South Africa's Abortion Law: A Comprehensive Overview

Abortion law in South Africa is governed by the Choice on Termination of Pregnancy Act (CTOPA), which was passed in 1996. The act gives women the right to access abortion services within the first 12 weeks of pregnancy, with extensions to 20 weeks in specific cases. Abortion is a woman's right in South Africa, regardless of age or marital status, and the procedure is provided free of charge at public healthcare facilities. The act was passed to reduce abortion-related deaths and served as one of the most liberal examples of abortion legislation globally.

Abortion law in South Africa: The Choice on Termination of Pregnancy Act

Abortion in South Africa is governed by the Choice on Termination of Pregnancy Act (CTOPA), which was passed in 1996. The Act gives women the right to access abortion services within the first 12 weeks of pregnancy, regardless of age or marital status. This can be extended to 20 weeks in specific cases, such as if the pregnancy poses a risk to the woman's physical or mental health, or if there is a substantial risk of severe physical or mental abnormality in the foetus. The Act also allows for abortions after 20 weeks if the pregnancy endangers the woman's life or could result in severe malformation of the foetus.

The Choice on Termination of Pregnancy Act was a significant piece of legislation, as it was one of the most liberal examples of abortion law globally at the time. It was passed during South Africa's transition from apartheid to independence and democracy and was fuelled by findings from a 1994 national study on the epidemiology of incomplete abortion. The Act repealed the 1975 Abortion and Sterilization Act, which had restricted access to abortion services by requiring approval from a physician and, in some cases, a court magistrate.

Since the Act was passed, abortion services have been expanded, and deaths from unsafe abortions have decreased. In 1996, a review of national data indicated that abortion mortality dropped by more than 90% between 1994 and 2001. Within the first three years of the Act being passed, services were incorporated into both private and public settings, leading to 40,000 legal terminations per year, a large increase from the 800 to 1,000 per year under previous laws.

However, there have been challenges to implementing the Act, including competing health priorities such as HIV/AIDS and a high number of conscientious objectors. There is also a geographic disparity in the accessibility of abortion services between provinces and between urban and rural areas. Despite these challenges, the Choice on Termination of Pregnancy Act remains a crucial piece of legislation for recognising reproductive rights and ensuring safe and legal abortions in South Africa.

Abortion services in South Africa

Abortion is legal in South Africa. The Choice on Termination of Pregnancy Act (CTOPA) was passed in 1996, giving women the right to access abortion services within the first 12 weeks of pregnancy. The Act can be extended to 20 weeks in specific cases. Abortion services are available in both private and public settings.

Where to Get an Abortion

Abortion services can be accessed at government hospitals or clinics, designated private doctors and gynaecologists, and non-profit providers such as the Marie Stopes centres. In South Africa, you can have a free abortion at a public healthcare facility if you so desire.

How to Get an Abortion

To access abortion services, you must first make a request at a primary healthcare clinic. Here, your pregnancy will be confirmed, and you will be provided with counselling and an appointment. You will then be given a referral letter to a facility where the procedure can be performed.

Abortion Procedures

There are two types of abortion procedures: medical and surgical. The medical abortion procedure involves taking two different medications to end the pregnancy. The first medication blocks the hormone progesterone, which is necessary for sustaining the pregnancy. The second medication opens the cervix and causes the uterus to contract, resulting in the expulsion of the pregnancy. The surgical abortion procedure involves using a suction technique to remove the pregnancy. This procedure is more complicated if undertaken in the second trimester.

Who Can Get an Abortion

Women of all ages have the right to terminate a pregnancy and should never be denied the service because of their age. While it is recommended that minors under the age of 18 are accompanied by a trusted adult, it is not required. Additionally, health workers cannot refuse to perform an abortion based on age, a person's spouse or partner, or any other reason unrelated to physical health.

Abortion pills in South Africa

The abortion pill is a safe, legal, and evidence-based method for terminating a pregnancy. However, access to this option is limited, and it faces resistance and apathy. The availability of abortion pills is restricted to only 119 public sector facilities out of 422 hospitals and 3,841 clinics in the public sector. This limited availability means that women in rural areas or outside major cities may have to travel long distances to access abortion services.

The abortion pill process typically involves two drugs: mifepristone and misoprostol. When used in combination, these drugs have an efficacy rate of 98%. Misoprostol can also be used alone, with a slightly lower efficacy rate of 90%. The cost of the combination regimen is around R700 in the private sector, while misoprostol alone costs R180.

To address the issue of illegal abortion providers, some organisations, such as Marie Stopes South Africa, offer free abortion pills along with professional nurse consultations, ultrasounds, pain medication, and post-abortion aftercare. This ensures women's safety and provides essential support throughout the process.

It is important to note that self-managed abortions are not routinely available in the public sector in South Africa. However, plans are underway for a pilot project for a digital sexual and reproductive health programme that will include telemedical abortion care.

Abortion clinics in South Africa

Abortion was legalised in South Africa in 1996, through the Choice on Termination of Pregnancy Act (CTOPA). The law states that women, regardless of age or marital status, have the right to access abortion services within the first 12 weeks of pregnancy. Doctors can provide abortions up to 20 weeks, but only if the woman or foetus' life is in danger or there are likely to be serious birth defects. The procedure can also be carried out after 20 weeks if the pregnancy poses a threat to the woman's life.

Abortion services are provided by government hospitals, public health clinics, private doctors, and non-profit organisations. Marie Stopes is a well-known and trusted abortion service provider in South Africa, offering a range of modern contraceptive methods, safe abortion clinics, and access to sexual and reproductive healthcare services.

To ensure the safety and legality of an abortion clinic, it is important to verify that the clinic is approved by the Department of Health and operated by trained and qualified staff. It is also recommended to look for a reputable name or brand, such as Marie Stopes. Illegal abortions are often advertised through flyers and can be dangerous and even life-threatening. It is important to be cautious of clinics that are willing to perform abortions outside the legal constraints, as well as those that operate in unsafe or unsanitary areas.

To find trusted abortion clinics in South Africa, individuals can refer to the Where to Care map, which provides a database of vetted abortion services. This map is updated regularly by trained mappers from the Triad Trust, who verify the information by calling the facilities and gathering details about the services offered.

Abortion rights in South Africa

Abortion is legal in South Africa. The Choice on Termination of Pregnancy Act (CTOPA), passed in 1996, gives women, regardless of age or marital status, the right to access abortion services within the first 12 weeks of pregnancy. The Act can also extend access to 20 weeks of pregnancy in specific cases.

The Act repealed the 1975 Abortion and Sterilization Act, which restricted access to abortion services by requiring approval from a physician and, in some cases, a court magistrate. The 1996 Act was enacted under South Africa's first democratically elected government and represented a crucial advancement for women's reproductive rights.

Under the current law, a woman must be under 13 weeks pregnant to end the pregnancy without giving reasons. If she is between 13 and 20 weeks pregnant, the pregnancy may be terminated only under specific conditions, such as if the woman's life or mental health is at risk, if the fetus is likely to have serious birth defects, or if the pregnancy resulted from rape or incest. After 20 weeks of pregnancy, abortion is only permitted if the woman's life is in danger or if the fetus has a severe malformation.

Abortion services in South Africa are provided by government hospitals, designated private doctors and gynaecologists, and non-profit providers such as the Marie Stopes centres. Abortion is free of charge at primary healthcare facilities, and women have the right to access safe and legal abortions without cost at a government hospital or clinic during the first 3 months of pregnancy. The procedure can be carried out by a doctor or a trained registered nurse or midwife, making abortion more accessible.

While abortion is legal and accessible in South Africa, there are still some challenges to implementation. These include competing health priorities, a high number of conscientious objectors, and a geographic disparity in accessibility between provinces and urban and rural areas. Additionally, many pregnant people are unaware of their rights and lack information on where to access safe abortion services.

Frequently asked questions