EC case study: How poor service in the public sector is pushing women to ‘backstreet’ abortion 

Women standing outside of a facility

In April 2022, *Grace Langa went to Frontier Hospital in Queenstown in the Eastern Cape for an abortion. 

“At first I went to the hospital on a Monday. I was told that they only perform abortions on Wednesdays. 

“I went there again on Wednesday but they said that I had to come back the following week as they only take 20 abortion patients a day,” she recalls.

Finally, Langa went back to the hospital the following week and got an ultrasound to see how far along her pregnancy was.   

“The scan showed that I was 12 weeks [three months] pregnant. They said I couldn’t get the procedure anymore because the foetus was already a human being,” she tells Health-e News

According to the Choice on Termination of Pregnancy Act women can still get an abortion after the 12th week of pregnancy. 

Sign of bigger problems

The social justice organisation, SECTION27, recently published a report looking at the state of abortion services in the Eastern Cape. Khanyisa Mapipa, who co-authored the report, says Langa’s story is not unique.  Women in need of abortion services in the province continue to be subjected to long waiting periods. This is especially the case for those in their second trimester (between four to six months or 13 to 26 weeks). 

SECTION27 has been monitoring access to abortion services around the province over the past four years. The report is based on  visits to 13 public health facilities between 17-27 May 2022. 

“What is happening in the Eastern Cape is a denial of abortion services. Some women are actually resorting to sleeping outside facilities, in hope that someone on the booking list for an abortion will cancel. Some go ‘backstreet’ for such services. The situation is not ideal and it is also inhumane,” she says.

This is what happened to Langa. In her most desperate moments she considered getting assistance from an unregistered abortion clinic in Queenstown. She says that she knew that the facility was unregistered when they could not provide her with the address of where they operate from.

Langa had made contact with the unregistered clinic using the cellphone number she found on a poster she came upon on her way back from Frontier Hospital. But she got scared and dropped the entire process.

Desperate and confused, Langa went home where she drank as much alcohol as she could to end the pregnancy. 

Phinah Kodisang, CEO of the Soul City Institute, a social justice organisation which advocates for the reproductive health of women, including access to safe abortion, explains that unsafe abortion exposes women to several health risks. 

“It is not safe, because whoever is doing such an abortion is not certified and we do not know what equipment they use and a lot of women end up in hospitals, either due to bleeding a lot or infections,” says Kodisang.

Limited abortion facilities 

“Our research has revealed that only two public health facilities in the Eastern Cape designated to offer second trimester abortion services are operational. This means that those in need eventually end up unable to access second trimester abortion services,” says Mapipa.

But Eastern Cape Department of Health spokesperson Mkhululi Ndamase refutes the findings shared by SECTION27. He says the province has 18 public health facilities that offer second trimester abortions – and they are all operational. 

Ndamase says that the department always encourages those who want to terminate their unwanted pregnancies to visit registered public or private facilities, instead of going to unregistered facilities. He says that the best way for women to access safe abortion services is to first visit their local clinics. From there, they will be referred to a hospital or healthcare centre that offers safe abortion services.

“The provincial department offers professional termination of unwanted pregnancies in safe and judgement-free zones. We are continuously improving and adding more facilities that offer the services,” says Ndamase.

Ndamase did not comment on Langa’s story of being denied access to abortion services. – Health-e News.

* Not her real name 


  • Ndivhuwo Mukwevho

    Ndivhuwo Mukwevho is citizen journalist who is based in the Vhembe District of Limpopo province. He joined OurHealth in 2015 and his interests lie in investigative journalism and reporting the untold stories of disadvantaged rural communities. Ndivhuwo holds a Bachelor of Arts degree in Media Studies from the University of Venda and he is currently a registered student with UNISA.

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