By Avia Ustanny, Freelance Reporter
OH GOD, NNNoooOOO!
Teeth unclench and the scream blooms from the dry, pink cave of her mouth as the white coated doctor works silently and methodically. The doctor plucks away at living flesh with cold metal as calmly as a chef slicing ripe melon for the day's salad.
Two hours later Sonia Charltonis at home, writhing on the floor. Two months later, she miscarries, bleeding her way back to another doctor's office. The abortion was incomplete.
The botched procedure, is a real event painfully related by a 32-year-old who swears she will never do it again.
Good for her, some anti-abortionists would say, as they believe that what she and the doctor did was murder. Others may want to find her and place her before the courts.
Locally, abortion "illegally procured" can bring a sentence of life imprisonment. Doctors who "illegally assist" and are found, will be heavily fined.
The abortion debate is an ancient one, eliciting a passion leading to death. Doctors have been murdered by anti-abortionists who believe that they, in turn, are engaging in murder. The arguments against abortion include those who say that there is life in the sperm and the egg and that a human being is created at the moment of conception. At the other extreme are those who say that it is a woman's right to choose what happens to her body. There are also those who object to it on principle, but say that there are circumstances such as pregnancies due to rape and incest and where a woman's health is seriously at risk where the termination of pregnancies should be permitted.
The last is the position of the Medical Association of Jamaica (MAJ) which has been calling for some time for the "clarification" of the local laws relating to abortion.
ARCHAIC LAW?
Jamaican laws state those who shall illegally procure an abortion and anyone who assists illegally will be liable to imprisonment and fines. The implication is that there is a way to legally do it.
Dr. Errol Daley, MAJ president, points out that the law is passé. In England, the abortion restriction has been substantively lifted and in Barbados also. The MAJ has stated that while it believes in the prevention of pregnancy through proper contraceptive use as a means of avoiding unplanned pregnancies, the termination of pregnancy may be needed where there is significant foetal abnormality, where there are conditions which threaten maternal welfare and health and where pregnancy is the result of rape or incest.
It is noted that the consequences of making abortion an illegal act include the literal death of hundreds of women who get their abortions from individuals who are willing to do it but who may not have the necessary medical experience.
Every year, unintended pregnancies lead to at least 20 million unsafe abortions, resulting in the deaths of some 80,000 women, World Health Organisation figures reveal. The United Nations Population Fund (UNFPA) reported last year that five million women aged 15-19 have abortions every year, 40 per cent of which are performed under unsafe conditions.
The prohibition of abortion may also result in the birth of unwanted hundreds who are subsequently mentally and physically abused and starved, concerned organisations note.
SAFER THAN PULLING TEETH
Dr. J, a local gynaecologist who performs an average of 10 abortions each week, informs us that abortion, as performed today, is safer than a tooth extraction. Doctors who are trained to do the procedure will experience a complication rate of less than 0.1 per cent. Only patients who have sex immediately after the operation are likely to develop problems such as infections. Patients who experience a perforated uterus as a result of abortion are less than one in one thousand, he also says. Perforation can also be treated conservatively, without hospitalisation and cutting, he says.
Locally, first trimester terminations are done with RU48 which is a tablet ( a pessary placed in the cervix) given to patients who are pregnant for no more than 4 weeks. They will pass out the foetus as a result. Any pregnancy over five or six weeks needs to be removed by suction curettage, the medical doctors states. The D&C is a procedure which lasts five minutes, and one hour is given to the patient to recover. The patient will also be placed on hormonal pills, injected or given an intrauterine device that will prevent another pregnancy from happening. No sex is permitted in the first two weeks after the procedure, as there is a risk of infection.
Second trimester pregnancies are done in hospitals where prosterglandins are used in the procedure. If the placenta is retained, the doctor will go back and get it.
Abortion, if done early, does not interfere with fertility and the ability to have children when one is ready for them, Dr. J states.
"The person who is pregnant makes her own decision, she alone knows the state of her health, what her financial position is and she should have the right to choose. I will not get into a moral argument," he says.
A COMMON PRACTICE
Abortions made available by local doctors who do not advertise their services for fear of criminal charges, are available for between $5000 to $10,000 for early stage (12 weeks or less) pregnancies and between $20,000 to $30,000 for second trimester (up to 20 weeks) abortions which usually involve hospitalisation.
"Everybody does it now. We now only see about 10 each week and these are the more complicated cases. I believe that out of every 100 cases between 10-15 per cent is terminated."
Dr. J, the gynaecologist with whom we spoke, believes that as many as nine in 10 Jamaican women have had abortions. He points out that among women, every age group has standard reasons for getting the procedure done.
Among the youngest girls aged 11 to 19, he says that 99.9 per cent of the cases he sees are requesting abortions because they do not want their education to be interrupted.
Those at the top of this age group are also unmarried and just starting their careers. They definitely cannot afford to have a child at this point in time.
Women in the 25 to 35 age group usually do, Dr. J says, because they already have two to three children, their birth control method has failed and do not want another. Occasionally, also, there are 41-45 year olds who believe they cannot get pregnant and stop using their birth control methods. Dr. J feels that women who have had all the children they want should have their tubes tied, so they will not have to have terminations done later on.
The figures put forward by this doctor are not known to be statistically correct (no one is doing the relevant research) but, from anecdotal evidence alone, it is clear that abortion is a much-used option for birth control.
REASONS FOR HAVING ABORTIONS
From anecdotal evidence, two reasons battle for first place in the list of those given by Jamaican women who decide in favour of doing abortions. First is the disruption of their education or career. The second and equally compelling reason is that they do not want to have a child for the man for whom they have become pregnant.
Several women with whom we spoke described their partners as "worthless" or "too jealous", stating that their decision to terminate was unilateral, and taken without discussion with anyone but close friends.
Patricia Coombswas only 19 when she had her first abortion.
"I was career focused and I just felt at the time that it would be the end of my career. It did not occur to me to discuss it with my employers. I felt it was a private matter. I felt no remorse. I just could not have a child at 19."
Patricia applied for a few days of vacation leave and journeyed to Montego Bay where the doctor had been located by a friend. One week after the termination, she returned to work, refreshed both mentally and physically.
At age 21, her second pregnancy occurred, discovered after the relationship had ended with the father. She wanted an abortion but had no money. The father of the child said he had none either. Even when she was six months pregnant she was still trying to find the funds.
The result she says, is a wonderful 11-year-old son who today is the apple of her eye. But, her story does not end there.
Patricia says that where contraceptives are concerned, she has always been very irresponsible. She became pregnant again, and again she decided to terminate it.
"My boyfriend at the time was very well off but I did not want to have a child for him. We both agreed." Again she did the procedure, this time in Kingston, "without remorse."
The problem for Patricia began when she became a Christian two years after the last abortion. She says she now recognises what she did as murder.
"Life does not have to be downhill after you get pregnant. The other two children (her terminated pregnancies) could have been very wonderful children. I have it on my conscience now," Patricia says.
ABORTION, RELIGION AND THE RIGHT TO CHOOSE
In religion is rooted the primary objection to abortion. Reverend Karl Johnson, general secretary of the Jamaica Baptist Union, told Flair, "We reaffirm the divine value of life. We realise that we live in an imperfect world where there are all sorts of things that affect the viability of mother and child. There is also rape and incest. But, one has to hold up life.
"It is for us a faith question. The foetus, at whatever stage it is, is a viable entity. We encourage the women to keep their children. Certainly, in the purview of the Divine what may seem now to be a dread and terrible mistake may turn out to be what makes life more liveable. Certainly you are now in a bind. But, you have to look beyond these circumstances which will not last forever," the Reverend says.
Others, though pragmatic in their beliefs, are convinced of the foetuses right to life. Dr. Daley calls himself a conscientious objector to abortion and says that he will never do an abortion today (though he was trained to do it in England).
"I am carrying a flag for women who I believe have the right to have the procedure done," he says, noting that the argument around the subject is centuries old and will continue to be a source of conflict. "Hippocrates father of modern medicine performed abortions but forbade his students to do them," he notes.
Reverend Johnson, a counsellor who says that he has advised numerous women on the issue, says that the emotional scarring left by abortion is permanent.
"One does not get over it. They survive it. They have taken a decision which affects them for life," Reverend Johnson says. "Many of us grew up with grandparents and other relatives and today we are not too badly off."
Names changed on request
