According to a study, women are attempting informal sector abortion because they seek privacy and fear mistreatment and stigma in health facilities Picture: Paballo Thekiso

At 17, * Joy had no idea that she was pregnant.

When she found out a few weeks later, she didn't know what to make of the news until her doctor called her mother into the consultation room.

When her mother arrived she had a conversation with the doctor and didn't exchange much words with her teenage daughter. She learnt that she was about to have an abortion when her mother gave her money and ordered her cousin to go with her to a Joburg private clinic.

“My mom did not tell me what I was about to do.  No questions on how I felt were asked.”

To date, Joy and her mother have never spoken about her experience to each other or their neighbours for fear of judgment and rejection.

“It is something that is looked down on... neighbours would gossip about you if they found out so we chose to keep a family secret,” said Joy.

Now aged 27, Joy still finds it difficult to talk about her abortion.

Under Choice on Termination of Pregnancy  Act (TOP), 1996, termination of pregnancy being has been legal in South Africa for the past two decades, but many women are still ashamed to talk openly about their choice of terminating pregnancy for fear of being "judged" and ostracised when they seek abortion services.

After Joy had her second abortion at 26, she says the judgment from family members was awful.

“One day my aunts told me I don't deserve good things in life because I had two terminations. The other one told me that I would never succeed because the baby's spirit has not rested,” she said.

Although she is getting therapy to stabilise her emotions, she says there are days where she battles with depression and she believes what her relatives say. 

Moreover, she feels that consent should have been asked for her first abortion.

Although Joy decided on her own to have a second abortion at 18 weeks, she still chose a private clinic despite the fact that it cost her R2 800 to avoid being ostracised. 

“Judgment is harsh at these places even from people who are there for the same thing. They stare and judge you without thinking twice,” said Joy.

Dr Eddie Mhlanga an obstetrician and gynaecologist, who was also instrumental in the development of the termination of pregnancy  Act, said although legislation recognised minors, but as soon a 'minor' fell pregnant  she was regarded competent to make her own decisions.

"So there is no age limit. The minors, however, are advised to consult with their parents or legal guardian, and friends, but there is no consent required from the parents. One has to be mindful that some minors have been impregnated by their biological relatives."

There was, however, no counselling services offered to women who terminate their pregnancy in the state sector, and women were encouraged to seek these services privately or within their families.

* Namhla Khumalo, an enrolled nurse who had been working in a state abortion clinic for the past five years admits that although termination of pregnancy is legal in SA, it also not easy for health workers to perform it it 'doesn't  sit well on our conscience. 

Although she felt less guilty to perform an abortion on a rape victim, but most times she felt 'disturbed' when young girls were using this procedure multiple times.

“We are nurses but also parents, so the parent side sometimes takes over...and you find yourself shouting at these girls for being irresponsible. Doing this every day is not a nice thing, many religious leaders and community members frown at us. 

"Sometimes they tell us that we sinning against God and that we will be punished for it,” said Khumalo.

Khumalo admits her job ends up affecting her parenting at home, and tends to be suspicious of girl children.

A study published in the BMC Women's Health site 2 October 2017, said women are attempting informal sector abortion because they seek privacy and fear mistreatment and stigma in health facilities. "Some were unaware how or where to seek formal sector services, or believed the cost was too high."

The study showed that many methods where ineffective and unsafe, leading to potential warning signs of complications and continued pregnancy.

Andrea Thompson, advocacy and engagement manager at Marie Stopes — a private clinic that offers family reproductive services — also admits that the decision to terminate pregnancy doesn't come easy. 

"Many times it's a case of put yourself in my shoes. Sometimes circumstances force young girls especially into making  the decision."

To help women who have a hard time dealing issues around abortion, Gaopalelwe Phalaetsile - who also had abortion as a teenager, has since found Facebook support group, Black Womxn Healing Garden. 

Phalaetsile says many women text her during awkward hours seeking help because they have a complication with abortions, but they are too scared to go to the public hospital. 

Having done two abortions herself she feels that women need a safe space for them to talk about abortion without being judged.  Her support group gives these women space to heal emotionally.

“Because the public does not off er such space, we need each other so we can heal and move forward without fear or judgment,” says  Phalaetsile

* Not their real names