Abortions are neither safe nor pain free

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Abortions are neither safe nor pain Free

Melissa Douman

With sweaty palms clinched in a tight supportive hold, they sat in the Marie Stopes Clinic in Sandton. Twenty-two year old Zoë O’Neill felt nervous, anxious and torn apart. Though her boyfriend’s gaze was gentle, she struggled to maintain eye contact with him. She felt unsure if they would ever get over the guilt, the consequences, and the emptiness of what was to come.

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The wait was long. All 14 seats in the waiting room were taken up by women. Some chatting casually with their partner or friend, others just sitting quietly with their eyes closed or staring straight ahead. Though the room was full of women awaiting the same fate, no one looked at each other or united in a sympathetic gaze. It was as though everyone was cocooned in their own bubble with reasons for being there, reasons that nobody else could possibly understand.

Zoë, with her own feelings of apprehensiveness and despair thought that she was lucky, at least she was not making this decision on her own, the man who got her pregnant was with her holding her hand whispering “Don’t cry baby, it’s going to be okay.”

She felt angry for being there. She felt angered by the choice that she was making and all she wanted to do was run out of the clinic and tell her boyfriend that the doctor was right, “we are not the first young couple in this position, we can still have a career, contact with our family and say that our children are the best thing that has ever happened to us.” But she couldn’t, she couldn’t fight their choice and see her baby born.

She remembered thinking abut her hopes and dreams. About the day she would receive the news of being pregnant. It was going to be one of the happiest days of her life, because by that time she would have had a stable job, got married and been ready to take on the responsibilities of being a mother.
It was as though the words “Stop, No, I don’t want this….” were being stifled in her throat for she knew that this was the best solution despite the fact that it wasn’t right.
If she keeps the baby, how is she going to tell her conservative parents who still believed that she was pure and innocent? Would they believe her when she tells them that she was not irresponsible but that the contraceptive pill that she had been on for the past year had failed her? She remembered the employer who paid for her studies, secured her a job and put a roof over her head saying in passing that “she must make certain that she doesn’t fall pregnant before she starts her new job.” She didn’t ask him what would happen if she did. “What would happen if I did?” she thought. She was on the verge of starting her career, starting her life and being able to move away from the struggle of not being able to do, to afford to achieve. She had it all and now this…

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Statistics collected by the National Department of health reveal that on average 50 000 legal abortions are performed each year. Abortions became legal in South Africa in 1996 but this does not mean that they were not performed prior to 1996 when the Choice of Termination of Pregnancy Act (CTOP) was passed. The passing of the CTOP sparked heated debate – and that debate has not lessened. In other countries in Africa where abortions are not legal 4, 2-million unsafe abortions are performed each year and from these approximately 30 000 women die.

“And then there’s the age of the young women who are getting the abortions. I don’t dispute that some of them use termination as birth control. This is irresponsible. But I do believe there are many more who see no other way out; who feel they’ve made the right to decision,” said Health Minister Manto Tshabalala Msimang in an interview on the controversy around abortions

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“Zoë, Zoë O’Neill” the nurse called, “Zoë you can come inside now.” Her heart started racing as she walked into the office, her hand clutching the purse that contained the R2 500-00 that she and her boyfriend struggled to come up with. The receptionist handed her the box of tissues and asked her what procedure she had decided to go with.
“The results of the sonar revealed that you are 4 weeks and 5 days pregnant. You came in last week Thursday, which means that you are now 5 weeks and 3 days pregnant. You can still have the medical abortion. If you take the pill today, you must go home and get some rest. Tomorrow morning you must come in for the next round of tablets, after which you should get home as soon as possible because then you will experience a miscarriage. You will not be able to do work for at least two days,” said the receptionist looking down at her blue file.
The receptionist did a quick calculation and then told her that the sonar was R240 which she had already paid and that the amount for the medical abortion would be R1888-50.
Zoë gave the money to her boyfriend who reluctantly paid with one hand and held her with the other. He led her outside and looked at her saying that he will not leave her side. That she is not alone and that they would get through this together. “Baby, do we have to do this?” she asked. He replied “We don’t have a choice, but you are strong and together we will be strong. I won’t leave your side.”

The Nurse called Zoë again, this time there was no turning back, the decision to go through with the abortion was made when she paid. The tears were streaming down her face as she sat in the chair opposite the nurse who administered the drug to her. “This is an oral tablet that you have to drink. It will start causing you to have mild contractions and may even dislodge the foetus. But this is a very rare occurrence. You have to come back tomorrow the same time as today so that we can insert 2 tablets into your cervix and then you will go home and get into bed. The bleeding will start and then it will be like you are having a miscarriage,” explained the nurse.

Zoë looked down at the glass with only a sip of water. The hand clutching the tablet was shaking and she felt as though her heart was going to explode. She looked at her boyfriend and began shaking her head, “I can’t, I can’t,” she said crying.

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Marie Stopes is one of a string of clinics where abortions can be practised legally. It has hosts of clinics situated around South Africa. They offer abortions and say that their abortions are safe and pain free. They do not perform free abortions as they are a private clinic, but government hospitals that do offer abortions do so free of charge. The problem with government hospitals like Johannesburg General Hospital is that they have a three month waiting list for abortions. The legal limit for termination is three months or 12 weeks. As a result many girls and women unable to have abortions done at these clinics and cannot afford private clinics like Marie Stopes are so desperate for the abortions that they have backstreet abortions because they are cheaper than private clinics. Backstreet abortions are not legal because they are often performed in an unhygienic setting or are performed by people who are not trained to perform them.

“The goal of Marie Stopes South Africa is the prevention of unwanted births, and our mission is to afford women the right to have children by choice not by chance,” reads the Marie Stopes advertisement. However, there seems to be a problem with their advertising as Zoë discovers. They promise to provide safe and pain free abortions.

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Two weeks later Zoë arrived back at the clinic. She was there to make sure that the foetus was gone. Her heart was sadder than it had ever been before. She remembers the pain that she felt when she lay in bed, severe cramping and no pain killer to take the pain away. But she didn’t complain, she bit her lip and bared it all for she knew that her actions made her deserve more pain than what she was experiencing. Her choice to kill her unborn baby deserved more than the continuous abdominal cramping that sometimes was so severe she couldn’t even walk, the heavy non-stop bleeding, the nauseous feeling that she had experienced for the past two weeks. She wanted to die.

She wanted to go back to that fateful day, where she would not have taken the pill or have had to go back the next day for the two they inserted inside of her. She wanted so badly to still be pregnant. She wanted so desperately to see the birth of her baby. The baby she, in a short period of time loved because it was hers and it was theirs and before everything had happened they seemed so in love.
Zoë found herself in the waiting room, waiting to be called into the reception office only to get sent back to the waiting room to wait for a nurse to call her.
When the nurse called, she led her into the examination room, told her to remove her pants and lie on the table. She slapped cold gel on her stomach and proceeded with the sonar. Zoë thought of the first time she had had a sonar done and remembered seeing a tiny bean-like blimp on the screen. It was not a baby yet but somehow she wished that it was still there.

The nurse looked up at her and said “You are still showing signs of pregnancy.”
She turned to her boyfriend who was holding her hand, “What do you mean I am still pregnant.” The nurse showed her the monitor and said “Look there, it is still there.”
The nurse explained that the procedure was unsuccessful. She was going to have to do the procedure again.
“What do you mean do it again? You mean that you are going to shove more tablets with that steel thing inside me again? You mean that I am going to go through more cramping and more bleeding and what then? No I want to keep it. I shouldn’t have done it. What happens if I keep the baby?”
“You will die,” said the nurse. “You can’t keep it because you are bleeding and the bleeding won’t stop. It is not really a baby anymore. It is just tissue that is still there.”

Zoë fought with the nurse to get a doctor to remove it. She couldn’t bare having the something stuck up inside of her and more tablets and more pain. She couldn’t afford staying out of school for more time than she had already taken and she couldn’t tell her parents for the third weekend in a row that she was too swamped with work to go and visit them. What was she going to do?

The nurse asked her to remove her underwear. “But I am still bleeding,” she said. The nurse laid a paper towel on the examining table. Told her to spread her legs wide and relax and then inserted the cold steel contraption containing the pills. Her boyfriend stroking her head, tears in their eyes.

The nurse left the contraption and called a doctor from her cellphone, “Doctor it is Sister Yvone Tshabalala from Sandton clinic. I have a patient here. She is bleeding too much and there are big blood clots coming out. The medical procedure did not work. Must I still put the tablets in or send her to you for it to be removed?”

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Jeanine McGill, the National coordinator of Africa Christian Union said that “The pills used to induce early labour have a number of side effects. They can cause prolonged bleeding and normally cause severe cramping. Because the pills take a long time to take effect, mothers often deliver their babies at home, resulting in psychological trauma as they realise that their baby is not mere “blob of tissue”, but a recognisable small scale human being from 6 to 8 weeks after conception.”
Zoë found herself being driven to the clinic. She couldn’t believe it. This nightmare was turning into a slow and painful torture. Ghandi Square was dark and dingy. The Marie Stopes Clinic in Ghandi Square was tucked away in a corner of a building that was being reconstructed.

There was another wait to see the doctor. The same looks on faces of girls in the waiting room. They were a lot younger than the ones she had encountered at the Sandton Clinic and they were not cocooned. They stared at her. She wished that she could disappear but realised that they were all there for the same reason and they were all scared just like her.

A male doctor called her into his machine filled room with a single bed, machinery on either side. He told her to lie down on the table. He said that the procedure would take 10 minutes if she lied really still and could withstand the pain. He said that he would insert a few instruments inside her cervix and then use suction to get the foetus out of her. He also said that he would scrape out her uterus. Zoë felt the walls caving in on her and asked in a choked voice, “I couldn’t even lie still when the nurse shoved the tablets up inside me, how am I going to do this doctor?” The doctor said that if she wanted an anaesthetic, she was going to have to pay another R600 upfront.

“We don’t have anymore money Shane,” said Zoë to her boyfriend. “Its okay baby, we’ll make a plan,” he said in a comforting voice.

Another loan and they managed to collect the money in an hour, just in time to be the last of around 20 girls to have the procedure done that day. The clinic closed early on Saturdays.
She waited for an hour in what felt like a solitary confinement. Sitting there in nothing but a blue overall she felt her head start spinning as the medication began taking effect. She was then escorted to the doctors’ room once more and heard him mumbling something or other and then there was pitch black.

Two weeks later, Zoë is back at the clinic. Her abortion took four weeks before they confirmed that she was no longer pregnant.

Though she is no longer pregnant Zoë is tortured by her dreams. “I forgot the physical pain of the procedure,” she says, “the hardest part is waking up every morning and living with the guilt, pretending that this didn’t happen and not being able to share the experience with anyone. The hardest part is realising that I will never be the same and still having a passion for the job I thought that I would love to do, when I blame the profession that I chose for influencing my decision to kill my baby.”

“We must emphasise that because of the guilt and shame involved, women who suffer as a result of abortions are not only less likely to complain, but they are less likely to seek medical treatment for injuries incurred,” said McGill.

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