
<h2 class="wp-block-heading" id="h-topline">Topline</h2>



<p>Managing the early stages of medication abortion care at home later in pregnancy is safe and cuts down time spent in hospital, according to new research&nbsp;<a href="https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)01079-1/fulltext" rel="noreferrer noopener" target="_blank">published</a>&nbsp;on Thursday, which researchers say could boost access to the procedure as reproductive rights stand out as a key issue in the 2024 election.</p>



<h2 class="wp-block-heading" id="h-key-facts">Key Facts</h2>



<p>Almost all abortions in the United States are&nbsp;<a href="https://www.cdc.gov/reproductive-health/data-statistics/abortion-surveillance-findings-reports.html" rel="noreferrer noopener" target="_blank">performed</a>&nbsp;at or before 13 weeks of pregnancy—the first trimester—according to the Centers for Disease Control and Prevention, and clinical guidelines typically recommend the procedure be performed exclusively in clinical settings after the 12-week mark so patients can remain under observation.</p>



<p>Medication abortions involve taking two types of pills to end pregnancy—mifepristone, which blocks a hormone needed for pregnancy to continue, and misoprostol, which makes the womb contract—and for abortions after 12 weeks patients are usually given mifepristone in a clinic and return to a day or two later to receive misoprostol until the procedure is complete, a process that frequently requires an overnight stay in hospital.</p>



<p>Based on a randomized control trial of 435 women having a medical abortion between 12 and 22 weeks published in the Lancet medical journal, researchers from universities and hospitals in Sweden found medical abortions conducted after 12 weeks of pregnancy were as safe and as effective when misoprostol was started at home instead of in hospital and that women managing the early stages of care at home spent less time in hospital.</p>



<p>Of the pregnant people starting misoprostol at home and returning to clinics to receive further doses—several are usually required to complete the procedure—71% spent fewer than nine hours in hospital, compared to 46% of those in the hospital treatment group, the peer reviewed study showed.</p>



<p>There were no differences in the pain reported by patients in either group, the type and number of side effects or rates of hospital admission earlier than what was planned, the researchers said, adding that a follow up survey revealed 78% of the home group said they preferred their allocated treatment option compared to just 49% of the hospital group.</p>



<p>One of the study’s authors Johanna Rydelius, a gynecologist at Sahlgrenska University Hospital and researcher at the University of Gothenburg, said the findings offer a safe alternative to a practice that often requires overnight stays many women “find stressful and isolating” and could potentially lead to more “feelings of autonomy during a time where women can feel extremely vulnerable.”</p>



<h2 class="wp-block-heading" id="h-crucial-quote">Crucial Quote</h2>



<p>“Increasing access to abortion later in pregnancy is a crucial component of the struggle for reproductive autonomy,” said Heidi Moseson and Caitlin Gerdts, researchers at Ibis Reproductive Health, a U.S. non-profit reproductive health research organization, in a linked comment piece published alongside the study in the Lancet. Given the “overwhelming preference for at-home” misoprostol administration among the pregnant people involved in the study, Moseson and Gerdts, who were not involved in the research, said reforming guidance and “moving towards a less clinically supervised model of medical abortion care later in pregnancy is an important first step” for improving access.</p>



<h2 class="wp-block-heading" id="h-why-do-current-guidelines-recommend-facility-based-medication-abortions-after-12-weeks">Why Do Current Guidelines Recommend Facility-Based Medication Abortions After 12 Weeks?</h2>



<p>This is because of the greater risk of complications the procedure carries in later stages of pregnancy that may require additional care. This could include pain, bleeding, infection or an incomplete abortion (material remaining). But despite “profound” implications for access, the requirement to administer medications in clinical settings is “driven primarily by the absence of data on alternative models of care,” Moseson and Gerdts explained. This system “limits the number and type of facilities that can offer abortion care after 12 weeks,” they added, pointing to limited bed spaces and staffing requirements needed to keep people overnight.</p>



<h2 class="wp-block-heading" id="h-key-background">Key Background</h2>



<p>Since the Supreme Court overturned Roe v. Wade in 2022, many states across the U.S. have harshly restricted access to abortion. The procedure is now&nbsp;<a href="https://www.theguardian.com/us-news/ng-interactive/2024/jul/29/abortion-laws-bans-by-state" rel="noreferrer noopener" target="_blank">banned</a>&nbsp;from conception in 14 states and from six weeks—a time many people are not even aware they are pregnant—in four states, with the future of abortion uncertain in a handful of other states due to legal challenges. While exceptions are made under limited circumstances in states banning abortion, these vary by state and clinicians and health experts have complained the vague or inconsistent language setting out exceptions are out of touch with medical reality and unworkable in practice. This fits within broader efforts to roll back reproductive care even further, such as Republican&nbsp;<a href="https://www.bbc.co.uk/news/articles/c2qq1wqw3w2o" rel="noreferrer noopener" target="_blank">attempts</a>&nbsp;to restrict access to mifepristone. The matter has polarized the country and both Democrats and Republicans have seized upon reproductive healthcare as a major dividing issue for the upcoming presidential election.</p>



<h2 class="wp-block-heading" id="h-big-number">Big Number</h2>



<p>625,978. That’s how many legal induced abortions there were in the U.S. in 2021,&nbsp;<a href="https://www.cdc.gov/reproductive-health/data-statistics/abortion-surveillance-findings-reports.html" rel="noreferrer noopener" target="_blank">according</a>&nbsp;to the CDC, excluding California, Maryland, New Hampshire and New Jersey, which did not submit data to the agency. Almost all of these, 93.5%, happened at or before 13 weeks.</p>


Woman holding pills and glass of water while standing in kitchen at home

Self-Managing Some Abortion Care Later In Pregnancy Is Safe, Effective And Boosts Access, Researchers Say


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>Medication abortions prescribed and delivered using video calls, text messages and pills delivered through the mail are just as safe and effective as a visit to the clinic, according to research published Thursday in Nature Medicine, as politicians across the country continue to fight over abortion access and the Supreme Court&nbsp;<a href="https://www.forbes.com/sites/alisondurkee/2023/12/13/supreme-court-agrees-to-hear-abortion-pill-cases-determine-whether-pills-should-be-restricted/?sh=2e0147367e27">prepares</a>&nbsp;to consider a challenge that could upend access to a key abortion drug, mifepristone.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>Medication abortion, which involves taking two pills—mifepristone followed by misoprostol—can be delivered safely and effectively using telehealth, according to new peer reviewed research from University of California, San Francisco.</p>



<p>In 2021, the Food and Drug Administration&nbsp;<a href="https://www.nytimes.com/2021/12/16/health/abortion-pills-fda.html" target="_blank" rel="noreferrer noopener">permanently lifted&nbsp;</a>restrictions that required mifepristone to be dispensed in a medical clinic, paving the way for the pill to be prescribed through a telemedicine appointment and shipped to the patient by mail.</p>



<p>Pregnant patients who obtained the abortion pills from virtual clinics and had two remote follow-up appointments after they’d taken them had no serious adverse events—such as needing major surgery and blood transfusion—99.8% of the time, the researchers said after analyzing data from more than 6,000 patients from virtual clinics operating in 20 states and Washington D.C. between April 2021 and January 2022.</p>



<p>Additionally, the researchers said around 98% of the abortions administered this way took place without needing any further medical care.</p>



<p>The figures are on par with outcomes for patients who receive medication and abortion care in-person, according to the researchers, who urged lawmakers to rethink policies that restrict access to this “essential healthcare service” over purported fears over safety.</p>



<h2 class="wp-block-heading" id="h-news-peg">NEWS PEG</h2>



<p>Since the Supreme Court overturned Roe v. Wade and ended the constitutional right to an abortion, anti-abortion activists and lawmakers have turned their attention to other ways of restricting access. Initially, this fight mainly focused on&nbsp;<a href="https://www.theguardian.com/world/2023/dec/05/us-abortion-clinics-close-after-roe-overturned" target="_blank" rel="noreferrer noopener">physical abortion clinics</a>, and the effort later expanded to target abortion medications like mifepristone and misoprostol, which respectively end pregnancy and empty the uterus by causing cramping and bleeding. Both drugs have undergone rigorous safety testing as part of the approval process in the U.S. and abroad and strong safety records from data collected over decades. Anti-abortion advocates have&nbsp;<a href="https://www.nytimes.com/2023/12/13/us/supreme-court-abortion-pill.html" target="_blank" rel="noreferrer noopener">questioned</a>&nbsp;the approval process behind the drugs and&nbsp;<a href="https://www.economist.com/united-states/2023/02/26/the-big-american-post-roe-battle-over-abortion-pills" target="_blank" rel="noreferrer noopener">claim</a>&nbsp;they are unsafe and harm women, urging officials and judges to take them off of shelves and ban them from being delivered through the post. Experts&nbsp;<a href="https://www.forbes.com/sites/alisondurkee/2023/04/11/mifepristone-ruling-here-are-the-unintended-health-consequences-of-attacks-on-abortion-pills/?sh=368c856e6405">warn</a>&nbsp;there could be unintended healthcare consequences from banning or curtailing access to the pills, as the drugs are also used for a variety of other medical conditions and to treat miscarriages.</p>



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<p>By signing up, you accept and agree to our&nbsp;<a href="https://www.forbes.com/terms-and-conditions" target="_blank" rel="noreferrer noopener">Terms of Service</a>&nbsp;(including the class action waiver and arbitration provisions), and you acknowledge our&nbsp;<a href="https://www.forbes.com/privacy" target="_blank" rel="noreferrer noopener">Privacy Statement</a>.</p>



<h2 class="wp-block-heading" id="h-what-to-watch-for">WHAT TO WATCH FOR</h2>



<p>Despite the Supreme Court returning the power to regulate abortion access back to states when it overturned Roe, the court is due to&nbsp;<a href="https://www.forbes.com/sites/alisondurkee/2023/12/13/supreme-court-agrees-to-hear-abortion-pill-cases-determine-whether-pills-should-be-restricted/?sh=2e0147367e27">consider</a>&nbsp;the issue of abortion access once again after a federal judge in Texas took the&nbsp;<a href="https://abcnews.go.com/Politics/unprecedented-texas-abortion-pill-ruling-sparks-debate-judge/story?id=98531203" target="_blank" rel="noreferrer noopener">unprecedented</a>&nbsp;step of suspending the Food and Drug Administration’s approval of mifepristone. The court is&nbsp;<a href="https://www.statnews.com/2024/01/29/mifepristone-scotus-abortion-pill-case-march/" target="_blank" rel="noreferrer noopener">slated</a>&nbsp;to hear arguments for the case restricting access to mifepristone in March. In a press release, UCSF said the study has “already been cited in the amicus brief submitted to the Supreme Court supported by more than 300 leading reproductive health researchers. ”</p>



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>“Since the Covid-19 pandemic, telemedicine has become the new frontier in health care, including for medication abortion,” said the study’s lead author Ushma Upadhyay, a professor of obstetrics, gynecology and reproductive sciences at UCSF. “A ruling against this method and the FDA’s rigorous science review process would be a huge blow to the American public and make this essential health service harder to get.”</p>


Abortion Pills: Telehealth Procedure Is As Safe As Clinic Visit, Research Finds


<h2 class="wp-block-heading" id="h-topline">TOPLINE</h2>



<p>YouTube <a href="https://twitter.com/YouTubeInsider/status/1550153517842587661" target="_blank" rel="noreferrer noopener">said</a> Thursday it will take down misinformation related to abortion on its platform worldwide, including content that “provides instructions” for unsafe abortion procedures without scientific support as well as false claims such as that the procedure causes infertility, as social media companies battle the spread of misinformation in the aftermath of the Supreme Court’s decision to overturn Roe v. Wade.</p>



<h2 class="wp-block-heading">KEY FACTS</h2>



<p>YouTube prioritizes “connecting people to content from authoritative sources on health topics,” and will “continuously review our policies &amp; products as real world events unfold,&#8221; the company said in a&nbsp;<a href="https://twitter.com/YouTubeInsider/status/1550153517842587661" target="_blank" rel="noreferrer noopener">thread</a>&nbsp;on Twitter.&nbsp;</p>



<p>YouTube also plans to attach an information panel to abortion-related content on the platform to direct viewers to credible sources.</p>



<p>The policy will come into effect Thursday, and marks an addition to the company’s existing misinformation policies on Covid-19, vaccine and elections.</p>



<h2 class="wp-block-heading">KEY BACKGROUND</h2>



<p>Experts have sounded&nbsp;<a href="https://www.bloomberg.com/news/articles/2022-07-01/deadly-abortion-misinformation-rings-alarm-bells-for-doctors-tiktok?sref=5EPYOKdS" target="_blank" rel="noreferrer noopener">alarms</a>&nbsp;about a spike in misinformation related to abortion in the wake of the Supreme Court’s Roe v. Wade ruling in June. Videos on social media platforms sharing potentially dangerous ways to induce abortions with herbs have since&nbsp;<a href="https://www.rollingstone.com/culture/culture-news/tiktok-abortion-herbs-misinformation-death-1376101/" target="_blank" rel="noreferrer noopener">proliferated</a>&nbsp;on TikTok, Facebook, Twitter and YouTube. TikTok has said it is working to remove videos about abortion that violate its medical misinformation policy,&nbsp;<a href="https://www.cnn.com/2022/07/13/health/abortion-misinformation-social-media/index.html" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to CNN. YouTube, meanwhile, has come under&nbsp;<a href="https://www.cnn.com/2022/01/12/tech/youtube-fact-checkers-letter/index.html" target="_blank" rel="noreferrer noopener">fire</a>&nbsp;from fact-checking organizations in recent years for failing to take enough action to combat the spread of misinformation on its platform. Google, YouTube’s parent company,&nbsp;<a href="https://www.theguardian.com/technology/2022/jul/01/google-delete-location-data-abortion-clinic" target="_blank" rel="noreferrer noopener">pledged</a>&nbsp;earlier this month to automatically delete the location data of users who visit abortion clinics after some abortion rights advocates raised concerns the data could be used to prosecute those who seek to access abortions in states where the procedure is illegal. Law enforcement has frequently turned to Google for data in recent years, executing more than 40,000 U.S. search warrants and subpoenas for user information in the first half of 2020,&nbsp;<a href="https://www.washingtonpost.com/politics/2022/07/05/abortion-bans-heighten-scrutiny-google-its-user-data/" target="_blank" rel="noreferrer noopener">according</a>&nbsp;to&nbsp;<a href="https://transparencyreport.google.com/user-data/overview" target="_blank" rel="noreferrer noopener">Google</a>.&nbsp;</p>



<h2 class="wp-block-heading">FURTHER READING</h2>



<p><a href="https://www.cnn.com/2022/07/21/tech/youtube-abortion-misinformation-policy/index.html" target="_blank" rel="noreferrer noopener">YouTube will start removing misinformation related to abortion</a>&nbsp;(CNN)</p>



<p><a href="https://www.cnn.com/2022/01/12/tech/youtube-fact-checkers-letter/index.html" target="_blank" rel="noreferrer noopener">More than 80 fact-checking organizations call out YouTube&#8217;s &#8216;insufficient&#8217; response to misinformation</a>&nbsp;(CNN)</p>



<p><a href="https://www.washingtonpost.com/politics/2022/07/05/abortion-bans-heighten-scrutiny-google-its-user-data/" target="_blank" rel="noreferrer noopener">Abortion bans heighten scrutiny on Google and its user data</a> (Washington Post)</p>



<p><strong><em>By Madeline Halpert, Forbes Staff</em></strong></p>


In this photo illustration, a silhouetted woman holds a

YouTube Will Take Down Abortion-Related Misinformation


<p>As American women in parts of the United States fight to have the right to choice literally given back to them, Sierra Leone’s president, Julius Maada Bio, introduced an act to decriminalize abortion in July.</p>



<p>“At a time when sexual and reproductive health rights for women are either being overturned or threatened, we are proud that Sierra Leone can once again lead with progressive reforms,” said President Bio according to <em>The Guardian</em>, referring to the US supreme court’s decision to <a href="https://www.theguardian.com/world/2022/jun/24/roe-v-wade-overturned-abortion-summary-supreme-court">overturn the constitutional right to abortion</a>. </p>



<p>The Safe Motherhood and Reproductive Health Act would overturn a strict ban on abortions and help reduce Sierra Leone’s maternal mortality rate which ranks the highest in the world.</p>



<p>Abortion is not permitted for any reason in 10 out of 54 African countries.</p>



<p>According to a<em> 2018 Guttmacher Institute report</em>, an estimated 93% of women of reproductive age in Africa live in countries with restrictive abortion laws. <em>Time Magazine</em> further elaborated that some 90 million (5%) women of reproductive age live in countries that prohibit abortion altogether.</p>



<p>“This monumental step forward is a victory for our communities and the coalition of women’s rights organizations and movements in Sierra Leone who have been advocating for legal, policy and social change to decriminalize abortion. The news of the act shows that President Bio and parliament are listening to women’s rights organizations,” says Rosa Bransky and Chernor Bah, co-CEOs of Purposeful, an Africa-rooted global hub for girls’ organizing and activism.</p>



<p>“However, we know that decriminalization of abortion will not make it accessible to everyone who needs<br>one overnight, and the stigma within our communities remains.”</p>



<p>“My government has unanimously approved a safe motherhood bill that will include a range of critical provisions to ensure the health and dignity of all girls and women of reproductive age in this country,” Bio said at the 10th Africa Conference on Sexual Health and Rights in the country’s capital at the start of the month. </p>


Abortion Demonstration Outside of White House

Sierra Leone Move to Decriminalize Abortion


<p><strong>TOPLINE</strong> Two of the most popular dating apps in the U.S., Match and Bumble, are kickstarting funds to help Texans access abortion services in the wake of a controversial new anti-abortion law that effectively bans the procedure after six weeks, before many have realized they’re pregnant.</p>



<h2 class="wp-block-heading" id="h-key-facts">KEY FACTS</h2>



<p>CEO Shar Dubey, whose Match Group Inc. operates Match.com, the largest dating site in the country, told employees Thursday in&nbsp;<a href="https://twitter.com/pardesoteric/status/1433458540992073735/photo/1" target="_blank" rel="noreferrer noopener">an internal memo</a>&nbsp;that she has set up a fund for workers affected by the new legislation.</p>



<p>The Dallas-based company’s fund will help cover costs for workers and their dependents who need to&nbsp;<a href="https://www.bloomberg.com/opinion/articles/2021-09-02/supreme-court-ruling-on-texas-abortion-law-isn-t-death-knell-for-roe" target="_blank" rel="noreferrer noopener">travel out-of-state</a>&nbsp;in order to have an abortion, Dubey said in the memo first reported by Bloomberg.</p>



<p>Austin-based Bumble, the second-most downloaded dating apps in the U.S., announced Wednesday it would launch a fund to support people trying to&nbsp;<a href="https://twitter.com/bumble/status/1433194713092403202?s=20" target="_blank" rel="noreferrer noopener">access abortion services</a>&nbsp;in Texas.</p>



<p>Bumble said that the company will lend its support in fighting Texas’ new abortion legislation, which it called “<a href="https://twitter.com/bumble/status/1433195884435681287?s=20" target="_blank" rel="noreferrer noopener">regressive</a>” in a statement.</p>



<h2 class="wp-block-heading" id="h-tangent">TANGENT</h2>



<p>With its low taxes and affordability, Texas bills itself as&nbsp;<a href="https://gov.texas.gov/business/page/why-texas#:~:text=As%20the%209th%20largest%20economy,robust%20infrastructure%20and%20predictable%20regulations." target="_blank" rel="noreferrer noopener">a business-friendly state</a>&nbsp;and has attracted companies like&nbsp;<a href="https://www.forbes.com/sites/carlieporterfield/2021/03/02/elon-musks-spacex-to-open-a-factory-in-austin-job-posting-reveals/">Tesla</a>, Apple, Oracle and Hewlett Packard to either open offices or relocate to the state. A recent poll indicates Texas may lose out on skilled workers over the state’s new restriction abortion policy. According to a PerryUndem poll released this week, two-thirds of workers with college educations said they&nbsp;<a href="https://www.forbes.com/sites/maggiemcgrath/2021/09/02/survey-two-thirds-of-college-educated-workers--may-avoid-texas-because-of--abortion-ban/?sh=6a0f49176e4c">would not take a job</a>&nbsp;in a state that bars abortions after six weeks of pregnancy, like Texas’ new law effectively does.&nbsp;</p>



<h2 class="wp-block-heading" id="h-crucial-quote">CRUCIAL QUOTE</h2>



<p>“I immigrated to America from India over 25 years ago … I am shocked that I now live in a state where women’s reproductive laws are&nbsp;<a href="https://twitter.com/pardesoteric/status/1433458540992073735/photo/1" target="_blank" rel="noreferrer noopener">more regressive</a>&nbsp;than most of the world, including India,” Dubey said in the memo Thursday. “Surely everyone should see the danger of this highly punitive and unfair law … I would hate for our state to take this big step back in women’s rights.”</p>



<h2 class="wp-block-heading" id="h-key-background">KEY BACKGROUND</h2>



<p>Texas’ new abortion legislation was&nbsp;<a href="https://www.forbes.com/sites/carlieporterfield/2021/05/19/texas-bans-abortion-as-early-as-six-weeks-with-new-heartbeat-bill/">signed into law</a>&nbsp;by Gov. Greb Abbott in May, but did not take effect until Wednesday. The law bans abortion after what the bill interprets as signs of a fetal heartbeat are detected, which can be picked up at about six weeks using a vaginal ulstrasound. However, medical experts dispute that what ultrasounds pick up that early into a pregnancy is&nbsp;<a href="https://www.forbes.com/sites/carlieporterfield/2021/05/19/texas-bans-abortion-as-early-as-six-weeks-with-new-heartbeat-bill/?sh=719b67932c0f">actually a heartbeat</a>, saying it’s more likely the twitching of tissue that will later develop into a heart as it’s “electronically induced” by the ultrasound machine.” Banning abortion after six weeks, before many people realize they’re pregnant, will make about&nbsp;<a href="https://www.forbes.com/sites/alisondurkee/2021/09/01/texas-now-has-the-most-restrictive-abortion-law-in-the-us-heres-what-could-happen-next/?sh=21af77c45f0c">85% of abortions</a>&nbsp;ineligible under the new Texas law, experts say. The legislation allows private citizens enforce the law by suing anyone involved in helping procure an abortion in civil court for&nbsp;<a href="https://www.forbes.com/sites/alisondurkee/2021/09/01/texas-now-has-the-most-restrictive-abortion-law-in-the-us-heres-what-could-happen-next/?sh=21af77c45f0c">up to $10,000</a>. Abortion is a safe and common medical procedure that nearly&nbsp;<a href="https://www.guttmacher.org/news-release/2017/abortion-common-experience-us-women-despite-dramatic-declines-rates" target="_blank" rel="noreferrer noopener">one in four women</a>&nbsp;will undergo before turning 45, according to a 2017 study from the Guttmacher Institute, a pro-choice think tank.&nbsp;</p>



<h2 class="wp-block-heading" id="h-further-reading">FURTHER READING</h2>



<p><a href="https://www.forbes.com/sites/alisondurkee/2021/09/01/texas-now-has-the-most-restrictive-abortion-law-in-the-us-heres-what-could-happen-next/?sh=285cea045f0c">Texas Now Has The Most Restrictive Abortion Law In The U.S.—Here’s What Could Happen Next</a>&nbsp;(<em>Forbes</em>)</p>



<p><a href="https://www.forbes.com/sites/alisondurkee/2021/09/02/biden-vows-action-against-texas-abortion-ban-with-whole-of-government-effort/?sh=433d07936acf">Biden Vows Action Against Texas Abortion Ban With ‘Whole-Of-Government Effort’</a>&nbsp;(<em>Forbes</em>)</p>



<p><a href="https://www.forbes.com/sites/alisondurkee/2021/09/02/florida-lawmakers-suggest-theyll-copy-texas-abortion-ban-and-other-gop-states-will-likely-follow/?sh=60e207d1bdfb">Florida Lawmakers Suggest They’ll Copy Texas’ Abortion Ban—And Other GOP States Will Likely Follow</a> (<em>Forbes</em>)</p>



<p><strong><em>By Carlie Porterfield, Forbes Staff</em></strong></p>


Bumble App Photo Illustrations

Bumble, Match Launch Funds To Cover Abortion Costs In Texas


<p>Clandestine clinics offering illegal abortions are one of the prime causes of unnecessary maternal deaths across Africa. The lack of facilities for safe procedures makes the statistics worse.</p>



<hr class="wp-block-separator"/>



<p>When the pain started, I called him. I begged him for help.I was bleeding so much. The pain became more and more severe. I could not sit,or stand or lie down. I could not move. He told me not to contact him again,that it was not his problem. He told me to go to hospital if I have problems. After that, I never got hold of him again.”</p>



<p>This is the story of Megan Naidoo (not real name), the survivor of an illegal backyard abortion procedure. Naidoo was seven weeks pregnant when her boyfriend forced her to have an abortion. </p>



<p>She lived with him and her father in a small two-bedroom flat on the outskirts of Kimberley in the Northern Cape province of South Africa. There are not many institutions providing safe abortions in Kimberley and Naidoo was afraid of shaming her Muslim father. </p>



<p>So, she took a bus to Johannesburg in search of a way out of her desperate situation. She had only about $144 for the trip. Her boyfriend gave it to her when he put her on the bus to Johannesburg and told her to return with a clean body. </p>



<p>As she walked through the city searching for someone to direct her to a designated facility, she came across a flyer, stuck to a lamppost. The flyer was advertising safe and painless abortions. At first, she did not realize what the flyer suggested. Then, she saw more flyers decorating electricity boxes, lamp posts, traffic lights and sidewalk walls; they were everywhere around her. “Safe 30-minute abortions, no pain guaranteed” the flyers beckoned her; “Phone ‘Dr Nick’ to make appointment”.</p>



<p>Although she was afraid of judgment, she managed to make the call. Back home in Kimberley, her family would have, in God’s name, stopped her from killing an innocent baby for selfish reasons. This is also what the nurse said to her when she first approached the local hospital in Kimberley for help.</p>



<p>But, this was not the reaction she got from the quack, ‘DrNick’, whose number was on the flyer. He told her there was nothing to be scared of and that he would make sure “everything is out” and she would have no pain at all. </p>



<p>She met Dr Nick in front of a dilapidated building entrance on Rissik Street, in Johannesburg’s gritty central business district. He told her to hand over the cash in an unnoticeable way.</p>



<p>Fortunately, she had set aside about $50 prior to their meeting. He handed her four tablets; two to put under her tongue, the third one was a suppository to be inserted immediately. He told her she would start to bleed after four hours and instructed her to then take the last tablet. She might experience a little pain, he advised, but nothing more than normal period pains. He told her to phone him if she needed him and then he left. </p>



<p>With nowhere else to go, she returned to the bus station. She took the tablets, and locked herself in the cubicle of a public toilet, near the station. </p>



<p>Four hours later, intense pain began. Six hours later, she started bleeding. The pain grew more intense with time. Naidoo phoned Dr Nick but he told her to go to hospital. </p>



<p>He also instructed her to tell the hospital staff that she had been to Marie Stopes, an international non-governmental organization (NGO) that provides safe abortion services. The third time she phoned, Dr Nick’s phone was switched off and he never answered again. </p>



<p>Naidoo had eventually bled out pieces of her uterus when she was found by the bathroom cleaners who assisted her, in the seventh hour of the severe pain. </p>



<p>They took her to a nearby clinic where health workers were unwilling to assist and reprimanded her that she deserved the pain because of what she had done. The cleaners then took her by taxi to the Charlotte Maxeke hospital nearby. A gynecologist&nbsp; on duty said that Dr Nick’s tablets forced Naidoo into induced labor that eventually lasted 10 hours.</p>



<p>She is one of thousands of women across Africa who nearly died at the hands of illegal abortion providers. </p>



<p>In South Africa, reportedly, only 7% of the country’s health facilities provide abortions. This is due to the lack of trained staff and the conscience objection right given to all South Africans by the Constitution,which enshrines the freedom of conscience, belief and opinion. </p>



<p>Often times,women are chased away from hospitals due to hospital managers being against abortions. Access to safe abortions is hampered as often, there are fewer facilities that provide abortion services to women in their second trimester. </p>



<p>In Africa, only Cape Verde, South Africa and Tunisia permit abortions without restrictions as to reason. </p>



<p>As a result, the influx of pregnant women from across the continent seeking safe abortions, adds to the increased need for designated abortion facilities. </p>



<p>To top that, various African NGOs that have been providing the service were recently choked by American president Donald Trump’s implementation of the Global Gag rule. </p>



<p>This ruling caused all funding for safe abortion facilities, across the developing world, to dry up completely.Hundreds of NGOs and outreach programs providing services and information, in especially poor countries across Africa, had to close their doors and halt awareness campaigns. Also, any NGO receiving United States-aid and funding is not allowed to co-operate with an NGO if the latter is pro-abortion. </p>



<p>This means that pro-choice women in countries such as Malawi and Zimbabwe have nowhere to go to have safe abortions. In Zimbabwe, family planning clinics that provided various services including safe abortions, had to close down. Not only did this result in a lack of medical services in rural parts of Zimbabwe, women can no longer get their contraceptive medication from these clinics. </p>



<p>In Zimbabwe, Zambia, Botswana, Mauritius and Namibia,abortion is only available in certain circumstances. In Seychelles, Tanzania, eSwatini (formerly Swaziland), Malawi and DRC, abortion is only available in extremely limited circumstances. Abortion is totally outlawed in Lesotho, Angola and Madagascar.</p>



<p>By all estimates, the more African states fail female citizens, the more money is pocketed by fake doctors and other backyard abortion providers. The more money is spent in this underground market, the more backyard providers are attracted to the trade. </p>



<p>According to Whitney Chinogweny, Head of Communications and Public Relations at Marie Stopes Sandton in South Africa, 52% to 58% of abortions in Africa are performed by illegal abortion providers, contributing to 12% to 15% maternal deaths across the continent. Without sufficient funding, NGOs cannot create awareness around the dangers of illegal abortions. </p>



<p>Sometimes illegal providers overdose women, giving them mixtures of laxatives, aspirin and medication used for stomach ulcers. At times,backyard doctors remove the foetus using household equipment like wire hangers and fire tongs. </p>



<p>Once these con artists have taken their victim’s money, they usually disappear, never to be found again. They cannot be tracked or traced. They change phone numbers and change locations. </p>



<p>If African governments do not amend abortion policies and facilitate the establishment of designated institutions, NGOs will continue to be forced to deal with the challenges weighed down by limited resources.  </p>



<p>&#8211;<em>Anina Peens</em></p>


Tag: abortion

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