Johannesburg morgue deals with about 20 cases a month
Many women still resort to illegal abortions in SA. Stock photo.
Image: 123RF/ sam74100
Despite free legal medical abortions, many women still do not have access to these services or feel judged by healthcare workers. They may feel they have no choice and resort to drastic measures to end pregnancy.
About 10% of bodies received by the Johannesburg mortuary are unidentified. Of those, only 7% to 8% are adults.
The Johannesburg Forensic Pathology Services (FPS) medico-legal mortuary is in Braamfontein in the CBD and is the busiest facility in Gauteng. Bodies received have died of unnatural causes and the most common cause of death is violent crime — shootings and stabbings.
Of the unidentified infants, most are foetuses. They are abandoned — discarded around the city.
Foetal osteologist Roxanne Thornton works on these cases, specialising in perinatal forensic identification criteria and developmental biology.
The foetuses come in as viable foetuses — more than 26 weeks, and non-viable — those which would not survive outside the womb.
Thornton said many of the abandoned foetuses are illegal abortion cases, mostly stillborn and abandoned.
Dr Louise Gilbert, clinical director at Marie Stopes SA, a private safe abortion services clinic, said though abortion is legal in SA and free of charge at a state health facility, access to safe and legal abortion remains “problematic” with limited numbers of state health facilities providing the service.
Gilbert said some women experience stigma when approaching a healthcare worker or facility to request an abortion.
Thornton tries to discern if the foetus had a natural anatomical reason for death or if it was homicide or accidental.
“Most of these cases are so decomposed a pathologist can't tell.”
In these cases, osteology — the study of the structure and function of bones — is used to identify information about the body.
There are hardly any inquests for dumped foetuses — they don't get investigated and they are forgotten. This is an injustice.Foetal osteologist Roxanne Thornton
“I work with foetal prenatal bones. The goal is to prove the case forensically. The reason I do this is because there are hardly any inquests for the dumped [foetuses] — they don't get investigated and they are forgotten. This is an injustice.
“I believe these children should have a voice. A lot are dumped just around the corner from a shelter or abortion clinic.”
Dr Gilbert believes illegal abortion and dumping of babies has always been an issue in SA. She said women may still be resorting to illegal abortions or killing their newborns because they may not know where to access a safe, legal abortion service.
“Women may not have the funds to pay for an abortion at a facility such as Marie Stopes. In my opinion, there are not enough facilities providing abortion services in SA. Due to budgetary constraints, Marie Stopes only has seven centres in four of the nine provinces.”
The organisation does have a national tele-abortion service for remote consultation for women who are less than nine weeks pregnant and would like a medical abortion.
Gilbert said though free abortions are available at state health facilities, many of the facilities don’t provide the service or only provide it within the first trimester of pregnancy.
“I think many women experience stigma when approaching a healthcare worker or facility to request an abortion and this may deter women from seeking a legal and safe abortion.”
Some women come to the clinic for help after attempting an illegal abortion.
The women say illegal abortion providers treat the interaction as a business transaction and “therefore the woman does not experience the same judgmental attitude that she would at some facilities that provide abortion care”.
“These women say the illegal provider is only interested in selling their product and therefore they don’t ask the woman about their reasons behind requesting the product.”
Abortion is a legal medical procedure under the Choice on Termination of Pregnancy Act. Abortion can be requested at up to 12 weeks of pregnancy without needing to give a reason. The act also allows abortion from 13 to 20 weeks, but only under circumstances, including:
- if the continued pregnancy poses a risk of injury to the physical or mental health of the woman;
- if there is a substantial risk that the foetus would suffer from a severe physical or mental abnormality;
- the pregnancy resulted from rape or incest; or
- the continued pregnancy would significantly affect the social or economic circumstances of the woman.
“Unfortunately, illegal providers do not stick to the guidelines in the Choice on Termination of Pregnancy Act and often provide abortion pills to women who are much further along in their pregnancy.
“When these women use abortion pills, apart from the woman having a greater likelihood of developing severe adverse reactions to the abortion pills, the pills would also induce labour and the woman may then present to a healthcare facility in premature labour — labour before the pregnancy has reached term, nine months or 40 weeks — or may deliver a premature baby outside a healthcare facility and the woman may then feel she has no choice but to ‘dump’ the baby.”
For Thornton the cases have become a burden.
“This work stays with you. There are about 20 cases a month. People don't understand what we deal with. I've had to cut more than 300 babies to get to the bones. I've seen paediatric injuries leading to 900 deaths.”
Getting help
The Women's Legal Centre has prepared a booklet on where safe abortion facilities can be obtained in Gauteng.
The Where to Care map also provides updated information on where to access services. Turn your mobile data service on and allow location permission when asked to view the map. The map is zero-rated, meaning it will not use your data.
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