/ 1 April 2008

An all-too-common ordeal

Written by an M&G reader in response to our story on illegal abortions

Despite being legalised in South Africa more than 10 years ago, abortion–or termination as I would prefer to call it — is still stigmatised. Women do not really have a choice and it is very difficult to get any support or information on this issue.

I am in my 40s, a devoted mother of two from a happy, secure and financially stable family. Recently, while still breastfeeding and enjoying our youngest, most welcome and adored late-come baby, I discovered that I was pregnant again. My gynaecologist warned me, after the birth of the last baby, that another pregnancy would be life-threatening. I simply adore babies and children, but experienced serious health problems with my previous pregnancies.

During the last pregnancy I ended up in hospital on several occasions and vomited for nine months. On top of that I had pre-eclampsia and a number of other health problems. My age and the fact that we now stand a one in 20 chance of having a Down’s syndrome baby did not make it easier.

Being a mature and educated woman who has been around the block, I should have prevented this from happening, I know. But that is not the point. We simply could not see ourselves going through with this pregnancy while at the same time taking care of our family and giving our other children the time and energy they deserve.

We talked it through, cried a lot and made the decision to terminate the pregnancy. The fact that I was only five weeks pregnant made it just a tiny bit easier. I confided in a close friend, who also happens to be a medical doctor, because I was too scared that my other friends would confuse me.

My first reaction was to see my trusted gynaecologist, who had supported me through my previous difficult pregnancy, but that was the beginning of a horrible and most painful ordeal.

Having already made the extremely painful decision, something I never expected I would do or ever have to do, my gynaecologist informed me that she did not “do terminations” and proceeded by giving us a moral lecture, based on her personal beliefs. She also said that, despite the high risks, she would support me through the pregnancy, because she did not believe in terminations.

From her point of view termination was not an option. Period. When we told her that we had already thought it through and that we wanted to terminate, she was appalled and became very emotional. I realise that she has to deal with many people who battle to have children because of fertility problems, but I found her conduct highly unprofessional.

I really empathise with childless couples, but I could not compromise my health at the risk of my other children and husband losing me. It simply made no sense. In the end she, albeit reluctantly, referred us to the Marie Stopes clinics, where they “did that type of thing”.

Desperate and emotionally drained, I called the toll-free number for Marie Stopes South Africa. I really needed to talk to someone sympathetic to get more information, but was brusquely told that if I wanted a termination I could make an appointment for the following day. I was informed that it would cost R1 600 with pain relief and about R1 200 without. That was it. The next morning I found myself in the drab surroundings of said clinic, tearful and clutching my husband’s hand. The clinic in my home town is in a stifling office block, with no privacy, no air- conditioning and little space.

On arrival you are asked for a few sketchy details (without any counselling) in an area where there is no privacy and then told to wait until your name is called. The large number of desperate scapegoats– many of them courageous young girls– filled up the waiting area in no time, attended to by a total of three punch-drunk sisters … There was no doctor in sight, no counsellors. All that remained for us was to study the expressions of sadness and desperation, but mostly fear, on one another’s faces.

Only three of us were supported by loved ones, the remainder had to face the ordeal on their own. There was no talking and no one dared leaving the sad room for a minute for fear of being reprimanded by the pedantic and strict reception sister who should have considered another career.

I wanted to run, but I was paralysed by, I think, fear. Instead, I cried silently and firmly held on to my husband’s hand. When my turn came two-and-a-half hours later, I was led to a small room with a narrow bed and straps hanging from the roof. I had vivid memories of all the torture chambers I could recall from the movies. The more motherly sister told me to lie down and I agonised, anticipating all sorts of cruel instruments poking into me.

She said she would first have to do an ultrasound to see how far the pregnancy had developed and for the next 15 minutes battled to find what she called “the pregnancy” on the screen. I told her that my specialist had done an ultrasound (no doubt on a more recent model of the ultrasound machine) just the day before and that I was five weeks pregnant. She looked as if she did not believe me. There was indeed not much to see and thankfully, no heartbeat yet, because that would have given me the courage to run.

On the ceiling a pure kitsch picture, the kind you would have found at jumble sales 30 years ago– a 3D image of some or other serene, yet colourful, Thai water landscape. The bedding was stale and smelly and obviously not changed that day. I stared from the picture on the ceiling to the perspiring sister into the agonising eyes of my husband.

She announced that I would get “a medical pill”, but I was too emotional to understand anything she was trying to say. My husband translated that I had “qualified” for an abortion pill and that we were to wait in the queue again. I was so relieved that no instrument would come near me that I was willing to do anything. I accidentally waited in the wrong room and was severely reprimanded by the strict reception sister in a tone of voice that I would not use on a five-year-old.

At last my turn came again and I was handed a tablet to swallow there — and four more to swallow the next day at home. This was the job of the most sympathetic sister of the three. She explained how the tablets should be taken and mentioned the side-effects. Still no counselling. We paid R1 200 and left. I took the pills the following night and suffered severe and very intense pain, nausea, fevers and the like, but by the following morning the physical pain was almost gone.

Only later did I read in a local daily paper that the abortion pill is available as self-medication in pharmacies. The tablets can be given only in cases where the pregnancy is no further than nine weeks, but why is this information so damn difficult to come by? They do mention the pill on the Maria Stopes website, but did not offer any information regarding it when I called.

Surely my gynaecologist could have prescribed this pill, or told me to go and ask a GP or my pharmacist? Surely they do not have to make you sit and wait for hours at a horrible clinic, charge you R1 200 and treat you like a naughty child if you need five tablets?

I know that I have made the right decision and I do not regret terminating the pregnancy. I realise that the emotional healing will take time. I have the support of my husband, who would also have supported me through a life‒threatening pregnancy if I had chosen to go ahead with it.

There are loads of international websites offering emotional support and information on abortion. In South Africa there is none. I have joined a British post-abortion support discussion forum and have done a lot of reading on a number of websites.

Was I just unlucky? I believe terminations can also be done at government hospitals, but I cannot even begin to imagine what the experience would be like there. What happens to young girls who have no access to the internet or other sources of information.

The decision to terminate a pregnancy is already an extremely difficult and, I think, very brave one. I am healing and I am coping, but I feel that there should be an easier and more humane way of dealing with pregnancy terminations and that they should be de-stigmatised.