South Africa’s progressive Choice on Termination of Pregnancy Act (No. 92
of 1996), which permits abortion at the request of a pregnant person in the
first trimester, was hailed as transformative in terms of reproductive health
and rights. Despite this promise, many challenges persist resulting in a lack
of services, especially in rural areas where distances and transport costs are
a factor.
Accessing abortion services in rural areas under conditions of liberal
abortion legislation is neither straightforward nor simple. As the South
African example shows, the liberalisation of abortion legislation was the first
step in granting pregnant persons access to abortion care. Despite this and
some progress in implementation, many challenges persist resulting in a lack
of services, especially in areas where distances and transport costs are a
factor.
Drawing on the findings of a study conducted in three rural districts of the
Eastern Cape, the authors highlight the complexities involved in
understanding problematic or unwanted pregnancies and abortion legislation within these communities; the reported barriers to, and facilitators of, access
to abortion services among rural populations; and preferences for types of
abortion services.
A key finding is the conundrum of costs versus confidentiality: lack of
confidentiality involves additional costs to access services outside the area;
high costs mean that confidentiality may have to be foregone, which leads to
stigma. The authors place the findings within a reparative reproductive
justice framework and present a comprehensive set of recommendations.
Abortion Services and Reproductive Justice in Rural South Africa is an
insightful and informative resource – the first of its kind –for scholars in
health and sociology, health anthropology, health psychology, health
sociology and social work, reproductive health policy makers, national
planners, health facility managers and providers, and activists.
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