27/09/2022
Abortion , contrary to what many think, just means loss of a pregnancy from any cause, spontaneous or induced at 24 weeks( 20 weeks in USA).When we mention abortion in our Patient’s files, many end up rioting thinking that we mean they did something wrong.
This is the reason some Patients use the word 'miscarriage 'as a substitute. The 1996 Abortion Act in South Africa allows abortion only in selected cases:
1. In cases where the life of the woman carrying the pregnancy can be endangered was she to continue with the pregnancy. Cases like severe heart disease.
2. In cases of very serious social economic circumstances that would endanger the life of the mother and child
3. In cases of In**st, r**e and defiling
4 Severe deformities of the baby in utero, not consistent with life outside it
What I have seen over time is that few girls or women can satisfy this criteria, so many opt for unsafe criminal abortions.
Methods range from inserting sticks into the cervix or drinking some herbal medications as well as overdosing themselves with conventional drugs like Panadols or Caffeoyl .
When I worked as a Junior doctor 2005-2006, we used to clean girls with incomplete abortions daily, numbering more than 20! Many we admitted with complications. Some lost their wombs at very young age.
Some we could not save from very serious complications like bleeding or wide spread infections. So whatever our attitudes to abortion may be, girls will do anything in order to abort.
They will go for criminal abortions, regardless. Many end up dying. This is the reason perhaps that RSA after Mandela came to power introduced a walk in , walk our abortion service, with no questions asked.
Most African countries have similar laws as in Zambia, and they too face very high mortality rates related to unsafe criminal abortions. I can’t forget when in 2003 while working in Botswana , two young ladies, who attempted to abort criminally, died in my hands , while resuscitating them. One was a girl from the house next door to mine, the other was a good family friend. They both had taken some strong herbs that knocked out their livers and kidneys. We could tell because they both presented with deep eye jaundice or yellowness.
And you may recall the other case of a botched criminal abortion , a 16 yr old girl who lost her womb and part of intestines and carried a p**p bag on her tummy!
Many years have passed but I still remember their faces and names..
I have always said South Africa needs to review this 1 February 1997, Abortion Act, make it more liberal, to prevent high maternal mortality figures.