Ask the Doctor: What causes bleeding during pregnancy?

When pregnant, many women in my family bleed and when we go to hospital, doctors think we are attempting abortion. What is the cause of this bleeding? Anita

Dear Anita,

An abortion is when a woman loses her pregnancy (early before the pregnancy is 20 weeks) before the expelled foetus is able to live on its own. This includes a spontaneous abortion, usually locally referred to as a miscarriage and an induced abortion, in which someone else or a woman herself, causes the abortion.

When doctors talk about an abortion, therefore, they are not just referring to a woman having tried to terminate the pregnancy but how old the pregnancy in question may have been. This means you misunderstood the doctors who were actually trying to save lives.

When a woman with an early pregnancy starts to bleed unexpectedly from the womb through the vagina but without pain, she is then said to have a threatened abortion. This which the doctor could have been referring to, may have nothing to do with the threat being induced. 

Though more than half of threatened abortions will abort, if the foetus is alive, even with repeated attacks of bleeding, loss of pregnancy does not usually follow. In most cases, where the foetus eventually is lost, the bleeding starts because the foetus is dead. 

So, the bleeding that occurs in pregnancy may not always end in one losing her baby.

Although the commonest cause of a pregnant woman losing a baby may be a baby’s genetic material or chromosomal makeup, some women with a family history of losing babies may also inexplicably lose babies. 

This so-called family history of loss, beginning with bleeding in pregnancy should always be checked by a doctor instead of a pregnant woman taking it to be a normal family problem.

Any woman intending to get pregnant, one who is already pregnant or has recently delivered should visit a doctor for evaluation and advice instead of seeing a doctor only when she has a medical problem. Sometimes, it might be too late for a doctor to do anything.

What causes UTIs whenever I travel?

Why is it that when I travel out of Uganda, whether by road or air, I get a UTI, even when I use condoms during sexual intercourse? Benita

Dear Benita,

Urinary tract infections, (UTIs) refers to any infection occurring in the urinary tract (urethra, bladder, ureters and kidneys).

Because of their anatomy, which makes it easier for bacteria from the anus to access the urethral opening, women often suffer from UTIs. This is coupled with having a very short urethra and not taking enough fluids to make a woman urinate more to flash germs out of the urinary tract to prevent UTIs.

Unfortunately, while travelling, women will avoid taking fluids because they want to pass urine in convenient and clean places which may not be available during travel. Not taking enough fluids, therefore, risks one getting a UTI. Sometimes, even when they feel like passing urine, they will hold it, risking getting UTIs.

Travelling a lot may contribute to travel stress and anxiety which weakens the body’s immunity so that one may fail to resist infections, including urinary tract infections.

Many travelling women wear multiple non-cotton panties, hard jeans and jackets resulting in too much sweating and damp underwear, also raising one’s risk of getting a UTI. 

Therefore, when travelling, a woman must take a lot of fluids and avoid holding urine. Also, one should dress lightly with cotton undergarments to lessen sweat dampening them.

Many Ugandans wrongly attribute UTIs to sex. However, much as they are more common in sexually active women, UTIs are not usually taken to be sexually transmitted.

A woman, however, may get a bladder infection known as honeymoon cystitis, caused by penile movements which may massage germs lingering around the female part into the bladder, leading to infection. Use of condoms here because of using more force during sex just like a man may do during a honeymoon, may risk a woman the infection.

Honeymoon cystitis may be prevented by passing urine at least within 30 minutes after sexual intercourse to flush out germs that may have been pumped into the urinary tract by sexual activity.