NEWS
MEDIA RELEASE ISSUED BY THE MEDICAL RESEARCH COUNCIL OF SOUTH AFRICA
30 September
Interventions to address the plight of women seeking abortions

Despite the termination of pregnancy or abortion legislation being relaxed in line with the new constitution, the South African health system is continuously failing to offer relief to women who need to perform abortions.

As a result some women die, or incur life-long ill health, and disability including infertility wrought by continued use of unsafe, backyard, or illegal termination of pregnancy services.

However, according to a review paper by Prof Jack Moodley, Director, Pregnancy Hypertension Unit at the Medical Research Council, a partnership between the society and the state could help in turning around this sad state of affairs.

Prof Moodley says “Unwanted pregnancies must be recognized as a specific health risk for women and their families. Besides unsafe abortions with resultant mortality and morbidity, unwanted pregnancies may also result in neglect or abandoned children and family violence.”

His study has again confirmed that even today women are still being denied access to termination of pregnancy services. Among others, hostile attitudes by health service providers citing moral reasons has inadvertently denied women control over their sexual and reproductive lives.

Other barriers identified by Prof Moodley and his team are ignorance of women of the law; acts of violence against clinics and physicians providing the service, inequitable distribution of medical personnel between urban and rural areas; failure of medical training programs to ensure that all health professionals in the relevant specialties are trained to perform abortions and that demands for abortions far outstrip the availability of services with hospitals facing staff cuts and beds.

In order to reverse this situation Prof Moodley has recommended that:

· Education of girls would raise the status of women. Women have to be educated about their rights under the Termination of Pregnancy (TOP) Act. Women’s awareness of their rights to legal recourse where information or access to services is denied has to be heightened. The state and other concerned organizations should make every effort to improve women’s rights, status, and health and should try to prevent unintended pregnancies by making available reliable information and services on family planning, and by developing more effective contraceptive methods. Education enhances the likelihood of appropriate employment opportunities and hence facilitates the empowerment of women. Parents need to be educated on the importance of communicating information on sexual matters to their children. Sex education must commence at home.

· Education of health professionals on the principles enshrined in the Constitution of the Republic of South Africa and access to TOP Act is necessary. It is an ethical imperative that health professionals are made aware of the limitation of their rights with respect to providing information and access to services. Health rights need to be made aware of competing rights of their patients and other health professionals who wish to provide TOP services, and the possibility of legal liability and disciplinary action by professional bodies where these rights are infringed. Education on ethical and legal issues concerning TOP s should be requisite of undergraduate curricula of doctors and midwives.

· Benefits of TOP services should be fairly distributed in society in keeping with principles of equity and distributive justice. Compensatory justice deems it necessary to ensure that the service is accessible, in particular to those who have been historically marginalized by poverty, previous racial classification, geographical location, age, literacy, employment status and other forms of dislocation; and this should be the responsibility of the state. The state has a positive obligation to implement the mechanisms to facilitate the progressive fulfillment of the demands of justice in health care and health service provision.

· A code of good practice should be introduced by the Department of Health to deal with some of the challenges to the implementation of the Act. The code should provide guidelines for health workers as to when they are required to perform terminations of pregnancy, set out information they must provide women who seek access to a termination and provide mechanisms to deal with grievances concerning obstruction of termination services and conscientious objection.

The World Health Organization estimates that about 75000 women die each year from complications following unsafe abortions. Unsafe abortion is, therefore, a leading cause of the almost 600 000 maternal deaths estimated to occur each year. Globally 1 in 8 pregnancy-related deaths, an estimated 13%, are due to an unsafe abortion.

Furthermore, WHO says that It is estimated that worldwide almost 20 million unsafe abortions take place each year. This is nearly one in ten pregnancies.

ENDS
For more information please contact Prof. Jack Moodley on (031) 260-4250/ 083-633-5616 or Mr. Vincent Moaga - MRC Media Relations on (031) 204-4700/082-827-9787

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