The passage of the Choice on Termination of Pregnancy Act of 1996, which gives women of any age or marital status access to abortion services upon request during the first 12 weeks of pregnancy, and on specific grounds through the first 20 weeks of pregnancy, should have made safe abortions accessible for everyone who needed them in South Africa. “The law’s passage was a crucial advance for women, as it represented the recognition of reproductive rights by South Africa’s first democratically elected parliament.”South Africa was also among the first countries to allow midwives to provide early abortions. In fact, although no healthcare worker can legally refuse the service to a woman who requests it, as they would be contravening the law, a study in the Eastern Cape found that women were being asked for their reasons and sent away if the health professional did not approve. Moreover, because of the foot dragging over many years by the Department of Health and the unwillingness of so many hospitals and health professionals to provide abortions, there are far too few registered clinics. Instead, thousands of backstreet providers continue to operate all over the country.The Department of Health has urged people to use their facilities to terminate pregnancies instead of resorting to bogus abortion clinics. However, only 367 facilities in the entire country reported providing abortion services in the previous financial year, whereas 2,643 facilities that are qualified to do so, did not. The Eastern Cape has the highest number of facilities, but even there, only 46 out of 1,011 provided abortions. Moreover, the minimal usage of the existing facilities shows their inaccessibility. 58% of South African women resort to backstreet clinics because they fear being victimised and denied access to the procedure by healthcare workers. An estimated 260,000 illegal abortions occur annually. Section 27, a public interest law centre, recently wrote an open letter to the Deputy Minister of Health to ask him to do more, and have tried to engage with some provincial departments as well, e.g. in the Eastern Cape. They have also been trying to lobby the Department of Health to introduce self-managed abortion, which would provide abortion pills for use outside of a healthcare facility to terminate a pregnancy. They have received little or no effective response. The Department of Health have said they will conduct a march against all the backstreet abortion facilities in all the provinces. But that will change nothing until and unless publicly provided services are made accessible across the country. SOURCE: IOL.CO.ZA, by Tshepiso Tshabalala, 19 October 2022 + PHOTO: An illegal abortion clinic is closed down by Msunduzi Municipality, Pietermaritzburg, undated.