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As a nurse, Barley Mahanyela used to be concerned about the high number of women arriving at the hospital with excessive bleeding caused by unsafe backstreet abortions that were incomplete or even losing their lives because of those dangerous procedures.
Mahanyela, operational manager for reproductive health services at George Mukhari Academic Hospital, had joined the profession to save lives and seeing desperate women losing theirs over something that could have been prevented spurred her into action.
She then decided to leave her job at the labour ward to work in the termination of pregnancies unit and today not only does Mahanyela provide access to safe terminations, but she also trains other nurses so they can help women who want to end unwanted pregnancies.
“The government legalised this procedure because of the escalating numbers of deaths that were happening, and it was too expensive for us to manage complications of unsafe terminations.
“The women would come to hospitals after they had bled a lot and would now need a blood transfusion. “Sometimes they would have to be sent to the theatre for something that could have been done in four hours,” Mahanyela said.
“My objective was to prevent these incidents from continuing but there were still women who opted for unsafe termination of pregnancies despite this procedure being legalised.”
According to Mahanyela, she has to constantly explain to society that all women have rights and they must be allowed to make decisions about their reproduction.
She said the women who approach them seeking terminations go to them feeling stressed, confused and not knowing what else to do.
It then becomes their responsibility as services providers to guide those women about the processes around the termination.
“We do not just do the procedure, we first educate them about the termination of pregnancies. We don’t channel the woman to one option, we also explain that there is adoption,” she said.
When it comes to terminations, there are two types, she said.
There is a surgical procedure done at a health facility with instruments and a medical one where a woman is given pills to consume at home. The latter is only done up to a 10-week pregnancy, she said.
Mahanyela said they do not only end wanted pregnancies but they also advise women about the risks that come with the termination of pregnancies.
“The procedure is not normal and it takes time for the cervix to close since they are irritating it”.
Mahanyela was also quick to point out that abortion does not cause fertility issues but cautioned that women must never use it as a contraceptive.
Regarding the reasons some women resorted to illegal terminations, Mahanyela said access was not a stumbling block but rather ignorance and lack of knowledge were driving them to endanger their lives. Others, she said, complained about the perceived lack of privacy in public hospitals.
“There is access, but the challenge is that most of the women don’t know that the procedure is legal in SA. Those that are aware still resort to backstreet terminations because they assume there is no privacy and confidentiality at public hospitals while with illegal ones it is just them and the service provider,” Mahanyela said.
“Some women also choose the illegal route because they avoid the process of being assessed as to how far along are they [so that a determination can be done whether it is a medical or surgical termination they will have to undergo] and they do not like that drama. However, unsafe abortions always come back to them because they are then rushed into our facilities after losing blood from illegal abortions.”
Mahanyela used to work in the private sector but moved to a public hospital because she wanted to provide more access and give women proper services by also training other nurses on the importance of privacy and offering the best care to those women who need their services.
“The more we have trained nurses, the more we have informed patients and the less they endanger their lives,” she said.
“What I love and appreciate about my job is the way the woman will be happy when she goes back home about the relief we provided her with.
“By respecting their wishes and taking them seriously, these women leave with a smile on their faces and are grateful,” said Mahanyela.
She said she prides herself on being one of the people who provide relief and freedom to women with unwanted and unplanned pregnancies.
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