Abortion is legal in South Africa, but over half of abortions remain
unsafe there. Evidence suggests women who are (Black) African, of lower
socioeconomic status, living with HIV, or residents of Gauteng, KwaZulu-Natal,
or Limpopo provinces are disproportionately vulnerable to morbidity or mortality
from unsafe abortion. Negative attitudes toward abortion have been documented in
purposively sampled studies, yet it remains unclear what attitudes exist
nationally or whether they differ across sociodemographic groups, with
implications for inequities in service accessibility and health. In the current
study, we analysed nationally representative data from 2013 to estimate the
prevalence of negative abortion attitudes in South Africa and to identify
racial, socioeconomic and geographic differences. More respondents felt abortion
was ‘always wrong’ in the case of family poverty (75.4%)
as compared to foetal anomaly (55%), and over half of respondents felt
abortion was ‘always wrong’ in both cases (52.5%). Using
binary logistic regression models, we found significantly higher odds of
negative abortion attitudes among non-Xhosa African and Coloured respondents
(compared to Xhosa respondents), those with primary education or less, and
residents of Gauteng and Limpopo (compared to Western Cape). We contextualise
and discuss these findings using a human rights-based approach to health.