Is two, a bad week is around four’
Back in Sunnyside, a tiny baby girl stared back at Chitlango, with nothing but a T-shirt and the dirty blanket to protect her from the biting cold. She had round cheeks, perfectly plump lips and inquisitive eyebrows.
With tears stinging his face, he frantically waved down a passing car. “Please, please, take us to the police station,” he gasped.
Within a few hours, the police delivered the baby to the Tshwane District Hospital. The social worker there named her Mbali, meaning flower. Her surname became Chitlango, after the man who found her.
For babies such as Mbali, the blank spaces defining their identity are often filled in by whoever happens to be on the morning shift.
We know nothing about the woman who abandoned Mbali. But in the nine months between the time that her mother’s search for the familiar redness of menstruation went in vain, to the time that the baby uttered her first cry, she is likely to have wondered many times what she was going to do.
Research into the mental health consequences for women who abandon babies is lacking. But the authors of the 2009 Health Policy article note that they are almost certainly traumatised.
“A lot of abandonments result from violence and rape,” says Nacsa’s Pieterse.
Studies have shown that pregnancies resulting from sexual assault are considerable. A 2002 study from the United States National Violence against Women survey found that the rate at which women fall pregnant after an incident of sexual assault is more than double that of a single act of consensual sex.
In South Africa, a 2007 study conducted by the Eastern Cape’s social development department found that 43.2% of teenage mothers had been “explicitly raped”.
“There’s definitely also the young person that comes from the rural areas to an urban area, not wanting to go home with a baby,” Pieterse says.
“But we do also find older women who are in a desperate situation; they have four or five other children and they can’t afford to keep the child.”
It’s at this crucially vulnerable time between conception and the first few weeks after childbirth that Nacsa tries to reach out to women experiencing unwanted pregnancies.
In 2015, Nacsa launched an extensive communication campaign aimed at women who were in the same position as Mbali’s mother. “The whole idea was to approach this differently,” says Pieterse. “You usually see photos of this stomach and nothing else. The emphasis is on the fact that the woman is pregnant and not on her as a person.
“Many don’t get counselling and opt for backstreet abortions.”
Alot of women don’t know that abortion is legal in South Africa,” says Mofokeng. “That gap in knowledge is a form of systemic violence. Many think a backstreet abortion is the only option available.”
South Africa is one of the few African countries where abortions are legal and free as a method to end unwanted pregnancies. The country instituted one of the most progressive abortion laws in Africa in 1996.
Until the 12th week of a pregnancy, a woman can have a legal abortion for whatever reason she chooses. Abortions between the 13th and 20th week of a pregnancy are legal if the woman can argue it will affect her socioeconomic status.
In March 2017, Bhekisisa conducted a telephonic survey to establish how many government clinics and hospitals provide abortions. At the time, the number was 197.
But abortion-related stigma still prevents many people with unwanted pregnancies from using this service.
“Many would rather approach a faceless businessperson than face the stigma and shaming they will encounter at the clinic where abortions are offered legally,” says Mofokeng.
“Some nurses use the ultrasound; they say: ‘Do you see this?’” explains Eddie Mhlanga, Mpumalanga’s chief government specialist of obstetrics and gynaecology.
“They say to the pregnant woman: ‘This is a little foot. Now, do you want to [get rid of this child]?’”
A 2017 study, conducted by Rhodes University’s Critical Studies in Sexualities and Reproduction research programme, confirms Mhlanga’s experiences.
Researchers audio-recorded 32 pre-abortion counselling sessions, and interviewed women about their experiences of waiting-room interactions. They found that “much of the talk in sessions undermined abortion as a possible choice”.
“Both nurses and independent counsellors ascribed independent personhood to the fetus, referring to the fetus as the ‘baby’ … providing visual representation of the fetus’s development through photographs,” the study revealed.
The World Health Organisation says up to 13% of deaths among pregnant women are the result of unsafe abortions — and that most such abortions take place in Africa, Asia and Latin America. In South Africa, there are no figures available on how many unsafe abortions are conducted a year, or how many people die because of unsafe abortions, because “illegal abortion” is not a category on the death certificates completed by doctors when women die.
“Often, women don’t realise that they are pregnant until they start feeling the baby move,” Blackie says.
“At that stage, she sees a poster advertising ‘safe, quick abortions’. She goes along to the so-called doctor [who is not a medical professional and is operating illegally], who gives her tablets to drink. He tells her: ‘Drink these tablets and you’ll have a heavy period and it will all go away.’ And that might happen in the early weeks of pregnancy, but at five or six months it brings on contractions and sends her into early labour.”
The social development department favours “reunification” of the abandoned baby with a family member. In the absence of that, child protection officers aim to facilitate a permanent adoption.
But in South Africa, where the United Nations Children’s Fund estimates there are 3.7-million orphans and 190 000 children in shelters, the adoption rates are low. In 2013, only 1699 adoptions took place in the entire country, down from 2 840 a decade prior.
Blackie’s findings indicate that deep-seated beliefs in South Africa inadvertently favour abandonment over abortion and adoption. “Abandonment is not seen as permanent, whereas adoption is permanent — when you abort a child or put it up for adoption, it is seen as problematic,” says Blackie.
Families and healthcare workers often condemn women who want to put their babies up for adoption, not wanting to be “guilty by association”, says Blackie.
As recorded in her research, a social worker said: “We have had so many cases where women are treated badly by nurses for wanting to voluntarily give their child up for adoption. They punish them; sometimes they don’t give them pain medication after they have had a C-section.”
Michelle Barrows, who has worked as a midwife and neonatal intensive care unit nurse at various facilities around the country, describes similar experiences. “I remember, once, a mother who was about 17 years old. She wanted to put her child up for adoption but she wasn’t yet sure.
“Eventually she decided to come to the ICU nursery to see the baby and hold the baby and decide. When she came into the ward, another nursing sister met her at the door, and she turned around and shouted into the nursery: ‘This is the woman who wants to just throw away her baby!’ There were other mothers in there who said: ‘How can you do that?’
“She was just devastated. I think for the rest of her life that will stay with her, do you know what I mean?” says Barrows. “I think she ended up taking that child home, and I don’t think she wanted to.”
Baby Mbali is now three years old. She ended up in a children’s home in Pretoria where she was adopted when she was three months old.
The toddler lives in Cape Town with her adoptive parents. She loves playing outside and has an infectious laugh.
“Mbali is the best thing that has ever happened to us,” says her adoptive mother, who prefers not to be named. “She has made our family and our lives complete, and every day with her is a new joy.
“But we’re always cognisant of the fact that she has a first family that she will probably never know, and a biological mother who must have experienced incredible emotional trauma in giving her up.”
“Abandonment is not seen as permanent, whereas adoption is permanent — when you abort a child or put it up for adoption, it is seen as problematic”