Girls take the road to abortions

It is 5am at the Chiawelo Clinic in Soweto. Girls as young as 14 are queueing outside the clinic's termination-of-pregnancy section.

Some are first-time visitors to Top, as the clinic is popularly known, while for those that have been here before it's D-Day for completing the process that will end their unwanted pregnancies.

Judging by the long queue, which goes almost to the main gate of the clinic, one would swear that these teenagers had slept at the premises. The long queues remind me of those when South Africans of all colours went to vote for the first time in 1994.

I listen attentively as the young women, mainly teenagers, chat nonchalantly about their abortions as if they were discussing the latest clothing trend or a hot new song.

"After 9 o'clock the sisters stop working so it is important to come here very early. I can't waste another day," says one girl, explaining why she arrived early at the clinic.

Her young boyfriend, accompanying her, seems to be deep in thought. As more people join the queue, the young man leaves, to his girlfriend's obvious disapproval. Maybe he could not take the teenagers' comments any more.

Those who have come for their "final touches" are sharing vividly their experiences after having taken the six pills - three swallowed orally and three suppositories.

One says: "The pain of giving birth is better than the pain I had yesterday. The way I was bleeding, I had to use nine pads."

"One minute I felt cold and the next I was hot, I just didn't know what was happening to me."

"I felt an excruciating pain across my abdomen and it felt as though it was going to my legs. Afterwards I felt something heavy coming out of me. I did not even want to look: what if it was the baby?"

She then laughs out loud.

Behind her stands another girl who says she is 14 and is not even sure she is pregnant but is worried because she has not had her periods since November.

Before this girl can talk about her situation, another one, accompanied by her boyfriend, bursts out laughing: "You are like me. I have not had mine since November as well." She is probably happy not to be alone.

"I see you brought your boyfriend," I comment.

"He must come as well. I am here because I am feeling sorry for him, he is not working and I must finish my matric," she says.

Another woman, mother of a six-year-old daughter, says she did not tell her partner she was going to have an abortion and took her pills the previous day.

"I felt sorry for him because he was worried yesterday when he saw me lying in bed. But I cannot afford to have another baby," she says.

The girl had pretended to take a day off work but "the minute he left, I got up because I had to come here again".

I ask one of the teenagers if she is not scared about having an abortion. "God knows that I cannot have another baby so I've already asked for His forgiveness, but, girl, I have to do this," she says.

Earlier in the week her pastor preached about abortions and appealed to girls to "stop killing babies".

"I left the church because I didn't want him to remind me of what I was going to do," she says.

Another says: "Isex ea tshwenya because emonate" (seSotho for "Sex is tricky because it is so nice").

At 7.15 the nurses arrive and open the doors to the Top section. Two nursing sisters emerge and give friendly instructions in isiZulu.

A nurse says: "If you are a friend, a boyfriend or a sister, you are not allowed to come in. You can wait outside. If you were here yesterday and you were told to come and get your pills, go to the room on your right, and if you are coming here for the first time go to the waiting room."

She then tells the young girls in the waiting room that two nurses will attend to them. "When they ask you when you had your last period, give them an exact date because they won't see you if you say 'last of last week' (meaning 'you are vague')," she advises.

I ask the nurse how she feels about working at Top. "I was reluctant at first, but I realised that I was not killing any babies. I just give the girls the pills, they swallow the pills themselves and insert the suppositories themselves."

She says it is painful when a young girl known to her comes to the clinic for an abortion.

"Sometimes I am a close friend of her family, but I have to respect her right not to have a child: it's her democratic right and I am required by law to keep my mouth shut."

The nurse says she cannot understand why "scores of young women could have unwanted pregnancies yet so many birth control options are available".

"Maybe the problem is that they have too many options these days."

All the facts

This information comes from the Choice of Termination of Pregnancy (CTOP) programme, and does not include illegal or spontaneous abortions:

1. Latest Gauteng information on termination of pregnancy:

Top's done for 2004: 56768 (source: monthly TOP report)

2. The number of TOPs being performed is increasing annually.

3. The average age of women requesting TOPs:

85 percent are between 18 and 35 years of age

six percent are younger than 18 years

nine percent are 36 or older

4. Reasons given for termination of pregnancy: According to the Choice of Termination of Pregnancy Act (92/1996), a pregnancy may be terminated upon request of a woman during the first 12 weeks of gestation without providing a reason. If the termination is done between 13 and 20 weeks, a reason must be provided. A total of 86% of TOPs perfomed are before 12 weeks of gestation. Of the 14 percent between 13 and 20 weeks, socio-economic reasons account for 69 percent of all reasons.

5. Annual research on termination of pregancy is done by the regions and presented at the Vallabh Prakash primary health conference.