patient is a 14-year-old female from Khayelitsha presenting with a premature born baby. Patient stays in a shark with her mother and 3 more siblings. The mother is the second born, the first born is in grade 11 and she is in grade 8. Her mother is unemployed, sells snacks on the road and besides, they are dependent on social grant. The baby is underweight and under malnutrition. The father of the baby is 21 years old unemployed, selling on the streets so the baby is purely dependent on social grant and the little that the grandmother and the boyfriend make.

Patient was denied abortion by the mother and the boyfriend because they do not want to carry the stigma of being with a person who had abortion. They cannot afford to live with that in their community they rather struggle with the baby once its born, so the mother kept the baby. The mother is quite detached from the baby, avoids any form of attachment with the baby because she did not want the baby in the first place. Now, the baby is suffering because of a withdrawn mother. The mother is now suffering all these because she feared the stigma around abortion.

I met the mother at the hospital for premature class for babies and their mothers. When I saw her in the department I thought to myself, what kind of a mother is this who does not have connection or show affections with their own baby! I could not understand. The clinician asked me to show her the relaxation massage techniques to help the baby relax and create a connection between them. I honestly did not want to because of the reason mentioned above, nevertheless i did.

I realized during the session that she does not want to connect with the baby at all. I asked why she is so detached and distanced from the baby. She told me the story above. The mother said she is in no position of being a mother. She wanted to have abortion not because she does not want the baby, but because of assorted reasons that she could not voice out. The mother was not given the opportunity to choose for herself what she wants to do with her pregnancy. She could not act upon her right to freedom and to abort because of the stigma. . Simply because of the stigma that her mom, the baby daddy, the doctors and the nurses have around abortion. In fact, the stigma that comes with having an abortion at large.

Hodes (2013) states that “Articles in the South African Medical Journal conveyed alarm about the punitive attitudes of doctors and nurses who refused women abortions. Some denied pain medication to women undergoing abortions”. The ill treatment for patients under going abortion at hospitals, shocking! The women do receive the right treatment that they are supposed to receive because of judgement from the doctors and nurses. Hodes (2013) continues to explain that “There’s a lot of judgment in the wards for women undergoing termination of pregnancy. Not being looked after by the nursing staff, just ignoring them. Or doctors refusing to have anything to do with them and giving them lectures, laying a whole (guilt)trip on them”. How is a person expected to practice their rights in such an environment? Why must we have the right to abortion if the health professionals themselves still carry the stigma and ill treat women undergoing pregnancy termination as if they are a disgrace?

Truman & Magwentshu(2013) state that the south African constitution has stated that “The importance of South Africa as a model for reproductive self-determination in Africa cannot be underestimated. Abortion has been legal since 1996, and the country has some of the most developed government systems for the provision of abortion care on the continent”. Abortion is legalized and there are systems developed to provide care during the termination. Amazingly, the people that are supposed to provide that service to women undergoing pregnancy termination, are instead judging them. The health professionals still have stigma around abortion, and that makes it difficult for women who wish to terminate unwanted pregnancy.

How about having an unwanted baby? A baby that you can not provide for in any way possible, financially, physically. Mentally and emotionally? A research conducted by Akbarzadeh, et al,. (2015) indicated that reactions and experiences of the pregnant mothers towards unwanted pregnancy had several dimensions including physical problems, psychological reactions, family problems and socio-economic and nurturing problems. The decision of having a baby is not only on the baby side, the mother is involved in the whole thing. The mother is the one who will have to provide for the child in every way possible. Therefore, if she did not want the baby she will not be able to do that.

She is going to suffer emotional drain, physical drain and social drain which in turn will affect the baby. If the mother is not there for the child then the baby will not be healthy. The baby will lack mother’s love and other things that the mother is supposed to provide.  How much more of the breakdown that the mother will go through in trying to reach out or be there for something that she did not ask for? The mother could not speak to the baby, she could not connect to the baby skin to skin and express that warm bright smile. The mother was very detached simply because certain people did not approve abortion. She feared the stigma around abortion especially in the environment where you are supposed to be assisted at.

 Additionally, as much as this affects the mother, it affects the baby too. The baby does not have to be born into an unhealthy environment and suffer the consequences of unwanted pregnancy. The mother does not have to suffer the drain and stress of having an unwanted baby too. “In terms of the Constitution, abortion exists as an implied right of privacy under the 14th amendment . Roe v. Wade established this right and it did so with the support of other decisions about privacy. The fundamental arguments for the pro-choice side of the debate centered around a woman’s right to privacy in making decisions to abort a fetus” states Truman & Magwentshu (2013). It will be good for people to respect one other’s decisions and their rights especially we as health professionals. We are expected to know better not to judge or disrespect patients’ decisions.

One has reasons for resorting to abortion and they do not owe anyone an explanation. It is only to us to stop being judgmental in our workplaces and respect people with the choices they make. Sometimes we look at people and start criticizing them for things we do not even know. We do not give them our ultimate service because of how we see them not knowing why they are what we see or making the decisions they make.

Reference

Akbarzadeh, M., Yazdanpanahi, Z., Zarshenas, L., & Sharif, F. (2015). The Women’S Perceptions About Unwanted Pregnancy: A Qualitative Study in Iran. Global journal of health science, 8(5), 189-96. doi:10.5539/gjhs.v8n5p189. retrieved from; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4877231/

Hodes, R. (2013). The medical history of abortion in South Africa, c. 1970–2000. Journal of Southern African Studies, 39(3), 527-542. Retrieved from; https://doi.org/10.1080/03057070.2013.824770

Institute of Medicine (US) Committee on Unintended Pregnancy; Brown SS, Eisenberg L, editors. The Best Intentions: Unintended Pregnancy and the Well-Being of Children and Families. Washington (DC): National Academies Press (US); 2015. 3, Consequences of Unintended Pregnancy. Available from: https://www.ncbi.nlm.nih.gov/books/NBK232137/

Klingberg-Allvin, M., Nguyen Thu Nga, Ransjö-Arvidson, A., & Johansson, A. (2006). Perspectives of midwives and doctors on adolescent sexuality and abortion care in Vietnam. Scandinavian Journal of Public Health, 34(4), 414–421. https://doi.org/10.1080/14034940500429046

Truman, K. A., & Magwentshu, M. (2013). Abortion in a progressive legal environment: the need for vigilance in protecting and promoting access to safe abortion services in South Africa. American journal of public health, 103(3), 397-399. jhttps://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2012.301194