Only 7% of health facilities provide abortion services, while some 50% of abortions take place outside the formal health setting
indicated unsafe abortion as an avoidable factor in 25% of maternal deaths due to miscarriage. Maternal mortality due to abortion-related complications in South Africa is probably underreported due to an overlap in how causes of maternal death are classified.
This indicated a substantial strain on South African public hospitals. Currently, researchers at the University of the Witwatersrand are repeating this study to quantify the burden of admissions from incomplete abortions. These comprehensive guidelines address the option of medical abortion with pills. They also address two additional areas that have needed urgent attention to address the lack of access to abortion services – obstructing access and counselling.One challenge to implementation has been the obstruction of access to services for those seeking abortion care. The guidelines provide a practical remedy for this and those who are refused access can report those who obstruct their right to access.
A register of TOP services refused should be kept in each facility, noting the clinical details of the individual, the referral process and the name of the clinician who refused services. In South Africa, those who refuse to provide TOPs do so in terms of section 15 of the Constitution, which guarantees the right to freedom of conscience, religion, thought, belief and opinion. But the term “conscientious objector” has recently been co-opted by anti-choice movements to refer to healthcare providers who refuse to provide abortions.
Findings of an investigation by Open Democracy, published in February last year, showed there was a grouping with US funding and links with some established networks already in the country.
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