Abortion clinic supports 'vocal local'
Ann Sanders and her husband decided years ago not to have children. Their reasons were, understandably, personal. When Sanders discovered she was pregnant early this year these reasons hadn't changed.
"I was so relieved that I lived in a country with sane abortion laws," she said. "I was relieved that I wouldn't have to spend a fortune travelling overseas or risk my life by having a backstreet abortion, like thousands of women had to do before."
"Before" ended three years ago, on February 1 1997, when the government legalised abortion, despite heated protests from religious and anti-abortion lobbies. Almost 100 000 women are said to have had legal abortions in South Africa since then.
But Sanders's experience shows that progressive legislation is no guarantee of a dignified process.
She chose to have her abortion at the Marie Stopes International Clinic in Cape Town. When she booked an appointment she was told the procedure would be quick and relatively pain-free. It was only when she arrived that she heard she wouldn't be getting an anaesthetic.
"They said they had run out of local anaesthetic, but that it didn't matter because they normally didn't use it," she said.
"I should have left right then, but I wanted to get it over with. They said the pain was very quick and bearable and that some women even went to work afterwards."
But Sanders found the pain unbearable.
"From the moment they started I was in agony. I told the nurse that I didn't think I could stand it, and she just said it was going to get worse."
"I can't describe the pain. It was excruciating. At one point, I lost control of my bowels it was so bad. By the time I came out, I was dripping in sweat and shaking. I couldn't even see properly."
Two weeks later, Sanders still doesn't sleep properly.
"I keep having nightmares about what happened; I feel that I was assaulted. I came (to the press) because I don't want other women to go through this."
Clearly, Sanders's experience was not what the government had in mind when they legalised abortion. Most women having the procedure at a private gynaecologist receive a general anaesthetic.
State hospitals like Groote Schuur provide either a local anaesthetic or, for early terminations, what they call "conscious sedation". This includes sedatives and an intravenous pain killer.
But Paul Cornelissen, the head of Marie Stopes in South Africa, defended what he called the "vocal local" on Monday.
"The pain is really negligible," he said. "Our experience is that most women can tolerate the procedure without an anaesthetic. We call it a vocal local because a nurse will talk them through the pain.
"Anyway, people who know a lot about termination will tell you that a local anaesthetic doesn't make a big difference."
He said that Marie Stopes clinics in other parts of the world followed the same procedure, yet the Website of Marie Stopes UK says clients are offered local and general anaesthetics alike. A detailed price list does not include an anaesthetic-free option.
Cornelissen said women were always offered a local anaesthetic, but the Cape Town clinic confirmed on Monday that they had run out when Sanders was there.
Zephne van der Spuy, the head of obstetrics and gynaecology at Groote Schuur, said women having abortions should not have to suffer.
"The ethic is not to punish women," she said. "If the patient is comfortable then the procedure will be easier for the doctor."
She said different women responded differently to the procedure.
"We would not do a termination without some form of pain control, but it is hard to comment on a case when you weren't there. The truth is that Marie Stopes provides an excellent service and helps thousands of women who can't afford private abortions."
About 200 women a month attend the city Marie Stopes clinic, paying R770 for the service. The clinic emphasises that 99 percent of these women are satisfied with the treatment, but admit that some people, like Sanders, do suffer.
Ann Sanders is a pseudonym.