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Abortions Legality Does Not Necessitate Safe Abortion Use in South Africa

By Scott Douglas Jacobsen

The Guardian reported on the need to considermore than the pro-choice laws in South Africa in order to prevent unsafe abortions for women, which can lead to the death of women. Abortions have been legal in South Africa since 1997.

There are advertisements for abortion in Johannesburg. However, the experts on the subject matter think about half of the terminations in South Africa occur external to the safe abortion areas. That is, the safer places known as the designated health facilities.

One doctor, Dr. Tlaleng Mofokeng, talked abut being an abortion provider for as long as being a qualified medical doctor. However, in the previous five years as a doctor and abortion provider, Mofokeng’s email, social media, and calls have been from many women, from every area of life, desperately requesting help from Mofokeng.

“I will never forget one young woman who came to the public clinic in the West Rand township near Johannesburg, panicking about massive blood loss from her vagina. It was only after some prompting that she and a family member admitted to using abortion pills purchased outside a shopping centre. She bought the pills after being denied an abortion by the local clinic, where health workers told her ‘We don’t do those things here,’ and shamed her for being young and sexually active,” Mofokeng stated.

The paramedics had come by and then the woman needed resuscitation. She was then transported to a close by private hospital. A couple hours later, the 17-year-old woman went into the operating theatre. She underwent a hysterectomy because of sepsis and haemorrhage. This was in South Africa. Abortion was liberalized 21 years prior, as noted in 1997.

Mofokeng used this as a warning of the referendum victory in Ireland. By which Mofokeng means, the laws can be passed. However, the implementation of those laws can be another hurdle off the books rather than on them — so to speak.

“The Choice on Termination of Pregnancy Act (Ctop) came into effect in South Africa in February 1997, with hopes it would promote female reproductive autonomy by providing free access to abortion. It has been described by the Guttmacher Institute as ‘one of the most liberal abortion laws in the world’ and secured all South African women — and minors — the right to decide to have an abortion,” Mofokeng explained.

The Act was seen as a historic moment for women. Nonetheless, the reality remains different on the ground, especially with the example provided before. One main factor comes from the lack of access to information. It creates a layered problem. Women have the right in the law. However, the information exists without access to the information.

It amounts to a socio-cultural restriction on the reproductive rights of women regarding safe and equitable access to abortion. Women and young women deserve the right to equitable and safe access to abortion as a human right. Then if someone has a religious objection, they can have access while not having to use it.

Mofokeng described, “The formal health system does as little as it can to comply with the law. A recent survey by Bhekisisa, the Mail & Guardian newspaper’s health journalism centre, found that less than 5% of public clinics and hospitals offer the procedure. The National Department of Health’s website fails to list any information on abortion and neither do its four mobile apps.”

Women will acquire an abortion with or without the abortion access. One 2017 study noted that approximately 1/3 of South African women do not know that abortion is legal in South Africa.

“Illegal abortion flyers have become recognisable on many lamp-posts across the country, including at the entrance of the Department of Health. They promise same-day abortions, which can include an indiscriminate concoction of pills and procedures that risk incomplete abortions, sepsis and even death,” Mofokeng stated.

Little political will exists for the upholding of the law, especially with the lack of information among women in the community. By implication, the authorities will not take measures in order to control or prosecute the provision or advertisement of illegal, or mostly unsafe and illicit, abortion services.

The Minister of Health, Aaron Motsoaledi, was named a champion within the She Decides movement, which is, obviously, a progressive movement. However, there has been concern about an unresponsiveness to the concerns of women in the last decade.

Mofokeng stated, “As a doctor, I have seen what lack of access to abortions means: too many South African women suffer needless complications and preventable deaths. But I cannot get much more specific than that, as the Health Systems Trust said in its 2011 report that the government’s abortion statistics are ‘increasingly unreliable.’”

With the United States’ Global Gag Rule, this has impacted the ability of South Africa to develop its abortion services as well. “Trump’s expansion of the rule further restricts NGOs to using their own funds to save lives. This will lead to preventable deaths and life-long ill health from complications due to unsafe procedures,” Mofokeng explained.

Mofokeng concluded with a question about the things that will be needed for the country to step up to the plate.

Scott Douglas Jacobsen founded In-Sight: Independent Interview-Based Journal and In-Sight Publishing. He authored/co-authored some e-books, free or low-cost. If you want to contact Scott:



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Scott Douglas Jacobsen

Scott Douglas Jacobsen is the Founder of In-Sight Publishing. Jacobsen supports science and human rights. Website: