It was a cold and wet Tuesday morning, just before the crack of dawn. A young woman and her friend boarded a combi that would take them to the place “where I would get rid of my problem”. Upon arrival, they were led through “mud and trenches” to a dingy back room.
“I kept reminding myself that I had no other alternative,” the young woman says as she narrates her story. She was ushered into the room, her friend told to wait on the veranda outside. The room was draughty, and sparsely furnished, save for a rickety cupboard and a threadbare mattress in the middle.
She was instructed to lie on the flimsy mattress. The old woman inside told her to shed her clothes and avoid making any noise that would alert the neighbours to the goings-on in the room. After rummaging through the cupboard, the old woman returned with forceps, a couple of tablets, petroleum jelly, and a roll of toilet paper.
She forced the cold forceps into the young woman’s private parts and after some probing inserted the tablets at the opening of her cervix. She then stuffed the toilet paper in to ensure the tablets stayed in place. “I was then told to get dressed and leave and was given strict instructions to stay in my room for the next five days as the tablets did their job,” says the young woman.
It is an increasingly common tale, pitiful and tragic in equal measure. The young lady in question had fallen pregnant, another woman’s husband being responsible. Unemployed and already with one child she had to fend for, she concluded that a back alley abortion was the only solution to her problem.
Abortion is illegal in Botswana, but this has not deterred desperate women like her from prowling the back alleys for a quick job. Termination of pregnancy is only allowed in the exception of instances of rape, incest or if the pregnancy is detrimental to the life of the mother. These days, however, termination of unwanted or unplanned pregnancies by people lacking proper skills is becoming a social blot. Worse, as is the case of the young woman in question, it is done in environments lacking the minimal medical standards.
Sometimes women resort to abortion purely out of choice and with no pressing issues. These women are usually the ones who are notorious for crossing the border and getting their abortion at a much higher cost by a professional in a professional and hygienic environment. This is unlike the back alley where unsafe abortions can cost between P500 and P1500. Depending on the stage of the pregnancy, the abortion can be administered by someone or a concoction given to the expectant woman to administer herself.
According to medical doctors, a pregnancy can be terminated within the first trimester (the first 12 weeks of pregnancy). However, with illegal, unsafe abortions, the issue becomes negotiable, leading to the many illegal graves unearthed by dogs and increasing instances of fully-formed babies found in pit latrines.
┬á“We often admit patients who appear to have gone into premature labor, but when blood test results come back we often find traces of chemicals administered to induce labor and other potentially lethal substances,” says a nurse at the Princess Marina Hospital’s Gynecology ward, speaking on condition of anonymity. “We treat these patients but then report them to the police since abortion is illegal in Botswana. Some of them are brought in to the hospital while in police custody.”
Women used to ingest all sorts of concoctions, ranging from copper residue to washing powder solution to ball pen ink. These possess labour-inducing chemicals. These days, however, the drug that is trending and is predominantly used in unsafe abortion is Misoprostol, which is a generic name. The most popular brand locally is Cytotec, a drug registered to prevent or treat gastric ulcers. Misoprostol helps by decreasing the risk of serious ulcer complications such as bleeding.
This medication protects the stomach lining by lowering the amount of acid that comes into contact with it. It can also be prescribed for the treatment of the pain and inflammation of conditions such as arthritis.
However, Misoprostol can also be used to induce uterine contractions, hence the often use off-label as an abortion pills for pregnancy termination. Studies have demonstrated that Misoprostol can be used to terminate pregnancies of any gestation. Still under investigation, it is not yet approved by the World Health Organisation. These findings were published in the International Journal of Gynaecology and Obstetrics (2007, vol. 99).
The Penal Code is clear on the illegality of abortion. Yet back-alley abortions continue to flourish in septic and potentially lethal conditions. According to a research paper written by Michell VandenBerg titled “Abortion and Women’s Health: A Closer Look at ‘Back-Alley’ Abortions”, the major argument in favour of the legalization of abortion is the health and safety of women.
Illegal abortions often lead to infection, heavy and uncontrolled bleeding and according VandeBerg, “abortion can cause post-abortion stress syndrome (PASS). It is determined that acute or pathological grief after the loss of an unborn child, whether by miscarriage or abortion, has a detrimental effect on the psychological and physical health of some women”.
Although there are medical and psychological side effects, there are some societal, religious and cultural opinions regarding this matter. Batswana are generally a conservative and religious nation and have very strong opinions against the legalisation of abortion despite the evidence that it is occurring in backyards. Legislators and human rights activists have been castigated for calling for the legalisation of abortion in Botswana.
┬á“Government should encourage people to have babies,” says Mmoloki Gabathaolwe, an International Relations scholar who lives in China. “They do alley abortion due to poverty and not being ready to have kids due to low economic statuses in the country of individuals.”
Gabathaolwe in fact believes people should be paid to have babies, especially given that Botswana’s population is small. “We can’t afford abortions; we lose babies to them. We need to increase our population; a high population means a high domestic market for our goods hence good economic benefits. We can saddle them with laws all we like, but people will continue to do it behind the police’s backs, because it’s some form of income generation for abortionists.”
According to Gabathaolwe, abortion is likewise illegal in China. He insists, however, that there is no scope for comparison between Botswana and China given the latter’s larger population and more diverse economy.
