Global Day for Safe and Legal Abortions

4e1359d8e206b850346e738d142216cdThe young woman left my consulting room after protracted counselling, with a completed J88 (a medical report of assault), a prescription for anxiolytics and pain medication, and a referral to a therapist. She was six weeks pregnant, but would not be for long. Her husband had inserted misoprostol tablets in her vagina, without her knowledge or consent. She was already in the throes of uterine cramps.

***

07cc7967ffd26d872fce5dafe4e3bd86The smell of blood permeated the ward I walked into that morning. Twelve beds with twelve women, who would be discharged that day and replaced by twelve more. And again. And again. Some women did not meet my eyes. Some looked angry. Some resolute. But the teenagers implored me with their big doe-eyes, waiting for me to pull back their sheets and discover the expelled products between their legs.

The night staff regularly refused to help the patients admitted for pregnancy termination. “It’s your mess. You clean it.” Many women would lie helplessly at night, groaning in unrelieved pain, with no assistance from the nurses sworn to care for them.

I was just an intern. I did my best. But maybe I should have done more.

***

4457445e1daf992adfbc37a6aa68a7e0An unidentified woman stumbled into the labour ward. Her long skirt was sticky with blood. She was diaphoretic, and breathing fast. She was weak with low blood pressure. She would not – could not? – speak.

“I think… I feel… bone shards?” the registrar reported on the vaginal examination.

An informal abortion gone awry. We will never know who did it, and the woman will never find justice. Abortion deaths were common in the days before legalisation. Our elders in medicine remember them well. These days, we are not meant to see women die from septic abortions. But that night, we did.

***

Today is the Global Day for Safe and Legal abortions. I feel like this protestor: I can’t believe we still have to protest this shit. How hard is it to leave women’s bodies alone? How hard is it to back off, and respect our autonomy?

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I am tired. Tired of hearing how women must run from pillar to post to find a facility that will help them, because so many healthcare workers choose to “conscientiously” object. Conscientious my foot.

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A very important report; worth reading. Click the image.

And I think that instead of suggesting a list of things readers can do, I’ll name just one:

Talk about it. 

Even just with your closest friends. If you can, talk to your colleagues. To family. Say the word out loud: abortion. Break the silence. You don’t have to have had an abortion to believe in choice and safety. Your voice is just as loud.

Say it.

I believe in the bodily autonomy, safety, and right to choose of all womxn. 

I believe that legal abortions are integral to the health of communities. 

Statistically, abortion is an everyday part of life. The sooner we start treating it that way, the better.

 

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Doctor. Counsellor. Freedom Fighter.

She was a healthy young woman who came to see me for a “complete check-up” before a holiday overseas. Although I tend to think “complete” check-ups are somewhat overkill, they do present a good opportunity for health promotion and disease prevention. As one does, I asked about sexual history and family planning. She hesitated just a split second before answering, “Well, my only partner is a woman, so I don’t have to worry about pregnancy scares.” And then, we moved on.  Continue reading “Doctor. Counsellor. Freedom Fighter.”

Are We Secretly Our Own Worst Enemies?

If you’ve been reading South African news, you’ll know that at least 300 interns and community service doctors stand to be unemployed next year, due to a lack of funded posts at accredited institutions.

Perhaps you read about our inhumane working hours last year.

Perhaps you have read about the overflowing hospitals where patients pile up in the corridors.

These are not new problems, we just hear about them more because doctors and patients have phones with cameras, and social media accounts.

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Continue reading “Are We Secretly Our Own Worst Enemies?”

Mental Health Begins With Medical Students

Every few months, the mental health of doctors/medical students makes it to popular media. It seems like these spikes in attention occur, and everyone shouts YOU SHOULD CARE FOR YOUR DOCTORS! and then we write blogs and we tweet and we make youtube videos and eventually we go back to work, and nothing has changed.

I think we are the missing link. And by “we”, I mean qualified doctors. And also, you, the older doctors. Continue reading “Mental Health Begins With Medical Students”

The Safe Working Hours Wristband Campaign is Missing the Point – Here’s Why

If you’ve been paying attention, working hours of doctors (especially junior doctors) have been getting some good airtime over the past few months. The Province of the Western Cape has committed to actively reducing maximum continuous working hours for doctors to twenty-four, the HPCSA has promised to “look into it” (not that we have too much confidence there), and our biggest representative, SAMA (South African Medical Association) has come out in our support.

One of the things to come from all this is the launching of an armband campaign. This has its origins, I believe, from a similar campaign in the UK – although I have not been able to find any source to this link.

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Abortion Care: Did I Provide My Best?

It’s funny how sometimes, long after the fact, you start questioning your levels of care and competence.

During my first rotation of internship (last year), which was Obstetrics and Gynaecology, I was one of the few interns willing to do pregnancy terminations. (For the purposes of this blog, the matter is not up for debate – I have been pro-choice for nearly half my life, and have thoroughly evaluated my own beliefs.)

Just recently I’ve found myself thinking back on those four months and wondering if I did everything I could, and if I was empathic enough. Continue reading “Abortion Care: Did I Provide My Best?”

Does It Have To End?

c4e635ecb89b5ed4844f087dca6580b1My four-month stint on the paediatric service comes to an end this week.

I enjoyed paediatrics in medical school, but never as much as this. How wonderful it was to be excited about work, to enjoy it so much that I willingly and eagerly read up more about all my cases.

It may have been one of the most challenging rotations – and it was good to see myself growing in confidence and ability.

There is so much work to do in paediatric healthcare, especially because you inadvertently treat the caregivers as well. And women are another group so sorely neglected in our environment.  Continue reading “Does It Have To End?”

My Evolving Opinions About Doctors’ Working Hours

I started working on this post two days ago. Since then, I have received news of a colleague who died in an accident while driving post-call. She went to my alma mater and graduated last year, and though I did not know her personally, my heart breaks. A country with a shortage of doctors has lost a young doctor who was just starting in her career. She was well-loved, and we will all feel her absence.

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 * * * Continue reading “My Evolving Opinions About Doctors’ Working Hours”