A pregnant teenager repeatedly visited her local clinic begging for an abortion, but she was turned away.
Three months later she drank pesticide in an attempt to end her pregnancy, and it killed her.
This is one of the case studies related by gynaecologists calling for a shakeup in the way unwanted pregnancies are handled by medical practitioners.
Writing in the South African Medical Journal, Dr Sylvia Cebekhulu and Professor Robert Pattinson of the University of Pretoria (UP) said cases of organophosphate poisoning among girls and young women trying to induce abortions were common.
According to Wikipedia, “organophosphates are the most widely used insecticides today. They are used in agriculture, the home, gardens and veterinary practice”.
The healthcare system often failed pregnant young women, said Cebekhulu and Pattinson, describing several cases from the national maternal deaths register:
- The teenager who was denied an abortion was acutely ill when she arrived at a hospital. She died within an hour from multi-organ failure caused by poisoning.
- A pregnant teenager was admitted to hospital six hours after consuming a pesticide. She died three days later and “mainly received nursing care and occasional telephonic advice from a doctor”.
- A pregnant woman in her 20s was found dead at home after drinking insecticide.
- A 20-year-old pregnant woman was unconscious when she arrived at a hospital and soon died from suspected pesticide poisoning. The doctors said she should have been diagnosed more quickly.
Organophosphates in pesticides cause more than 200,000 deaths a year in the developing world, particularly in rural areas, said Cebekhulu and Pattinson.
Within a few days, the poisons compromise the central nervous system, and survivors may need long-term therapy or rehabilitation.
The doctors, from the obstetrics and gynaecology department at UP, outlined the protocols that should be followed when patients arrive with suspected pesticide poisoning.
And they said requests for abortions should be taken seriously. “Unplanned and unwanted pregnancies in young women are a reality,” they said.
“Young women with organophosphate poisoning have usually not attended antenatal care and/or have a history of a previous request for an [abortion].
“Organophosphates are easily accessible and a high index of suspicion should be maintained in young women [with] signs of mental alteration, pinpoint pupils … [and] shortness of breath.”
The doctors also called for greater use of long-acting, reversible contraception to prevent young women turning to pesticides to deal with unwanted pregnancies.
