In South Africa, approximately 500 000 abortions are performed each year, with over 50% of these being illegal, this according to research by the School of Public Health at the University of Witwatersrand.

Despite three decades of strong legal protections, illegal abortions disproportionately affect poor, rural, and immigrant women, as well as adolescent girls who face heightened stigma and confidentiality barriers.

The research indicates that facility-based stigma, resource constraints, insufficient provider training, and inconsistent application of conscientious objection provisions hinder equitable access to safe abortion services.

The Choice on Termination of Pregnancy Act of 1996 guarantees safe, legal abortions up to 12 weeks, and under specific conditions up to 20 weeks.

However, systemic barriers such as stigma, overcrowded clinics, lack of provider training, and poverty continue to push women into the hands of unregistered doctors and the dangerous use of pills sold through posters and social media.

Sister Malebeko Rantsho, owner of Karabo Clinic in Bloemfontein, a termination of pregnancy center that performs between 70 and 80 abortions per month, explains that the easy access to illegal facilities and abortion pills on social media is the root cause of the high number of illegal abortions.

Rantsho warns that these illegal pills can lead to fatal bleeding or permanent infertility.

“There are posters advertising these illegal abortions that provide young women easy access to these services and fake doctors, resulting in an increase in recorded illegal abortions.

“These illegal doctors give girls pills obtained from unregistered pharmacies, which sometimes do not work.

“They are highly dangerous, as women may bleed to death, she said.

Charmain Swart from the Pregnancy Crisis Centre in Bloemfontein says poverty and unemployment contribute to young women resorting to illegal abortions or abandoning their infants.

“The fear of parents and guardians plays a role, as young women are afraid to talk to them about an unexpected pregnancy,” she explains. “We need to educate parents to understand that an unexpected pregnancy is not the end of the world and that their children can still pursue their studies and have bright futures.

“Fear drives young women to take drastic measures, said Swart.

To combat this issue, the House of Hope Community Life Development Centre in Welkom has initiated the Baby Safe program, where women can safely surrender unplanned babies.

The baby box is in a discreet passageway with high walls, ensuring the privacy of women depositing their babies.

Centre manager, Tseleng Molefe, explains that once a baby is placed safely in the baby safe, the box locks automatically, and an alarm alerts ER24 and the care workers.

“The baby will then be placed in an exclusion room for a health examination by medical personnel, she said.

Molefe says, since its inception in 2021, the center has received up to ten babies through its door of hope.

“Previously, we would open a case of abandonment with the police, but they often cited insufficient information.

“Now we refer the matter to the Department of Social Development for a case to be opened.

“The box is not used as frequently as before, but we still hear about children being abandoned.

“Even though we strive to create awareness during our outreach in Thabong, we are told that abandoned foetuses and newborn babies are frequently found at dumping sites, Molefe said.

Spokesperson for the Free State Department of Social Development, Thembile Ngabeni, stated that the department offers free support services for unplanned pregnancies.

“We provide free social workers who can offer psychosocial support to women.

 “Communities can also play a role by being trained and screened as temporary safe care parents.

“They should be educated about reporting procedures and raised awareness of alternative care options for babies and children when parents are unable to care for them, Nqabeni said.