Illegal abortion and the dumping of babies has always been an issue in South Africa, despite free, legal medical abortions being available, with women continuing to resort to drastic measures to end their pregnancies.
The Johannesburg Forensic Pathology Services (FPS) medico-legal mortuary in Braamfontein in the CBD is the busiest facility in Gauteng. About 10% of bodies received by the mortuary are unidentified. Of those, only 7% to 8% are adults. Of the unidentified infants, most are foetuses. They have been abandoned, discarded around the city, reports TimesLIVE.
Foetal osteologist Roxanne Thornton works on these cases, specialising in perinatal forensic identification criteria and developmental biology.
She said women still resort to illegal abortions or killing their newborns because they may not know where to access a safe, legal abortion service.
The foetuses come in as viable foetuses – more than 26 weeks, and non-viable – those which would not survive outside the womb.
Thornton tries to discern if the foetus had a natural anatomical reason for death or if it was homicide or accidental. “Most of these cases are so decomposed a pathologist can't tell.” In these cases, osteology, the study of the structure and function of bones, is used to identify information about the body.
“I work with foetal prenatal bones. The goal is to prove the case forensically. The reason I do this is because there are hardly any inquests for the dumped (foetuses) – they don’t get investigated and they are forgotten. This is an injustice. I believe these children should have a voice. A lot are dumped just around the corner from a shelter or abortion clinic.”
Dr Louise Gilbert, clinical director at Marie Stopes SA, a private safe abortion services clinic, said though abortion is legal in SA and free at a state health facility, access to safe and legal abortion remains “problematic”, with limited numbers of state health facilities providing the service. She said some women experience stigma when approaching a healthcare worker or facility to ask for an abortion.
“Women may not have the funds to pay for an abortion at a facility like Marie Stopes. There are not enough facilities providing abortion services in SA. Due to budgetary constraints, Marie Stopes only has seven centres in four provinces.”
Gilbert said though free abortions are available at state health facilities, many of the facilities don’t provide the service or only provide it within the first trimester of pregnancy.
Some women go to their clinic for help after attempting an illegal abortion.
“They say illegal abortion providers treat this as a business transaction and they don’t experience the same judgmental attitude as they would at facilities providing free abortion care.”
The illegal provider is “only interested in selling their product and therefore they don’t ask the woman about their reasons”.
Abortion is a legal medical procedure under the Choice on Termination of Pregnancy Act. Abortion can be requested at up to 12 weeks of pregnancy without needing to give a reason. The Act also allows abortion from 13 to 20 weeks, but only under circumstances, including:
• if the continued pregnancy poses a risk of injury to the physical or mental health of the woman;
• if there is a substantial risk that the foetus would suffer from a severe physical or mental abnormality;
• the pregnancy resulted from rape or incest; or
• the continued pregnancy would significantly affect the social or economic circumstances of the woman.
“Unfortunately, illegal providers do not stick to the guidelines in the Choice on Termination of Pregnancy Act and often provide abortion pills to women who are much further along in their pregnancy.
“When these women use abortion pills, apart from the risk of severe adverse reactions, they also induce labour and she might then go to a healthcare facility in premature labour or even deliver a premature baby outside a healthcare facility. She may feel she has no choice but to dump the baby.”
For Thornton the cases are a burden.
“This work stays with you. There are about 20 cases a month. I’ve had to cut more than 300 babies to get to the bones. I’ve seen paediatric injuries leading to 900 deaths.”
TimesLIVE article – Why women still go for backstreet abortions, dump babies (Open access)
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University of Kent wants South African input on abortion project
Exodus of people qualified to perform abortion services in SA
Hawks arrest nurse who allegedly demanded a bribe for an abortion
Western Cape Health adds seven new abortion facilities
Despite legislation, barriers to legal abortions in SA remain