A day in the life of a Sexologist - Keeping abortion safe and legal

2015-07-07 20:55

As a Sexual Health Practitioner I receive hundreds of e-mails, some friendly and asking for advice and some attacking and hostile, sometimes even threatening. This week, I am saddened by the following mail that was sent to me by an anonymous person. Clearly this person is concerned about the rights of women that should have access to safe and legal abortions, according to the Choice on termination of pregnancy Act of 1996.

Good day,

There's something that concerns me that will never ever be rectified in South Africa,

Illegal Abortions,

People go the illegal route because they can't afford to go to family planning clinics and private facilities. When they go to government hospitals they're ill-treated, ridiculed (95% of the time) and fooled by nurses that they're further along than they think. The nurses get to the point where they give them numbers for illegal abortion options which THEY (the nurses) facilitate to make a quick buck outside of the clinic.

It's great to have campaigns such as "Say No To Illegal Abortions" to help women but most women's hands are tied because of affordability and while the private clinics make money from an extremely small percentage of women (let's be honest, MOST South African women can't afford the price tag or private clinics), other women - from the ages of 12 - all over SA become infertile, have complications and even DIE because the people they should trust, the health department, aren't trustworthy whatsoever and private institutions are too expensive.

I know you won't do anything about this email because you'll probably say "it is not our problem" and it's sad.

I just thought I'd inform in you on what's going on.



On the African continent South Africa is one of only a few countries where termination of pregnancy is legal. The Choice on Termination of Pregnancy Act was introduced in the first post-Apartheid parliament. It applied the statement in the governing ANC’ policy framework that “every woman must have the right to choose whether or not to have an early termination of pregnancy according to her own beliefs”. Although it was requested that parliament members be allowed to vote according to their personal beliefs, the ruling party ruled that its own members may not vote against the act, and the act passed by 209 votes to 87 (5 abstained, 99 were absent). It came into force on 1 February 1997.

Right now there are more illegal than legal abortions taking place in a country with an Act that has been described by the Guttmacher Institute as "one of the most liberal abortion laws in the world".

How did this happen? Does women’s lives not matter? It is not an argument for or against abortion, but rather a cry for safe and legal access for those women who find themselves in a desperate situation.

Since abortion was legalized, it has become more acceptable and normal in the minds of many, therefore more women are having abortions. Backstreet abortionists, who buy the abortion pill on the black market, are operating with impunity in every town and city in SA. It is possible that more women are dying from backstreet abortions than before abortion was legalized, although it is impossible to know how many.  Doctors have reported that many of these women who buy the abortion pill from backstreet abortionists are having incomplete abortions that lead to sepsis and even death.

A quick Google search for Abortion pills will bring up hundreds of backstreet abortionists posing as legal clinics and / or medical doctors. For the trained eye it is easy to spot the illegal clinics and back street abortionists, but for a desperate school girl or an unemployed young mother, she might not be aware of what to look out for when searching for help on line.

It is very easy to distinguish between legal and safe service providers compared to illegal providers. By following the guide lines below, not only will the patient receive the best care possible, their ability to bear children in future would not be hampered.

Legal service providers:

• Has a physical clinic with a street address

• Has a land line

• Clinic staff are qualified doctors registered with the HPCSA or registered nurses with the SA Nursing council – ask for proof

• Clinic is equipped to do Sonars and other medical procedures

• Legal clinics offer medical and surgical procedures

• When you visit the clinic you have counselling and a detailed medical history as well as an examination before any procedure is performed

• Legal clinics will keep records and also have a consent form that the patient has to complete before any procedure is performed

• Take home medication such as antibiotics and pain medication is supplied

• Follow up appointments are arranged

• 24 hour helpline or contact to reach the health care professional is provided

 Illegal service providers:

• Has no clinic or a physical address

• Works from a cell phone

• Often calls himself doctor, but has no relevant qualifications

• Only sells pills, or will deliver

• Does not consult or examine patients

• Has no follow up.

 The heavy toll of unsafe abortion

The fact is that almost all unsafe abortions occur in the developing world. According to the World Health Organization, unsafe abortion is the cause of 70,000 maternal deaths each year, or one in eight pregnancy-related deaths among women. That translates to seven women per hour. Approximately eight million more women per year suffer post-abortion complications that can lead to short- or long-term consequences, including anaemia, prolonged weakness, chronic inflammation of the reproductive tract and secondary infertility. Of the women who experience serious complications each year, nearly three million never receive treatment.

Anonymous challenged me by saying - " I know you won't do anything about this email because you'll probably say "it is not our problem" and it's sad." But she/ he is wrong, it is my problem and I am doing something about it. I am alerting everyone that care about women and their reproductive health. I am asking every parent that has teenagers, “Please talk to your children and have that birds and bees talk, make them aware of the consequences of unprotected sex and unsafe abortion.”

Better access to family planning information and contraception is of vital importance, but it is not enough. Medical personal need more training in safe abortion techniques, including the provision of medical abortion services and improving the conditions under which abortions are provided and the quality of services. More access to information and education provided to health personnel and to women and enhancing life-saving post abortion care.

Keep our young school girls and women safe, report illegal abortion providers and backstreet abortionists to the Crime Line. Do not walk past a pamphlet or poster that is selling abortion pills, remove that pamphlet and report. Send an anonymous tip off on Twitter to @CrimeLineZA or anonymous reports may also be made by visiting www.crimeline.co.za, SMSing 32211 or calling 08600-10111.

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