T.O.P Day 2

MATURE READERS ONLY

These are my observations of the health care provided minus the graphic details. I have put all politics and beliefs aside:

I arrived in the T.O.P clinic at about 8:30 this morning. Procedures began at 9 AM. The women scheduled to have terminations arrived at 7 AM and were given another dose of cytotec internally. Each are instructed to bring a towel to wrap around themselves as well as a plastic bag to catch anything that may come out before the procedure. They begin with the earliest gestations and progress to the latest. The registered nurses are allowed to perform the first trimester terminations without physician supervision. I watched 18 first trimester terminations which were finished around 11:30. I was the designated hand holder for many of the women, especially the younger ones. These women are not given any anesthetic. The reasoning behind this is that the procedure is quick and the injection is equally painful. Thus, they choose to forgo the pain relief. The nurses are rather unsympathetic to those in pain and conduct the procedures in an unemotional manner. There are only 3 physicians (all female) in Cape Town that perform 2nd trimester terminations. The doctor arrived and got set up for these ones. There were 17 second trimester terminations performed today. They are only given a local anesthetic around the cervix for pain relief. About half the women abort the fetus before entering the procedure room. Those that have not delivered are finished in the room. It is crucial to remove all products to avoid infection. Thus, the physician expels all contents carefully and makes sure that all the parts are accounted for. I apologize for the delicate nature of this topic, but I felt that it was important to share. These women are extremely grateful for the medical care they are provided. Many social as well as economic factors come into play in these communities and it is certainly an extremely complicated issue.
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