Heartache as ‘avoidable cause of death’ on rise
SHE came to Dora Nginza Hospital in the morning. Seventeen years old, bleeding uncontrollably.
She lived in Middelburg, 300km away. The hospital there had already tried to help her. She had taken abortion pills but had not expelled the foetus.
Her uterus became septic. In a desperate effort to help her, more than five litres of septic fluid were drained from her abdomen.
By the time she arrived at Dora Nginza, her blood was no longer clotting and she had to have a hysterectomy. Doctors gave her adrenalin when her heart stopped. But even that was not enough.
"She died in my hospital. Her parents asked me why I killed their child,” Dora Nginza’s head of obstetrics, Mfundo Mabenge, said the day after his desperate battle to save the young girl.
For him, like so many other cases, she has become the desperate, suffering face of illegal abortions in the province.
"What tears my heart apart is that I have to account for her. She was here for less than six hours. Her family now comes to us and says: ‘Why have you killed our child?’”
In 1997, when South Africa legalised abortion, deaths caused by unsafe procedures dropped by more than 90%.
In its assessment based on maternal death statistics for 2005-07, the national Health Department raised the alarm for the first time over an increase in what it described as a "completely avoidable cause of death”, ranking unsafe abortion as the fourth leading cause of maternal death in South Africa.
The department’s latest report, on 2008-10 maternal death statistics, attributes close to 25% of deaths nationally to pregnancy-related sepsis and uncontrolled bleeding.
Septic miscarriage – an indication of illegal abortion – further accounted for 66% of deaths caused by miscarriage.
Jean Downey, of the New Life Pregnancy Crisis Centre in Uitenhage, says just about every woman who comes seeking counselling after an abortion had an illegal one.
"Women come here severely traumatised. They took the pills and ended up squatting over buckets for hours, aborting the foetus at home ... when they come to me they have nightmares of babies crying.”
Social worker Thandi Plaatjie, from the Healthy Mom and Baby Clinic in Jeffreys Bay, said they recently found out through community workers that girls as young as 12 were aborting their babies in the municipal toilets near the informal settlement’s rubbish dump. "Some take tik and other drugs to bring on the miscarriages.”
The Medical Research Council’s survey of youth risk behaviour found that 30% of pregnant teenagers who had abortions indicated they went to either a traditional healer or "another place” for an abortion.
"We are seeing the rate of unsafe abortions rising again,” Mabenge said. "We cannot meet the demand for abortion. If a woman has to wait, she will go to a backstreet abortionist.
"A functional abortion service is one of the most effective ways to reduce maternal deaths in the province, as illegal abortion is one of the top five contributors.”
The maternal death rate in the Eastern Cape has doubled in the past three years, with 710 pregnant women dying in the province’s state hospitals between 2008 and 2010.