Abortion in South Africa

Abortion in South Africa was legal for very limited reasons until 1997, when the Choice on Termination of Pregnancy Act (Act 92 of 1996) was passed, providing abortion on demand for a variety of cases.

Public opinion and political motives
Studies from 2004 have shown that the majority of South Africans believe that abortion is always wrong, whereas one fifth of the population believe it is never wrong.

Some 56% of South Africans believe abortion is always wrong even if there is a strong chance that the baby will have serious birth defects. A total of 70% believe it is wrong if abortion is done simply because the parents have low income and can likely not afford to care for additional children.

In South Africa, abortion on demand is regarded by government as an attempt to combat sexism and racism: combating sexism directly by not requiring male consent, and combating racism indirectly by promoting better quality of living among black women and poor black families.

Eligibility
In South Africa, any woman of any age can get an abortion by simply requesting with no reasons given if she is less than 12 weeks pregnant. If she is between 13 and 20 weeks pregnant, she can get the abortion if (a) her own physical or mental health is at stake, (b) the baby will have severe mental or physical abnormalities, (c) she is pregnant because of incest, (d) she is pregnant because of rape, or (e) she is of the personal opinion that her economic or social situation is sufficient reason for the termination of pregnancy. If she is more than 20 weeks pregnant, she can get the abortion only if her or the fetus' life is in danger.

Women under the age of 18 will be advised to consult her parents, but she can decide not to inform or consult them if she so chooses. Women who are married or in a life-partner relationship will be advised to consulter her partner, but again she can decide not to inform or consult him/her.

An exception is that if the woman is severely mentally ill or has been unconscious for a long time, consent of a life-partner (only if male), parent or legal guardian is required.

Rules for health workers
In general, only medical doctors may perform abortions. Nurses who have received special training may also perform abortions up to the 12th week of pregnancy.

Health workers are under no obligation to perform or take active part in an abortion if they do not wish to, however they are obligated by law to assist if it is required to save the life of the patient, even if the emergency is related to an abortion.

A health worker who is approached by a woman for an abortion, may decline if they choose to do so, but are obligated by law to inform the woman of her rights and refer her to another health worker or facility where she can get the abortion.

Most abortion centres will insist on providing pre- and post-abortion counselling, and the woman can legally demand it, but it is not a legal requirement that abortion centres provide it.

Abortion can be had for free at certain state hospitals or clinics, although sometimes only if the woman is referred by a health workers.

Non-surgical abortion
A medicine-induced abortion can be performed by any medical doctor at his premises up to 7 weeks from the first day of the last menstrual period. The usual method is a dose of an antiprogestin, followed by a dose of a prostaglandin analogue two days later.

Effects of current abortion legislation
There has since the passing of this Act been a decrease in deaths from backstreet abortions, but the number of deaths following abortions are still quite high -- 5% of maternal deaths following childbirth are abortion related, and 57% of these are related to illegal abortions.

A recent study in Soweto showed the following: the rate of abortions for women older than 20 years decreased from 15,2% in 1999 to 13,2% in 2001, the rate for women aged 16-20 decreased from 21% to 14,9%, and the rate for women aged 13-16 decreased from 28% to 23%. In 2001, 27% of abortions were second-trimester.

Abortion is the third biggest cause of death among children younger than 1 year old in South Africa (keep in mind that the unborn are referred to as "baby" or "child" in South African legislation and many South African statistical studies). The biggest case of death in the same age group is abandonment (2001 figures).

Invalidated amendment act of 2005
In 2005, the Choice on Termination of Pregnancy Amendment Act was passed by Parliament. In terms of the amendment:


 * clinics offering a 24-hour maternity service need no longer obtain special approval to conduct abortions;
 * clinics conducting abortions are required to keep and submit certain statistics;
 * registered nurses who have completed special training may also conduct abortions (previously only doctors and midwifes were allowed to conduct abortions).

The amendment was challenged in the Constitutional Court by Doctors For Life International on the basis that inadequate public participation had preceded it. In August 2006 the Constitutional Court declared that the amendment was indeed unconstitutional on those grounds, but suspended the invalidation for 18 months during which time Parliament would have to ensure proper public involvement.