Elizabeth Amoaa, 36, was born different. She was diagnosed with a double womb, double vagina and double cervix in 2016. She had been in and out of hospital since she was six with no cure in sight. She talks to SONI KANAKE about her journey.
I was born with two wombs, two cervices and two vaginal canals. My childhood was spent in Ghana, where I was born, until around 12, when my family relocated to France. Growing up, I would complain of tummy aches since I was six years old and since then, I have been in and out of hospitals. The doctors could not figure out what was ailing me and would always prescribe painkillers. Unlike other girls who were excited on reaching puberty, mine was a very difficult experience. I’m a late bloomer and I got my first period at 15. My periods were not only irregular, but also extremely painful and heavy.
I was born anaemic and was on multivitamins and iron supplements. Most of the time I was unwell and constantly tired. Unfortunately, my health challenges were linked to anaemia. In 2003, I moved from France to the UK. My hospital visits continued as most of the time I was unwell. Scans did not find anything unusual. The chronic pains and fatigue only got worse. I also suffered from recurrent vaginal thrust, lower back pains and irregular menstrual periods.
In 2008, I was diagnosed with uterine fibroids, which the doctor said would make conception very difficult. That was heartbreaking news as I desired a child. Eighteen months after that diagnosis, I conceived in 2010. I was overjoyed. However, I had a tough pregnancy. I was always tired and I bled throughout. The doctors could not explain this. Sometimes they would detect the foetal heartbeat, while at other times they could not. They suspected an ectopic pregnancy. When I think about it today, it’s like they were scanning the ‘wrong’ womb because they could not explain why sometimes the scan missed the baby. I must have done, on average, 15 scans while pregnant.
At 32 weeks of pregnancy, I had gone to the hospital for a check-up when I went into labour. The birthing process wasn’t complicated, but my baby was preterm. My baby needed specialised care and my problems seemed to have recurred. I sank into depression, which the doctors attributed to post-partum depression and said it wasn’t unusual for a new mum. And since my baby was also having health challenges, they said it also contributed to my depression. Six months after my baby was born, a scan revealed I did not have fibroids. This was good news as I now thought the cause of my problems was gone. Sadly, my joy was short-lived and a year later, the pain came back with a vengeance.
In 2014, my husband and I moved to Germany and that was where we started getting answers. In 2016, during a laparoscopy (keyhole surgery), surgeons discovered I had two cervices and two vaginas, a condition called Uterus Didelphys. I came to learn the condition affects one in every 3,000 women. Doctors also discovered I had endometriosis Stage 5, which had spread to my bladder. The condition makes one susceptible to other gynaecological conditions.
I became pregnant again in November, 2016. However, the following year, I experienced a silent miscarriage (missed miscarriage). This, the doctor told me, is where a miscarriage occurs without the usual bleeding and the doctors had to evacuate the foetus from my womb. Last year, I was diagnosed with ovarian cysts, but a scan earlier this month showed they have cleared. I do a lot of herbal teas and I notice this relieves some of the symptoms.
The silent miscarriage was a turning point and I decided to set up a foundation called Speciallady Awareness to educate women and young girls on gynaecological conditions, menstrual hygiene and reproductive health. I realised there is stigma surrounding uterus didelphys due to lack of awareness. I have also been a victim of social media bullying because of my condition.
My family and I currently live in the UK, where I work part-time as I’m always sick and unable to take up a very demanding job. However, I still managed to get my postgraduate degree in law. I want women to know they can come out of their closets and seek help. I also want to encourage them to pursue their dreams even as they battle their conditions. And also let them know that they can still get a decent education and live a full life.EXPERT'S TAKE
In humans, the uterus is formed during embryogenesis (the formation and development of the embryo) by the fusion of the two paramesonephric ducts (these develop to form the Fallopian tubes, uterus, cervix and the upper one-third of the vagina). Uterine didelphys is a malformation where the uterus appears as a paired organ in cases where the embryogenetic fusion of the ducts failed to occur. This can result in a double uterus with two separate cervices and sometimes a double vagina.
Dr Edward Sang, an obstetrician gynaecologist at MP Shah Hospital in Nairobi, says there are many abnormalities that can occur during foetal development. “Every female has two uteruses, which join and becomes one before birth. At birth, most of the girls have one uterus, but some can still have two due to developmental problems,” explains Dr Sang. “Most women realise there is a problem when they have challenges with conception.”
“There are many abnormalities that can occur, for instance, there are cases where a woman might not have a cervix or have a blind ending vagina, where the vagina is not connected to the uterus,” says Dr Sang.
How prevalent is it ?
“They are not very prevalent, but there’s a possibility every gynaecologist you ask has encountered a woman or two,” he says. In his line of duty, Dr Sang encountered a young girl who did not have a cervix. The girl, about 18 years old, had not started menstruation and her mother was concerned. A scan showed she did not have a cervix and could, therefore, not get children in future.
He has also encountered a woman with two vaginas and one with a double cervix. “Recently, during a routine Pap smear, I noticed one of my patients had a double cervix. She, however, was aware and her anatomy had not hindered her from conceiving and delivering a healthy baby,” says Dr Sang.
Since the renal system and the reproductive system are interconnected, it is important to have the doctor review a woman who has any of these gynaecological issues. “There have been cases where such women have been discovered to have a single kidney or a malfunctioning one,” notes Dr Sang. He says if the woman is leading a normal life and there’s no need for medical intervention, they do not intervene.