Everything you need to know about safe abortions in South Africa in 2020

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There are hundreds of reasons a woman might not want to carry a baby
There are hundreds of reasons a woman might not want to carry a baby

Every woman is legally entitled to an abortion in SA, but what are the facts?

Is abortion legal in SA? 

Since February 1997, it has been legal in South Africa for any woman of any age to request and get an abortion with no reasons given if she is less than 13 weeks pregnant. 

If she is between 13 and 20 weeks pregnant, she can get the abortion if:

  • Her own physical or mental health is at stake
  • The baby will have severe mental or physical abnormalities
  • She is pregnant because of incest, she is pregnant because of rape
  • 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 foetus' life is in danger or there are likely to be serious birth defects.

Do I have to tell anyone if I don’t want to?

Those under 18 are advised to speak to their parents, and those in a marriage or long term partnership are advised to speak to their partners, but they have the right not to do so.

If the woman in question cannot advocate for her herself due to being unconscious or severely mentally ill, then a legal guardian or next of kin may make that decision for her.

Also see: BABY HOW TO: Our handy guide to babies!

What about people who have a uterus but are not female?

This language is what is described in the original act and does not include transmen or non-binary people explicitly.

We spoke to Marion Stevens, director of the Sexual and Reproductive Justice Coalition, about queer bodies and abortion.

Marion says that, after speaking to people from queer rights organisations and a few healthcare providers, that there don’t seem to be any issues with providing abortions to those whose gender identity is different from the one they were assigned at birth.

But the issue here is that the law is not explicitly inclusive of these people.

South Africa’s laws are actually quite progressive when it comes to bodily autonomy and Marion points out that even though the Choice on Termination of Pregnancy Act does not explicitly provide protection for queer bodies, the Constitution would override its possible limitations.

“Given the orientation of the law in the preamble, my sense is that health providers and queer folks would be enabled to access services and while the law is gender normative, it is academic whether it is exclusionary although it is not inclusive in language,” says Marion.

There is also the larger issue of queer health issues not being properly addressed.

Marion says their organisation is writing a policy brief to be addressed to a range of people including the big decision makers as well as those in education, health providers and activists so as to talk about why these issues are not being provided for. 

Also read: Will labour complications effect my child's development?

Where can I get an abortion?

Did you know that over 10 000 illegal abortions are performed in South Africa every year? Don’t fall into this trap.

You can find your nearest local clinic and find out if they perform abortions.

They will provide you with free assistance.But not every government hospital or clinic provides abortions.

You can go to Marie Stopes which has centres across the country to help you.

They provide you with pre-procedure advice and confirm your pregnancy before making you understand all your options.

If you still choose to terminate, the nurses are trained to assist you and provide counselling. 

You can also go to your GP and get it done if they are correctly trained and designated to provide the service according to Whitney Chinogwenya, Brand and Marketing Manager for Marie Stopes.

“If they are unable to provide the service; whether it is because they are untrained or unwilling to provide, they are obligated to refer the patient to someone who can,” she says. 

This is the law. If a doctor cannot assist you with an abortion, they HAVE to provide you with details for someone who can regardless of their personal feelings about the situation. 

Are there different types? 

There are two types of safe abortion based on the stage of your pregnancy:The medical abortion is for when you are between 5 – 9 weeks pregnant.

After this time, you’ll need to have a surgical abortion. The method involves using a combination of two medications which work together to terminate the pregnancy. Mifepristone stops the ovaries from producing the hormone progesterone.

The second pill, misoprostol, needs to be taken 6 – 48 hours after taking the first pill. It causes cramping and bleeding which empties your uterus.

This method is 98-99% effective.The in clinic procedure is when a doctor stretches your uterus and inserts a hollow tube, removing the lining of the uterus through aspiration of the tissue.

This is minimally invasive and can be done on the same day. This method is 99% effective. 

How much does it cost?

Can I get it done through my medical aid?Prices at your GP will vary if you go with this option.

 Prices at Marie Stopes start from R800 depending on gestation and the method you choose.

 It is a prescribed minimum benefit on some medical aids, but Whitney says due to red tape with the medical aid system, this is not often the case.

You might want to review your policy if you are considering an abortion and want them to pay for it. 

How will I feel afterwards?

According to the Marie Stopes website, 95% of women do not regret their decision to have an abortion.

Whitney says that most women express a feeling of great relief that they were able to access a safe abortion.

There is a counselling session beforehand so that the person in question can make an informed decision.

“We trust that women’s decision making processes when it comes to terminating a pregnancy is sound and we know that most women who make the decision to terminate a pregnancy make the right decision for themselves and for their lives,” says Whitney.

She also says that regret is not really something they come across often.

“The stigma and judgment that comes with terminating a pregnancy is another factor that may influence women to have negative feelings about their decision,” she says.

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