• Anal sex loosens the membrane between the rectum and the vagina until the baby cannot be pushed out
• Medics improvise or resort to C-sections to save the baby but the women keep doing as their men please, with some socialised to accept it as conjugal right
What is the worst thing that could happen to a woman during menstruation? Cramps? Mood swings? A nagging partner who insists on sex?
Well, it gets worse for many women in Lamu. Not only are they denied a break from sex, they are made to give their backsides instead.
Considered unclean for vaginal sex while on their periods, this is the compromise their husbands demand. They threaten to divorce them or marry another wife who will be submissive to their whims should they refuse.
Because they want to stay married, the women agree to the anal sex, whether they like it or not. Only for it to cost them their babies or reproductive health, midwives at a Lamu hospital told the Star.
“During pregnancy and childbirth, we have observed that such women face so many complications,” one midwife said.
“From birth asphyxia, poor progress of labour, prolonged second stage of labour, post-traumatic stress and, most of all, perinatal deaths (during and soon after pregnancy).”
The midwives, who requested anonymity for fear of being targeted or fired, said there are at least 120 such cases in a month, which translates to 23 per cent of all births in a month.
HOW COMPLICATIONS ARISE
The midwife explained that the rectum and vagina are separated by sensitive membranes. The constant friction of the rectum that happens during anal sex loosens these membranes. Which means during labour, a lot of pressure is directed to the wrong opening for child expulsion.
In a normal delivery, the descent of the foetal head follows the vertebral column through the lumber region to the sacrum and coccyx.
However, for the case of women who are actively partaking in anal sex, since the rectum has by this time slackened, instead of the baby being propelled through the vagina, the head of the baby sinks into the sacral region anterior to the rectum.
“At this point, the delivery process has already been inhibited due to the state of the vagina, and so it takes longer than necessary for the birthing process to complete,” the midwife said.
“Mostly, there are two consequences: either the baby will be too exhausted at the time or asphyxiate (lack oxygen and blood flow to the brain), which eventually could lead to brain damage and to our second scenario, which is stillbirth.”
The midwife explained that the deficient supply of oxygen to the body arises from abnormal breathing.
“In the case of this baby, the situation results once their heads cannot pass through the vaginal canal due to the collapsed membranes.”
The asphyxia causes generalised hypoxia, which is when tissues and organs are starved of oxygen.
“For these tiny babies, once the oxygen cannot reach their vital organs, the affected tissues and organs collapse, leading to in most cases to immediate death,” they said.
Many women tell us they have been having anal sex, and that enables us to prepare efficiently for the birthing processMidwife
SAVING THE BABY
The midwife, however, said they have devised ways to deal with the situation so as to help these mothers not lose their babies during and after birth.
“Fortunately, even the traditional birth attendants know about it and have been able to help in their own capacity to save these babies," the midwife said.
"Once we realise that the baby is sinking into the rectum area, we take a big chunk of cotton wool and insert it into the rectum to give counter pressure of the foetus head and at the same time align the birth canal, after which we now pull out the baby safely."
The midwife said most women are forthcoming and have always informed the medics about their anal sex, enabling the medics to prepare ahead for any eventualities.
“We encourage them to talk to us once they come to be admitted at the maternity wards. Many will always tell us they have been having anal sex, and that enables us to prepare efficiently for the birthing process,” the midwife said.
Midwife number two said when worse comes to worst, an emergency Caesarian-section (CS) has to be performed on the mother to save the baby.
Labour is divided into three stages, the midwife explained. The first stage starts with contractions and the cervix dilating and ends when the cervix is fully open.
The second stage is when one pushes the baby through the birth canal. The third stage ends with the delivery of the placenta, also called afterbirth.
For women whose rectum has been damaged by anal sex, the second stage of labour (pushing) will always delay, which is the most pertinent reason for a CS.
“When the cervix opens adequately, the baby is supposed to be delivered soonest, but if one can't be able to effectively diagnose and align the birth canal, the best shot at saving the baby is a CS as soon as possible,” the midwife said.
It's actually not painful or anything once you get used to it. It seemed quite off the first time I did it, but a woman mentor told me to tolerate it lest I lose my husband to other women out thereLamu wife
ANYTHING TO PLEASE MEN
Most of these women, however, say the prefer to have anal sex with their husbands during menstruation to prevent them from going to seek the same gratification from other women out there.
Fatma Abdalla* (not her real name), a mother of seven from Kashmiri village in Lamu island, says birthing all her seven children has been a struggle as she has indulged in anal sex ever since she got married in 1991.
“It's actually not painful or anything once you get used to it. It seemed quite off the first time I did it, but a woman mentor told me to tolerate it lest I lose my husband to other women out there. I just didn’t know it would affect me this much,” she said.
She says once the doctors detected it with her first delivery, she would always make a point to inform the midwife each time she went to get her other children.
“I felt embarrassed telling them the first time because I thought they would judge me but they didn’t, and that really encouraged me to be forthright every other time I went to birth my other children. I still do it with my husband and he hasn’t married a third wife now that I'm the second, and so to an extent, it has worked for me,” she says.
Mwanaisha Husna*, 26, a mother of two, just had her second baby via CS, and she was informed that the surgery would be necessary so as to save the baby.
“I didn’t know that my rectum was damaged by the time I was going into labour, and so I didn’t say anything. However, after some time I was informed that the baby wasn’t progressing well,” she said.
“He seemed to have stuck his head in the rectum and wasn’t breathing well, hence the CS. I'm just glad I have my baby and will be sure to inform medics about it [anal sex] in my future pregnancies.”
Traditional midwife Shufaa Mohamed of Faza island said there are three scenarios that will make a woman have anal sex with a man.
One, when a woman is on her periods but still wants to satisfy her man sexually, she will offer anal sex.
Two, there are men who are bisexual, meaning they can have sexual relations with both men and women.
“This kind of a man will demand anal sex from the wife just like he does with the male partner, and since it is their right regardless of the orifice, the women oblige,” she said.
Three, for Swahilis, young girls get good dowry deals when they marry as virgins, and so such girls will have anal sex but save their vaginas for the wedding night for their husbands.
“Therefore, a girl who has a boyfriend and wants to please him sexually will engage in anal sex. They save the vaginal sex for the wedding night as they should be virgins so that proper dowry can be paid,” she said.
Edited by T Jalio