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Do 200,000 abortions – many a ‘repeat’ – take place in South Africa each year?

“More information” would help women seeking abortion services in South Africa to be “fully informed”, a parliamentarian seeking changes to the country’s abortion law argued in March 2018.

“With 200,000 abortions a year in South Africa – and many of these are repeat abortions; not a second, but a third, sometimes even a fourth – more information could help women make better choices re contraception and safer sex,” Cheryllyn Dudley told parliament’s portfolio committee on health.

Dudley is a member of the African Christian Democratic Party, which opposes public funding of abortion services. She sponsored the Choice on Termination of Pregnancy Amendment Bill.

Among the changes her bill proposed was compulsory counselling for women seeking abortion services and showing them ultrasound images of the foetus before the termination.

Current law allows for counselling, but it is not mandatory.

In May 2018 the portfolio committee rejected Dudley’s bill as “not desirable”. It said the changes would put abortion services out of the reach of those seeking them, and the proposed new services would be too expensive.

But does Dudley’s claim of 200,000 abortions a year stand up to scrutiny?

Number ‘a slight generalisation’

Dudley told Africa Check that although the figure was “a slight generalisation”, it was supported by data from the department of health.

Parliament “will now and then ask questions of the department and they usually give provincial [figures] so they are not probably extremely accurate, but it does give a ballpark”, she said.

Dudley shared the health minister’s official response to her August 2017 request for the latest provincial data on abortion. This showed 14,934 abortions recorded in South Africa in the three months from April to June 2017. But it did not give annual figures.

The MP also provided an academic article titled “Attitudes and intentions regarding abortion provision among medical school students in South Africa”.

Published in 2012, it notes that there are “approximately 200,000 total abortions” annually in South Africa. Africa Check reviewed the five sources cited, but none contained the figure. (Note: We have asked the article’s authors for the information and will update this report should we hear from them.)

Government ‘not familiar’ with Dudley’s number

The national department of health is “not familiar” with the 200,000 abortions figure, Foster Mohale, its director for communication, told Africa Check.

He provided a breakdown of pregnancy terminations by province in the last three financial years. This listed 88,807 abortions in 2014/15, another 83,707 in 2015/16 and 105,358 in 2016/17.

Pregnancy terminations in designated South African facilities
2014/2015 2015/2016 2016/2017
Eastern Cape 14,096 12,782 12,977
Free State 6,145 5,632 6,441
Gauteng 18,288 14,741 28,491
KwaZulu-Natal 9,564 12,300 15,714
Limpopo 8,378 9,565 10,845
Mpumalanga 2,405 1,806 3,724
Northern Cape 1,756 1,362 1,380
North West 8,186 6,531 6,235
Western Cape 19,989 18,988 19,551
Total 88,807 83,707 105,358

Source: National Department of Health

This information was collected using the department’s Web District Health Information System (or Web DHIS), Mohale said, and was grouped by “age category (10-14, 15-19, above 20 years) and trimester of the pregnancy”.

It was only captured from designated health facilities, which include approved private providers, he said. Provinces are by law responsible for approving these providers.

“Some of the conditions of certificate of operation include regular provision of termination statistics by the institution to the nearest district in which they operate.”

But Whitney Chinogwenya, the marketing and brand manager of private provider Marie Stopes South Africa, told Africa Check she “can’t actually say if we are included or not” as the department only reports totals.

“There isn’t a national guideline that is followed nationally,” she said.

What of the ‘repeat’ abortions claim?

Both Mohale and Chinogwenya said they couldn’t speak to the accuracy of the claim that many women have more than one abortion in a year.

“It is still a challenge to collect data on repeats; clients are not [necessarily] using the same facility,” Mohale said. “If a client aborted in facility A, for a repeat she will go to facility B as a new client.”

Chinogwenya said Marie Stopes’s data “does not track how many abortions a woman has had”. She added that “to give a figure on how many abortions were repeats is purely speculative”.

Prof Rachel Jewkes is head of research strategy for the South African Medical Research Council. She told Africa Check that, to her knowledge, “there has been no recent independent research” on terminations in undesignated facilities and women having more than one abortion.

Conclusion: No data backs up MP’s claim that 200,000 abortions, many a repeat, take place in SA annually

To convince South Africa’s parliament to change the law that guides the termination of pregnancies, a parliamentarian said that 200,000 abortions take place each year, many of them “repeats”.

But none of the data Cheryllyn Dudley shared with Africa Check supported this claim. Government data – to which designated private providers are supposed to contribute – showed there were about half this number in 2016/17.

Further, we could not find data on illegal abortions or for women who have had more than abortion. We therefore rate the claim as unproven.

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