Pèdisyon: Haitian Myth or Medical Fact?

I came across the word “pedisyon” two years ago while doing a seminar with underprivileged families in Haiti who were looking to give their children up for adoption. The goal was to prevent them from abandoning their children in orphanages and to maintain their family unit. In Haiti, over 80% of children placed in orphanages are not orphans, as missionaries love to call them, they are simply poor. During one of those sessions, a teenage mother stated that she was pregnant, but has suffered from “pedisyon.” This was my first time hearing such a medical condition. When I asked for clarification, the entire assembly looked at me like I was the biggest idiot on the planet. Below, Dr. Kenny Moise explains what is “pedisyon” and whether there is any medical truth to this widely held belief in Haiti. – Nathalie N. (Associate Editor, Woy Magazine)

I once examined a 50 year-old woman who claimed to have what Haitians call pèdisyon since 2010, after the January earthquake. With a positive urinary pregnancy test, she was completely convinced that she had a baby living in her uterus for five years, and even claimed she could feel the fetal movements. I ordered an ultrasound exam of her pelvis and abdomen and noticed that no fetus was inside. Further exams helped the team diagnose some days later that she had cervical cancer. Three months later, another woman, 34 years old, came for a prenatal visit saying she also had pèdisyon. She couldn’t remember the exact date of her last menstrual cycle because she believed she had been pregnant since 2013 (2 years). Indeed, she was pregnant, but the ultrasound indicated that it had been less than 40 weeks of pregnancy. Is pèdisyon simply a figment of Haitians’ imaginations?

Health is directly or indirectly influenced by a wide range of factors: biology, education, culture, social status among others. According to the World Bank analysts, 59% of Haitians live under poverty line 6. Not more than 22% of boys and 29% of girls have access to secondary school 7. This cultural context results in a never ending battle between traditional and modern medicine in the country where most of the people turn to a vodou priest for health care. In the midst of this environment, pèdisyon (perdition) lies as a curious and common health problem. It is believed to be a condition in which a woman carries her baby longer than the normal term, ranging from 10 months up to several years. More common in urban areas, pèdisyon is somewhat of a culture-bound, biomagical disorder believed to be associated with infertility as the fetus is kept in the uterus by a vodou priest by way of magical forces.

But is Pèdisyon actually considered as a real disease in modern medicine? Terms such as “Repressed pregnancy (Richmann 2002)” and “Arrested Pregnancy (Murray 1976)” are used to describe this strange syndrome. As André Marcel wrote in his book “Haiti: Paysage et Société”, for doctors it is just an imaginary or psychosomatic condition 8. Dr Philippe Desmangles explains it as a syndrome of repetitive miscarriages that the women are not willing to accept 9. Because of a phenomenon doctors call fetomaternal Rhesus incompatibility, these women tend to have miscarriages in the first trimester of pregnancy due to a blood type incompatibility that causes the mother’s body to reject the fetus. In 1996, a national survey was held in Haiti showing that arrested pregnancy syndrome is fairly common and affects a large proportion of Haitian women 10.

This conflict of belief systems shows how difficult it is to arrive to a clear conclusion when it comes to things like. As a Haitian doctor, I can confirm that poor health is a oftentimes a result of poor health literacy. Pèdisyon is the ultimate opportunity and bridge for fruitful communication between traditional and modern medicine in Haiti. May we break the barriers and learn from each other.

Photo credit: Cl Nerette
clnerette.com

Notes:

  1. http://www.banquemondiale.org/fr/country/haiti/overview 16/04/15 
  2. http://www.unicef.org/french/infobycountry/haiti_statistics.html 16/04/15 
  3. André Marcel d’Ans, Haiti: Paysage et societe, Editions Karthala, 1987
  4. Dr Philippe desmangles, La perdition: mythe ou realite? In: Le nouvelliste, 1 juillet 2014
  5. Creil J. et al. Arrested pregnancy syndrome in Haiti: findings from a national survey, Med Anthropol Q. 1996 
  6. http://www.banquemondiale.org/fr/country/haiti/overview 16/04/15 
  7. http://www.unicef.org/french/infobycountry/haiti_statistics.html 16/04/15 
  8. André Marcel d’Ans, Haiti: Paysage et societe, Editions Karthala, 1987
  9. Dr Philippe desmangles, La perdition: mythe ou realite? In: Le nouvelliste, 1 juillet 2014
  10. Creil J. et al. Arrested pregnancy syndrome in Haiti: findings from a national survey, Med Anthropol Q. 1996 
Kenny Moise

Kenny Moise

Dr. Moise is a medical doctor, currently living and working in Haiti. He is the co-founder of IntregAction. He can be found on twitter @KennyMoise, where he tweets about his interests in public health, politics, social development and art.

1 Comment
  1. As you said, poor health can sometimes be a consequence of poor health literacy. I wonder if poor literacy in general could be a factor in the pèdisyon phenomenon. As an American living and working in Haiti, I see Haitians having a very different understanding of time than what I’m used to. In the rural areas especially, people often don’t have clocks which means they are lacking even on the most basic level of time accountability. This shows up frequently when people are unaware of their own age. When things are unwritten (no documentation) they become “unreal”. What we think we know begins to shift and become cloudy until the truth becomes something other than true.
    Mixed with Haiti’s strong inclination toward mystical practices, I can see the challenge doctors face in finding the truth.

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