Medical Abortion – Clinics and Methods in South Africa

An unwanted pregnancy can be a daunting prospect for many women and teen girls especially without appropriate financial or social support. Fortunately within South Africa, the Choice on Termination of Pregnancy Act, 1996 allows an expectant mother to terminate the pregnancy through safe and cost effective abortions. Choosing the correct abortion method is essential in maintaining both your reproductive health and preventing complications or even death.

The Choice on Termination of Pregnancy Act 1996 allows a women to terminate pregnancy upon her request if she is within the first 12 weeks of pregnancy (gestation). However an abortion can be performed from the the 13th to 20th week of pregnancy if approved by a medical practitioner under the following conditions :

• continuing the pregnancy may be a risk to the mother’s physical or mental health.
• the fetus (foetus) may suffer with severe physical or mental abnormalities should the pregnancy continue to full term.
• the pregnancy is a result of rape or incest.
• continuing the pregnancy may have severe economic or social impact on the mother.

Abortion Clinics in South Africa

Many private and public health facilities now provide medical and surgical abortions at an affordable rate or free to expectant mothers. A private abortion clinic in South Africa is often the facility of choice for pregnant women as it provides affordable and safe abortions in addition to counseling and a choice of abortion methods. Public health facilities also provide these services but the strained public health care system in South Africa means that pregnant women may not always be given the same level of care or priority compared to a private abortion clinic.

Abortion Methods in South Africa

Certain abortion clinics may provide a range of abortion methods depending on the individual case or personal choice of the pregnant mother.

• Safe surgical abortions
• Medical abortions – Abortion pill

The morning after pill (emergency contraceptive) is often used as an abortion pill but should not be taken more than 3 days after intercourse. For a more advanced pregnancy, medical intervention is required to reduce complications and ensure a safe abortion.  Consult with a medical practitioner on suitable abortion methods for your pregnancy. If you are less than 9 weeks pregnant, you can consider a medical abortion which involves using the abortion pill. For a pregnancy that is further along, you will need to undergo a surgical abortion. Medical abortions usually involve a process known as dilation and curettage (d&c) – a pill is used for dilation of the cervix and foetal  contents are removed through a tube inserted via the vagina (manual vacuum aspiration or MVA). The process is not pain free but with proper medical supervision, it is quick and fairly painless. Speak to a medical doctor about the abortion method so that you have fully understand the procedure.

Dangers of Abortion

Most medical abortions are safe when conducted by a medical specialist in appropriate facility. However illegal abortions are still common in South Africa and you will often find advertisements for abortions in newspapers and street posters, irrespective of your stage of pregnancy. Always be cautious when undergoing an abortion or using any abortion pill (tablet, capsule or liquid) that is sold through shady street dealers.

Beware of the following persons or scenarios when seeking a quick abortion.

• Any person claiming to be a medical doctor, medical student, nurse or pharmacist who is prepared to sell you an abortion pill on the street.
• Any person who is willing to come to your home to perform an abortion.
• Any abortion that is performed in unhygienic and inappropriate settings.
• Any person who claims that their abortion method is safe for any stage of pregnancy.
• Any person who can only be contacted on a cell phone, does not wish to disclose their full identity and cannot provide any proof of registration with a medical council or health authority in South Africa.
• Any person promising a cheap abortion.

These illegal abortion practitioners and pill peddlers are operating in almost every city in South African and their abortion methods are dangerous and could possibly cause death.

Although medical abortions are very safe, any abortion may come with some risk and complications.

• Danger to your reproductive health – you may not be able to fall pregnant again or be at risk of an ectopic pregnancy.
• Infections – can result in removal of your reproductive organs, septicemia (blood poisoning) or death.
• Excessive bleeding which may result in death.

The occurrence of the above risks and dangers is very unlikely if you opt for a safe medical abortion by a gynaecologist in an appropriate abortion clinic. Even if complications do arise, your gynaecologist will be able to attend to it immediately and with appropriate medical treatment, the risks of more severe side effects or complications are reduced. However if you opt for an illegal abortion, the above risks and complications are very likely and if you do not receive proper medical treatment in time, you can lose your life.

South African women and girls are fortunate to be allowed to terminate their pregnancy at a range of suitable abortion facilities. An abortion is your constitutional right and may often be a better option than having a child without appropriate financial and social support. However religious and cultural factors along with personal choice may not make an abortion a suitable option for some women. Whether you opt for an abortion or putting your baby up for adoption, always use legitimate and reputable channels which are widely available in South Africa.