Snapshots of Safe and Unsafe Abortion Around the World

Photo by Jaime-Alexis Fowler

Without these safe abortion services for youth, Anna* said, “I don’t know what I would have done. I certainly wouldn’t be here now.”
*Named changed to protect her identity.

On Friday, September 28, Pathfinder International joins thousands around the world for the Global Day of Action for Safe, Legal Abortion. We asked a few of our stellar staff around the world for their thoughts and stories about the importance of safe abortion. Below are a few excerpts. Share your thoughts about why you believe access to safe abortion is important in the comments section below.

My Experience in Tanzania

Jayne Lyons, Director of Operations, Pathfinder International Tanzania

“Not long ago I had a personal experience with a friend who experienced the barriers to safe abortion in Tanzania first hand. When I met “Josie,” a young, beautiful woman and mother of one son, she had just started a relationship with a man who loved and cared for her son. Her mother was against the union and took Josie for a back-street abortion. Josie started to bleed heavily and her partner came to me for help because he knew I worked in the area of reproductive health.

It was night time so I called one of the Pathfinder clinical staff to get help for Josie who had been turned away at the hospital because she could not pay for an ultrasound or the doctor fees to get care. With the intervention of the Pathfinder staff who knew the district medical officer, Josie was admitted for emergency care. Yet, even with this assistance, she was given a D&C without anesthesia while the doctor mistreated her, verbally accusing her of immorality. The doctor provided such bad care that Josie ended up with an injury that needed special care at the fistula repair center.

Josie and her partner are using a family planning method now, following the advice of the Pathfinder clinical officer to wait at least 6 months before trying to get pregnant. Josie's mother is more accepting now that she saw the partner’s helpful actions and the concern for her daughter. Yet, why did Josie have to suffer so?

With better trained staff, non-judgmental providers and modern techniques, much of this suffering could have been avoided. For me the barriers to safe abortion here—and worldwide—are the legal definition of when an abortion can be provided and the steps that have to be taken to obtain a legal abortion: the lack of trained medical staff in MVA and medical abortion; lack of adequate medical for women regarding contraception in general to prevent unplanned, unwanted pregnancies.”

 

The Need in Ghana

John Lazame Tindanbil, Programme Officer, Pathfinder International Ghana

“Unsafe abortion in Ghana is very serious across all regions, districts, and communities. Almost every day there is a story about a death due to unsafe abortion. The nature of the problem varies from community to community. Two examples highlight the challenges surrounding abortion:

1. At the community level, quack “doctors” administer local herbs to women seeking abortion services. Some of these fake doctors use sticks to insert into the vagina to destroy the fetus or for the stick to absorb fluid and dilate the cervix, but in the process, the uterus, cervix, or other organs are perforated. Sticks have been removed from women’s wombs at the hospital.

2. Some non-professional hospital or clinic staff perform unsafe abortions in their places with instruments they haven’t been trained to use, and in the process they damage internal organs. Intestines pulled through the vagina is a classic example of unsafe abortion done by this untrained, or poorly trained health providers.

But there is hope and change is happening. Pathfinder International’s Comprehensive Abortion Care Project (SAAF funded) has changed the situation to some extent in the northern part of Ghana. Many community members have been sensitized on the dangers of unsafe abortion, and more education on the law has been done so that women would know their rights. More facilities have also been supported to start safe abortion services. In addition, staff, mainly midwives, have been trained who now have positive attitudes, and have the needed skills to perform safe abortion, especially in accepting young women and learning to support them through the abortion process and provide good contraceptive services on the spot. These interventions have reduced significantly the incidence of unsafe abortion in the three northern regions. Stigma has been significantly reduced, and more access to safe abortion has been created.

Although much has been done, more access to safe abortion needs to be created. There are more districts in the northern region that are yet to start up comprehensive abortion care services. In an effort to create access, Pathfinder with Ghana Health Services started a pilot project of moving comprehensive abortion care services beyond district hospitals to the sub-district level. More of such efforts are needed to bring information and services to the doorsteps of the people.

In addition, there is the need to involve more private service providers to improve upon the quality of services they provide. Comprehensive abortion care services have to be communicated in a better way to the client through provision of services at adolescent corners, make services more affordable (reduced cost), create more dialogue to include CAC coverage in insurance plans, etc.”

What I See in South Africa

Zandi Bakaco, Program Specialist, Pathfinder International South Africa

“In my daily work in Pathfinder supported Youth-Friendly Abortion Services (SAAF funded), I encounter great need of all kinds. Here are a few quotes from clients I’ve worked with recently:

  • “I came expecting to be judged, I was surprised by the warm attitude and caring environment in this clinic.”
  • “I tried everything I heard of that could cause me to abort but failed. I did not want to come to the clinic as I thought it would be a long process.  [The clinic service] was simple and safer than what I tried. I become nervous to think that I could have died.”
  • “I was gang raped because I am a lesbian. They said they are going to teach me how to behave as a girl. This pregnancy reminds me of the painful experience. I do not know who the father is and I cannot continue with this pregnancy.”
  • “I was repeatedly raped by my own brother since I was young. My mother knows about it, she does not want me to talk about it. Every time he is drunk he sleeps with me. I do not have a place of my own and cannot move out. I cannot have my own brother's child.”
  • “I am a university student and I admit, I did not use protection. I did not think about pregnancy. I am doing my final year and cannot afford a child right now. I have to terminate this pregnancy!”

These quotes remind me of the great need that’s there, and the benefit of investing in programs that support women of all ages in accessing safe abortion.”

Country: Ghana , South Africa , Tanzania
Focus Area: Abortion
Photo of Ellen Israel

Ellen I. Israel

Ellen I. Israel is Pathfinder International's Senior Technical Advisor for Women's Health and Rights.

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