Data sharing is not applicable to this article as no new data were created or analysed in this study.
Access to sexual and reproductive healthcare is a constitutional right and on a broader perspective is part of the universal right to health. The Choice on Termination of Pregnancy (CTOP) Act of 1996 was a major step towards commitment to providing comprehensive sexual and reproductive health services in an equitable and rights-based approach. Despite abortion being legally available, unsafe abortion is still an avoidable factor of maternal deaths after more than two decades of abortion law reform in South Africa. The CTOP Act 92 of 1996, with its amendments, provides a legislative framework; however, more is needed to reaffirm the sexual and reproductive health freedom.
Keywords: abortion, amendment, counselling, CTOP Act, TOPSouth Africa remains committed to providing comprehensive sexual and reproductive health services in an equitable and rights-based approach. Access to sexual and reproductive healthcare is a constitutional right and on a broader perspective as part of the universal right to health. South Africa’s Choice on Termination of Pregnancy (CTOP) Act of 1996 was a major step towards achieving sexual and reproductive health freedom. 1,2 The Act serves as a global role model of reform in the area of abortion laws. South Africa is amongst the top-ranking countries with the most liberal laws on abortions.
The CTOP Act of 1996 is manifestly a radical change in the reproductive health sector in South Africa. The CTOP Act was passed in November 1996 and first came to effect in February 1997. It replaced the old law of Abortion and Sterilisation Act of 1975. 3 Following this act, abortion-related maternal morbidity and mortality decreased by a dramatic 91% between 1997 and 2002. 4,5 The 2004 and 2008 amendments reform of the CTOP Act of 1996 brought a further reduction in abortion-related maternal morbidity and mortality. 6,7
Unsafe abortion is a preventable phenomenon and continues to be a major public health problem. Despite abortion being legally available in South Africa after a change in legislation in 1996, barriers to accessing safe abortion services continue to exist. 8 According to the Saving mothers report, unsafe abortion is still an avoidable factor of maternal deaths after more than two decades of abortion law reform in South Africa. 9
Several studies that have highlighted the barriers to safe abortion in South Africa include provider-related factors such as stigma, provider opposition to abortion, limited knowledge of abortion legislation, unavailability of the services especially in rural areas and lack of technical skill amongst providers because of inadequate training. 10,11 When the legal abortion services are not assessible or available, women seek help outside the established legal health system, and that brought serious implications on women’s reproductive health and well-being. 12,13 The conceptual framework for women’s abortion-related healthcare needs is demonstrated in Figure 1 . The CTOP Act brought a significant improvement in sexual and reproductive health, but barriers to access the safe abortion are still an obstacle to the full benefits of abortion reforms in South Africa. 14,15