1,000 abortions a month - which is estimated to occur 1 every 10 minutes. Most are on teenagers between the ages from 12 to 18 years old - and this is just the number of legal abortions in one province
Estelle Ellis spent 5 months speaking to doctors, nurses, community workers and teenagers to understand the reasons behind these shocking statistics:
PREGNANT teenagers are putting such a massive strain on Eastern Cape state abortion clinics that overwhelmed staff cannot meet the demand – forcing more desperate women into the lethal clutches of backstreet butchers.
On average, 50 abortions a day are performed at Eastern Cape clinics – many of them performed on children as young as 12.
Some of these children have been raped, some have been coerced into sex with promises of airtime and shoes, while others use abortion as a means of contraception.
"Our patients are getting younger and younger.
"We have seen about six pregnant primary school pupils in the past month," says social worker Thandi Plaatjie, who works at the Healthy Mom and Baby clinic in Jeffreys Bay.
"These girls know about sex. There is no problem with access to contraceptives.
"We do not know how to get through to them. They are not even scared of HIV. They often tell me, 'I don't mind about that. I can live with that'.
"One girl was 12 when she started having sex. Her mother put her on contraceptives. When I talked to her she said that it was for airtime and for a relaxant cream for her hair."
In the last year more than 12,000 legal abortions were done at state hospitals and clinics in the Eastern Cape.
Staff at the women’s clinic at Dora Nginza Hospital in Nelson Mandela Bay see up to 20 patients a seeking abortions, and the monthly abortion rate has already doubled since January.
In the past five months dozens of women were turned away from clinics because they were more than 12 weeks pregnant and the procedure must then be performed at a hospital, where there are long delays.
Many of these women then resort to backstreet abortions.
This, in turn, is pushing up maternal death figures, which have doubled in the past three years in the Eastern Cape.
DANGER OF ILLEGAL ABORTIONS
SHE came to Port Elizabeth's Dora Nginza Hospital in the morning. Seventeen years old, bleeding uncontrollably.
She lived in Middleburg, 300km away. The hospital there had already tried to help her. She had taken abortion pills but had not expelled the foetus. Her uterus became septic. In a desperate effort to help her, more than five litres of septic fluid were drained from her abdomen.
By the time she arrived at Dora Nginza, her blood was no longer clotting and she had to have a hysterectomy. Doctors gave her adrenalin when her stopped. But even that was not enough.
“She died in my hospital. Her parents asked me why I killed their child,” Dora Nginza’s head of obstetrics, Mfundo Mabenge, said the day after his desperate battle to save the young girl.
For him, like so many other cases, she has become the desperate, suffering face of illegal abortions in the province.
“What tears my heart apart is that I have to account for her. She was here for less than six hours. Her family now comes to us and says: ‘Why have you killed our child?’,” he said.
In 1997, when South Africa legalised abortion, deaths caused by unsafe procedures dropped by more than 90%.
In its assessment based on maternal death statistics for 2005-07, the national Health Department raised the alarm for the first time over an increase in what it described as a “completely avoidable of death”, ranking unsafe abortion as the fourth leading cause of maternal death in South Africa.
The department’s latest report on 2008-10 maternal death (death while pregnant) statistics, attributes close to 25% of deaths nationally to pregnancy-related sepsis and 'un-con-bleeding'.
Septic miscarriage – an indication of illegal abortion – further accounted for 66% of deaths caused by miscarriage.
Jean Downey, who runs the New Life Pregnancy Crisis Centre in Uitenhage, says just about every woman who comes through her door seeking counselling after an abortion had an illegal one.
“Women come here severally traumatised. They took the pills and end up squatting over buckets for hours, aborting the foetus at home ... when they come to me they have nightmares of babies crying,” she said.
Social worker Thandi Plaatjie, from the Healthy Mom and Baby Clinic in Jeffreys Bay, said they recently found out through community workers that girls as young as 12 were aborting their babies in the municipal toilets near the informal settlement’s rubbish dump.
“The community workers go there early in the morning to clean up these aborted foetuses.
“Some of the girls take Tik and other drugs to bring on the miscarriages.”
The Medical Research Council’s survey of youth risk behaviour found that 30% of pregnant teenagers who had abortions indicated they went to either a traditional healer or “another place” for an abortion.
"We are seeing the rate of unsafe abortions rising again,” Mabenge said. “We cannot meet the demand for abortion. If a woman has to wait, she will go to a backstreet abortionist."
MORE WOMEN ARE DYING
“A functional abortion service is one of the most effective ways to reduce maternal deaths in the province, as illegal abortion is of the top five contributors to the sky-high maternal death rate in the province.”
The maternal death rate in the Eastern Cape has doubled in the past three years, with 710 pregnant women dying in the province’s state hospitals between 2008 and 2010.
The national Health Department says the rate of legal abortion is about 6 per 1,000 women and estimates illegal abortions at 38 per 1,000 women.