Ayodeji Ayotunde Oluwole is a consultant obstetrician at the Lagos University Teaching Hospital, Idi-Araba. He is a Christian and worships in Mountain of Fire and Miracles Churches in Nigeria. He spoke with Church Times on why many women have delay in getting pregnant and other pregnancy related issues. Below are excerpts from the interview
When is a woman said to be pregnant?
Pregnancy is said to occur when a female ovum fertilizes a male spermatozoa. A male sperm penetrates an egg and fertilizes it. This usually happens in the woman’s fallopian tube. And this can be confirmed by two things: One, if a woman does not see her next menses or a pregnancy test is done to confirm if the woman is pregnant.
But we hear of cases of women who are said to be pregnant yet they still see their menses?
There are a lot of psychological situations that surround pregnancy. You can be pregnant and still bleed but it is not menses. This could arise if the pregnancy is being threatened. It is not possible to carry pregnancy in the uterine cavity and still be having menses. It is an unusual phenomenon. It is not the typical scenario.
You talked about pregnancy growing in the uterus but there are cases of ectopic pregnancy where the pregnancy grows outside the uterus. What accounts for that?
There are many factors that can account for that. It is not a good sign at all. Once this is discovered it has to be tackled as early as possible by the expert. There are a number of places where the pregnancy can grow outside the uterus. In the case of abdominal pregnancy for instance there is space for the baby to develop but it is not the best. It has to be addressed as soon as possible by the expert
But why is it that some women find it difficult to conceive?
There are so many issues involved in a woman’s inability to conceive. There are both male and female factors. The male factor could be low sperm count, inability of the man to achieve erection and ejaculate, or the effect of drugs on the man. If a man is using drugs for hypertension for instance it may affect his fertility. There are female factors too. It could be that the tubes in the uterus of the woman are bad or she has hormonal imbalance and so many other factors which cannot be discussed here.
But there are cases where the woman and the man do not have problem and yet the woman does not get pregnant. This is called unexplained infertility. But we don’t label a woman as infertile until she and her husband have cohabited for one year having regular unprotected sexual intercourse.
Let’s talk about the unexplained infertility?
My position about the unexplained could just be that the woman is unable to calculate her ovulation period very well. Many women are not versatile in this. Women’s menses differ and their ovulation could be different. If you have a 28 day cycle and you calculate like people who have 21 day cycle you will miss it. A lot of people come around and say they are not getting pregnant. But the bottom line is there inability to calculate their ovulation period because their ovulation period determines when they ovulate and when conception can take place.
There are couples that marry and don’t get pregnant and the moment they separate and go different ways their fertility come alive. What could be responsible for this?
Usually there could be problems that are not known to the two parties. But basically a couple needs to understand that for pregnancy to take place, the woman must ovulate, the semen must be okay, the uterus and tubes must be okay. Once those factors are there conception will take place.
There are stories of women who carry pregnancy for years and they have to go through special deliverance before they have their baby. What do you have to say about this?
Science does not recognize that. Medically it cannot be explained. But the ones we have seen or that I have seen were not pregnant.
Really? So what could have happened to them?
They don’t see their menses but they are not pregnant. When they do pregnancy test we find out that they are not pregnant. Science and miracle are not the same. Medical science looks at things from scientific point of view. In science 1+1 equals 2 but in spiritual things it is not always so.
Have you seen cases like that before?
Not really because most of the ones I saw, if you tell them to come for test it is negative and sometimes it is a psychological thing. They believe they are pregnant because one pastor or prophet told them that they are pregnant and that they are being tormented by witchcraft.
But I keep wondering why such people cannot be operated on to take out the thing in their stomach?
That is why I said medical science cannot explain such occurrence. But from what I have found out, such people eventually turn out not to be pregnant.
So what is your advice for couples who are waiting for the fruit of the womb? The woman has done all the tests and there is no problem yet she is not getting pregnant?
The good thing is that a lot of medical options are now available that could help conception. If a couple is unable to conceive after one year and they have done all the tests and they are found to be normal they just need to relax and trust that pregnancy would come. I think most time it is anxiety that causes delay for most women waiting for the fruit of the womb. Pregnancy comes when you least expect it to come. Once a woman is able to conquer anxiety she will conceive. But Nigerians put pressure on newly wedded couples. When you are married everybody expects that you get pregnant the following month. All eyes are on you and you are put under unnecessary pressure and all these pressures have negative effect on conception. We find out that when women are not focused on getting pregnant that is when they conceive.
So there is no need to run around seeking for help?
If at all you want to run around, go to the right place and the place to go is the hospital and seek the face of God by yourself. If all the necessary steps have been taken and there is no problem, just hold on and believe that pregnancy would come but after one or two years and nothing is happening you can undergo artificial means of getting pregnant.
But are those artificial means full proof?
Nothing is full proof. But there are ways that medical science can help a waiting couple. We must realize that this knowledge by medical experts is God-given. It’s just like you and I cannot walk to London we have to travel by air. God did not come down to make the airplane He gave man the knowledge to do it. So also God gave medical doctors the knowledge on how to tackle infertility.
Do you believe women are sometimes held down spiritually from getting pregnant?
Even the Bible recognizes the fact that there is power of darkness. So it is foolish to say there is no power of darkness. It is possible for people to be held down spiritually but I don’t know how they do it since I’m not in that kingdom. The fact that the power of darkness exist does not mean they have power over believers. If Jesus can recognize there is power of darkness who are we not to appreciate that fact. But the beauty of it is that Jesus has overcome for us. We are working in that liberty.
Let’s talk about young girls of age 9 and 10 who get pregnant. How do we explain this?
They are women. Some women enter puberty very early in life. You will be surprised to see a 10 year old menstruating and once a girl starts doing menstruation it means the productive potentials in her are ready. This was not so years ago. A lot of factors could be responsible for this.
Does such portend danger?
Yes they do. It is not so common in the south but we have cases like that in the north. But they are fraught with a lot of complications like VVF because their pelvic is not developed enough to undergo pregnancy strain.
What are the lessons you have leant dealing with women in the last 20 years of your practice?
I have learnt to be very patient with them. You have to understand where they are coming from. You need to show empathy and give them hope that even though you are trying science they should pray more and trust God more. We have seen cases where we think they cannot get pregnant and they get pregnant. We have seen 50 year old and 51 year old getting pregnant.
That negates science?
No it doesn’t negate science. As long as they are seeing their menses they can get pregnant. There are women who menstruate till old age. It can’t be explained by science but it happens.
Are there drugs men can use to enhance their fertility?
There are drugs that can boost their semen and which the women can use too but if they use them and nothing happens that means the drugs are not meant for them.
What then is your counsel for pregnant women?
Once you discover you are pregnant it is better you see a specialist who will counsel you on what to eat and how to comport yourself. The expert will tell you to avoid sex for the first three months of pregnancy and to take things easy. The body of a woman reacts differently to pregnancy. So what applies to A may not apply to B.
Why is it common for women to be made to undergo caesarean section these days, are the fears about such operation real?
Well, first and foremost, caesarean section is an alternative way of delivery and any obstetricians should appreciate that it is not for financial gain. But we must also know that there are good eggs and bad eggs in the medical profession. There are some doctors who do it for gain. Caesarean section is supposed to be a safe surgical procedure if it is done by qualified personnel, in a clean and sterile environment and if good antibiotics are used. No woman should die from complications of caesarean section. But unfortunately we have cases of women dying from it because they fell into the hands of quacks but ideally 99 percent of caesarean sections are safe.