The Abortion Entry

If you know me well, you knew this was coming. Maybe you didn't know it was coming. This post isn't meant to be controversial in anyway or start up moral debates.

On Tuesday we had a lecture on abortion in South Africa in my Gender and Health course. Prior to the class, we read two studies that the guest speaker, Jane Harries, had conducted: one on health workers' attitudes on abortion and the other on delays in seeking abortion until the second trimester. She also recently did another study but is having trouble finding a publisher. As one might imagine, it can be difficult for researchers to receive support in examining abortion.

It's impossible to cover everything that I learned in one entry, so I'll try to summarize my thoughts (all of the info is coming from her presentation and studies. Email me if you want more detailed info). First of all, South Africa has some of the most liberal abortion legislation in the world. This is a recent development that occurred in 1996; prior to that it was very restricted. Most of the rest of African nations still have very restrictive laws on abortion, which leads to unsafe, illegal abortions. Approximately 68,000 women die every year from illegal abortion and many more are injured, often permanently. Keep in mind that abortion is an extremely safe procedure when done in a legitimate medical setting, so the liberal laws in South Africa have saved thousands of lives. Abortion is available on demand in the first trimester of pregnancy, though it is more restricted in the second trimester (only for pregnancies resulting from rape or incest, fetal abnormality, life threat to the woman carrying, or if the woman can prove low income status). Abortions are also FREE in the public sector. Yes, free! In the U.S, first trimester abortions cost about $300-$700 depending on where you are, and second trimester procedures can be $2000-3000. Something else exciting is that "mid-level" providers, such as midwives, are allowed to perform first trimester abortions here with MVA. (By the way, abortion rights are increasingly under attack in the U.S. If you'd like to learn more and support abortion access in the U.S., please click here).

Something surprising was the high percentage of South African abortions that occur in the second trimester. Later term abortions are relatively rare in the States, but here they account for 20+% of all abortions. Harries' study on delays in seeking abortion covered most of the same issues I've heard from women back home, so I haven't drawn a conclusion myself for why there are more delays here.

Probably the biggest shock for me was that medication abortion is very commonly used for second trimester procedures. Back home, it was offered to nine weeks at the latest, and to seven weeks in the FDA approved version. Here, a woman in the second trimester can be admitted to a hospital, administered medication, and then waits it out until she passes the pregnancy. To me, I can only imagine that that is a very difficult, painful (physically and emotionally) process for the woman. I would really love to see a study on women's experiences of second trimester medication abortion (I believe that is what Harries' latest study examines, so I am going to try and get my hands on it!).

Overall, despite the liberal legislation, there are certainly problems with the implementation. When the most recent legislation came out in the nineties, very few doctors were trained or prepared to offer abortion services. Also, the stigma of abortion often keeps providers from getting training even when they are seeking it out. Most disheartening to me was to hear that there isn't much pre or post abortion counseling being given to clients, and that includes contraceptive counseling. I wish there were some type of organization to offer these services, even outside of the clinic setting, like CHOICE or Exhale back home. Giving women safe spaces to discuss their health, particularly with a professional, is something that I am very passionate about. I wish I could find away to be involved with such initiatives here.

I'm going to leave the abortion portion of this entry there. But if you have questions or want more info, leave it in the comments or email me (disrespectful anti comments will be removed, so please show courtesy!).

Some updates in addition to all of that...we now have home internet (thank you, Thomas)! Schedule your skype call with me when you have time!

I've been a bit of a hermit this weekend after a bunch of classmates and I went out on Thursday to celebrate handing in our first paper. Tonight, I am going with my friends Bob and Ozie to some type of church gala dinner thingy. I have no idea what religion it's for, so it could be interesting! But it should be fun. Tomorrow night, Thomas gets home for a couple of days (yay!), so we're planning on possibly going to beach and also going out with the MPHers on Monday. I'm also going to try to persuade him that we should buy our couch this week!

Missing y'all!