Author: Klaudja Karabolli
Termination of pregnancies, the pill turns out to be an out-of-control practice endangering girls' lives and their reproductive future every day.
Klodjana B. suffered from hemorrhaging for six hours in a row, while she was at home alone and there was no one to ask for help.
20-year-old Jonada H. collapsed after vomiting continuously for more than two hours.
Viola D. woke up alarmed on the third morning with the same high fever of two days before, having tried every kind of medication to bring it down.
Arisa Y. was 23 years old when, after continuous bleeding and high fever, she lost consciousness while waiting for her friend to accompany her to the hospital.
All four girls testified for PSE, that they had experienced these health complications, after they had tried to abort with pills bought at the pharmacy, without first consulting and obtaining the approval of a doctor.
The lives of girls and women are seriously endangered by this impermissible practice, leaving in many cases irreparable consequences on their reproductive health.
An investigation by PSE shows that, despite the fact that it is not officially allowed to sell them in pharmacies, this turns out to be a normal practice. Thousands of girls and women are thought to be having medical abortions outside the eyes of doctors and the health system, picking up pills at neighborhood pharmacies as easily as they would an aspirin.
The investigation revealed that, out of 30 pharmacies in the capital, where abortion pills were requested to be purchased, in 10 of them they were given freely, without the need for a doctor's recommendation or means of identification.
This reality raises doubts that the same thing happens in hundreds of other pharmacies across Albania, while the National Medicines Agency states that it is not aware of this phenomenon.
Likewise, the Ministry of Health has shown complete disregard for the issue, leaving the fate of many girls and women in the hands of speculative pharmacists.
While the official figures speak of a decrease in the number of abortions in Albania, what has decreased are only the abortions registered in the country's maternity hospitals.
Outside of this legal, medical procedure lies a parallel reality.
Doctor Avenir Balili believes that this figure does not reflect reality, as a significant number of abortions go outside the health system.
"I don't think that the number of abortions has decreased in Albania, I can say that it has probably increased, but the cases are not registered", he emphasized.
Pharmacies, where abortion pills are taken as aspirin
Medical abortion is an accepted practice in many countries of the world, but in no case can Mifepristone and Misoprostol pills, used to perform it, be given without a doctor's recommendation, after the latter has carried out a series of examinations for the health of the the woman.
Gynecologists told PSE that this type of abortion practice can be performed up to the seventh week of pregnancy and that it can lead to serious health complications, if it is performed outside this period and without ultrasounds and health examinations of the woman.
But what happens on the ground is a completely different reality. After the testimonies of the four girls, that they had bought the abortion pills at the pharmacy without a medical recommendation, PSE verified in 30 pharmacies in the capital, whether they could be bought freely.
In 10 of them, PSE journalists were offered pills without the need for a medical recommendation or means of identification. These pharmacies are located near the "Queen Geraldine" maternity hospital, on Dibra street, near the "Mother Teresa" university hospital center, in the former Block area and in the "Community of Paris" neighborhood.
From PSE's observation, it appears that these pills can be purchased starting from 4 to 10 thousand Lek. Meanwhile, the interviewed girls claim that they encountered little or no resistance from the pharmacists when they asked them.
Jonada H. from Fieri told PSE that, the moment she found out about her pregnancy, she immediately went to the pharmacy and bought the abortion pills easily, without a prescription.
"I went to the pharmacy and bought the pills. The pharmacist instructed me how to take these pills to have a safe abortion", she said.
Arisa Y. from Durrësi emphasized that, even for her, not having a medical recommendation had not been an obstacle to taking the pill at the pharmacy.
"I had heard about the abortion pill and immediately headed to the pharmacy downstairs. The pharmacist asked me for a doctor's recommendation, I didn't have one, so I asked at another pharmacy. I bought the pills for 5 thousand ALL and drank them, according to the instructions on the box", she said.
However, legally, even a doctor's recommendation is not enough to get abortion pills at the pharmacy, because Mifepristone and Misoprostol are not registered for sale, but must be distributed only by gynecologists.
PSE confirmed this by filing a right to information request with the National Medicines and Medical Devices Agency.
"We inform you that Mifepristone and Misoprostol are not registered for sale and trade in the Republic of Albania. As a result, citizens who use them must also take into account the risk of their use, since they are drugs not controlled by the relevant authority.", - says the agency's response.
Likewise, the Medicines Agency denied knowing that these pills were sold in Albanian pharmacies.
"Our institution performs periodic checks in every pharmacy, inspecting the storage conditions of medicines and the way they are traded. The medicines in question were not found to be sold", - is said in response.
Mentality in the face of life
Medical abortion costs less than surgical abortion, but that is not the reason why women choose this method of abortion.
The four girls interviewed indicate that the pregnancy had come at an inopportune moment in their lives and its exposure would damage the reputation in the family and society.
Buying pills at the pharmacy for them was an abortion in complete confidentiality, without anyone finding out and without registering the name for a gynecological visit to the maternity hospital.
Jonada H. says that her pregnancy at that stage of life could not be understood by her family.
"I was a second year student when I got pregnant by accident. I couldn't believe it. It was terrifying, when I thought of the reaction of my brother, parents, acquaintances and friends. They were not aware of my relationship. I came to Tirana for studies", she said.
Klodjana B. from Fieri told PSE that abortion was the only solution, in the conditions when her conservative family could not tolerate an extramarital pregnancy.
"I had been told about the side effects of this type of abortion, but I had made the decision. I come from a family with strong rules, somewhat conservative, so confronting them did not occur to me", she emphasized.
But what they risk in defense of their reputation is their very life. Doctor Avenir Balili claims that, during his work, he has faced cases where he has helped many girls overcome the consequences of abortion with pills.
"I have treated many women and girls who have had medical abortions without consulting a doctor. The girls buy the pills at the pharmacy without doing any tests. Abortions are not registered, everything happens outside our care, but when the health condition worsens, the girls are submitted to surgical medicine", he said.
The gynecologist of a private clinic in Tirana, Mimoza Keta, says that she has assisted in many cases, where complications caused by pills taken without a recommendation, have forced girls to go to medical clinics, forgetting the social stigma.
"In my work experience, I have had cases when girls have gone to pharmacies to get tablets for termination of pregnancy. They did not take them properly and necessarily the consequences were not good and then they were forced to go to medical clinics", she says.
Doctors also warn that the complications can be so great that they can prevent girls from becoming mothers.
"Abortion with pills and without medical care can lead to infertility. The consequences are related to the condition of the patient, the age of the pregnancy and the way of taking the abortion pills. When the condition worsens, girls must undergo surgical interventions to repair the problems", - says Avenir Balili.
Jonada H. is one of the girls who also underwent surgical intervention, after having a medical abortion.
"After the vicissitudes I went through, after taking abortion pills without a recommendation, I also required a surgical intervention. Despite the efforts, the consequences remained. Today I have a hard time getting pregnant, the doctors believe that the infection I got from the medical abortion has an effect", She stressed.
*Photo: Pixabay
