at the moment.  I need to induce myself to pass the miscarriage.  Olen has just left for America for a conference at Loma Linda, so I’m on my own at night.  And, if I hemorrhage, the only other surgeon is my dad.  Ya….no thanks.  Dad, you’re a wonderful surgeon, but ya, no.  

So in my head I think about how I’m going to do an emergency D & C on myself in case I hemorrhage.  With no anesthesia because I don’t really want Mason in the room either.  Sorry Mase.  

And if I bleed too much, I really don’t want a blood transfusion either because, even though they were HIV negative at the time a donor gave to our tiny blood bank, the risk is still higher here. And we very rarely have rhesus-negative blood in the bank. And when we do, it’s B-negative, which you can’t give me, as A-negative. Ya, no thanks!  

So pretty much….No thanks to this whole situation.  

No thanks to not having RhoGAM.  No thanks to doing surgery on myself.  No thanks to having my father do it either if I’m hemorrhaging.  No thanks to our nasty OR if needed.  I see what goes on in there.  The blood everywhere.  Gross.  No thanks to our sterile instruments that are probably sterile, but we have run out of indicator strips long ago, so who really knows.  No thanks to having an IPAS (manual aspirator for miscarriages) that I re-use over and over again on patients after cleaning it, but it’s not really sterile either.  I am not using that on myself!  

But truly, thanks be to God because I know He does have a plan for our family.  Even though this plan of ours didn’t turn out the way we had hoped, I still have peace in His plans.  

Today, I have done 3 D&C’s on patients.  One was a young woman who came in hemorrhaging with a 12-week miscarriage.  As I went to put the speculum in, the amniotic sac delivered right into my hands.  You could see the fetus perfectly formed floating inside the amniotic sac, not yet broken.  He was so perfectly formed.

Each life is a miracle, even the ones that don’t make it.  

You made all the delicate, inner parts of my body and knit me together in my mother's womb. Psalm 139:13

I chose you before I formed you in the womb; I set you apart before you were born. Jeremiah 1:5

Since this blog writing, Olen was able to find some RhoGAM in the capital on his way to the airport.  He went to several pharmacies to find it and sent it back with a friend who made the 10-hour bus ride with it in a cooler.  It looks legitimate since it’s from Belgium.

Don’t take first-world medicine for granted!