Abortion in South-Africa: Does a liberal legislation really impact safe access and use?

Abstract

The World Health Organization (WHO) considers comprehensive abortion care as part of their essential healthcare service package, which includes the provision of information, abortion management, and post-abortion care. The WHO estimated that globally, 45% of all induced abortions were unsafe, and it noted that nearly half of all the abortions occurred under the least safe circumstances in Africa. Abortion has been legal in South Africa since the implementation of the Choice of Termination of Pregnancy (CTOP) Act (No. 92 of 1996), which was a significant departure from the country's previously restrictive abortion laws. While the CTOP Act (1996) has made provision for access to safe abortion services and pre- and post-abortion counselling, this has not been effectively implemented into effective service delivery. It's estimated that between 52% and 58% of abortions take place in informal medical settings, and that only 7% of the public health facilities in South Africa were performing abortion services in 2017. The WHO noted that the lack of access to safe, affordable, timely, and respectful abortion care, and the stigma associated with abortion pose risks to women's physical and mental well-being throughout the life-course. The aim of this paper was to explore how women in South Africa experience and cope with induced abortion. Additionally, this research looks at how religion, culture and stigma, impact abortion and mental health post-abortion of South African's women. This study utilises data from the latest South African Demographic and Health Surveys (SADHS), in 2016, which includes data from 8514 women aged 15-49 years. This study highlights the need for more data and research related to challenges and experiences of South African women around mental health and the nature of abortion within the country. In this interview conducted by Professor Jean-Pierre Bouchard, population analysts Robynn Ashely Hera and Siposethu Nojoko together with demographer Professor Nancy Stiegler from the University of the Western Cape discuss safe and unsafe abortion incidence and access and the psychological effects thereof.