For many years women with unwanted
pregnancies resorted to unsafe abortion. Many maternal
deaths resulted from this practice, which is a tragedy
as such deaths are almost entirely preventable.
Globally 90% of unsafe abortions take place in developing
countries where there are frequently also legal
barriers in obtaining safe abortion.
February 1997, when the Choice on Termination of
Pregnancy Act was introduced in South Africa, termination
of pregnancy (TOP) has been legally permitted upon
request of the woman up to the end of the 12th week
of gestation, and also under specified circumstances
from the 13th to the 20th week of gestation. After
the 20th week, very limited medical conditions allow
for termination of pregnancy.
of the new Act showed some problems as access to
TOP services remained restricted and unequal. At
the end of the first year of the new Act, most TOPs
were performed in urban areas and in tertiary institutions,
and 50% of the total in Gauteng Province. Initially
less than one third of designated hospitals did
SASOG supports the wider availability
of TOP services to all women in the country, and
urges the health authorities to make available dedicated
facilities for in particular second trimester TOP.
As midwives can legally perform TOP in the first
trimester, midwife run services should be extended
to rural areas.
SASOG supports the practice
of TOP as part of health care provision for South
African women. SASOG urges women not to undergo
unsafe abortion, but to attend timeously at designated
facilities in the public as well as private sectors.
Where TOP is performed as a legal service, the maternal
morbidity and mortality is much lower as with unsafe
abortion. In this regard SASOG supports the recommendation
of the Confidential Enquiry into Maternal Deaths
of widespread facilities made available for TOP
Prepared by Dr Heather Brown. Edited by Prof
Gerhard Lindeque. August 2001