What it means to live without a uterus

Doreen Mbabazi met her sweetheart at  university when she was pursuing a Bachelor’s in Business Administration. Soon after her course, the 23-year-old chose to start living with him in 2017 after visiting their parents.

Mbabazi got pregnant, but miscarried at six months. The doctors said it might have been due to travelling long distances while pregnant. 
In 2019, she realised she was pregnant again and started antenatal care at three months. 

“My baby of six months had died in the incubator and, I could not let this one follow,” she says.
Close to nine months, she left Kagadi her husband’s home for Bushenyi(her parent’s home). There, she visited one hospital that gave her a week to due date. When she felt contractions, she rushed to Ishaka Adventist Hospital in Bushenyi District.

Three days later, Mbabazi who had been planning to have her child delivered by vaginal birth,  was instead told to prepare for a Caesarian section. 
“In the theatre, in my half anaesthesia stupor I heard the doctor say my child had died. They talked about checking my pulse. I could not do anything. They said I had lost much blood,” she recounts.

Doctors told her mother about the ruptured uterus and low blood count. 
“The only way I could be saved was to remove my uterus. My mother signed the consent form and in my subconscious state, I was assisted to do the same.”
Three days after the procedure, her child was going to be buried. Her husband who had come for the burial also went to check on Mbabazi at hospital.

Unconscious, the only words she heard him say were; “They have removed your uterus, what are you going to do?”
“At this point, all I saw were pints of blood for transfusion and being wheeled into ICU. I went in and out of consciousness,” she says.
A week later, back to her senses,  Mbabazi learnt that most people thought she would not make it. She also realised that her husband had left shortly after their baby’s burial.

“I started thinking about my uterus. I thought I was in a trance until the doctor confirmed my situation. I could neither carry a child nor menstruate anymore,” she says. Was I still a woman? How would I talk to my husband about it?” 

According to Dr Hill Ahaisibwe, a gynaecologist, the most common cause of ruptured uterus is if  something goes wrong during labour.
In other cases such as Mbabazi’s, post-partum haemorrhage, (excessive bleeding vaginally after delivery) can sometimes be treated by surgically removing the uterus. 

“The doctors told me that some mothers get a rupture due to severe contractions, pushing hard before the uterus opens or a bad operation,” the 30-year-old says.
According to Birthinjuryhealthcenter, uterine rupture occurs in less than one per cent (0.07 percent) of all pregnancies, making it one of the least common pregnancy complications. It can occur during labour or earlier during pregnancy.

The doctor had told the then 27-year-old would still give birth, only by surrogacy since she still had eggs. He promised to talk to her once she was fully recovered.
The young woman mourned her baby alongside her ‘womanhood’. “I just had to force myself to eat since I was still on medication.”

Life after hospital
A month later, her spouse came to take her back to Kagadi. In tow was Mbabazi’s young sister who would help around during recuperation.
“The first two weeks were great. My husband took good care of me. I worried less, but struggled with poor appetite,” she relates.

Soon, her husband started returning home late and drunk.
“You are not woman enough. You should not even be married,” he always echoed to me. “He started beating me for occupying his space adding that ‘women who could give him what he wanted could not because of me,” she recalls.

Everyone Mbabazi talked to about her plight, including her mother, as the abuse escalated told her tolet her sister go, because she might suffer at the expense of  her sister’s marriage.  Meanwhile, Mbabazi had to hang in there, so she did – until she could not.

New beginnings?
In 2021, her husband was transferred to Kampala. She believed this was her chance at new beginnings, in a place where people did not know her past.
He had long stopped caring for her and told her to get a job and take care of herself. (Soon after graduation, she got married and had never got a job since she stayed home to care for him.)

The hurtful words distressed her more and losing her uterus was her trademark. When they went to gatherings, his introduction of her was:
‘Meet Mbabazi, my wife. She lost her uterus after losing our child’.
The strangers’ reactions kept her tossing and turning at night. Her in-laws reminded her that she was ‘no longer a woman’.

Toward Easter holidays, she decided to go home. When she asked for transport home, she was given Shs50, o00. She had nothing else but wondered how she would go empty-handed or show distress.
 
She sought out her friend’s help who was coincidentally travelling home that Easter.
“My friend, a pastor, said we would go home with his family. That gave me a window for small shopping.”
She had made up her mind not return to her husband’s.

Moving on
As a first born, Mbabazi’s siblings looked up to her. She was afraid she had let them down. Even then, she cried and wallowed in misery.
She cried and turned to Piriton tablets for sleep. All the while, Mbabazi tried to keep a different façade from those around her. “My mother asked about when I would return to my husband but I had no answer. I had stopped telling her about my woes,” she says.

Later, a friend called her about a job opportunity and she took it believing this would ease the burden.
She passed the interview and started work as a cashier at a private medical school. This came with free accommodation.

The once vibrant young woman never talked much at work. She cried all night, dried herself in the morning for work.
“I was like a zombie. But people always praised my work.” 
One day, she was looking through her phone and her husband had posted a picture of a girl flashing a ring saying, ‘Decision made cannot be reversed, sorry to the ones who are hurt’.

“I almost ran mad. I left work and took alcohol for the first time. This left me with a splitting headache and I swore not to repeat it,” she says.
She had stopped sharing her story because even her colleagues wanted to take advantage of her. Tears would roll down when  she was invited for baby showers. 

“How could God keep me alive after losing my child and uterus? What more did he want from me?” she often asked herself.
Mbabazi changed her phone number for peace of mind. She had also developed ulcers because of not eating and high blood pressure as well.

Turning point
One day, she met a friend from university on Facebook where they exchanged  contacts. After a while, she opened up to him. 
“He connected me to his wife, who is a therapist. My healing journey began,” she recounts.  We talked about things totally unrelated to my situation and soon, I regained confidence.” She talked about her fears.
Towards the end of 2022, her friend and his wife returned to Uganda for vacation and the therapist invited her to a health camp. There, she opened up again and the burden eased.
“It was the most peaceful three days of my life ever since the incident,” she says.
The next year, she quit her job to heal faster. She left her relatives who were always asking her about jobs and marriage, the things she was not ready to talk about. 

Still in therapy, she started living with her friends who were helpful. Soon, she stopped  sedatives. By May 2023, she was comfortable enough to open up to them which shocked them at first but they became more supportive.

“We started going to fellowships, they started taking me with them to parties and my life started getting better, and so did my ulcers and blood pressure,” she says.

Before she knew it, she was starting to think of doing something, channelling her energy for good and taking care of herself. With her small circle of friends’ help, she got money to rent her own house and start small businesses  such as selling popcorn and fruits.
“I no longer feel self-pity when someone sympathises with me. Today,  sharing has made me realise that I am ready to share my story, and sympathise with people who have similar pain,” she says.

She now believes she was born for more and that there is life after losing a uterus. She was told about surrogacy although it is not something she had put her mind to. She believes the information will help another person in her situation.

Only if…
Mbabazi’s only wish was that if someone had followed up on her from the hospital, to see how she was doing, it would not have been that bad.
She prays that no woman should ever be ostracised for things she cannot control.
She also believes that had her husband been counselled about their circumstances, things would have been different.

“My husband handled an office of authority. Would he be able to help someone in my position, when he could care less about mine? Everyone believed I was at fault. I wish that the public was educated about handling people who are vulnerable,” she says.
Apart from not menstruating anymore, I have not really felt any other changes after I lost my uterus.

What about marriage?
“I am not yet ready for marriage, since I still have a constant reminder of how my first one went. What if the next one does not understand me and undermines the progress I have made so far?” Mbabazi wonders. 
The men who have approached her  so far treat her situation lightly.
“They feel they can be with me since I cannot get pregnant. That alone pushes me as far from thinking of settling down with someone as possible,” she says.
“If possible, I would like to get someone I can have children with since I have the eggs to do that.  I really want children.”

Free time?
Mbabazi says she used to be outgoing  and attended social events, and leadership meetings.
“When I got married, I became withdrawn, but would always go to church, or out once in a while, just to be around people,”  she recollects continuing: “After I lost my uterus, I would spend my free time indoors afraid of people asking me about what happened and having to relive the experience.” 
Lately, if  she is not at her popcorn stall, she is either at home, church, or seeing  her friends. “These days, I can even bring up my story if the mood is right and I can answer anything about it.”

Future plan
Mbabazi looks forward to supporting mothers who may have gone through hardships like hers. She dreams of creating a rehabilitation centre where the goal is to provide counselling and guidance to women in distress, taking care of children who lost their mothers at birth, among other services.

Doctor says

Dr  Hill Ahaisibwe, a gynaecologist, says causes uteri rupture include:      
     Congenital uterine anomalies, for example if one has a unicornuate uterus, a rare genetic condition in which only one half of a girl’s uterus forms or even a bicornuate uterus, a heart-shaped uterus. 
    Multiparity: Having had five or more pregnancies and previous history of myomectomy (procedure to surgically remove fibroids). 

     Previous Caesarean deliveries or classical incision on the uterus. The women who have gone under such are advised not to wait for labour onset.
      Fetal macrosomia (having abig baby more than four kilogrammes)
     Labour induction (injudicious use of medicines such as Misoprostol or Oxytocin for inducing labour).
      Augmentation of labour which is done on those already in active labour, but with poor uterine contractions can also be predisposed to uterine rupture.