A girl named Alejandra stands before me – tall, shy, pretty, speaking in short phrases, dimples flashing when she smiles. If this girl lived in Mexico City or Havana, even without economic resources, she would have been able to interrupt her pregnancy under safe and hygienic conditions.
There, she could have gone to any one of the more than 40 clinics that exist in the capital and request the interruption of her weeks-old pregnancy. The pregnancy was unwanted, and she wasn’t willing to continue it at any price.
But we’re in Managua, the capital of a country that criminalizes the interruption of a pregnancy, even if it puts the mother’s life in danger, or the fetus has no possibilities of surviving. Alejandra had already had a baby when she was just fifteen. This time, her odyssey began some four months ago when she ended up making four separate visits to the emergency rooms of two different public hospitals in Managua. The last time, she ended up in Intensive Care, where she spent two days in critical condition.
The young woman went to the doctor the first time because she felt a general malaise with fever, nausea and fatigue. After the acetaminophen tablets prescribed during the first visit failed to work, she returned to the clinic a second time, feeling worse. This time the doctors ordered lab tests and – Bingo! She had a few ailments, but mainly she was pregnant.
Alejandra left the hospital with her head reeling. The floor was a whirlpool under her feet, and she felt like a block of ice had lodged in her intestines. An immense desperation took hold of her, imagining the consequences of having another child: at 18, without a job, without having finished elementary school due to the first pregnancy, without a home of her own, and living in her mother’s crowded home, amid sisters, nieces and nephews.
On top of this, she could already hear the chattering of the neighbor women, pointing her out as the one who got involved with another man while her partner was working outside the country to send money home. She has an ongoing relationship with an older man who supports her: he’s boorish and all, she says, but he helps her with her child, because the biological Dad legally recognized the baby, but refuses to pay child support.
Her knowledge of reproductive health is somewhere below zero. She doesn’t know that there are different contraception methods. She tried the pill, but it caused a lot of side effects. Today, after all that’s happened, she’s using the morning-after pill as a contraceptive method. When I explained to her that this can be harmful and that there are other options, she told me that she’ll think about it. In any case, she’s extremely fearful that any method will fail, because she’s determined not to have any more children. She made this decision when she was left at loose ends with the child she gave birth to at 15.
When she left the hospital, she wanted to die and she tried to throw herself out of a taxi. Her mother grabbed her, the taxi stopped, and they got out. They walked down the street, but Alejandra was beside herself, hysterical. I’m not going to leave you by yourself, her mother said. And they began a desperate search for someone who would help them.
If she had been in Mexico City, she would already have solved her problem. The clinics’ addresses are posted on the Internet, and the site explains that the medical abortion is done through the application of Misoprostol, a medication that causes the uterus to contract and provoke bleeding that expels the embryo. A few days later, the patent comes in to check that everything came out well.
Translated by Habana Times