Women can call me at any time. Some have called during emergencies, often when they are hemorrhaging from a miscarriage and don’t know what to do. I always try to convince them to hang up the phone and get to the nearest hospital even if they are ashamed.
I administer local anesthesia pre-surgery through a syringe to numb the pain, but patients remain conscious during the procedure. Many women are anxious, so I try to talk to them the whole time, to calm and distract them.
These are a basic sanitary measure for a clean clinic. Underground clinics, which can be in garages, are gross. The problem is bigger, though; some women come in after trying an unsanitary DIY technique, such as putting parsley into their vaginas.
I was a general surgeon, but it wasn’t until my father died in 2001 that I began performing abortions. Women who were his patients started coming to me for advice on reproductive health, and I decided to follow in his footsteps.
During childbirth, the cervix naturally dilates. During the abortion procedure, which usually takes less than an hour, we try to mimic that using this device to manually open the cervix. That way, the fetus and placenta can exit the body.
These pull out the fetus. Prior to becoming an abortion doctor, I mostly performed abdominal surgeries. When I was performing stomach, colon, and liver operations, I didn’t think I’d someday work as a gynecologist to extract fetuses.
Now I mostly use an aspirator, but sometimes a curette is still necessary when the embryo or placenta isn’t completely removed. I’d use it to scrape the uterus clean because otherwise, the remains could cause an infection or hemorrhage.
If there is a heavy hemorrhage, I place the device — basically an inflatable rubber ball — inside the uterus. It applies pressure to stop the bleeding. In extreme cases, I would send the patient to a hospital; I’ve only had to do that once, though.
This separates the vaginal walls; it’s the first step. Each time I use this, I have a flash that brings me back to the first time I performed an abortion. I was definitely nervous then, but after thousands of procedures, now it’s old hat.
I always give consultations on reproductive health. I want to help women avoid other unwanted pregnancies. Yet many refuse to use contraception, saying it’s the man’s responsibility. I’ve had a few that have come back for another procedure.
Gynecologist Germán Cardoso’s abortion clinic is easy to find. Located on a residential street in Tandil, Argentina, a small city four hours south of Buenos Aires, the office is marked with a placard bearing the 59-year-old doctor’s name. His website prominently features a phone number and email address. This may just seem like good advertising — but in Argentina, it’s risky.
Terminating a pregnancy is illegal in the predominately Catholic country except under narrow circumstances: when a woman’s life or health is in danger, or when she’s been raped. Doctors who perform consensual abortions can face up to six years in prison. Cardoso, though, offers unrestricted access by claiming that any unwanted pregnancy threatens a woman’s health.
Although the courts have yet to test his legal interpretation, Cardoso hasn’t escaped the government’s crosshairs entirely. He worked in Buenos Aires until 2011, when police raided his clinic in what he viewed as a warning. Cardoso then moved to Tandil, his hometown, where his father once provided abortions. He sees about 400 patients annually and charges around $800 per procedure (less if a patient can’t afford it).
Cardoso sees his job as crisis response. The most recent statistics, from 2009, estimate that up to 500,000 Argentine women get abortions each year — ending about 40 percent of pregnancies — and that many go to underground clinics. The World Health Organization says unsafe abortions cause over one-third of the deaths from pregnancy complications in the country.
“Women are going to have abortions,” Cardoso told Foreign Policy in April. “If a doctor doesn’t do it, someone else is going to.”