| represent yourself, people will inevitably
ask “what” you are. This sort of societal pressure often
leads people to choose one ethnicity to identify with in public but
maintain a private multi-racial identity with family and friends.
However, research shows that people who are able
to feel comfortable with the ethnic backgrounds of both parents have
a better sense of ethnic identity and, in turn, a better sense of
self. While you have expressed that you feel out of place, it seems
that, to some degree, you have been able to accept both ethnicities.
The fact that neither of your parents focused specifically on one
ethnic group is a positive thing that may have led to your comfort
in making friends from both groups. A significant advantage of balancing
both ethnicities is that you have probably developed a greater tolerance
for ambiguity and change, which increases your ability to handle conflict
and stress.
It is important to continue to strive for a balance between both
ethnicities to maintain a healthy sense of self. This becomes particularly
important when in a relationship, since even under normal circumstances
it is easy to lose yourself when you are so closely tied to someone
else. A good way to maintain a healthy sense of self is to place yourself
in situations where you feel comfortable and accepted.
From what you have said, it sounds like you are in a loving relationship.
Whatever your reasons for choosing an Indian boyfriend, it seems as
though he has allowed you to feel at ease with your identity and is
willing to be with you despite what his parents may think. You must
realize, however, that your boyfriend’s parents may not be as
comfortable with the situation as he is. While intermarriage amongst
Indians in the United States is becoming more common, it is difficult
to determine exactly how your boyfriend’s parents will react.
Many Indians believe strongly in preserving their culture through
marrying other Indians and hold their children to the same expectations.
If this is the case, you will need to decide how important their acceptance
is to you. Will rejection from Indian parents damage your ethnic identity
in some way?
On the other hand, it is entirely possible that your boyfriend’s
parents will appreciate you for who you are, especially if they realize
that their son is happy. Either way, be proud of your heritage and
your unique ability to understand the world from different perspectives!
QUESTION
I’ve been married for three years, and my wife has had three
miscarriages. Both of us have gotten complete medical check-ups and
the reports were normal. Our last miscarriage was due to the child
suffering from Cystic Hygroma. After that, we both each had another
complete medical check-up (including a genetic test) and all reports
were still normal. What could be the cause of that disease? We worry
about our next pregnancy. Please guide me so that we could have a
healthy child. Our last miscarriage was in the month of December 2005.
ANSWER by Dipika Dandade
You and your wife have been through a very difficult time over the
past few years. A positive pregnancy test alone can spark thoughts
of all your hopes and dreams for a baby and as the pregnancy progresses
that bonding intensifies. The loss of a pregnancy at any gestational
age is traumatic and heartbreaking.
When a couple has two or three miscarriages, this is referred to
as recurrent pregnancy loss. Keep in mind that as many as 20 percent
of recognized pregnancies end in pregnancy loss. As you mentioned,
there is a workup to try to identify a cause.
Most commonly, a miscarriage is caused by a genetic abnormality in
the fetus. Both mother and father should undergo a blood test to check
their chromosomes. Any tissue available from a miscarriage can be
sent for analysis as well. If there is any indication of a genetic
cause, a couple should undergo genetic counseling. Additionally, with
future pregnancies, testing of the fetus can be offered either through
chorionic villus sampling (CVS, which entails taking a biopsy from
the placenta at approximately 11 weeks) or amniocentesis (removal
of fluid from around the baby at approximately 16 weeks).
Autoimmune abnormalities such as antiphospholipid antibody syndrome
(APLAS) can lead to abnormal clotting and subsequent miscarriage.
Other clotting abnormalities such as Factor V Leiden deficiency can
lead to pregnancy loss. There are specific blood tests, along with
clinical history, to help identify these conditions. If these conditions
are indicated by tests, an expectant mother can be treated with blood
thinning agents such as aspirin or heparin.
The uterus can be evaluated with imaging (such as ultrasound or MRI)
or surgery to diagnose anatomical defects. The shape of the uterus
can be assessed, as well as the presence of any masses, such as a
fibroid or polyp. Sometimes surgical correction can be undertaken
with subsequent successful pregnancy.
Any concurrent medical problems should be well under control. Uncontrolled
diabetes, for example, is a known risk factor for miscarriage and
fetal malformations. Try to identify any habits, such as smoking and
excessive alcohol or caffeine intake, that can be improved on.
To address your particular situation, a cystic hygroma is a cyst
that forms due to an abnormality in the lymphatic system. The most
common location for a cystic hygroma is in the head and neck. It may
occur as an isolated finding, possibly due to infection, an unknown
cause or associated with genetic abnormalities and syndromes, including
Turner’s syndrome, trisomy 21 (Down Syndrome) and Noonan’s
syndrome. The defect may resolve on its own, persist or potentially
continue to grow and possibly lead to obstruction of other organs.
It may also cause generalized swelling and possible death of the fetus.
When a fetus has a cystic hygroma, a thorough ultrasound should be
done to see if there are other anomalies suggesting the presence of
a syndrome. Because almost half of these fetuses have a chromosomal
abnormality, CVS testing or amniocentesis can be offered, as mentioned
previously. If the pregnancy continues, serial ultrasounds should
be performed at set intervals to evaluate for progression. In the
event of a pregnancy loss, the tissue should be examined by a pathologist.
You and your wife should definitely speak with a genetic counselor
to review your personal and family histories to identify any hereditary
syndromes. A counselor can review your prior test results and help
advise you about risks of recurrence for cystic hygroma. Additionally,
you might think about seeing an obstetrician who specializes in high-risk
OB (known as a maternal fetal medicine, or MFM, specialist) prior
to your next pregnancy for further counseling.
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