Tuesday, January 31, 2012

The boy longed for . . . and the unwanted girl(s)

Yesterday, there was the news about an unfortunate incident in Afghanistan in which a woman strangled her daughter-in-law to death for giving birth to a third daughter. 

At NJH, it is quite common to be reminded about the preference for girls . . . 

3 instances . . . 

The first one, PD, the mother of four girls was brought last Friday afternoon - unconscious and frothing, almost at the edge . . .  The fact that there were 4 little girls at home waiting for their mother to come back home made our doctor on duty to try the best to save her life. PD had a blood pressure of 200/120 and Urine albumin was 4+. The baby was already dead. And there was no indication of her delivering normally for the next 12 hours. 

Dr Johnson made a decision to deliver the dead baby by surgery. She was already intubated and being mechanically ventilated. The surgery was uneventful - but PD could just not be weaned off the ventilator. Over the last 2 days, she has also gone into renal failure. . . I've discussed with the relatives that we shall keep her in the ventilator for another 24 hours. . .  Kindly pray that PD will make a miraculous recovery. 

The family had been wanting a boy - the reason for PD getting into the present state. And the dead baby was a boy. . . It is unthinkable for 4 little girls to grow up without their mom. . . 

The second one is KD. KD was in her second pregnancy. KD's last baby was born 5 years back. In spite of being only 2.5 kgs, the baby was born by an instrumental delivery. The second baby looked bigger - but then she had an ultrasound which showed that the baby was smaller. But, clinically, the baby looked big. . . 

I explained to the relatives that she could end up with a Cesarian section. The relatives were begging me to somehow ensure that KD delivers normally. We have seen quite a lot of our antenatal patients who beg us to somehow ensure a normal delivery end up with having a girl baby. 

I'm not sure whether it is my prejudice - but I've a gut feeling that most of such families are quite sure that they have a girl child. And, I'm sure that there are many an ultrasound facility to give the sex of the baby to the family. (It is illegal to divulge the sex of the baby in India as quite a lot of girl children are aborted off)

And I've seen the vice versa happening too - families agreeing for Cesarian section at the drop of a hat and even taking all possible efforts to salvage a boy baby who is born moribund sick. 

Now, I've one more lady in the labour room. SA, a primi with nephrolithiasis, severe hydronephrosis and chronic urinary tract infection - we've been advising the family from the very beginning to have her delivery at a tertiary or teaching hospital in Ranchi. The advice has fallen to deaf ears and they want to do the delivery here.  

She came to outpatient today with post dates. And her blood pressure is on the higher side. I made one more effort to convince the family to take SA to Ranchi for the delivery. I've quite sure that they've discovered that the baby is a girl . . . Maybe, I'm wrong . . .  I shall let you know when the delivery happens within the next couple of days. . . 

Well, this line was put in much later . . . What happened with SA? It was hilarious. . . 


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