Friday, July 4, 2008

The Baby

I performed a post-mortem today. He was an unwanted baby left by the streets.
Name : Unknown (Let’s just call him, Baby)
Age : Unknown
Race : Unknown
Parents : Unknown
Body found: 03/07/2008 0610
Autopsy on: 04/07/2008 0935
The umbilical cord and placental was still attached to Baby, when I saw him on the forensic table. The forensic room was unusually cold today. The layers of clothing wrapped around me did no help at all. I felt that the world was too cruel,.. how could anyone just abandon a baby on the street! With placental attached and cord unclamped… theorically, either the baby had died in-utero, or he was left to die by the streets…

We proceeded with forensic investigations. Baby was inspected for any injuries. His eyes were dark, staring back melancholy. His expression was stiff. He had a crooked jaw, and excessive caput and moulding. For the benefit of non-medical students, if the baby had caput(swelling at the head) or moulding (overlapping skull bones), this indicate that this baby was delivered SVD (spontaneous vertex delivery, head out first) and not a breech delivery. There were no injuries at the buttocks.

Sex: Boy
Weight: 2.20kg

Then, we investigated the age of the baby. We concluded that he was a term baby evidenced by:
1. Creases on the hands and feet
2. Body hair measuring 10mm
3. Testes palpable in the scrotum (already descended)
4. Dark meconium passed out (passed motion)
5. When cut across the calcaneum (one of the bones at the heel), from the 3rd toe towards the middle of the heel, we could appreciate secondary ossification center of the bones (bone maturation). Secondary ossification takes place at the 8th months, therefore Baby was at least 8 month old(40weeks), term.

Measurements of Baby’s parameter were corresponding to a term baby. Placental 14cm x 17cm x 2.5cm, complete, with blood clots.

The brain was removed, weight and sliced. The brains did not appear hypoxic.

Later, we continued by autopsying the lungs, liver, spleen, heart and kidneys to look for any other pathological injury or disease. A suspension test was done: Baby’s lung was squeeze flat and put into a bowl of water. We found that the lungs floated on the water, which translates to -> there was air in Baby’s lung -> Baby breath first, then die -> this was a livebirth -> baby was delivered SVD and left dying…

Sigh, the world is a cruel world… I could not imagine any mother in this world who could have left a crying baby to die. Before this, I had witnessed many mothers in the labour room who would do ANYTHING to save their baby… different maneuvers, pushing as hard as possible, enduring the pain… But this mother, I really could not comprehend..

A teenage mother came across my mind. Perhaps she was young, confused and did not know what to do with the baby. Prof Adeeb said: Guys only know how to make the girl pregnant. But I suppose the father of Baby did not even know the existence of Baby.

Girls out there, for God’s sake, if you EVER had premarital sex, please use contraception. Condom not only protects you from pregnancies, it also protects you from STDs (Sexually Transmitted Diseases) and HIV.

And IF you missed that contraception, options are MORNING-AFTER-PILLS within 72hours after sex. The eithical issue in this was if morning-after pills became widely available through pharmacies, unscrupulous men could exploit vulnerable young women by saying: "you can always go to the chemist and get the morning-after pill." Do see a doctor to check health status and medical history for anything which might make taking such pills dangerous.

And IF you missed your period that month, please do a pregnancy test.

And IF the test was positive, please discuss with your partner or your family, whether should you continue with the pregnancy and raise the baby.

IF you plan to keep the baby, please ensure that you can mentally and financially support the baby. Raising a baby is not easy. If you are not capable of it, you can discuss with the social worker to give the baby up for adoption, either to a family member or by others.


The first visit is the most important visit, where antenatal screening will be done (eg: Height, Weight, Blood Pressure, Hemoglobin level, Blood Grouping, VDRL/HIV/Hepatitis B Screening, Urine analysis). Any disease eg: Anemia, Diabetes Melitus, Hypertension, if detected early can be controlled and managed to optimize both mother and fetal throughout pregnancy and for delivery. An early dating scan (pelvic ultrasound scan) is very important before 20 weeks to know the age of the baby, the right time to deliver and to detect nuchal translucency (suggestive of down syndrome).

The risk of keeping the pregnancy to term without antenatal screening and follow up is increase morbidity and mortality to BOTH fetal and mother. And attempting to deliver a baby on your own is certainly VERY UNSMART! It’s not easy to deliver a baby and the pain is terrible (without analgesia). GO TO THE NEAREST HOSPITAL. Why else do you think medical student had to study 5years and midwifes 4years to understand that? YOU AND YOUR BABY COULD DIE

IF you wish to terminate the pregnancy, please go to a clinic and seek professional medical advice. Some might argue that a TOP (Termination Of Pregnancy) is unethical, but compared to bringing a baby to term and living it to die by the streets, I shall leave it for you to decide. According to WHO (World Health Organization), any pregnancy below 22 weeks is not yet a viable fetal. Religious and cultural beliefs may have a different opinions. The process of TOP, I shall leave it to another blog entry… I guess I should pen off here, this had been a long entry. Glad you made it to this line! :)

I hoped for a better world, still hoping…

Related links:
My 1st Forensic Experience


  1. This post left me heartbroken. The constant human display of cruelty never seized to shock me. I guess we just need to cling on to the thought that there's still hope and good in mankind, and this is just a few cases of rotten apples.

    This is a very good message you're sending. I applaud that.

  2. Thank you. I agree with you,.. i am still hoping for a better world...

  3. Disturbing to know that people are capable of such cruelty. Most times we are insulated from the harsher realities of life. The no. of unwanted pregnancies that get carried to full term resulting in abandoned babies or infanticide is disturbing and not enough is being done to provide a safety net for these young mothers. Something ought to be done to address this legislatively to allow unwed mothers to bring their pregnancies to term without fear of reprisals.

  4. Ola nuffnanger!

    Was that the bady...this is rather disturbing. But undoubtedly "cruel" as it is...I suppose we have no idea what circumstance the mother was in. Perhaps abandoning the child in hopes that he would be found by someone else was the best solution of her.

    I cannot possibly fathom what could go through a mother's mind that would make her abandon the kid...but I don't quite believe it is as simple as just not "wanting" to have the kid around.

    It is still very sad though. My heart really went out to it...

  5. >daryl teo>> yes, young unwed mothers do not know who to turn to... in the end, they suffer, the baby suffer.... perhaps they did not know of the social service available and the befrienders...

    then again, it all began with lust, premarital sex, etc... our Malaysia society had poor sex education, with it being a social stigma.. and something too embarrassed to be discussed...

    >cyren z.wong>> No, that was not the picture of the baby, we weren't allowed to take pictures during the postmortem, the picture was from my textbook.. but i can still clearly picture the baby in my mind...

    the mother delivering the baby herself and abandoning it--- and i thought such situation only happened in movies, until i saw this.... it's really, really sad, but it happens.... i really hope young mothers would think before they act... there is always help.. but u need to seek help first....

    i saw a patient 2 weeks back at the obstetric ward, she was 38weeks pregnant and hide her pregnancy from her parents until she had contraction pain. She had no antenatal screening, and the doctors managed to perform the basic investigation. Lucky for her, she had a normal delivery and the doctor was there to manage the blood loss during delivery... but bear in mind, not all pregnancy is that lucky... maternal mortality and morbidity rates are still considerable high in this country.. the society should realise that pregnancy is not something to be taken lightly...common pregnancy condition like gestational diabetes, hypertension in pregnancy, placenta previa, etc are of high risk to both mother and fetal...

    p/s: she was referred to the social workers and her baby was op for adoption

  6. This is what happens when sex is taboo. When the moralistic paradigm raises it's ugly head over society.

  7. >ezralimm>> yes.. it's so sad... the social stigma sometimes suffocates a women... if only we could change that..

  8. poor baby.gosh, only heartless ppl do this. :(
    anyho, can i linked urs? hehe.

  9. indeed, it's so sad for the baby..

    link? sure ^^ no problem! my pleasure... =)

  10. cruel!how can a mother treated Her own baby that way!?!feel sorry fot the baby..

  11. >joethew>>yes, it's a sad world :( ...still hoping for a better world....

  12. Girls getting caughtin such situations could give away the baby. There are many childless couples who would give the world to have a child like much so that they may even be willing to pay a fortune for one. At least, selling the baby is better than killing it!...This is not the first, and it will not be the last!

  13. stp, selling a baby is illegal, isn't it? True, there are childless couples who might adopt this baby.. but only few.. The numbers of orphans in homes are drastically increasing, especially children with many medical problems, abandoned by their parents.. If you ever had a chance to visit Tengku Budriah Orphanage Home, you may find that the orphanage home may not be the ideal place for a child to grow up.. these unwanted children, many are emotional deprived, and suffering from multiple medical illness and developmental delay... it's so sad to see this... that's why i'm all out for abstinence, good moral values, and contraception..

  14. hmm....izit ethical to disclose the detail of a postmortem finding or any other related information like this through the web?? or this is a fake report?

  15. almost d same as my 1st forensic, just tat mine one is much more terrible..really..stil remember after d day of forensic, i feel like cant do anything after tis for whole, appreciate life, n thanksgiving for stil able to breath...

  16. > anonymous, this is a diary of my experience at the forensic hall.. this is not how a forensic report should be written.. (my doctor will nag if i submit my forensic report in this format)... a forensic report is more detailed, formal and the format is totally different... and of course i did NOT post the forensic report i submitted to my consultant, here(my blog)!! sigh... and the picture is not the real one.. we were not allow to take pictures of the baby or publish the baby pictures.. this is just some other baby picture i took off the web.. (which i had explained earlier)... don't worry, i am very careful of ethical issues... i just merely hoping to send the message out to the public that, they should never abandon a baby... and that delivering a baby without medical assistance can be life-threatening... and the message of contraception and all... i hope you understood my message too and do pass it on :)

    p/s: oh yes, next time, do leave a name.. would appreciate that :)

    >jessie, yup, it makes us appreciate life even more.. especially when we see bodies from accidents and suicidal attempts..


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Author's Note

Dear friends and readers, Thank you for dropping by and leaving comments/ shoutouts. More importantly, thank you for being there... please accept my apology that, lately, i may be busy with work and not have time to reply youir messages/comments, but rest assured, each and everyone is read, and highly appreciated :) have a nice day! ^^

of love

Today, i heard a story which was not a story of falling...
of living in the dark end of winter turmoil..
instead, it was a love story..
of a couple who did not live happily ever after...
but they live, loving each other..