The Sunday News
Walter Mswazie
AFTER ten years of marriage Ms Ratidzo Nhongo (not her real name) from Masvingo’s leafy suburb of Rhodene had lost all hope of ever conceiving.
When she was 36 years and almost giving up on having a child in her life, Ms Nhongo conceived, a situation which brought joy to her marriage.
For a woman who had been ridiculed by her in-laws as being barren, falling pregnant became the turning point in her life. She quickly turned from being a liability to a darling of her husband’s entire family as they looked forward to holding their son’s first child.
Nine months elapsed and it was time for labour and her husband Aaron Matombo (43)(not real name) had to ask for leave days from his workplace to come and be with his wife during their special moment. They chose one of the best hospitals in the country as the enthusiastic Matombo wanted the best service for his wife and child.
At around 12 midnight Ms Nhongo successfully gave birth to a bouncing baby boy, who unfortunately was an anencephaly (a baby born without a skull) much to the horror of many, let alone Mr Matombo and his family who had anxiously waited for the child’s arrival. As fate would have it, the baby was pronounced dead a few minutes after delivery, exerting more strain on the couple.
Narrating her ordeal, the distraught Ms Nhongo gave a gloomy picture of her marriage although she is determined to soldier on until she has a child of her own despite the age. Now 42, she derives her inspiration from the story of biblical Sarah and hopes that one day God will restore her lost pride and she would have a child for the Matombo family.
“You know I am in a terrible situation. The thought of not having a child has affected my marriage and my in-laws are now calling me names. I dread the whole idea of conceiving now given the trauma that I went through with my first pregnancy as I gave birth to a baby without a skull and he died a few minutes after delivery,” said a sobbing Ms Nhongo.
Ms Nhongo says her husband seems to have given up on having a child with her and suspects that her in-laws are putting pressure on him to find another woman.
“My fate now rests in the hands of the Almighty. My husband seems to have given up on having a child with me but I am still hopeful and get inspiration from the biblical Sarah who had a child at an advanced age. Having a child fulfils womanhood, so I feel inadequate without a fruit of my own,” she said.
Her child, doctors said, suffered from congenital anomalies. This condition can be defined as structural or functional anomalies such as metabolic disorders that occur during intrauterine life and can be identified prenatally, at birth or later in life. Congenital anomalies are also known as birth defects, congenital disorders or congenital malformations.
According to research, an estimated 276 000 babies die within four weeks of birth every year worldwide from congenital anomalies. Although congenital anomalies may be genetic, infectious, nutritional or environmental in origin, most often it is difficult to identify the exact causes. Some congenital anomalies can be prevented. For example, vaccination, adequate intake of folic acid or iodine through fortification of staple foods or provision of supplements, and adequate antenatal care are keys for prevention.
These congenital deformities on babies bring a lifetime trauma to many women of childbearing age thereby leaving them in perpetual fear of giving birth let alone conceiving. It is a maternal health issue that experts need to unravel and counsel women to appreciate.
A woman from Mucheke whose name could not be revealed on ethical grounds gave birth to twins, one headless, at Masvingo General Hospital’s maternity ward recently. The other twin who appeared normal died a few minutes after delivery had an abnormally big head, a condition that medical experts described as incompatible with life. Doctors said the woman who had to spend some weeks receiving counselling for her traumatic experience needs close monitoring.
Acting Masvingo provincial medical director Dr Amadeus Shamu said the condition was caused by congenital abnormalities.
“Yes, there is a case of that nature which occurred at our hospital. However, it is a rare incident although it is generally known as congenital abnormality which basically is the deformation that happens to a foetus during the early stages of pregnancy,” said Dr Shamu.
“The headless foetus was incompatible with life while the other twin who was born normal but with a big head died, a few minutes after birth.”
He said the deformity on the headless foetus might have been caused by a neural tube defect during the organogenesis stage.
“The organogenesis stage is the stage when the organs begin to develop into a pregnancy and there might have been a neural tube defect that caused deformities on the foetus resulting it being delivered without a head,” he added.
Another victim Mrs Memory Rumbowa (40) who gave birth to a child with a cerebral palsy, now 12 years old and attending school at Ratidzo Zimcare Trust said she had to be admitted for almost two months in hospital after delivering because of stress.
Mrs Rumbowa said it took her ten years to have another child who fortunately has no congenital disorder.
“It is not easy to have a child with deformities. Every woman wishes to have an able bodied child. I had to extend my stay in hospital as I suffered a stroke due to stress emanating from my child’s condition. Instead of me feeling happy that I had given birth, I felt angry and blamed myself for my child’s disability but through counselling I accepted my fate,” said Mrs Rumbowa.
“While I accepted that it was God’s plan that I have a disabled child I did not want to conceive again as I feared the worse. But after ten years, I gathered the courage and stopped using contraception in order to have my second child but it was after rigorous scanning and counselling by doctors,” she said.
A senior medical doctor who is also Zimbabwe Medical Association (Zima) Masvingo branch president Dr Kudzai Masimire said while it was hard to tell the exact cause of congenital abnormalities there were many factors which might lead to the condition.
“There are four risky factors which may lead to such abnormalities. Some congenital abnormalities have something to do with the mother’s behaviour like smoking or abuse of alcohol.
“The other one is to do with infections like syphilis or diabetes where the woman could give birth to a very big child and lastly it may have something to do with nutrients deficiency which affects the brain or the spinal cord. For example foliate or iron nutrient deficiency may cause congenital disability to the unborn baby which may lead to death.
“Zika virus can also cause such abnormalities even though it has not been confirmed in Zimbabwe but it’s never easy to tell,” said Dr Masimire.
He says age can also be a factor that causes congenital abnormalities on unborn babies as women who are above 39 years of age or under-age girls have a high risk factor of giving birth to babies with Down syndrome.
Dr Masimire added that a special scan called amniocentesis which can only be found in developed countries should be done to foresee such abnormalities. He said the scanning would involve analysing the fluid around the foetus and tell if there was any abnormality or not.
Online research has shown that congenital disorders can also be caused by chromosomal non-disjunction which is an error in cell division that admits three, rather than two, copies of one of the chromosome 21 into the cells of the affected zygote.
This causes Down syndrome, in which three copies (trisomy) of chromosome 21 are present. Trisomies of chromosomes 13 and 18 are also relatively common in live-born infants. In the drown syndrome disorder there is a common chromosomal disorder in which a child is born with three — not two — copies of chromosome. It causes varying degrees of mental and growth retardation, a characteristic facial appearance, and multiple malformations.
It is associated with a major risk for heart malformations, a risk of duodenal atresia in which part of the small intestine is not developed, and a small but significant risk of acute leukemia.
