Claiming and defending abortion rights in South Africa

Abstract

The South African transition to democracy enabled successful claims for gender equality and reproductive rights in the Constitution and in law. This article explores that transition with a focus on the enactment of a progressive abortion law; the feminist, rights and public health narratives that justified it; and the manner in which it transformed constitutional and legal norms about women and reproductive choice, despite a broadly conservative society. Then, it discusses twenty years of the Act in practice, highlighting its uneven implementation in the face of significant normative resistance and changing narratives. It also describes the ebb and flow of rights protection in changing social and political conditions, and demonstrates the importance of constitutional and legal guarantees to abortion as a bulwark against their erosion. At the same time, it illustrates the importance of political will, feminist narratives and civil society activism in maintaining effective access to safe, legal abortion for poor, black, working class and rural women.

Implementing and expanding safe abortion care: An international comparative case study of six countries

“…In contrast, the legalization of abortion services in South Africa and Colombia was embedded within human rights discourses. While abortions also accounted for a high proportion of maternal mortality in these countries, the fight for legalization was framed in terms of women's rights in the post‐conflict and post‐apartheid contexts and the health sectors were less centrally involved in advocacy leading up to legal change or the subsequent establishment of abortion services …”

“…One was to focus on the public health necessity of reducing maternal death and morbidity—a tactic utilized in all our case countries . In South Africa, proponents of the new law used both women's rights and equity arguments as well as those surrounding maternal health . Colombia creatively straddled the two positions by framing abortion in terms of health as a human right…”

“…While the South African law imposed the fewest additional steps for women seeking the procedure, the most important guarantor of timely access was the Portuguese stipulation that the National Health Service had to ensure provision of the procedure within 5 days of the woman's request . Liberal interpretations of existing grounds comprised broad application of maternal health, inclusion of mental health as a health condition in Colombia, Ethiopia, and Ghana, and acceptance of the woman's word that she had been sexually assaulted in Ethiopia and Ghana…”

“…In all six countries the public sector is supposed to assure that abortion care is free, has nominal charges, or is covered by insurance. However, for various reasons, private provision (including by NGOs) in Colombia, Ghana, Portugal, and South Africa is still significant and may be costly …”

“…While monitoring and evaluation are standard cornerstones for assessing programmatic efficiency and effectiveness, they proved particularly useful in assuaging fears about these new programs. In countries as different as Ghana and Portugal, data demonstrated the rapid decline in abortion associated death that followed availability of safe procedures . While many complained that data were overly aggregated or problematically coded, precluding fine‐tuned analysis, interviewees also reported that they learned from these data how to constructively modify the program, and had been able to refute incorrect stereotypes about characteristics of those seeking abortion.…”