Corazon Kwamboka: My painful and bumpy road to motherhood

In 2019, Corazon Kwamboka, an entrepreneur and advocate, got pregnant with her first child. Corazon, 29, says the pregnancy, which came as a pleasant surprise, became one of her greatest blessings.

Growing up, she had not pictured herself having children, but that she knew that one day she would like to get married and have a family of her own. However, that aspiration was threatened by endometriosis, a painful disorder that has been linked to infertility.

According to the World Health Organization, the disease affects roughly 10 per cent (190 million) of reproductive age women and girls globally, and manifests in endometriotic tissue either growing on the surface of the ovary or deep inside it.

Infertility occurs due to the probable effects of endometriosis on the pelvic cavity, ovaries, fallopian tubes or uterus, state WHO.

WHO attributes the cause of endometriosis to retrograde menstruation, which occurs when menstrual blood containing endometrial cells flows back through the fallopian tubes and into the pelvic cavity at the time that blood is flowing out of the body through the cervix and vagina during periods. This can result in endometrial-like cells being deposited outside the uterus where they can implant and grow.

Corazon found out she had the condition in 2018, even though she doesn’t know exactly how long she had had it. She remembers that back when she was in high school, aged around 16, her menstrual periods had always been accompanied by a severe pain that had her crawling or rolling on the floor.

 “I always had to go to the sickbay because I could not walk and had to always be on painkillers. It was a horrible experience that I never looked forward to.”

Low pain tolerance

 Even though it was none of her fault, she beat herself up for it, thinking she had low pain tolerance. She asked her friends whether they had periods as painful as hers, but no, they didn’t.

 “I remember my mother telling me to see a doctor for medical intervention, and that people who had such periods are at risk of infertility, but I thought she was only feeling sorry for me. ”

Her mother let go of the topic and supported her by buying painkillers whenever she needed them.

On the very day she discovered that she also had the condition, she had gone out for lunch with a friend when she felt extreme abdominal pain.

She jumped into her car to drive home, and while at the wheel, she became drowsy, had trouble seeing, and was scared that she would cause an accident and, worse yet, lose her life.

She was lucky to get home safe but passed out at the parking lot after locking her car. When she came to, she found herself at the hospital. Her friend and neighbours had rushed her there.

 “I feel like the discovery that I had endometriosis was divine, that God wanted me to find out. I would have never gone to the hospital to find out why I had painful periods,” says Corazon.

 “At the hospital, the doctors couldn’t figure out what was wrong, my blood pressure was normal, and everything was fine except the pain in my tummy. I was referred to another hospital, and the second doctor recommended a scan to find out what was going on.”

Her nurse informed her she had an ovarian cyst. Two visits to two gynaecologists later, she didn’t feel she was well informed.

 “I reached out to my cousin who has a similar condition, and she referred me to her gynaecologist, whose recommendation and insistence on a second scan led us to find out that I had two cysts. He advised that I had to go under the knife, and I eventually got laparoscopic surgery in January of 2019.”

 Laparoscopic surgery is a minimally invasive surgery. The surgeon makes several minor cuts and inserts a tube through each opening, then uses a camera and surgical instruments to conduct the operation.

 After the surgery, Corazon reveals that her doctor put her on six-month medication to stop her periods temporarily and that her first post-surgery period was the most painful. She adds that she did not experience any pain in the few subsequent ones, and that she got pregnant soon after.

“I was only worried about my ability to conceive when I was diagnosed with endometriosis and my doctor informed me that the condition is linked to infertility. I wasn’t actively looking for a child then, but I wanted to be able to have the chance to have one when I was ready or when I wanted to. Endometriosis was threatening that, and it had to be addressed immediately.”

“At the same time, I had also been diagnosed with fibroids, but the doctor felt there was no rush to get rid of them as they didn’t pose any problem. They were finally removed during a caesarean section to deliver my baby,” says the soon to be the mother of two.

But even with the surgery, she knew that her chances of being a mother would not measure up to that of someone without the condition. The information exacerbated her worry that as long as she had a history of the condition, it could recur.

She is the only one in her immediate family that has had endometriosis and fibroids, she discloses.

“When I got the diagnosis, I finally realised why I had never even had a pregnancy scare like other girls. However, with or without my condition, being a mom has been the best journey I’ve ever taken, and I’m beyond blessed. Every day has been blissful since; even the hard days are still full of joy and smiles because of my son. I am currently expecting baby number two, and I could not be more blessed.”

 Even though her wildest prayer has been answered, her journey to motherhood has not been a smooth ride.

 “Sometimes I feel very inadequate, other times I feel like I’m aching! All in all, I’m loving every little thing about being responsible for my little human. I look forward to seeing my children grow up happy and to achieve everything they want to,” she says.

 As she awaits her second baby, she projects that the ride will get bumpier, as she will have to contend with a toddler and a new-born.

 “I know it will be hectic, because my firstborn only turned one recently, and by the time the second baby is born, he will be barely two. He will be a typical toddler in need of attention, and so will my new-born. I am, however, grateful to have a very supportive and hands- on partner and an excellent nanny, so I am assured everything will turn out well.”

FACT BOX

According to John Hopkins Medicine, endometriosis is a common gynaecological condition that affects 2 to 10 per cent of American women of childbearing age. The condition earns its name from the word endometrium, the tissue that lines the uterus.

 During a woman’s regular menstrual cycle, this tissue builds up to prepare for attachment by the embryo.

 It sheds off if she does not become pregnant. Women with endometriosis develop tissue that looks and acts like endometrial tissue outside of the uterus, usually on other reproductive organs inside the pelvis or in the abdominal cavity.

 Like the endometrium, this misplaced tissue builds up and breaks down every month, resulting in small bleeding inside the pelvis. This leads to inflammation, swelling and scarring of the normal tissue surrounding the endometriosis implants.

 When the ovary is involved, blood can become embedded in the normal ovarian tissue, forming a “blood blister” surrounded by a fibrous cyst, called an endometrioma.

 John Hopkins explains that while any woman may develop endometriosis, women who have a first-degree relative with the disease, those giving birth for the first time after the age of 30 and women with an abnormal uterus seem to be at an increased risk for the disease.

 The most common symptoms include excessive menstrual cramps that may be felt in the abdomen or lower back, pain during intercourse, abnormal or heavy menstrual flow, Infertility, Painful urination and bowel movements during menstrual periods and other gastrointestinal problems, such as nausea, diarrhoea and constipation.

They note that each woman may experience symptoms differently, or some may not exhibit any symptoms at all.

Four stages

Endometriosis can present in four stages, ranging from minimal, mild, moderate to severe, and are based on the location, amount, depth and size of the endometrial tissue.

 However, they note that the stage does not necessarily reflect the level of pain experienced, nor the risk of infertility or symptoms present: “it is possible for a woman in stage 1 to be in tremendous pain, while a woman in stage 4 may be asymptomatic.”

 Endometriosis is considered one of the three major causes of female infertility. According to the American Society for Reproductive Medicine, endometriosis can be found in 24 to 50 per cent of women who experience infertility. In mild to moderate cases, the infertility may be temporary. In these cases, surgery to remove adhesions, cysts and scar tissue can restore fertility. In other cases, a very small percentage — women may remain infertile.

 How endometriosis affects fertility is not clearly understood. It is thought that scar tissue from endometriosis can impair the release of the egg from the ovary and subsequent pickup by the fallopian tube.

Other mechanisms thought to affect fertility include changes in the pelvic environment that results in impaired implantation of the fertilised egg.

 In general, treatment for endometriosis may include Watchful waiting to observe the course of the disease, pain medication, hormone therapy and surgery.

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