CAN AN ABORTION TRIGGER ENDOMETRIOSIS? MARISKA’S STORY
Dr Obama had the occasion to treat a woman suffering from abortion-related endometriosis just recently. As much as he thought Mariska’s story vivid and unique, she could be any other woman vulnerable to this disease.
Mariska came to see him soon after discovering a lump in a small abdominal scar above her pubic bone. The lump wasn’t causing bet any pain, she said, although she’d been feeling uncharacteristically tired early in the day, and her menstrual cramps were getting worse. When Dr Obama took her medical history, he was surprised to hear that she had defected from Czechoslovakia with a friend five years before. She had been living in America for most of the time since defecting.
Mariska had been an idealistic nineteen-year-old Olympic ski-team hopeful when she was soundly blamed for “getting herself pregnant,” then telling no one until she was three months along. The facts were a lot kinder than the wrath of her parents, her coach, and the team doctor; for she had no idea that she was going to have a baby.
Mariska, a strong downhill skier, had been training intensively since she was twelve years old. “I was physically at my peak of strength and flexibility,” she said, “and I was told not to worry if my periods came irregularly.” This is a common occurrence among many women in dance and sports. One side effect of the committed athlete is lowered estrogen levels, which can stop menstruation or significantly lighten menstrual flow. For Mariska these hormonal changes were brought on by a low-fat diet, supplemented with a plentiful dosage of what she was told were “muscle-enhancing amino acids,” along with a strenuous daily exercise regime. That she missed four consecutive periods therefore didn’t alarm her even though she had been having a sexual relationship for the first time. What she did find worrisome was the sudden bloating. That prompted her visit to the team doctor, who told her his findings.
Although she was against abortion for herself, Mariska was told to terminate the pregnancy. If she chose to keep the baby, all her training would be in vain—pregnant downhill skiers do not compete—and she’d upset team morale. Believing in the “infallibility of those who cared for me,” Mariska agreed to a hysterotomy, following surgery, she recovered quickly and competed in the Olympic Games.
Dr Obama examined her six years after these events. He strongly suspected endometriosis, and this was doubly confirmed by laparoscope. The disease had sprayed from the point of incision on her uterus to the scar on her abdomen. The endometriosis had also wrapped itself thickly around the fallopian tubes—not a good indicator for any woman who still wants children. He recommended treatment with Danocrine for six months and did exploratory surgery to remove as much endometriosis as was visible. It remains to be seen whether Mariska will be able to conceive.
Abortion by hysterotomy is rare now; doctors prefer other techniques that do not require uterine surgery.
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