Abortion in South Africa – legal but inaccessible Nomtika Mjwana and Marion Stevens Sexual and Reproductive Justice Coalition

Abortion Abortion always legal but inaccessible – Roman Dutch Law, Abortion and Sterilization Act (Approx 1000 generally white woman got access – suicide or rape, Black women died – 429 deaths annually) Abortion liberalised in 1996 – CTOPA (2004 – Trained nurses alongside midwives and address illegal providers) Abortion on demand 12 weeks. (70% of first trimester abortions provided by midwives and nurses) After 12 weeks Doctor to provide (Resourced W Cape, only three providers in the public sector) 20 weeks health of woman or fetus (one or two providers in the country) Important to consider in relation to African Decriminalisation Campaign – Decriminalisation is just one step

Abortion Medical abortion guidelines only in W Cape Mifepristone not on EDL 40% or less of surgical services operational nationally 17% second trimester abortions in W Cape started informal provider 50% of abortions provided by informal provider (not legal and could be safe or unsafe) Poor data collection on what is provided – do not disaggregate medical or surgical options NDOH does not provide information regarding designated facilities, what to expect eg. Pain, bleeding or what to do Maternal mortality in SA recent data HIV 34% and unsafe abortion 9.5%. Has increased since decrease in designated facilities. NDOH has changed recording of deaths – thought that a woman dying of unsafe abortion who is HIV positive is recorded as an HIV death

Medical students believe opt out, Health workers (Doctors and Nurses) do not refer – despite law to address conscientious objection Services uneven – main teaching hospital in Johannesburg attached to University of Witwatersrand has stopped services this month as *gap* in service providers Deaths from unsafe abortion - https://awethu.amandla.mobi/petitions/reproductive-justice-now End Abortion Stigma Initiative (28 September 2015) https://www.facebook.com/endabortionstigmasa/

Conclusion Legal but inaccessible Little political will and accountability – legal but inaccessible Extremely stigmatised SRJC only SA women’s health organisation addressing abortion – greater focus on single issues eg HIV, Queer issues etc. Limited funding – challenges of US private and public foundations Many groups deal with identity or vertical issues eg. Queer issues or HIV Black women still die from unsafe abortions in SA in 2016

Thank you @_srjc https://www.facebook.com/srjcza https://www.srjc.org.za