The risk of relying on backstreet abortions has been further lessened as public hospitals across the country – except for the Georgetown Public Hospital, which views medical termination as an added burden on its already heavy workload – have started to offer the service to women locally.
Women who lack the finances to have terminations done privately in the city are making the trip out of town to the hospitals at New Amsterdam and Suddie while those in far-flung areas are accessing it at Mahdia and Mabaruma.
“If the public hospital starts terminating pregnancies the service may be constantly demanded and they currently do not have the human resource to deal with this. This is the fear the hospital has and given the demand for services every day it is understandable, at least for now,” Minister of Health Dr Leslie Ramsammy told Stabroek News in an interview on Friday.
The public hospital is only treating incomplete abortions, which is after a woman would have induced an abortion. So if a woman turns up at the hospital for a termination, the facility would not be available for her. The hospital also carries out medically indicated terminations: taking the baby if the mother’s life is at risk.
Just over two years ago, no public institution was offering terminations and in the absence of the service women had resorted to unsafe backstreet methods resulting in serious complications and in some cases, death.
A few confirmed reports had revealed that some women were so desperate, the backstreet method they resorted to involved the use of wire to bring down the fetus.
Though the Medical Termination Act, which was passed in 1995 made provision for terminations in the public health system, the service only began in January 2006.
The reason the Act was created and whether it has served its purpose these past twelve years have come up in discussions, some publicly over the years but public health officials have not openly addressed it. Ramsammy weighed in on it saying that the Act has served its purpose but only partially.
Has the Act made it safer for women to have abortions? The minister responded yes pointing out that certified doctors are supervising the terminations at the public institutions. But on the other hand a number of uncertified medical practitioners and persons with no medical background are terminating pregnancies, and often in unsafe environments.
Among the concerns raised is the use of the drug Cytotec during unsupervised terminations. Ramsammy said it is dangerous to use the drug unsupervised since this can and has contributed to maternal deaths in Guyana yet many pharmacies across the country dispense the drug without prescriptions.
Cytotec (misoprostol) is a synthetic prostaglandin (hormone-like substance), which reduces the production of stomach acid and protects the stomach lining. It is prescribed for people who take nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, to help prevent stomach ulcers.
The manufacturers warn that the drug causes uterine contractions that could lead to an incomplete miscarriage with the risk of bleeding, hospitalization, surgery, infertility, or even death. Despite this, however, some pharmacies sell this drug to pregnant women and women of child-bearing age.
The Act specifically states that a medical doctor must first be certified by the medical council before he/she terminates a pregnancy.
According to Ramsammy, this is one aspect of the legislation that has been ignored and continues to be flouted but will soon be rigidly implemented.
Within the past two years there has been a reduction in the number of abortions done in Guyana but there are still too many, which Ramsammy said, drives home the point that it remains a significant problem in the country.
Annually the figure stood between 4,000 and 6,000 but abortions are underreported in addition to many of the cases not being captured in the health data collected.
Information available on sexual reproductive health and contraceptives are accessible any part of the Guyana but based on the number of abortions and teenage pregnancies it seems as though many are not paying heed.
Reports continue to surface that teenage pregnancy is higher than it was several years ago but in the absence of any recent study the scale of the problem is not entirely known. More importantly, teenage terminations are not being addressed.
Ramsammy said the ministry is currently studying statistics on the number of terminations done by teenage girls in addition to looking at teenage pregnancy figures and information on this would be available some time next year.
Evidence exists in the system that some women in Guyana are still using abortion as a method of contraception but this is not widespread, according to Chair-man of the Medical Termination of Pregnancy (MPT) Advisory Board, Frederick Cox.
He said the emergency contraception or the ‘morning-after pill’ seems to be catching on among young people, advising that while it was available it was not for constant use.
Over the past two years, he said, the board has been working along with public institutions and with clinics throughout the country providing information on sexual reproductive health. The focus of the board’s work within this period had been centered around the state making provisions for the medical terminations.
Cox noted that the board has succeeded in setting up committees in Regions Five, Six, Seven and Nine and is working on the other regions, adding that Regions Three and Ten were among their next targets.
He pointed out that the board assists in the groundwork at the community level that they are unable to carry out with the same measure of success.
