Doctor please abort this pregnancy for me; I am presently breastfeeding a 5 month old baby

That afternoon I saw a woman carrying a baby on her shoulder who looked very sad, knocked and opened the door of my consulting room down as she entered. Over many years of my practice I have seen such situations. Patients who do that have heavy hearts they want to pour out to you or they have an urgent fear they want solution to. I politely appealed to her to please gently close the door. She did and went straight to sit in the consulting chair. I knew something very serious was about to be offloaded.

"Madam what is your name" as I looked at the name at the back of the folder before me to re-confirm i have the right patient before me. She answered "I am Mrs Akinwole" "So why are you here to see me today?" She answered, " Doctor as you can see, this baby I am carrying, I had him 5 months ago and I am feeling like I will vomit which started 3 weeks ago but today I vomited once early in the morning before I decided to come and see you. Doctor I know my body it is doing me like I am pregnant."

I said " okay in one word your reason for this encounter is to confirm if you are pregnant." " Yes doctor and to appeal to you to help me abort the pregnancy because my baby is still small. She is just 5 months old please. Besides some older women who had completed their families told me that if I keep this pregnancy and at the same time breastfeeding my baby that the baby being breastfed will either die or become an imbecile and may not grow very well. Doctor I don't want this to happen to my baby"

Then I answered "so your fears for coming to see me today are all these you have just listed and your idea, how this will affect you and expectation of the solution you want me to give you are all what you highlighted? " she responded promptly "yes doctor. Besides doctor I have 3 children already, this one I am carrying is number 4. That was our original family plan, my husband and I to have 4 children, that is all. My husband and I don't want to have more than 4 children. We already have 3 girls and 1 boy. This baby I am carrying is a boy she has 3 elder sisters. What am I looking for again? Doctor please help us please."

"Okay Mrs Akinwole I have heard all your heart as poured out but we are not even sure you are pregnant because feeling vomiting or vomiting alone can be caused by even malaria and many other diseases so we need to even have a problem in our hands first before I will now tell you the implications of your request physically, psychologically, spiritually and socially, I will also tell you the true management of this kind of situation in Nigeria according to the existing laws on procuring abortion." She responded yes to me reluctantly looking even sadder. "

I have one more question for you Mrs Akinwole" she said please ask all your questions doctor but I am just appealing to you please help me. "Were you doing exclusive breastfeeding? " she said, " doctor I exclusively breastfed all my babies for 6 months and I even continued breastfeeding till one and half years after introducing family diet and I don't see my period until after I wean my babies. This has been my pattern throughout my delivery history and I used to meet with my husband and I don't get pregnant until I wean them and my period returns. My doctor and nurse in the hospital I used for my first antenatal care told me that If I breastfeed very well I will not see my menses and can use it as a form of family planning method and this has worked for me in my first 3 children. So I don't understand this o."

At this junction I knew I had to educate Mrs Akinwole further on what she was talking about. I went ahead "Not seeing your period during breastfeeding ma is what we call BREASTFEEDING AMENORRHEA which simply means lack of menses due to breastfeeding. True to what you were told yes you may not be able to get pregnant because prolactin the hormone behind breastfeeding and breast milk most times is enemy of the ones behind menses and ovulation so it may truly help you but the problem is if you truly don't want any pregnancy at all, then there is need to combine it with another family planning method as back up because it is not totally reliable as only family planning method."

I went on besides, there are some conditions that make BREASTFEEDING AMENORRHEA method more effective and these are, your baby must be less than 6 months old, the older your baby is the less effective you breastfeed him or her and the quicker your ovulation returns. Other situations are you must breastfeed your baby every time she demands breastfeeding, you cannot breastfeed timing your baby and expect BREASTFEEDING AMENORRHEA to work effectively for you as a form of family planning. Other conditions you must meet is you breastfeed at night and totally EXCLUSIVELY without adding water or feeding formula. Even with all these conditions met, it is not 100% certain. The most certain thing is for you to still combine it with other method of family planning because one bad thing about ovulation is after delivery, ovulation occurs before your menses return so you can go from one delivery to another pregnancy without setting your eyes on any menses."

Mrs Akinwole's eyes were curiously glued to me looking at my mouth with impression like " I have never heard all these before o doctor". "No problem ma let us even do the pregnancy test first to confirm your fear." I said with some ray of hope that it might just be assumption that she was pregnant. She went to our side lab for the test and came back in 10 minutes. I opened the result and confirmed the fear of Mrs Akinwole. I went ahead to break the "bad" news.

"Madam I am afraid the news is not too good" she interrupted quickly " doctor I told you I know my body. I am pregnant right? " she asked and I nodded in affirmation and quietly giving her time to assimilate the "bad" news. These were one of such moments in my career since I started practising that telling a woman or a family "you are pregnant" was bad news. She said " doctor abort this pregnancy for me I am presently breastfeeding a 5 month old baby. I cant keep this pregnancy so that it will not affect this baby negatively like I told you "

With all sort of lies some women with some unfounded beliefs and myths out there had told Mrs Akinwole, I knew my job of convincing her had been made harder but i had to try all the same to convince her she should keep the pregnancy and nothing would happen to her baby, after all she was even lucky the baby was about being introduced to family diet. I went into the counselling of first debunking all the lies of how her baby would become imbecilic or sick because she was carrying another pregnancy. "This is a big lie some women had told Mrs Akinwole. Nothing can make your baby become imbecile because you are pregnant and breastfeeding your baby. The only thing is the the stress of taking care of the baby and the stress of carrying the pregnancy same time. This can truly affect the baby if the mother cannot cope very well in feeding him or her but this is a minor problem if you have a strong FAMILY SUPPORT.

I took my time to educate Mrs Akinwole very well. She was, let me say 70%, convinced but with a heavy heart that her dream of having only 4 children would be shattered. I told her to call her husband who was sitting outside for me. I counselled both of them together on the social (law), psychological and spiritual implications and complications of abortion as two of them told me they are strong Christians. They even told me that they knew abortion was wrong but their fear of their baby becoming imbecile was more than their faith. I told them they made the mistake of not combining another family planning method with the BREASTFEEDING AMENORRHEA but that now the deed was done. We needed to focus on the future and the solution.

Eventually they were convinced, after all the husband and wife worked in a very good agency with very good income. So money was not their problem. I counselled them to bring in the mother of any of them to help out and get all the other family support. They were eventually convinced. They agreed to keep the pregnancy. I gave them SCAN to do and see me in two weeks. Fast forward, Ladies and gentlemen, it was two weeks, Mr and Mrs Akinwole entered my consulting room with big smiles on their faces. I was a little bit confused. Two weeks ago in the same office, it was like you were depressed now like you were super excited. What could be the good news? Mr and Mrs Akinwole echoed it together "doctor it is twins and they are 8 weeks on scan. The SCAN doctor told us he saw two sacs." I was speechless. Mr and Mrs Akinwole said if there was anything they liked most in their lives individually it was twins, in fact at a time in their marriage it was their everyday prayer point that God should give them twins so this was how devil would have made them terminated the answer to their prayer. I was just speechless looking at the whole Thanksgiving atmosphere in my office.

Fast forward, Mrs Akinwole was booked for antenatal care straight away. At around 5 months in the pregnancy she went for another scan. Ladies and gentlemen, who said God is not perfect and good? And His plan for us sometimes is to give us our expected end even when we don't know ourselves. It was another atmosphere of thanksgiving in my consulting room again. The scan showed clearly the twins were identical and they were two boys. I was speechless again, just watching the dancing and the singing inside my consulting room. I laughed at Mrs Akinwole dancing steps so much that I felt like jokingly reminding her about our first encounter. I am happy they listened to my counselling.

Fast forward, nine months completed. The first baby leading the way was coming with bum bum and the baby was big. Mr and Mrs Akinwole agreed to caesarean section and that the two tubes should be tied during the operation and they don't want any more baby. All their consented requests were met. Fast forward, everything went well. I happened to come around later to check Mr and Mrs Akinwole in the ward. The joyful atmosphere for their two bouncing baby boys knew no bounds. We thank God. They were discharged after few days in the hospital. The day of their discharge they came to my consulting room to thank me profusely. I now went ahead to ask her if the baby she was breastfeeding then had become an imbecile she said "doctor please forgive my ignorance. It is all these women in my neighbourhood and my mother and mother in law telling us all that. Doctor the boy is now a big boy o. He is one of the smartest intelligent boys I have ever seen in my life. Thank you doctor for not agreeing to my request of terminating this pregnancy. God bless you. We now have 3 girls 3 boys so perfect doctor. God bless you"

As they exit the door of my office, many lessons flooded my mind from the life story of Mr and Mrs Akinwole's family experience. Let me share those lessons with you below:

Lesson number 1:

Breastfeeding AMENORRHEA (also known as LACTATIONAL AMENORRHEA (LAM))is truly a form of family planning method but It alone is not that reliable. It is always better to add another family planning method as back up to avoid disrupting the way you want your family planned.

Lesson Number 2:

Stop listening to stories and myths from other women who are not doctors before they will feed you with all sort of lies. This is where Mrs Akinwole's fear started from.

Lesson number 3:

Never abort pregnancy except your doctor says so for medical reasons like the baby is deformed and not compatible with life or your life is at stake. Any other reasons besides this, is ungodly and you will give account to God on the day of judgement.

Lesson number 4:

How do you know the kind of children that God is sending to you through that pregnancy you called mistake? How are you so sure the baby is not answer to your life long prayers? how are you sure the baby is not the UN secretary general or president the world and the nation respectively have been waiting for? Please beware of aborting destinies.