Mirirai Nsingo, H-Metro Reporter
“The pain was unbearable, I lost a lot of blood. I thought I would die. I remember how I squatted over a bucket in my small room and continued to bleed profusely. I couldn’t call for help.”
Rudo, 23, still vividly recalls the memories of the backyard abortion she had 4 years back.
She had just started university when she realised that she was pregnant. She had just been fresh out of a long holiday as she waited for her Advanced Level results until she got a place at university for an August intake.
“Well I had so much time on my hands and had pretty much nothing to do as I waited to go to university. I only realised I was pregnant when I had just started university.
“I knew I could not keep the pregnancy let alone break the news to my mother who has single-handedly catered for my welfare in the face of the prevailing economic challenges. I had to terminate it but I didn’t have the money to do it the safe medical way,” she said.
As her world crumbled around her, she had to make a plan or the hopes of making it as a university student would peter out and die a natural death.
Rudo says she had heard about an unsafe abortion house in Highfield’s Lusaka high density suburb in the capital Harare, where they terminate pregnancies using herbs and concoctions. She decided to visit the place. Her hope lay in the hands of none-trained fly-by-nights; but that is the best she could do if she wanted to continue with her studies.
“I had to travel from university to that place in Highfield and was given a concoction after making my payment. I travelled back to school the very same day and because I needed some privacy, I only took the concoction when I got back to my room.
“Hours later, I felt so much pain, the pain continued then I started bleeding. I bled so hard, I thought I would die.”
Being a hermit had its twin edged consequences. She would be alone and no one would see her terminate her pregnancy. And yet too she would be alone and would receive no help from anyone should she desperately need the help.
“I went to a nearby clinic a day later after the abortion where I had difficulties in accessing post-abortion care. I was referred to a provincial hospital hence got treatment after four days of excruciating pain and continuous bleeding. The nurses were not friendly at all, they interrogated me about the abortion and I could not wait to leave the facility.”
The delay in accessing service and interrogation from the health workers at the hospital further worsened her misery.
Four-years on, Rudo still has vivid memories of the abortion experience and the pain she experienced etched cruelly in the back of her mind. Sometimes in the still of the night when the stars dim on her joy, she has dreams about it. She has even sought spiritual healing as she is so desperate to erase the memories of the traumatic experience of the backyard abortion.
Rudo is still nursing a psychological trauma and believes counselling and orthodox abortion could have saved her a lot.
And yet the cloud follows her, the demons haunt her at night and her soul is plagued by the pain, suffering and trauma.
Abortion is a taboo in Zimbabwe and is only permissible under limited circumstances that include a pregnancy resulting from rape, incest or a pregnancy that threatens the life of the mother or foetal impairment.
Complications of unsafe abortions include excessive bleeding and infections, which may lead to hysterectomy (complete removal of the uterus) or death in worst case scenarios.
While psychological trauma that the girls go through is underrated, under-investigated, and understated, a community psychologist, Noreen Dari told this publication that this was one of the devastating injuries that comes with unsafe abortions.
“All abortions cause trauma to the individuals but it is even worse when the person has no support at any point as they have to conceal the abortions. In all its essence, abortion produces trauma and if the experience is unsafe and unorthodox, it worsens the trauma.
“So the survivors of these backyard abortions definitely need psychological support to get over all this. It is much more complex than meets the eye,” says Dari.
A communication for development specialist, David Wood adds that whether legal or illegal, the abortions were happening and contributing to a high maternal mortality rate especially in the sub-Saharan African region noting that the complexities caused by ‘black market’ abortions worsens the plight of the young women.
“There is so much trauma associated with these black market abortions as in most cases they are carried out by non-professionals in illegal settings hence complicating the whole process.
“Even in countries that outlaw abortions, you will realise that abortions are happening and because they are illegal, they happen mostly under unsafe and illegal settings. The abortion discourse has to continue especially in sub-Sahara so as to reduce the maternal mortality ratio.”
While abortion is illegal in Zimbabwe and only permissible under limited circumstances, the country through the Ministry of Health and Child Care has a policy that allows post abortion care access at public health institutions in order to reduce maternal mortality.
Despite the existence of the post abortion care policy, a gender lobby group, Women Action Group (WAG) notes that most abortion patients find it difficult to access this service hence worsening the dilemma especially for back yard abortion victims.
“Many women experiencing complications from unsafe abortion or miscarriage in 2016 faced delays in obtaining post abortion care.
“On average, nearly two full days elapsed between experiencing complications and receiving completed treatment. Common reasons for treatment delays included attitude, lack of money, lack of transportation and distance to a health facility.
“Post abortion care is not offered at the majority of primary health centres, which are the facilities most accessible to rural women. Overall, nearly half of post abortion care patients in 2016 had to seek care at more than one facility to get complete treatment,” read part of the report
Given the negative perceptions on abortion in Zimbabwe, another research by the University of Zimbabwe conducted in conjunction with US based- Guttmacher Institute revealed that a majority of women opt for backyard abortions, which are usually unsafe, impacting negatively on their health and sometimes leading to death.
According to the research findings, one in every 10 pregnancies end in abortion yet less than half of them sought post abortion care services.
“Forty percent of women who had an abortion in Zimbabwe experienced complications that required medical treatment.
“However, only half of women with complications received the treatment they needed,” reads part of the study.
Backyard abortions are often conducted by unskilled people who use a range of methods from medical tablets to herbs, gadgets and powders.
While the Ministry of Health and Child Care has since revised its policy on treatment of women seeking post abortal care from its facilities, Family Health Director Dr Bernard Madzima notes with concern that attitudes of some health workers among other factors were hindering women from accessing the service adding that the care also include counselling which people like Rudo needed.
“The Government took the decision following the realisation that women were dying due to abortion complications. The services also include counselling but and these should be accessed without any interrogation of any form
“Women who would have done abortion would definitely need post abortion care services. If they don’t get these services, a majority of them experience complications and probably die,” says Dr Madzima.
Latest statistics from Government shows that unsafe abortions contribute about 20 percent of maternal deaths in Zimbabwe, half of which occur among adolescents.
In fact, in the first quarter of 2019, 71 deaths from abortion complications were recorded according to WAG.
Although Zimbabwe’s Maternal Mortality Ratio (MMR) has declined from 960 deaths per 100,000 live births in 2010 to the current 614 deaths per 100,000 live (2014, ZDHS), the rate is still unacceptably high.
According to the 2016 national adolescent fertility study, at least 16 percent of maternal deaths in Zimbabwe are due to unsafe abortions, half of which occur among adolescents.
In contrast to a worldwide trend of declines, maternal mortality has increased in Zimbabwe over the past 25 years thus according to the latest Zimbabwe Demographic Health Survey.
WAG reports that in 2016, an estimated 65 300 induced abortions occurred in Zimbabwe and notes that while the abortion discourse continues in Zimbabwe, people like Rudo should have easy access to services thus including psychological so as to save lives and reduce cases of depression.