The impact of legalising abortion in South Africa

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The impact of legalising abortion in South Africa

• Busisiwe Kunene Mags Beksinska
• Women deliver
• October 2007

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Background

• The Roman Dutch law till 1975
• The Abortion and Sterilization Act of 1975 (Act
  No. 2 of 1975
• It is estimated that per year
• At least 200,000 abortions were conducted
  illegally and
• 45,000 of these resulted in hospitalization due
  to incomplete abortion and led to
• 1,500 to 3,000 deaths
• Study conducted in estimated 425 deaths per
  annum

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SA Background cont

• Campaigned on a platform of liberalized abortion
  of the ANC party
• Democracy 1994
• Need for sexual and reproductive health
• Maternal health made free and priority
• Legalization of abortion
• Maternal death notification-
• NCEEMD -Saving mother report

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Overview of the Termination of Pregnancy (TOP) Act

• Feb 1st 1997 the TOP Act came into effect
• National guidelines for implementation were
  developed and circulated to provinces
• Health providers trained
• Values clarification was included in training

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TOP statistics post legislation-cont

• In the first 3 months of the Act nearly 7 300
  terminations were performed.
• Over half (60) were performed in Gauteng, an
  urban province and 40 were after 12 weeks
• Only 40 TOPs were recorded in one of the most
  rural provinces (Northern Province)

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Stat from 1997-2004
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Knowledge of the legality of abortion

• Over a year after the Act had been passed, the
  SADHS asked women if they knew about the law.
• Only 53 knew that abortion was legal before 12
  weeks. This fell to 39 in rural areas and women
  with little or no education were least likely to
  know (33)

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Impact of legalizing abortion

• Morbidity medical management
• Less anesthesia used,
• less blood transfusion,
• antibiotics and pain relief seemed in adequate

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Impact on Mortality- Saving mothers Report
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Implementation challanges

• Accredited facilities
• Providers
• Their attitude affects me at times I tell myself
  that they are ignorant why should I be offended.
  However they break you. (Varky 2000)
• Systems
• Waiting lists long
• Patients
• Distance range between 1- 4 hours to the facility

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Challenges

• Reproductive Health rights knowledge
• Systems to be put in place
• Access to service
• Challenges of getting willing providers
• Referral system
• Including TOP in the basic training
• Broadening training for in service to include
  other SRH service
• Values clarification for all health workers

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Thank you Ngiyabonga