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How to cope with distress when pregnant


Dear doctor,

I am 32 weeks pregnant and paranoid about ever getting caught out in any form of attack. What precautions should I take while pregnant if I was ever in the midst of terror?


Dear Catherine,

You have genuine concerns, as we are indeed living in an age where terror attacks are common and unpredictable. Each of us stands a chance of being caught unawares. In such cases, the best strategy may end up being the specific actions we take in extremely precarious circumstances.

Being pregnant always puts you at a special category of risk for any untoward events. You are not only worried about yourself, but you would also constantly worry about your unborn baby. But the overriding principle is to uphold your own safety. Your unborn baby remains safe if you are safe yourself in the first place. Your actions should be directed at maximising the potential to survive the ordeal wholly intact, or with salvageable trauma.

Your very first actions should be pre-emptive. True, you are unlikely to have any intelligence to tell you where the next strike will be. Terror patterns may sometimes give a clue, and you may wish to avoid going to certain places if at all possible. Wherever you are, make sure you are clear about escape routes. Having an escape plan comes in handy if it becomes necessary to evacuate quickly.

Heed advisories from the authorities as much as possible. Testing out an advisory hoping it’s just a bluff is foolhardy. Always keep in touch with family and friends when out there, you will stand a good chance of being traced if people have an idea where you have been. And if you notice some suspicious activities, steer well clear of such and inform the responsible authorities soonest possible.

If you unfortunately find yourself in the thick of an attack, you still stand a chance of surviving. Keep as low as possible, and shield behind any obstacles that may be nearby. There is no best place to be hit by shrapnel or bullets, but hits in key areas like the head and chest leave you particularly vulnerable. A hit in the abdomen in pregnancy may cause some direct injuries to the unborn baby. Confronting an armed attacker whilst pregnant is unwise, you may stand a chance of being spared by simply obeying their orders.

Only worry about the pregnancy after you have been rescued, or have managed to escape. You would need to be stabilised first if you happened to sustain any injuries, then decisions specific to the pregnancy can be made. Most pregnancies will survive non-penetrating trauma.

But sadly some pregnancies may be lost due to massive maternal injuries, or as a result of direct trauma to the unborn baby. 

— Dr Alfred Murage is a consultant obstetrician and gynaecologist.

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