When alcoholism causes miscarriage

If there’s a wrong that Caroline Kagia wishes she could right, it’s to bring back the babies she miscarried due to alcohol addiction. For this former alcohol addict, this a wish, but also a sense of guilt she cannot put in words. She’s unsure if she will ever get over it.

One day while two months pregnant, she started bleeding. She didn’t have money, and would stay with a bleeding foetus inside her womb for nearly a month. Unknown to her, she had had her first miscarriage.

The following year, she conceived again. Even this new pregnancy terminated. “How I wish I had those babies,” she tells says solemnly.

The grief of her miscarriages occasionally takes her back to her life two decades ago. In 1999, aged 19, she had her first drink, a token from a friend. “My first drink was a bottle of red wine with a 12 per cent alcohol content. I downed it all but didn’t get drank. For someone who was drinking for the first time, I was surprised that I could function normally the following day,’’ she recalls.

Unknown to her,  Kagia had a high tolerance to alcohol, and was genetically predisposed to alcohol from her paternal side of the family. 

She had awoken a sleeping giant. For nearly 20 years, Kagia would plunge into alcoholism and smoking, a battle that she always lost whenever she attempted to stop her addiction.

In 2001, she left for East Asia to study media and advertising. The plan was to move on to another country for work after graduation. This was never to be. Her drinking soon escalated as she turned to strong liquor.

She recounts: ‘‘I had grown so thin I had to wear two pairs of jeans just to fit and to feel like I had anything on. When I came back home, my family was disappointed in me.’’

She later joined the Kenya Institute of Mass Communication to finish her course, at which point her drinking receded. In 2005, just before finishing her course, she became pregnant with her son. But she was in denial. She didn’t even attend antenatal clinics.

To escape the reality, she went back to the bottle, drinking as though her life depended on it. ‘‘I put on baggy clothes to hide the bulge. During the third trimester, people started noticing the change. When my brother commented about it one day, I pretended not to know what he was talking about,’’ she says.

That night, she went into labour. When her father took her to the hospital in pain, he was unaware of what was going on only for the doctor to announce that she was about to get a baby.

This would mark the beginning of an intensive 26-hour labour that nearly cost the lives of mother and baby.  “Both of us almost died,” she says.

She was 25 when her son was born.

Now a mother, Kagia had to stop drinking. When she got a job few months later, she started shirking work and childcare, forcing her family to care for her baby. During one of her drinking escapades, Kagia would meet a man with whom she later fell pregnant. Only to miscarry again.

Eventually, the couple bore a daughter. But her troubles were far from over. First the relationship ended, then she went into depression. 

“I couldn’t finance my drinking without him. To function, I needed three bottles of a strong spirit every day. So heavy was my drinking that my menstrual cycle became erratic before disappearing for a year,’’ she relates.

At this point she was ready to put her child up for adoption as she secretly contemplated suicide. Her plan? To sell her passport for Sh10,000, spend the money then commit suicide. ‘‘On the day I was to meet the potential buyer, his phone went unanswered. At that point, I decided enough was enough. I realised I needed help.’’

Kagia had cheated death. She called her father, who enrolled her in a rehabilitation centre. It’s after her recovery that she took a diploma in addiction counselling. “I like sharing my regrets because they help me to heal. I have no physical scars to show; only emotional and mental scars,’’ says the certified addictions professional.

In 2018, she founded Caroline Kagia Wellness Initiative to give hope to addicts of alcohol and substances. She warns: ‘‘If you’re a mother or hope to become one, stay away from alcohol. Alcohol will make you lose your pregnancies.”

“Alcoholism isn’t a men-only problem. Women too are struggling with addiction. When you walk into a bar, most of the clients seated at the counter are women. We all start as social drinkers, but soon it escalates to addiction,” she says. She notes that the ability to drink socially and to maintain a normal life, which many people find hard, is what separates social drinkers and addicts. She recommends the CAGE (cut down, anger, guilt, and eye opener) test to gauge whether one is on their way to addiction.

“Have you tried to cut down your intake but been unable to? Have you or others been angry with you because of your drinking? Do you feel guilty every time you open a drink? Do you need to drink first thing in the morning? If yes to any of the above, you are an addict or on the way to addiction,” she says.

Kagia explains that people fall into addiction because of genetic predisposition and, sometimes, childhood trauma. She says a strong support system was critical in her recovery journey.

She has been sober for four years now.  ‘‘My father never judged me despite my misdeeds. He never gave up on me, even after I stole from him. He always spoke life into me.’’

"Sobriety is liberating, but also depressing. With the restrictions that came with Covid-19, and having a lot of time on your hands, it’s easy to trigger relapses because of boredom,’’ she says, noting that while addiction is real, recovery is also possible.

Dr Maureen Owiti, a gynaecologist at Kenyatta National Hospital, explains that when a pregnant woman takes alcohol, the alcohol passes through the placenta to the baby. Prolonged use can get the baby addicted, she warns. After such a baby is born, it develops drug withdrawal symptoms and doctors often have to wean the baby off the drugs. She adds that alcohol destroys brain cells and can impair neurological development of the baby. It can also potentially cause miscarriage.

“When it comes to menstrual cycle, we have to understand that alcoholics operate on extremes. They either eat too much or too little. Both extremes are dangerous because being either underweight or overweight affects your cycle,” she explains.

She adds: “On the one hand, underweight mothers often have their periods disappear.  Overweight mothers get frequent cycles because they have more oestrogen stores.’’

American Addiction Centers (ADC) says there is no safe amount of alcohol intake during pregnancy and that drinking pregnant women risk premature labour, miscarriage, stillbirth and a range of developmental, physical, emotional or mental disorders to the baby.

“After consumption, it takes only about two hours for the foetus’ blood alcohol level to reach that of the mother. Any amount of alcohol remains in the foetus’ system longer than the mother’s because the foetal alcohol metabolism is slower,’’ says ADC.

Some of the birth defects associated with drinking during pregnancy include abnormal facial characteristics, smaller head circumference, low height and weight and eyesight or hearing problems. Others are bone, heart and kidney deformities. 

ADC warns that there’s more risk to the developing baby when the mother drinks during weeks 6-12 of the pregnancy. This hinders the development of the baby’s teeth, palate, and external genitals. Even worse, the brain and spinal cord too develop defects. Several studies over the years show that harmful use of alcohol results in three million deaths worldwide every year. 

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