Barriers to implementing South Africa's Termination of Pregnancy Act in rural KwaZulu/Natal

Abstract

Legalization alone cannot ensure implementation of abortion services. In South Africa, extensive media coverage prior to passage of the law ensured almost universal awareness of the Act, but little public education took place at the same time. In spite of general opposition to the law, however, there is an encouraging level of support for abortion in some circumstances. These findings suggest that abortion services can be implemented, even in conservative rural areas, but that a process of information dissemination and community consent prior to implementation is essential. Locating abortion within broader reproductive health services could be an effective way to improve access and acceptability.

Termination of pregnancy: Perspectives of female students in Durban, South Africa

“…Most health workers supported abortion in the case of rape or incest, or if it would endanger a woman's health, but few supported it for social or economic reasons. (Harrison et al, 2000;Harries et al, 2009). Providers may also assert conscientious objection and ignore the legal obligation to refer women to other facilities, creating a barrier to care (Cooper et al, 2004).…”

Age Patterns of Unsafe Abortion in Developing Country Regions

“…[15][16][17] In some countries, the liberalisation of abortion laws has not been systematically followed by the availability of safe abortion services or the elimination of unsafe abortion. [18][19][20] The World Health Organization (WHO) defines unsafe abortion as a procedure for terminating an unintended pregnancy either by persons lacking the necessary skills or in an environment lacking the minimal medical standards, or both. 21 Unsafe abortions may also be selfinduced using hazardous techniques or using pharmaceuticals without the involvement of a skilled provider or the necessary support.…”

Clarifying Values and Transforming Attitudes to Improve Access to Second Trimester Abortion

“…48 Because of stigma, women have expressed reluctance to seek a termination in their own communities for fear of being recognised and ostracised. 49 Some women encounter rudeness, hostility, and judgmental attitudes from staff members and protestors at public facilities. Stories of moralising and attempts at dissuasion by facility personnel include quoting the Bible during a consultation.…”