Avia Collinder, Sunday Gleaner Writer

MEDICAL DOCTORS agree that what Deborah Smith - a mother who attempted to terminate her pregnancy, but was still carrying the baby - experienced was a botched abortion. Delay in returning to the doctor could have led to infection and death of both mother and child, medics also say.

According to gynaecologist Dr Charles Rockhead at the Ripon Surgi-Centre in St Andrew, missing the foetus and the gestational sac is especially possible when dilatation and curettage (D&C) is done early when the foetus is very small.

"You are working in a cavity, pushing an instrument and scraping blindly. You can be scraping and scraping and absolutely missing the foetus," Rockhead says.

still possible

He explains further: "In the old days, one could scrape and totally miss the actually foetus. It is still possible to do that today too."

In Smith's case, the gynaecologist says it was unlikely that the foetus was touched or the child would not have survived.

"If the doctor had breached the gestational sac, infection would have set in, leading, possibly, to septic abortion," Rockhead says, while warning of the health risks associated with botched abortions.

"When an infection is picked up early, a D&C repeated usually saves the mother," Rockhead tells The Sunday Gleaner. In the worst of all cases where the patient, especially a young woman, who has not received permission from parents is afraid to return to the doctor, delay in seeking appropriate treatment could lead to pelvic sepsis and possibly death," he adds.

In July, Affette McCaw-Binns, professor of reproductive health epidemiology at the University of the West Indies (UWI) Department of Community Health and Psychiatry, reported that about five women die each year from botched abortions. However, she said hundreds of women are admitted to hospital annually for complications associated with poorly done terminations.

abortion deaths

The abortion policy review advisory group, in its presentation to Parliament in January, revealed that at one premier hospital in Jamaica, in a period of just six months, there were 641 patients admitted with abortion complications.

Abortion is said to be the fifth-leading cause of maternal death for women over 40 years, and the second-highest cause of maternal death among adolescents.

McCaw-Binns recommends that medical providers who are registered to do abortions should be monitored. In addition, regional public facilities, which could provide procedures safely to persons meeting the criteria, should be created.

She further argues that international statistics showed that once abortion is legalised and clinics are operated within proper guidelines, the mortality rate from abortion goes down.

avia.ustanny@gleanerjm.com