Abbey’s Story

#UnderTheBlankets Campaign

“The question pops up every time - is it because I am a foreigner?”: Navigating the South African reproductive healthcare system

Abey* has given birth three times in South Africa – and each experience has been very different – from giving birth during the 2008 xenophobic attacks to being referred for sterilsation against her knowledge. Abey, who is originally from Angola herself, wants to see people from migrant backgrounds talk more openly about sexual health. She encourages people like herself to find out information online and empower themselves, so that they can stand up for themselves in clinics and hospitals.

A time of fear

In 2008, South Africa made global news for the deadly xenophobic violence that started in Gauteng and spread across the country. It was during this time that Abey was due to give birth to her first child. “I was afraid of going to the hospital”, she says. Abey was living in Samora Machel in Cape Town at the time. She explains how she was afraid to even leave her house because of the violence – nevermind having to travel to hospital. She was not sure how she would be received at the hospital, being a foreign national during that time. 

While heavily pregnant, they packed up their bags and left Samora Machel – moving to a small room inside a shop building in the city centre. Abey waited for as long as she could before going to the hospital to give birth. 

Once at the hospital, “they treated me like everyone else.” Abey was admitted into the hospital, but due to no longer having proof of address after leaving her home, there were a few complications. With the help of a friend, Abey was able to get proof of address and gave birth to her first child.

Documentation woes/difficulties

A few years later, Abey fell pregnant with her second child. Due to a documentation query, the hospital was expecting Abey to pay more than was required. “The problems often have to do with documentation. I don’t think they [the hospital staff] understand the documentation.”

At a government hospital, if you’re not pregnant or a child under 6, if you have an SA ID or are a refugee, asylum seeker or undocumented person from a country in Southern Africa (SADC), you’re entitled to be treated the same as a South African citizen at the hospital. This means that the treatment will be “means tested” (the fee depends on your circumstances). 

Armed with the knowledge of her rights, Abey was able to calmly explain these rights to the hospital staff and was admitted.

The last hospital visit

Not wanting to fall pregnant again too soon after her second child, Abey accessed a clinic to get an IUD. The IUD caused bleeding for three years. “No one gave me sufficient information or assistance. I had to go to the clinic about five times before they would remove it and when they eventually did, a nurse told me that I was wasting government resources. I felt like she said that because I was a foreigner.” 

Just before the birth of her third child, Abey wanted to look into other forms of contraception.” One of the doctors kept insisting that she be sterilised. Abey refused the sterilisation and thought that was the end of it. 

“When I was being admitted, a different doctor raised the fact that I had a form in my file requesting a sterilisation.” The only reason Abey found out that this form was in her file, was because the doctor flagged it. “The question pops up everytime – is it because I am a foreigner?” 

Abey goes on to say that she has heard many similar stories of women who are not South African being sterilised without their consent. “I’ve heard of one lady who only found out years later that she had been sterilised.”

Empowering each other through knowledge

All of Abey’s experiences within the South African healthcare system bring up the same question for her – “is this protocol or is this because I am a foreigner?”. For Abey, it is important that people who are migrants know their rights and are able to advocate for themselves when accessing services. One way that this can be done is by speaking about sexual health more openly, sharing information and experiences. 


*Abey is not her real name. We have changed her name to protect her identity.