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We enrolled women; Many women reported concerns about the affordability of raising a nother child Many had to pay for transportation, a pregnancy test, sanitary pads or pain medication.

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Although theoretically available free of charge in the public sector, women experienced challenges accessing abortion services and incurred costs which may have been burdensome given average local earnings. These potential barriers could be addressed by reducing the number of required visits and improving availability of pregnancy tests and supplies in public facilities.

Many women cited concerns about the affordability of having a nother child when requesting an abortion.

Although public services are technically free or low-cost in South Africa, women incurred costs for first-trimester abortions. Women's costs could be lowered by reducing facility visits and improving availability of pregnancy tests and supplies. Financial disclosure: The authors did not report any potential conflicts of interest. We use cookies to help provide and enhance our service and tailor content and ads. By continuing you agree to the use of cookies. The number of women interviewed at each facility was proportional to clinic size based on total patient load and varied from 11 to We interviewed consecutive women until the target sample size was reached.

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Semi-structured interviews were conducted in participants' home languages and lasted approximately 15 minutes. To assess knowledge of the abortion law, we asked the following key questions: 1 "Does the present law on abortion in South Africa allow for a woman to have an abortion? After responding to these questions, a description of legal abortion was then read to all participants and they were asked open ended questions about their attitudes towards legal abortion and their perceptions of its safety.

In the analysis, responses to open-ended questions were coded and collapsed into categories to facilitate quantitative assessment. A multiple logistic regression model was developed to examine how demographic and behavioral factors were associated with abortion knowledge. Variables were retained in the final model if they demonstrated a significant independent association with the outcome of interest, or if their removal altered the association between other covariates and the outcome of interest [ 8 ].

Abortion in South Africa - Wikipedia

All participants provided written informed consent and ethical approval to conduct the survey was granted by the Provincial Department of Health, the City of Cape Town Health Department, each participating clinic and the Research Ethics Committee of the University of Cape Town. The median age was 28 years and the median level of education was grade 10 Table 1.

Age, level of education and employment were not associated with knowledge of legal abortion in the bivariate analysis. In the multivariate analysis, characteristics independently associated with knowledge of legal abortion were: living in the urban vs. This is one of the few studies focusing on South African women's knowledge of the abortion law. These findings show that one-third of women surveyed do not know that abortion is legal in South Africa. Although this study used the same questions as the DHS, the DHS figures are not directly comparable to these findings due to different sampling methodologies: the DHS was a community-based sample of women and this study sampled women attending health services.

A comparison of these two sets of data suggests that more women know about legal abortion now than did in However, another explanation for this apparent difference in levels of knowledge is that this survey was conducted among individuals attending public health clinics, with greater access to health education. In general, it is likely that awareness of abortion legislation in this clinic-based sample in the Western Cape Province, which has a better reproductive health infrastructure than most other areas of the country, is higher than in the general population of South Africa.

Not only are an appreciable proportion of these women uninformed about the option of abortion in the case of unwanted pregnancy, they are also unable to protect themselves from unintended pregnancy in the first place. This study shows that lack of knowledge of legal abortion is associated with lack of other reproductive health knowledge, such as awareness of EC and contraceptive use. Furthermore, this study reveals tremendous variability from clinic to clinic in terms of women's knowledge of the abortion legislation. Reasons for this inter-clinic variability are poorly understood.

This is a key finding that requires further research so that the health services are able to appropriately target certain clinics and areas for intervention. Regardless of individual provider beliefs, relaying basic information on the legality of abortion may need to become part of routine reproductive health counseling.

It takes more than pro-choice laws to end deaths from unsafe abortions

In addition, community-based health information campaigns and school-based sex education and life skills programs should incorporate information on abortion services. Expanding access to information about abortion beyond the clinic setting is essential in that women who are at highest risk for unintended pregnancy and therefore for abortion — women who cannot or do not access family planning services — are unlikely to visit a healthcare provider who could discuss the law with them. Overall, these findings indicate that there is a substantial unmet need among women for information on abortion.

For the abortion legislation to fully contribute to improve health in South Africa, all South African women must know that abortion is a legal and accessible option in the case of unwanted pregnancy. S Afr Med J.

Additional information

Health Policy Plan. Health Systems Trust. Shocking abortion figures. Accessed July 5, Int J Obstet Gynecol. Reprod Health Matters.

Download references. We are grateful to our interviewers and our study coordinator, Regina Mlobeli. Correspondence to Chelsea Morroni. CM conceptualised and designed the study, oversaw data collection and data analysis, was primarily responsible for the interpretation of results and drafting the manuscript. LM participated in designing the study, conducted the data analysis and participated in the interpretation of results and drafting and critically reviewing the manuscript.

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