In some provinces, safe, free abortions may only be provided at about 260 public facilities.
Less than 7% of the country’s 3 880 health facilities provide abortions, according to recent research by the global human rights organisation, Amnesty International.
The health department has a human rights obligation to guarantee women access to abortion services, but isn’t doing enough to implement the Choice on Termination of Pregnancy Act, found a briefing report released in February.
“We conducted research into access to termination of pregnancy at some public clinics and found that there were many barriers to abortion,” says Louise Carmody, an Amnesty International researcher.
Access to information was one of the chief obstacles. “Many women and girls do not know about the law and the services they are entitled to,” Carmody says.
“There is no central place where women can get information about abortions. There isn’t even a list of the facilities around the country where the services are offered on the department’s website. It’s difficult for women to find out where they need to go and what the process entails.”
Many still in the dark
According to Carmody, some people still don’t know that abortion is legal, nor until what stage of a pregnancy they can have the procedure. In South Africa, abortion is legal up to 20 weeks of pregnancy.
South Africa’s Choice on Termination of Pregnancy Act, legalised abortion in the country more than 20 years ago. The Act was amended in 2008 to expand access to abortion services by removing some of the administrative constraints.
But Yogan Pillay, the national deputy director general for maternal and women’s health in the national health department, says lists of government facilities providing abortions are available in district health offices around the country.
South Africa has 52 health districts and their head offices are usually situated in bigger towns or cities.
Dearth of care
Meanwhile, only five public health facilities in the Northern Cape offer abortion services with a similar number operating in the Free State. In KwaZulu-Natal, women can go to 27 health facilities across the province but districts such as Umzinyathi, Zululand and Umkhanyakude have either one or no public facilities providing these services, according to a health department list
Pillay says the department has increased access to contraception and family planning services to address the demand for unsafe abortions.
He says provincial health departments are working with the police to deal with illegal abortionists.
“However these illegal abortionists do not operate as fixed clinics but rather as mobile providers where they make appointments with their clients to meet along the street and take them to a house or to any structure that is not easily identifiable – this is done surreptitiously.
“To stamp out illegal services we must raise awareness, increase access to safe contraception and ensure that the public works with government.”
State needs to do more
But Carmody argues that government must also improve and expand abortion services “rather than placing the emphasis on improved access to family planning services”.
“The department has some great mobile platforms that provide women and girls with information around HIV and pregnancy, such as MomConnect [a free cellphone SMS service which provides information to pregnant women].” She says: “These platforms should include information on abortions.”