Demand for medical abortion : a case study of university students in Durban, KwaZulu-Natal, South Africa.

Abstract

Abortion remains one of the most controversial sexual health topics and yet is a common experience for women around the world. Making sure that women are practicing safe abortions is integral to women’s sexual and reproductive health as well as their sexual rights. South Africa has one of the most progressive and liberal abortion laws in the world, yet women still face major barriers in accessing these services. Introducing medical abortion as another termination of pregnancy option could potentially save women’s lives, while reducing the number of unsafe abortions in South Africa. Medical abortion also contributes to fulfilling women’s sexual and reproductive rights, providing more choices to best suit their needs. In 2001, the South African Medicines Control Council (MCC) approved the use of mifepristone in conjunction with misoprostol for termination of pregnancy. Currently there is no formal national policy that allows for the provision of medical abortion in public health facilities, and the Department of Health is considering introducing it into the public sector. In order for any public health intervention to be successful it must be acceptable to potential clients and the context in which it is being implemented must be assessed. This study first looks at women’s attitudes toward abortion; following Eaton’s model of sexual behavior it examines the personal, proximal, and distal environments that influence reproductive decision-making, specifically regarding abortion. With this background information, the study then aims to assess women’s knowledge of medical abortion and whether or not they find it to be an acceptable method for the South African public health system and South African women. The findings suggest that there is a demand for medical abortion among this sample of women. The majority of women find medical abortion to be an acceptable method, and would choose it if they were ever faced with having to terminate a pregnancy. The overwhelming majority of women felt that medical abortion should be introduced into the public sector and efforts should be made to ensure that this method is affordable, accessible, and available for women in South Africa in order to expand their sexual and reproductive health rights.