Medical Termination of Pregnancy Act: Little to celebrate

 (A Guest Column by Sherlina Nageer* to mark the Latin American and Caribbean Day of Action for the Decriminalisation of Abortion)
Women have always been having abortions. Growing up, a ‘fast’ child always ‘batting my ears’ at adult conversations, I heard the story of “A,” who was a schoolteacher, good Christian woman and married with four young children.  One day, “A” found herself unexpectedly pregnant. The doctor had advised her not to have any more children since her last difficult birth and a subsequent miscarriage. But somehow, never mind all her education, “A” found herself in this position.

Abortion was illegal in Guyana at this time. Women who found themselves with unplanned, unwanted pregnancies had few choices.

20130928stellaThey could throw themselves down the steps, drink bush tea, push a bicycle spoke up inside themselves, or – if they had money – try to find a doctor to ‘scrape them out.’ hoping all the while that it would work and they would not be seriously injured. Luckily for “A,” her husband was a government official with connections. He took her somewhere and that was the end of that.

Fast forward a quarter century and some would say that we have progressed. One could even say, theoretically, that Guyanese women and girls are luckier than women in other Caribbean and Latin/South America countries. That’s because abortion is now legal here in Guyana. In other countries around the region, abortion laws remain archaic and restrictive.

In Jamaica, a woman in hospital recovering from a self-induced abortion can potentially be handcuffed to her bed as a suspected felon and if convicted, could receive a life sentence with hard labour. In Trinidad and Tobago, the penalty is up to four years’ jail time. In Brazil, abortion is only permitted if the life of the woman is in danger. In Suriname, it is prohibited even in that instance. But here in Guyana, girls and women are lucky. Theoretically, that is.

Like many laws in Guyana, the Medical Termination of Pregnancy Act sits on the books making us look good, while the reality – especially for poor women and girls and those in rural and hinterland areas – remains one of continued pain and suffering. Almost two decades after the legalisation of abortion in Guyana, poor women seeking abortions in the public sector find themselves turned away.

The Ministry of Health has done little to ensure that there are sufficient trained medical practitioners in the public health system. Poor women and girls needing an abortion are left with the same old options – throw themselves down the steps, drink bush tea or push a bicycle spoke up inside themselves. Private doctors are for those who have money and connections; others who do not have thousands of dollars to spare just have to take their chances.

Karen Badal was one of the unfortunate ones. She was a teenager when she first gave birth, and was still a teenager when she died. At 18, married, with two toddlers, Karen faced a third, unwanted pregnancy too soon after giving birth to her second son. Two days before Christmas 2011, she went to a house in a village where she had heard that abortions were done. A day after having her uterus scraped, Karen began experiencing severe pain. Eventually, it was discovered that her uterus and bowels had been punctured during the ‘scraping.’ Karen died five days later.

The doctor who performed her abortion holds a prominent position at private city hospital. However, he was not licensed to perform abortions.

Sherlina Nageer
Sherlina Nageer

He denied everything, even though numerous women have described going to him for this procedure, over many years. He was never punished and continues to work freely. Karen’s baby is almost three years now and his older brother five plus. This will be their second Christmas without her.

Women and girls have been having abortions, legally and illegally for generations. It is our choice about what to do with our bodies. However, it should never be a choice between life or death. Women and girls who want birth control and abortion services should be able to easily access such, with a minimum of cost and without being judged, criticised or rebuked by others.

The reality is that not every pregnancy is a wanted pregnancy. Too often, women and girls are raped. Sometimes the condom breaks or the birth control fails. Often, women (and girls especially) lack accurate information about birth control altogether, don’t know where to go to get it or don’t have enough money to buy and use it regularly. Sometimes they are in abusive, unhealthy relationships where they cannot communicate and negotiate such things with their partner. Sometimes women already have as many children as they are able to care for. This is the reality.

It is not enough to put a law on the books. If women who need abortions cannot afford or access safe medical care in the public domain and are forced to go to unlicensed, incompetent butchers operating bottom-house clinics, the problem remains. Children growing up without their mother who was killed because she was poor and the public health system did not address her needs – this is not what progress looks like!

Real progress – also known as really implementing the Medical Termination of Pregnancy Act – means the Ministry of Health taking the needs of poor and hinterland women seriously. It means providing safe and affordable abortion services in the public sector, nationwide. It means making non-surgical abortion options (the Cytotec pill) available, as well as ensuring that only vacuum aspiration is done (no more scraping!).

It means training nurses and midwives in these procedures, not just doctors, so there are more qualified providers especially in rural and hinterland areas. It means always stocking adequate and varied birth control methods (not just the condom) in all public clinics, hospitals and health centres. It means providing clear and accurate information about sexual and reproductive health, including abortion, to all – including schoolchildren and those in protective/state custody. Only then will Guyanese girls and women have something to celebrate.

*Sherlina Nageer is a writer, human rights and social activist

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