Over a long and distinguished career, Professor Susan Fawcus has become known for her work trying to reduce the deaths of mothers and babies in South Africa. In her home in Cape Town, the soft-spoken champion for health equity chats with Spotlight about her journey as a researcher, doctor, and obstetrician, and shares her fears of rising maternal mortality in an age of austerity.
While abortion in South Africa is legal and free in public healthcare facilities, it is thought that a large percentage of abortions are performed by illegal providers. This is attributed to a variety of factors, ranging from lack of capacity at clinics to fear of being found out and stigma. Self-managed abortions have the potential to change this. Amy Green reports on the state of abortion in South Africa and how self-managed abortions could help increase access to legal abortions.
The right to abortion has been catapulted into the spotlight by Dobbs v Jackson, the landmark judgment of the United States Supreme Court that overturned Roe v Wade – a 50-year-old precedent of that court that first recognised the constitutional right to abortion in the US.
Second-trimester abortions, which occur between the beginning of the 13th and the end of the 20th week of pregnancy, are difficult to access in the public sector. This is mainly due to the lack of designated abortion facilities and the unavailability of abortion providers to provide the service and the Eastern Cape is no exception, writes Sibusisiwe Ndlela, Khanyisa Mapipa, and Thokozile Mtsolongo.
Women and girls seeking abortions are often forced to seek informal, illegal, and unsafe abortions as a result of various systemic barriers. Khanyisa Mapipa, Sibusisiwe Ndlela, and Thokozile Mtsolongo look at the state of abortion services in the public sector in the Eastern Cape.
On 17 February, Deputy Health Minister Dr Sibongiseni Dhlomo led a march against unsafe abortions in Rustenburg, North West, but a march alone cannot eliminate barriers that prevent women and girls from accessing safe abortions in the public health system. Much more is needed, argue Sibusiwe Ndlela, Khanyisa Mapipa and Thokozile Mtsolongo in an open letter.
Since the enactment of the Choice on Termination of Pregnancy Act (CTOP Act) in 1996, there has been a significant disconnect between the official policy on safe abortion and its implementation. The situation has worsened with the onset of the COVID-19 pandemic and access to abortion services is now severely limited, write Boitumelo Masipa and Thembi Mahlathi.
The new national clinical guidelines for the implementation of the Choice on Termination of Pregnancy Act serve as an opportunity to strengthen services in providing much-needed clarity and guidance to health workers. Marion Stevens and Nozizwe Conco unpack these guidelines on International Safe Abortion Day.
It is time to engage communities through community healthcare workers and to leverage COVID-19 innovations to advance the urgent need for high-quality, person-centred tuberculosis (TB) care for all, argue authors from leading TB advocacy organisation TB Proof.
Among several significant barriers to accessing abortion services, experts cite a lack of management support at health facilities, costs, fear of breach of confidentiality and stigma. Many of these barriers are compounded in rural areas. Tiyese Jeranji reports.
Abortion providers say self-managed abortions can give women more autonomy over their bodies, but access to this form of abortion remains limited in South Africa. Tiyese Jeranji looks at what exactly self-managed abortion entails.
With abortion services now available through telemedicine and the increasing practice of self-managed abortion, Marion Stevens asks if abortion law still has any relevance given these practices.
