The right to sexual and reproductive health (SRH) is an essential component of the right to life, the right to health, the right to education, and the right to equality and non-discrimination. Many women, young women, adolescent girls, and gender non-conforming people in South Africa are vulnerable to ill-health due to several economic and social barriers that prevent them from accessing timely and life-saving SRH services, including safe abortion and contraception. Better access to these services can prevent unsupported pregnancies and reduce unsafe abortions. When a woman is denied unencumbered access to these services, her agency and the right to make decisions about her body are limited.
More than two decades have passed since the progressive Choice on Termination of Pregnancy Act (CTOPA), 1996, liberalised abortion in South Africa. However, women in South Africa continue to face barriers in accessing safe abortion services. This is due to severe stigma, refusal by healthcare providers to provide services due to their religious or moral beliefs, lack of information on the legally safeguarded rights under the CTOPA, and poor infrastructure and limited availability of safe abortion services.
Due to these barriers, women and adolescent girls often resort to illegal and unsafe abortion services, which put their health and lives at risk. Unchecked advertising of ‘quick and pain free abortions’ by illegal providers perpetuates the stigma and misinformation about abortion among the population. According to a 2009 study, two illegal abortion procedures took place in South Africa for every safe legal procedure.
Globally, unsafe abortion is one of the top five causes of maternal mortality, along with post-partum haemorrhage, sepsis, complications from delivery, and hypertensive disorder. In our country, many women die every year, or sustain injuries and disabilities due to unsafe abortions. For example, the 2014 Saving Mothers report, covering the period from 2011 to 2013, reveals that pregnancy-related sepsis accounted for 9.5% of maternal deaths during the said period.
In light of the significant challenges that women continue to face while attempting to access safe abortion services, we, the undersigned, urge South Africa’s National and Provincial Departments of Health to take urgent action to improve access to safe abortion services for all women in the country.
We recognise the significant strides made towards realisation of women’s rights in South Africa, which includes the enactment of the Choice on Termination of Pregnancy Act (CTOPA) 1996 (Act no. 96 of 1996). However, we implore the government to acknowledge and address the hardships that women face when they seek to exercise their right to choose as granted to them by CTOPA.
We, therefore, call on the government to:
- Urgently finalise national termination of pregnancy guidelines and ensure their dissemination in all provinces of South Africa;
- Ensure provision of reproductive health commodities – medical abortion drugs and MVA apparatus and ensure health providers are well trained through CPD processes to maintain their registration;
- Work with inter-ministerial partners and local governments for the stringent enforcement of by-laws to tackle illegal abortion providers, including introducing steps to address illegal advertising;
- Mainstream sexual and reproductive health and rights, including contraception and safe abortion, into the health agenda;
- Celebrate ‘Abortion Provider Appreciation Day’ annually on 10 March; and
- Engage the US government about the urgent need to repeal the ‘Global Gag Rule’ in South Africa.