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HOW CAN HE TELL !
Dr. A K Debdas
debdas2000@hotmail.com
Jamshedpur
A striking observation
In my then new job in an industrial
hospital, in the antenatal clinic, at the time of clinical
interview, as I used to (still do) ask patients, like any
other obstetrician, whether she was feeling her fetal
movements alright or not. Strikingly, I often used to notice
that before the woman answered the husband used to come out
with some candid comment about it like – ‘Yes doctor it
moves alright’, ‘Oh, it moves such a lot’, ‘It has slowed
down a bit’, ‘Some nights it almost revolts to be released
from that cramped place.’, ‘It is going to be either a
footballer or a break dancer’ etc. These rather smart
couples invariably were all educated and were primiparae
carrying late pregnancy. It is this that turned on my mind
and made me think – how can he tell ! and so precisely, so
confidently !.
It is the year 1976 and Telco (now
called Tata Motors) Hospital that I am talking about.
In this hospital a large majority of my patients were wives
of young brilliant (Tata worthy !) engineers and many were
engineers themselves married to an engineer boy of her
college because by that era in India the engineering
colleges had started looking colourful like the medical
colleges.
A light probing
One day I decided that I have to clear this soft mystery
and directly asked one husband about it – as to how does he
know it so well and this was the answer I got :“Every
night before we actually fall asleep we chat for a little
while in bed lying on our sides face to face lightly
embraced. It is then that I can feel occasional movement of
the baby on the surface of my tummy transmitted through the
wall of my wife’s protruding tummy which somewhat bulges
into my tummy”
This immediately reminded of my own
experience while my wife was carrying our first child and so
I decided to do a small study of such couples/husbands. I
inter-viewed total 30 husbands and each admitted of
perceiving the occasional fetal movement on their tummy.
Implementation of the finding
into practice
Based on the above experience I decided
to use this everyday routine of the young couples as an
additional means of checking the status of movement of their
fetuses.
Since then I have been advising
selected patients carrying uncomplicated pregnancy of 37
plus weeks of gestation to do this additional pleasurable
exercise in addition to the two one hourly session of the
usual solo Fetal movement count during the dayby the wife on
her own.
Possible advantages of husband
monitoring fetal movement
-
It guarantees that the fetus has
actually moved because even another external individual
has been able to feel it. This can do away with the odd
incidence of mother going on counting fetal movement
even three days after intrauterine fetal death.
-
It also certifies that the movement
was strong – strong enough for an external individual to
feel it – such babies are expected to be a vigorous
baby. Sick fetuses (e g fetuses with gross IUGR) on the
other hand may be expected to move feebly – which may
not be perceivable by the husband.
-
For mothers who are somewhat poorly
sensitive to recognition of their fetal movement, their
husbands can guide them as to when the fetus moved and
what is a real fetal movement by trying for joint
perception of the movements.
-
No additional expense is involved.
-
Daily and domestic fetal monitoring
is possible
-
It promotes BONDING of the
fetus with its Father
Three unique advantages of using the
husband for fetal monitoring
· He is readily available
· He is naturally keenly interested because it is his child
· He, a valuable human resource, remains totally unutilized
during the whole antenatal period like a bystander, why not
use him?
Disadvantage
-
Chance of husband/the father falling asleep.
-
It slightly increases the frequency of coitus ! This has
also been the finding of Dr. Pratap Kumar of Manipal
(personal communication). But, let us rethink, could it
constitute an advantage rather than a disadvantage for the
37 plus weeks gravidae carrying normal pregnancy. Of course,
it naturally occurred from the posterior which the couple
instinctively arranged as I found out.
-
The method is of course not applicable if the wife is sent
to her mother’s place for delivery which has been customary
in India.However, nowadays, since most organizations give
free medical facility as perks of the husbands job, the old
trend has significantly reversed and now usually the mothers
go to their daughter’s house to take care of her rather
than daughter going to their mother’s place. This is
happening more frequently amongst the working couples.
Published record
The method has been published in the International Journal
of Obst & Gyne, September 1991, FIGO Supplement, Elsevier,
p-47.:
A striking feedback on the method
Of the many feedbacks that I have received the following are
worth mentioning which I got from the obstetricians of the
developed world -
“It can be a powerful tool to promote bonding”, “It can
generate a special kind of ‘Triple bonding’ – a composite
bond between the mother and the fetus and the father
altogether and all at the same time – a FAMILY BOND !.
Our immediate past President of FOGSI, Dr. Pankaj Desai, as
long as 20 years ago enthusiastically commented about it
during the Pre-congress workshop at AICOG
Nagpur in
1988..
Anyway, if nothing else, this practice makes the pregnancy
perhaps little more enjoyable specially for the enlightened
couple.______________________________________________'
YOUR COMMENTS ARE INVITED
shahsudhir@yahoo.com
drpankajdesai@gmail.com
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