Garth A. Rattray | Home-made abortions
I had not seen one of my patients for way over a decade. I knew her parents long before she was conceived. I saw her through her formative years, but then she fell off my radar. When I saw her for the first in a very long time, I had to catch up on her medical and social history. It turns out that she was now in her early 30s and had given natural birth to three children.
I asked if she had experienced any miscarriages or terminations of pregnancy. She hesitated before telling me that she had terminated pregnancies. When I asked her how many, I was not expecting to hear, “Mi stop count after 10 …”
I’ve been practising medicine for close to four decades and I had never heard of anyone having 10 abortions let alone more, perhaps many more than 10. I thought that I misunderstood, so I looked at her lips and repeated my question. When the very same reply came out and I observed that she said exactly what I had heard, I was speechless. I referred her to a family planning centre.
She went on to explain that it was easy to buy the abortion pill, Cytotec, on the streets. I remember when Cytotec (Misoprostol) first became available in Jamaica. It was originally manufactured to prevent and treat stomach ulcers. But then, the side effect on the uterus caused it to be used for starting labour, treating post-partum bleeding (because of a weakly contracting uterus), and for causing an abortion.
I vaguely recall prescribing the drug for the prevention of stomach ulcers on one occasion. However, as soon as I learnt of the off-label use in procuring abortions (terminations of pregnancies), I never prescribed it again. My ‘flabbah was gasted’ when I realised that the abortion pill was big business on the streets. Not only was I taken aback by the apparent demand and use for this potentially dangerous drug, I was also shocked to learn that so many young women were performing home-made abortions.
I have always had mixed feelings about abortions. I understand the religious/spiritual problem with destroying a foetus, the potential for human life, and that is why I have never performed one. But, on the other hand, I believe that if a woman’s physical and/or mental health is threatened by a pregnancy, I see no reason to endanger her life for a tiny foetus. Going by the rule of law, even if a woman will die if she carries a pregnancy, she must die rather than have an abortion. And the sacrosanct foetus will also die, but that’s our law.
And, if a woman conceives because of a rape, she must bear any child conceived. I can’t agree with that. If a father rapes his 10-year-old daughter and she becomes pregnant, the law states that she must carry that pregnancy to full term. Aside from the obvious extreme danger to her physical health, the mental sequel will be devastating. But our laws make no allowance for that.
However, I strongly disagree with terminations of convenience, and this is what drives the black market in Cytotec. Who knows if the pills are being taken correctly? What if the termination is only partial and the woman bleeds incessantly or becomes infected internally? What if she was carrying twins and only one is expelled, what kind of foetus will she carry to term? And what if the pregnancy is ectopic? Since Cytotec only acts on the womb, the pregnancy outside the womb will continue to grow and kill her.
I hope that the authorities will use undercover cops to buy Cytotec on the streets and stop home-made abortions to protect those young women from themselves.