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Defying the odds in serving, saving women

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By Nelisiwe Msomi:

Though legal, access to abortion here in Malawi is highly restricted. Despite the restrictions, some medical professionals and health workers defy the odds by providing the service to ensure that women enjoy Sexual and Reproductive Health and Rights including access to safe abortions. Some midwives are among those that are providing the services in various medical facilities. Because of the diverse differences on the issue of abortion, even in countries like South Africa where women can freely walk into a clinic and access a service stigma remains a problem.

South African-based Sister Margaret Mojapelo had dedicated her life to providing safe abortions to women in Limpopo but she was stigmatised for her commitment to a woman’s right to choice. “They called me ‘Lucifer’, ‘Satan’, ‘murderer’ and every ugly word under the sun,” Sister Margaret Mojapelo tells Health-e News as she reflects on her time spent as a midwife performing abortions at a public health facility in Limpopo.

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Mojapelo was the sole midwife at the healthcare centre, and says her collegues treated her like an outcast for her decision to perform abortions for women who wanted to terminate their pregnancies.

Some colleagues prayed for God to “save the baby killer”, while others whispered about her “evil” work. Under South African law, women can have an abortion up until the 12th week of pregnancy.

Women are legally allowed to have abortions until 20 weeks under certain circumstances such as rape, incest and economic hardship. Midwives can perform abortions within the 12 week time period, whereas medical doctors can perform a termination of pregnancy in the 12 – 20 week period.

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For Mojapelo, providing medical help to women who were also ostracised for wanting an abortion was non-negotiable, and the negative comments hardened her resolve. “I turned those harsh words into something unique and special. I am unique because I do things that not everyone wants to do. And I am special because of the women that want me, and those are women with unwanted pregnancies. They want me and no one else. They want my help. So I am very special,” she says.

But, Mojapelo confesses that she wasn’t always pro-choice. As a nurse in public health in the days when abortion was illegal, she witnessed the number of women who came to hospital seeking treatment after botched abortions. She saw many die. Over time this changed her heart and her opinions about a woman’s choice to have an abortion.

Mojapelo was part of the second cohort of midwives who were trained to perform abortions after the pro-choice legislation was passed. She has been performing abortions for 19 years and says she won’t be stopping anytime soon. An exploratory study into the landscape of midwifery in Limpopo, published in 2019 in the Open Public Health Journal, notes that existing negative attitudes towards midwives’ work often halts provision of quality healthcare.

Poor referral systems for maternal health, and lack of material and human resources were other concerns outlined in the journal article. After a stint in the private sector, Mojepelo finally opened her own clinic where she provides sexual and reproductive health services to women who need them.

Maggy’s Hope Clinic, located in the Capricorn District, provides termination of pregnancy, sexually transmitted infection (STI) screening and management, pap smears and family planning services. Pre- and post-termination of pregnancy counselling is mandatory to those accessing the clinic’s abortion services.

According to a Masters of Public Health thesis about Maggy’s Hope Clinic, the midwives interviewed were knowledgeable, and the clinic offered comprehensive reproductive health services that were youth-friendly. Teenagers who accessed abortion services and were interviewed for the study believed that more information should be offered to others about the work done at the clinic — not only about the abortion services, but other sexual and reproductive health services too.

“My other name is Mmadihlare, which means ‘Mother of medicine’ in Sepedi. I was born to do this. I love being a midwife,” Mojapelo adds.

“When women leave my clinic — they are happy. Sometimes I even get chocolates from them, thanking me for my work.” — Health-e News

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