Abortion in South Africa is legal by request (no reason needs to be provided) when the pregnancy is under 13 weeks. It is also legal to terminate a pregnancy between week 13 and week 20 under the following conditions: the continued pregnancy would significantly affect the pregnant person's social or economic circumstances, the continued pregnancy poses a risk of injury to the pregnant person's physical or mental health, there is a substantial risk that the foetus would suffer from a severe physical or mental abnormality, or the pregnancy resulted from rape or incest. If the pregnancy is more than 20 weeks, a termination is legal if the foetus' life is in danger, or there is a likelihood of serious birth defects.
Abortion is provided for free at government hospitals providing the request is made at a primary healthcare clinic and a referral letter provided to the facility performing the procedure. Abortion is provided for a fee at private clinics. Marie Stopes South Africa and Abortion Support South Africa provide telemedical abortion services across the country.
History
Abortion was first legalised in South Africa under the Abortion and Sterilization Act, 1975 (Act No.2 of 1975). This law stated that women could access pregnancy terminations if; continuing the pregnancy could be life-threatening or cause serious health issues, continuing the pregnancy could be of severe risk to the woman's mental health, the child is likely to be born with significant irreparable physical or mental defects, or, the foetus was conceived by means of rape or incest. This was later overridden on 1 February 1997, when the Choice on Termination of Pregnancy Act (Act 92 of 1996) came into force.
Before legalisation in 1975, abortion was prohibited throughout the country, however some white women, could request private doctors to perform a dilation and curettage, on the grounds that the continuation of pregnancy threatened the woman's mental wellbeing. This was generally not an option for women of colour, due to the Apartheid regime, meaning the choice by doctors to carry out this procedure was both a personal and professional risk. Black women and those of mixed heritage often had to rely on "backstreet" abortions or their own efforts to terminate pregnancies, often resulting in severe injuries and fatalities.
The Choice on Termination of Pregnancy Act which came into force in 1997 now allows all women to access abortions in their first trimester, and on the above-mentioned terms after week 13 of the pregnancy.
The Law
In South Africa, a woman of any age can get an abortion on request with no reasons given if she is less than 12 weeks pregnant. Minors will be advised to consult their parents, but it is up to the individual to decide whether or not to do so. Equally, a woman who is married or in a relationship with a longterm partner, will be advised to consult them, but again, that decision is for her to make. Exceptions to this, are if the woman is severely mentally ill or in a state of continuous unconsciousness, where consent of a spouse, parent or legal guardian is required.
The Constitution does not explicitly mention abortion, but two sections of the Bill of Rights mention reproductive rights. Section 12(2)(a) states that, "Everyone has the right to bodily and psychological integrity, which includes the right... to make decisions concerning reproduction," while section 27(1)(a) states "Everyone has the right to have access to... health care services, including reproductive health care." In the case of Christian Lawyers Association v Minister of Health, an anti-abortion organisation which challenged the validity of the Choice on Termination of Pregnancy Act on the basis that it violated the right to life in section 11 of the Bill of Rights, the Transvaal Provincial Division of the High Court dismissed this argument, ruling that constitutional rights only apply to those who are born, and not to foetuses.
Health workers are under no obligation to perform or take active part in an abortion if they do not wish to; however, they are obligated by law to assist if it is required to save the life of the patient, such as in an emergency situation. A health worker who is approached by a woman for an abortion may decline if they choose to do so, but are obligated by law to inform the woman of her rights and refer her to another health worker or facility where she can get the abortion. Most abortion centres will provide pre- and post-abortion counselling, something which women can legally demand, however it is not a legal requirement that abortion centres provide it without request.