After six miscarriages, the birth of my son brightened my life'

With a heavy heart, Lilian Wanza, now 59 years old, narrates her ordeal, having gone through six miscarriages as a young woman in her 20s. 

Back then, there was no counselling or therapy available following the loss of a child. Her losses led to her being ostracised in her Kamba community, as having multiple miscarriages. 

And just as she was coming to terms with her losses, she tested positive for HIV. Her world was shattered.

“It was back in the 80s when we didn’t have much information about the disease. I did not know how long I would live, but I knew my days on earth were numbered and it would not take long,” Lilian narrates from her rental house in Makueni. 

She recalls witnessing dozens of people die, and families isolating their loved ones. The dead would be buried in polythene bags.

It was the multiple miscarriages that had led Wanza to test for HIV, a disease she believes she had lived with for about 10 years before conducting the tests.

The news of her contracting HIV did not shock her husband, a police officer. Lillian later realised that he was silently on HIV treatment, claiming the drugs he was taking were to boost his immunity.

Wanza had no option but to live positively as there was no support system.

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“Nobody spoke about HIV openly. Everybody saw HIV as a death sentence. The only option I had was to pray to God to keep me alive,” recalls Wanza.

In 1984, she conceived a pregnancy that lasted to term and was overjoyed to deliver her only child after a series of miscarriages. The child was HIV-negative.

Wanza says that although there wasn’t much information on the prevention of mother-to-child transmission, Wanza followed her instincts and did not breastfeed her son. Every year, she would take her son for tests until he was eight years old.

The husband was furious at her for not breastfeeding their son. He believed that by her not doing so, the community would easily tell the couple’s HIV status.

“I cannot believe I gave birth and raised an HIV-negative child. Sometimes when I look at my son, tears of joy fill my eyes. This was purely God’s making because I did not know how to take care of the pregnancy to avoid transmitting the virus to him,” Wanza says.

Over the years, every time she lost a pregnancy, word would spread through the village like bushfire. The rumour was that her husband’s family was cursed and that her husband, who died in 1998 was born with 16 siblings who had all died.

“The birth of my child was a light in our family,” says Wanza who is not sure about the causes of the miscarriages.

Prof Koigi Kamau, a fertility specialist at the University of Nairobi the Department of Obstetric and Gynaecology, said the quality of the embryo is the highest contributor to miscarriage.

“If the quality of the embryo is not good, the pregnancy doesn’t survive well. This is the most common reason for miscarriage or pregnancy loss,” says Prof Kamau.

Quality, he explains, means the uterus may not be able to carry the pregnancy, due to age. The best age to carry a pregnancy is between 22 and 34 years.

HIV, according to the specialist, may have little contribution because it may affect the quality of the process of implantation, as it affects blood vessels and causes infections easily because of the compromised immune system.

However, in Wanza’s case, he observes that other factors may have applied, as there was little knowledge about HIV/Aids in the early years.

Prof Omu Anzala, a virologist in the Department of Microbiology, College of Health Sciences, University of Nairobi said HIV there are other reasons for miscarriage for example infections, the use of certain drugs and uterus-related complications.

HIV, he observes, might not have directly contributed to miscarriages, but other factors. However, he maintains that the couple should have been put on treatment to avoid infections and transmitting the virus to unborn babies.

“Failure to use ARVS may not have caused loss of the pregnancies. There must have been other underlying problems” says the virologist.

The researcher adds, “Immunosuppression and viral loads, including low immunity, are not associated with miscarriages. It just leads to infections which can lead to miscarriages, but not in HIV. Other concurrent infections can lead to miscarriage”.

To avoid mother-child transmission, he maintains that viral loads should be checked regularly. “There should be constant use of ARVs and checking of viral loads as such dictates breastfeeding, avoiding mother-child transmission,” says Prof Anzala.

Dr Kireki Omanwa, an obstetrician and gynaecologist based in Nairobi, attributed the causes of miscarriage to the structure of the eggs and sperm. Specifically, older women produce eggs for fertilisation, but because of nature, they do not fully develop which leads to miscarriage. “At times there is a faulty embryo, which results in miscarriage.”

He says that some chronic diseases also trigger miscarriage, for example, hypertension and diabetes.

He adds that any infection in pregnancy, for example, urinary tract infections, can affect the health of the foetus. 

Certain medications should be avoided as they are likely to trigger the loss of the pregnancy.

“Medications like hypertension drugs are stopped during the first trimester as they are likely to affect the pregnancy,” says Omanwa, who further encourages any woman who experiences a miscarriage to go for a medical check-up for solutions.