An 18-year-old from rural Limpopo said she had to resort to an illegal abortion from a traditional healer after a nurse at a public clinic denied her a legal abortion last month, refusing to help her on religious grounds, reports Health-e News.
The matriculant from Makotopong village said she had suspected she was pregnant, and this was confirmed by a pregnancy test kit from a pharmacy.
Liza* said another urine test was done at her local community clinic, which also showed a positive result, and as she didn’t want the pregnancy, she opted for abortion. She didn’t want to go back to her local clinic, where she is known, so travelled 29km to the Rethabile Community Health Centre in Polokwane, accompanied by her cousin.
But the nurse refused an abortion based on religious beliefs. Instead of receiving care, Liza* says she was judged.
“I was shocked by the reaction of the nurse after I told her that I was there for an abortion. She stared at me, shook her head and called her colleague, to whom she spoke privately. Then she said she couldn’t help me.”
Liza* said when she asked the nurse why, she replied: “My religion is against abortion.”
Liza* then approached another nurse. “She shrugged and walked away. None of them bothered to give me another option.”
In South Africa, the Choice on Termination of Pregnancy (TOP) Act allows abortion on request during the first 12 weeks of pregnancy, with no reasons required. Between 13 and 20 weeks, abortion is legal only under specified circumstances.
Traditional healers do the job
Liza* said after being turned away from the Rethabile clinic, she felt desperate and approached a traditional healer who is not authorised to provide abortion services under South African law.
“My cousin suggested to a traditional healer, who is known to perform abortions from her home. I was reluctant but ended up going there on 16 May, with my cousin. No one at home knew that I was pregnant.”
They agreed on a fee of R500. “Unlike the nurses at Rethabile, the traditional healer was polite,” Liza* said. “She brought a powdered muti and a brownish concoction in a two-litre bottle. She told me to drink it every morning on an empty stomach over three days.”
She was told to return after five days, after she had finished the concoction.
“I followed her instructions, but I suddenly experienced nausea, diarrhoea and severe abdominal cramps a day later. I bled profusely, and the pain was unbearable. The only person who knew about my situation was my cousin. I only told my mom that I was having a headache,” she said.
“After five days, I returned to the healer who assured me that the procedure was successful and gave me another concoction, which she said was to cleanse my womb.”
The teen said the experience left her shaken, and she has not returned to any medical facility to confirm whether the pregnancy was terminated. “I believe the pregnancy is gone, but I’m not sure whether the procedure could have dire consequences in the future. I’m scared that I might struggle to conceive.”
Her experience echoes findings in a recent report by SECTION27, which found that some healthcare workers in Limpopo and the Eastern Cape refuse to provide abortion care on the grounds of conscientious objection – because of religious or ethical beliefs.
SECTION27 paralegal Kholofelo Mphahlele said they have been inundated with calls from distraught women complaining that they were unable to undergo Termination of Pregnancy (TOP) care due to various challenges.
“There is a worrying shortage of trained nurses in rural healthcare facilities, and this often forces patients to travel long distances to get services,” she says.
“Patients say they are insulted by rude nurses who tell them that they won’t go to heaven for terminating their pregnancies and end up being turned away by nurses who cite religious beliefs.”
The report identifies a chronic shortage of abortion providers and says conscientious objection, together with staff shortages, delayed transfers and the failure to replace providers, contribute to barriers to care.
“In South Africa, the right to a safe, legal abortion, especially for poor, black, rural and township women, remains unrealised,” said Mphahlele, adding that backyard abortion services are widely advertised through pamphlets displayed in public areas in towns, townships, and rural villages.
“Illegal abortions persist because of delays in care, insufficient number of abortion providers to meet demand, the arbitrary practice of conscientious objection. and a shortage of abortion medicine,” she noted.
Religious objections and patient rights
The Democratic Nurses Organisation of South Africa (Denosa) in Limpopo said nurses are allowed to practise their ethical beliefs, as provided by the Bill of Rights.
The union’s provincial secretary, Jacob Mamabolo said: “Nurses face a profound legal-ethical dilemma when placed in sections performing terminations of pregnancy, which conflicts with their religious or moral beliefs.”
According to Mamabolo, the Constitution guarantees freedom of conscience and religion, affording nurses the right to refuse to actively perform or directly assist in abortion procedures.
“However, nurses cannot refuse to treat a patient facing a life-threatening medical emergency or severe obstetric complications. If a nurse cannot provide TOP services because of religious or ethical beliefs, she or he is legally and ethically obliged to provide the patient with accurate information and refer them to another provider or facility where they can receive safe, legal care,” he said
Limpopo Health Department responds
The National Department of Health’s Clinical Guideline for Implementation of the Choice on Termination of Pregnancy Act states that healthcare workers who object to providing abortion services on religious or moral grounds must ensure patients are referred to another provider without delaying access to care.
The Limpopo Department of Health was asked specific questions about Liza’s* allegations, but spokesperson Neil Shikwambana did not address those directly, However, he pointed out that ethically, nurses are not allowed to refuse Termination of Pregnancy (TOP) care based on religious beliefs.
“While we respect the right of religion as a fundamental right enshrined in the Constitution, the work of nurses and public servants, by and large, is governed by the public service regulations and policies.
“TOP is allowed by the laws of this country and forms part of the duties that certain healthcare professionals need to undertake, depending on their area of deployment.”
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Despite legislation, barriers to legal abortions in SA remain
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