Abortion Clinic in South Africa
Abortion is legal in South Africa, yet most pregnant people do not know that they are legally entitled to affordable abortion at Dr ss mateza Clinic
Do you know your rights when it comes to abortions?
Did you know
That reproductive rights are human rights?
That the decision to have children resides with the person who is able to fall pregnant?
That universal access to reproductive health care services includes contraception, termination of pregnancy, sexuality education and counselling services?
That all those able to fall pregnant have the right to be informed of and to have access to safe, effective, affordable and acceptable methods of fertility regulation of their choice?
That those able to fall pregnant have the right to access appropriate health care services and the state has the responsibility to provide reproductive health to all?
That the state also has the responsibility to provide safe conditions under which the right of choice can be exercised without fear of harm or stigma?
South African law says
All pregnant people have the right to access safe and legal abortions, for free at a government hospital or clinic, during the first 3 months of pregnancy. Before the end of the first 3 months of pregnancy, an abortion can be carried out by a doctor or a trained registered nurse or midwife, therefore making an abortion more accessible earlier in the pregnancy.
Health workers CANNOT refuse to perform an abortion because of
Your age: If you are under 18, you can ask a trusted adult for support or to accompany you while you have the abortion, only if you want to. No one, including your parents, has the right to say you cannot have the abortion if you want it.
What your spouse or partner says.
Any other reason not related to your physical health, such as your choice of work, your relationship status, or your immigration status.
Did you know?
There is no limit on the number of abortions that you are allowed to have under South African Law!
Where can you have an abortion in South Africa?
You may choose to visit a clinic or prefer to self-manage your abortion at home using medication. Self-management at home is possible if your pregnancy is less than 10 weeks.
If you choose at-home abortion, you can do an online consultation with Abortion Support South Africa. Visit www.drcynthiaabortionclinic.com to answer questions about your pregnancy and medical history. A partner doctor will review your information and, if you are medically eligible for at-home abortion, the doctor will prescribe abortion medication (mifepristone and misoprostol, or misoprostol alone). You can collect your medicines at a pharmacy that is convenient for you. You will be provided with instructions on how to safely self-manage your abortion at home and what to do in the rare case of complication.
If you decide to have an abortion at a clinic, you can use the WheretoCare map here to locate a nearby public or private abortion clinic. This is a data free map if used on your mobile phone. Please turn on your mobile data service and allow location permission when asked so that the map can show clinics near you.
Please keep in mind that this map does not include all abortion clinics so there may be a clinic near to you that is not listed. You can always visit your closest clinic to check if they offer abortion or ask for a referral to the closest clinic that does provide abortion services.
Types of abortion
There are two types of abortion procedures: medical and surgical abortion
There are two types of abortion procedures: medical and surgical abortion. Medica abortion is when you take tablets to have an abortion. A surgical abortion is when you have a surgical procedure to remove the contents of your womb. For each person, the preferred or most effective method for abortion will be different, depending on a range of circumstances, including your stage of pregnancy.
Medical abortion
In South Africa, medical abortion is generally available up until 10 weeks after your last period. In some settings, doctors provide medical abortions until 13 weeks, or even up until 18 weeks after your last period, depending on different provincial and hospital protocols.
How does medical abortion work?
Medical abortion requires the use of two drugs: mifepristone and misoprostol. Mifepristone is an antiprogestin taken orally. It blocks receptors of the hormone progesterone. As a result, the lining of the uterus can no longer sustain the growing embryo. The drug also increases prostaglandin levels and dilates the cervix, facilitating abortion. Misoprostol is a prostaglandin analog that is marketed worldwide in over 60 countries for treatment and prevention of gastric ulcers. It is widely used “off-label” for a number of reproductive health indications.
One tablet of mifepristone is swallowed first, causing the embryo to stop growing. Two days later, you take misoprostol, causing contractions of the uterus and expelling its contents. The timing, dose, and route of administration of misoprostol often vary slightly. Studies have shown that these drugs effectively terminate more than 9 out of 10 pregnancies in the early first trimester.
The drugs that induce medical abortions cause birth defects. A person who takes these drugs must be prepared to have a surgical abortion if the medical abortion is unsuccessful. A follow-up exam is done one or two weeks after to make sure that the abortion has been effective.
You should not have a medical abortion if:
You have an Ectopic pregnancy (a pregnancy which lies outside the uterus)
Your adrenal glands do not function normally
You are on long-term corticosteriods (eg. for the long – term treatment of asthma), you are taking blood-thinning medication, or have a history of a bleeding disorder.
You are allergic to any of the components of the medication.
You have severe, uncontrolled asthma.
You have a disease called porphyria.
You have an intra-uterine contraceptive device (IUCD) in your uterus
You have serious cardiovascular problems or severe high blood pressure
You cannot return for a follow-up visit to the clinic 14 days after the medical abortion has taken place
You cannot get to an emergency medical clinic / hospital during the treatment (in case of emergency)
How safe is a Medical Abortion?
Medical abortion is extremely safe. The medicines used in medical abortions have been widely studied and have been used by millions of pregnant people in other countries for the past ten years. The South African Medicines Control Council also approves them. Of every 100 pregnant people who have a medical abortion, 1 will have very heavy bleeding that does not stop and requires a surgical abortion.
Is a medical abortion always effective?
Medical abortion is successful in about 95% of cases. This means that out of every 100 pregnant people taking both of the medicines for a medical abortion, about 5 will not have a complete abortion. In this case, a surgical abortion will need to be done to complete the process. Surgical abortion usually involves removing the pregnancy by suction. Once a medical abortion has started, it needs to be completed, because of the damage to the foetus.
What happens during a medical abortion?
Step 1: At the clinic
When you come to the clinic, the doctor or nurse will explain the process and answer questions. After your medical history has been reviewed and you have been examined, and a pregnancy test and a sonar has been performed, you will be given the first medicine to be swallowed at the clinic. You may experience some cramps and bleeding in the days after taking the first medicine, but very few people will have a complete abortion before taking the second medicine.
Step 2: Two days later, at home
Unless the doctor or nurse says that the abortion is complete, two days after your visit to the clinic, you will place 2 to 4 tablets of the second medicine under your tongue at home. This is usually done in the morning before you have had anything to eat or drink. Within two hours, you can have breakfast and something to drink. You should then take pain medication, because you will probably start to experience strong cramps and bleeding. The bleeding can be heavier than an ordinary period.
You can expect to bleed or spot for about two weeks after taking the tables. You may also see blood clots and tissue coming from the uterus. This is an expected part of ending the pregnancy. The heaviest bleeding will happen while the abortion occurs, usually within the first 6 hours after taking the second medicine.
Step 3: 10-14 days later, follow-up visit to the clinic
The medicine causes bleeding and cramping. These symptoms mean that the treatment is working. However, sometimes you can get cramping and bleeding and still be pregnant. This is why it is very important to return to the clinic 10 – 14 days after taking the first medicine to make sure that the pregnancy has ended. If you are still pregnant after taking the medicine, you will have a surgical procedure to end the process.
What are the possible side effects of a medical abortion?
Bleeding and cramping are a normal part of the process and show that the medicines are working. Cramps generally last a few days. Bleeding is heavier at first but some bleeding or spotting may continue for as long as 12 days.
You may also experience some nausea, vomiting and diarrhoea on the days that you take the medicines.
Occasionally, some people also experience headaches, dizziness, chills or fever. These symptoms usually last a short time and can be reduced by taking pain medicines or anti-nausea medicines.
Can I go to work after taking the medicine? How should I prepare for taking the second set of tablets?
On the day you take the second set of tablets, it would be best for you to take the day off if you can. Let your work know you will be taking sick leave that day. Ideally, prepare to make sure you are in a safe place on the day you take the second set of tablets, close to a flushing toilet and your comforts. In preparation, make sure you have stocked up on sanitary pads, and have with you anything that makes you feel comforted, such as a hot water bottle, your favourite snacks, and pain medication. You should expel the foetal sac that day. Snuggle in bed with a hot water bottle, take your pain medication, and change your pad regularly.
The following day you can go back to work, but do continue to care for yourself, changing your pads, and taking pain medication if needed.
What to expect
Now that you’ve been referred to a safe and legal abortion clinic and have booked your appointment, you might be feeling nervous and not sure of what to do.
Here are some tips on what to expect and what to prepare
On your first visit to the clinic, you can expect to be told what method of abortion will be used, why and what side-effects you may feel afterwards. If you are late and you need to have the procedure before the next cut off of either 12 weeks or 20 weeks, you may be required to have the procedure on the day you are at the clinic.
Make sure to bring your favourite fluids (a drink or tea in a flask), hot water bottle, extra supplies of Brufen, and some snacks.
Silence bugging you in the waiting room? If you have music on your phone and your earphones ready, play all the music that relaxes you.
If you have a trusted friend or family member, ask them to join you as support! If you prefer to do it alone, that is also okay. You are not alone in spirit!
Pain relief
Some people experience pain and discomfort after an abortion. This is totally normal and, in most cases, nothing to worry about. There are various pain relief options for different methods and stages of pregnancy available.
For many, medical abortion is viewed as possibly more painful, but it is important to remember that everybody is different and that this may not be the case for all. You should be given Brufen 2 hours or so after the second set of medicines (Misoprostol). Paracetomol is not likely to be effective. If you are allergic to Brufen, there are other prescription pain drugs (Analgesia). Please ask your health provider.
It is important to address possible pain and cramps to ensure that you are relaxed, so you can release the fetial sac. Following this, the pains are moderate and similar to a painful period.
Bleeding during a medical abortion
Are you scared of what might happen after you have a medical abortion?
Bleeding is often the first sign that the abortion has begun. As the abortion continues, bleeding and cramps may become more severe. Bleeding as part of an abortion is often heavier than a normal menstruation, and there can be clots. The longer the pregnancy has developed, the heavier the cramps and the bleeding will be. If the abortion is complete, the bleeding and the cramps diminish. When you notice a peak of heavier blood loss and experience more pain and cramps, this could be a sign that most of the abortion has passed.
The heaviest bleeding typically occurs 2-5 hours after using misoprostol and usually slows down within 24 hours. The most intense cramping and bleeding generally lasts for 3-5 hours, but this is just a guide, and in fact, it can last for less or more time. Some people bleed heavily for up to 48 hours and may pass clots, days or even weeks after taking the Misoprostol. This is common and is not dangerous, unless you soak through more than two maxi pads per hour for 2 hours or more, or when you lose heavy clots bigger than an orange. It is normal for your body to take time to empty the uterus completely. Every person’s body is different. Normally, the bleeding will continue lightly for one to three weeks after the abortion, but times may vary. The normal menstrual period usually returns after four to six weeks.
Emotions
In 1995, Professor Eleanor Nash from the Psychiatry Department at the University of Cape Town, shared her research in Parliament regarding the emotional impact and after-effects of abortion. She noted that the most overwhelming emotion following an abortion is that of relief.
The most reliable indicator of whether someone will experience feelings of distress after an abortion is their emotional stability before the abortion. Choosing to have an abortion is an important decision. The decision-making process may be stressful, even if the outcome is ultimately positive.
