In South Africa the Choice on Termination of Pregnancy Act of 1996 permits access to safe and legal abortion services upon request during the first 12 weeks of gestation and can be performed by a registered nurse or midwife. After 12 weeks and up to 20 weeks gestation, a pregnancy can only be terminated under specific stipulations by a registered medical doctor. From 20 weeks gestation onwards, abortion is only available under exceptional and life-threatening circumstances and can only be performed by a registered medical doctor. In contrast to first-trimester abortion services, the availability of health facilities offering second-trimester abortion care is limited across South Africa. Second-trimester abortion services are also further challenged by the requirement for a medical doctor to perform them and access to safe second-trimester abortion remains a challenge for many seeking the service.
Since 2017, Ibis has collaborated with a group of reproductive health organisations, researchers, abortion providers, and Department of Health SRH coordinators from provincial and national levels in South Africa to build understanding of and improve access to quality second-trimester abortion services in South Africa. The Strengthening Second-Trimester Termination of Pregnancy Group - an initiative coordinated by Ibis - has identified critical gaps in the provision of second-trimester abortion services, including the need to conduct values clarification for action and transformation (VCAT) workshops in order to address stigma at facility level, to enhance focus on the training of providers, and to increase infrastructural support which would in turn bring in and maintain abortion providers. The Strengthening Second-Trimester Termination of Pregnancy Group is committed to establishing a platform for partners to convene and share knowledge, as well as to collaborate on the production of rigorous research and evidence-based interventions that strengthen and support second-trimester abortion services in the country.