Abortion is legal in South Africa in accordance with the Choice on Termination of Pregnancy Act 1996 (CTOPA) and 2008 amendments to the same Act. Medical abortions can be accessed at licenced government and private facilities. Despite the existence of these comparatively liberal abortion laws, access to abortion services has been hampered by competing health priorities, such as HIV/AIDS, and a high number of conscientious objectors who have continued to spread abortion stigma.1
Is abortion legal in South Africa?
Abortion is legal in South Africa in accordance with the above act,) which allows a woman of any age to terminate a pregnancy upon her request, if she is within the first 12 weeks of gestation. However, if approved by a medical practitioner, an abortion can also be performed from the 13th to 20th week of pregnancy under the following conditions:
- continuing the pregnancy may be a risk to the mother’s physical or mental health;
- the fetus may suffer with severe physical or mental abnormalities should the pregnancy continue to full term;
- the pregnancy is a result of rape or incest; and/or
- continuing the pregnancy may have a severe economic or social impact on the mother.
Abortion may also be legal after the 20th week of gestation if a medical practitioner, after consultation with another medical practitioner or a registered midwife, is of the opinion that the continued pregnancy would:
- endanger the woman’s life;
- result in a severe malformation of the fetus; or
- pose a risk of injury to the fetus.
What are the different abortion services available in South Africa?
South Africa provides both medical and in-clinic abortion services. For a Medical Abortion (MA), a combination of two drugs, Mifepristone and Misoprostol, is used. The in-clinic procedures available are Manual Vacuum Aspiration (MVA) and Dilation and Evacuation (D&E).
- MA – permitted from 4 to 9 weeks’ gestation.
- MVA – permitted from 9 to 14 weeks’ gestation.
- D&E – permitted from 14 to 20 weeks’ gestation.
- Post-abortion care.
Who can perform legal abortions in South Africa?
Since the 2008 amendment to the CTOPA, abortion services in South Africa can only be provided by:
- medical doctors,
- registered nurses, and
- midwives.
Nurses and midwives, who have completed the prescribed training, are only allowed to perform abortions for pregnancies under 12 weeks. After three months’ gestation, only a medical doctor can perform an abortion.
Where can I go for legal and safe abortion services in South Africa?
Safe and legal abortions in South Africa can be performed at public or private medical facilities designated by the government through a gazette notice. The facilities may fall into the following categories:
- private hospitals,
- community clinics,
- district hospitals,
- provincial hospitals
- registered health professionals’ private practices, and
- specialized non-government sexual and reproductive health facilities, i.e. Marie Stopes and Médecins Sans Frontières(MSF).
In South Africa, only the pregnant woman’s consent is required for the termination of a pregnancy. If the pregnant person is a minor, the abortion service provider is required to advise her to consult with her parents, guardians, family members or friends before the pregnancy is terminated. The law clearly states that the provision of abortion services to a minor should not be denied just because the minor did not consult the recommended persons.2
What is the cost of a safe abortion in South Africa?
All government (public) facilities provide free abortion services.
In private clinics:
- A medical abortion, from five to nine weeks, costs on average between R620-R1 200.
- MVA, from 10 to 14 weeks, costs on average between R1700-R2500.
- A surgical abortion, from 14 to 20 weeks, varies from case to case but one can expect to pay around R5 500.
- Medical aid (insurance) has criteria for covering abortion. Please check what yours covers.
Which abortion pills are available in South Africa?
There are several types of abortion pills available in South Africa:
- A combination of Misoprostol and Mifepristone,
- Mifepristone, alone, and
- Misoprostol, alone.
Mifepristone is a drug that blocks the hormone, progesterone, which is needed for a pregnancy to continue. Misoprostol can be used on its own, or after Mifepristone, to encourage a complete medical abortion. You can find more information on Misoprostol and Mifepristone usage here.
Where can I buy abortion pills in South Africa?
South Africa has a huge problem with unregistered people selling miscellaneous abortion pills to women, thereby increasing the rate of women hospitalized due to unsafe abortion practices.
Abortion pills are only safely available in public facilities across South Africa. You will, however, need a prescription.
Note:
Illegal sellers often provide abortion pills without a prescription; however, they do not always provide proper instructions on eligibility, dosage and usage.3 To be safe, women must ensure that they get abortion services from registered providers. We suggest that you visit our website for comprehensive information on how to use the pill: https://www.howtouseabortionpill.org/howto/
What do the abortion pills look like in South Africa?
The most common brand name for abortion pills in South Africa is Cytotec. This is what the Cytotec abortion pills look like:
This is what the Mifegyne abortion pills look like:
This is what the Mifeprex abortion pills look like:
Who can I contact for additional abortion information and support in South Africa?
- Safer Sex runs the DISA Clinic located in Hurlingham Manor, Sandton, which offers Sexual and Reproductive Health (SRH) services to men and women.
Always call to book an appointment: Tel: 011 787 1222/886 2286
Opening hours: Monday- Friday 8.00 a.m. – 5.00p.m.
Saturday 8.00 a.m. -2 p.m. - For safe abortion information and support, please contact the following:
Marie Stopes South Africa is a government-approved health-care organization with clinics across South Africa. It offers safe abortions; family planning services, including birth control, pregnancy tests, and male and female sterilisation; HIV testing and antenatal services. Clients are charged according to their income bracket.
Toll free: 0800 11 77 85
Email: info@mariestopes.org.za - Doctors Without Borders project in Rustenburg.
52 Marais St, Rustenburg, 2999, South Africa
Email: office-joburg@joburg.msf.org
Tel: +27(011 403 4440/1/2
IN CASE OF EMERGENCY: +27 (010 900 0840 - Blue Ribbon Clinics:
Toll-free number: 0800 11 77 85
Office number: +27 (021 681 1547
Email: info@blueribbon.org.za - #SizaMap by Bhekisisa
Bhekisisa has created #SizaMap, South Africa’s first searchable map showing free abortion providers. Please note that the map is based on facilities’ self-reporting, so it’s best to call ahead and confirm what services are offered. - Sex Rights Africa Network provides verifiable information on abortion in South Africa.
Facebook: https://www.facebook.com/SexRightsAfricaNetwork/ - UCare Medical Centers: Tel: 010 600 2670
Was this useful? What else would you like to see here? Contact us at: info@howtouseabortionpill.org
References:
- 1 Favier, M. Greenberg, J.S.M., Stevens, M. “Safe abortion in South Africa: ‘We have wonderful laws but we don’t have people to implement those laws’.” International Journal of Obstetrics and Gynaecology, 2018. http://www.obgyn.onlinelibrary.wiley.com/doi/full/10.1002/ijgo.12676.
- 2 Guttmacher Institute. “Abortion Reform in South Africa: A Case Study of the 1996 Choice on Termination of Pregnancy Act.” International Perspectives on Sexual and Reproductive Health, Vol. 24, Issue 4, pp.191, 1998. https://www.guttmacher.org/journals/ipsrh/1998/12/abortion-reform-south-africa-case-study-1996-choice-termination-pregnancy-act
- 3 Powell, A. “South Africa’s Liberal Abortion Laws Hampered by Widespread Stigma.” VOA, 22 March 2019. https://www.voanews.com/a/south-africa-s-liberal-abortion-laws-hampered-by-widespread-stigma/4841297.html.