CONTRACEPTION AFTER CHILDBIRTH – THE IMMEDIATE PUERPERIUM (INSTANCE)
Mrs T.’s baby had died shortly after birth. No abnormality of the baby had been expected antenatally. The family family planning doctor saw Mrs T. through the glass door of the single room she had been given, away from the ward full of flowers and babies. She was dressed and waiting to go home. The doctor resisted the temptation to pass her by. She sat on the bed beside the patient, and after comforting her for a few minutes she asked gently about contraception. ‘I used to take the Pill but they think the baby had a tumour. Could it have been . . . ?’ She faltered. The doctor rifled through the notes. The postmortem report was not yet available and with difficulty, in the absence of proper information, the doctor tried to reassure her. ‘Perhaps I’ll take the Pill then,’ said the patient. ‘But I’ll wait till my postnatal.’ The doctor who was still looking at the notes said, ‘You’ll be sure to go won’t you, because I see your last cervical smear showed a few abnormal cells and you should have it repeated.’ There was a silence. The doctor looked up. Mrs T. sat very still her eyes brimming with tears. The doctor, with a flash of insight said, ‘You think you gave the baby cancer, don’t you?’ As the tears fell, the doctor comforted her, knowing that she could now offer reassurance with confidence as she knew the real cause of Mrs T.’s anxiety. ‘So it’s all right to use the Pill again? These abnormal cells – it’s to do with sex, isn’t it?’
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