Unsafe abortions still killing Africa's women

To celebrate International Women’s Day on Thursday, Ipas, an NGO promoting women’s health around the world, is holding a seminar in Rosebank, Johannesburg, where leaders in the field will analyse progress made in the promotion of women’s health in South Africa and on the continent. 

With 4,2-million unsafe abortions performed each year in Africa, from which 30 000 women die, much work remains to be done. Nonetheless, the South African country director of Ipas, Mosotho Gabriel, is positive about past achievements and the outlook on the future.

What are unsafe abortions exactly?

The definition of an unsafe abortion is an abortion performed by an untrained health provider and/or in unhygienic conditions. In our work, we know that when a woman is pregnant and she doesn’t want it, she will decide to get rid of it. So when there is no legal way, she will find other ways. Frequently these are unhygienic and unprofessional, which can result in infertility, blocking of the tubes, other chronic disease and even death.

How many South African women have abortions each year?

There are 50 000 (on average) legal abortions in South Africa each year. The statistics are collected by the national Department of Health.

How is the situation regarding safe access to termination of pregnancy in other countries?

There are some countries which have liberal laws concerning the rights of women, like Zambia, Ghana and Tunisia. However, the problem is that governments do not implement the law, or the implementation process proceeds very slowly.

Consequently, also in these countries the situation for women remains unchanged. Women still get chronically ill, or die. There is a lot to be done to improve the rights of women concerning safe access to the termination of pregnancy in the rest of Africa.

What role can South Africa play regarding the rest of Africa?

South Africa is a model for the rest of the African continent for many reasons. First, the language of the CTOP [Choice of Termination of Pregnancy] Act is based on principles of internationally recognised human rights as well as public health.

Second, South Africa has implemented the law on a national scale in a rapid manner. And, third, we have excellent monitoring data that clearly show that the law, coupled with rapid implementation, has resulted in the saving of lives.

Given the toll of maternal deaths in the rest of the continent, other African countries would be wise to learn from this experience.

The CTOP Act is active for 10 years now. What has been achieved so far?

South Africa has reduced the rate of abortion-related deaths among woman by 90% since the CTOP Act was implemented 10 years ago. Also, there has been a decline of 50% in the number of women coming to hospitals very ill due to unsafe abortions. These figures were retrieved from a comparison between 1994 and 2000 studies of unsafe abortions.

What are the main obstacles you encounter doing your job in South Africa and Africa as a whole?

There are still great disparities between the availability and quality of services in more developed provinces and those in poorer, rural provinces. Also, healthcare facilities throughout the country do not have sufficient staff, training and equipment to meet the need for abortion care.

Therefore, Ipas South Africa focuses on training and equipping public- and private-sector providers in order to expand the number of sites in targeted provinces that provide safe, woman-centred care.

Also, there are ongoing challenges to the CTOP Act that are being posed by the anti-choice movement. South Africans need to be aware that this movement is not only opposed to abortion, but is also a danger to women’s rights and health. In the African context, where women literally die due to a denial of our fundamental rights, the anti-choice movement must be rejected.

What are the prospects for women in need of an abortion in the poorer and more rural areas of South Africa?

We need to reach them and educate them. Especially because in the more rural and black parts of South Africa they have a culture wherein it is a taboo to talk about sex and related topics.

Therefore, Ipas is working with community-based organisations that work with the women on the ground. The workers have the same cultural background as the women with whom they are working.

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