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September 1990, Volume 40, Issue 9

I Wnat To Say


She was pregnant for the eighth time. She looked younger than her 30 years. Anxiety masked her features as she entered my office with her husband. The Obstetrician had referred her with a diagnosis of gestational diabetes mellitus. I tried to relax the atmosphere by trying to make things appear not so grim, as she sat across my desk looking tense and nervous. There were only 3 living children, two girls and one boy. Four pregnancies had ended in still births or neo-natal deaths. Her mother and brother were suffering from diabetes mellitus. As I talked to her asking for the relevant details I observed the husband to be not so concerned. Eventually after explaining the dietary restric­tions I had to cross the bridge.”You will have to be started on Insulin injections,” I said. The husband suddenly stirred. “But doctor isn’t that risky and dangerous, “he said. It took me some time to explain the details and convince him. Najma seemed to have no right to decide. The husband’s word was final. But she accepted my verdict without any question. Being intelligent she picked up the technique of injection and settled in the routine. We had a rather rough time for the next couple of months in keeping the blood sugar in the normal limits. She required frequent blood tests which again went against the family’s understanding. During the coming visits I got to know Najma better. Her husband never came again and she was usually escorted by a younger nephew. She belonged to a conservative family but had managed to complete her schooling much against her family’s wishes. She was married young and again in a much more conservative family, where she had to live with all the other members. “I was not allowed to talk to my husband when people were around, “she related. “Also I could never sit on the same table for meals with my husband, “she com­plained. The mother-in-law a very assertive woman, who probablyhad passed through difficult circumstancesinher early age, was determined to be strict and create a similar state of affairs for her daughter-in-law. She was in her imaginative world still living in the early twentieth century. She had given birth to 18 children of which only 6 had survived to adulthood. Infantile deaths were taken in the stride by her. “Swelling of the feet and face in the last few weeks of pregnancy is quite normal,” she would comment. Najma had a difficult time following the dietary regime because the mother-in-law took diabetes as a big fuss. She insisted that Najma should drink a big bowlful of hot milk with lots of butter and sugar in it. “The delivery is made quicker and easier with the butter,” she would tell Najma with authority. “These injections you take every day will make you an addict and will also damage your heart and liver,!! She would add. I had to fight against odds by keeping Najma convinced to continue the dietary regime and the Insulin injections. The time passed on and Najma gave birth to a normal sweet little baby girl. Due to the difficult pregnancy tubal ligation had been discussed earlier. Najma was keen about it and her husband seemed to be agreeable too. But when the time finally arrived they backed out and Najma went home from the hospital with all the chances of a very difficult to manage pregnancy again. Najma came to see me some time later when she related her story. “!very much wanted the tubal ligation,” she explained. “We have three daughters and a son and I don’t have the strength and courage to go through another difficult pregnancy,” she had pleaded to her husband. But her husband who was himself partially convinced did not have the right to take a decision on this very personal matter too. A round-table conference was held in the family with the father presiding. It was decided that there were multiple factors going against the procedure to stop the future generation from growing. “It was a big sin,” was the first consideration. “God would punish the entire family for it.” Secondly Najma had only one male child. He definitely needs a brother. Girls are unimportant because they belong to others. “We need more sons to carry forth the family’s name.” The last and the least important was the consideration of Najma\'s health which according to the old wive’s beliefs would be damaged. The weight would increase, joint pains would develop and the eyesight would get weak. Najma had tears in her eyes as she told me the entire details. “My mother-in-law is the policy makerin the house, She said. “She makes all the small and big decisions in the house even so regarding my children’s clothes and food”. Najma con­tinued., “But this time she took the reins in her hand when the decision was about my baby, my torso and my relations with my husband. Do not we women have any rights at all? Do we quietlyfollowthe rules laid down first by now parents and later our parents-in-laws and husbands? Are we no better than pet animals?” questioned Najma in a sequence I had difficulty in consoling Najma because! could not find plausible answers to her questions. I did not want to convert her to a rebel as that would damage her family life. But it did leave a deep impact on my mind. We talk of women’s Lib all over the world and here in the third world and in the advancing twentieth century we see women still bound in chains of traditions, the links of which grow stronger day by day. A woman is a prisoner in her own family and home where a dictatorial rule prevails. She does not have the right to make decisions even regarding her very own body. Is this the freedom for women in this modern world or is it all a farce?

Fatema Jawad

Journal of the Pakistan Medical Association has agreed to receive and publish manuscripts in accordance with the principles of the following committees: