What women in South Africa need to know about the costs of an abortion

When deciding which abortion method to choose, cost can play a large role in the process. This blog highlights the range in pricing for abortion services in the Southern Africa region.

By Belinda Munyeza.

Abortion costs (as well as accessibility to information about them) vary across Africa depending on the region and the legal restrictions set in place. In Southern Africa—South Africa, Namibia, Botswana, Zimbabwe, Mozambique, Zambia, and Angola—legal medical and in-clinic abortions cost between US$20 and US$380. Illegal procedures cost much less to perform initially but frequently have unfavorable health consequences that end up costing much more to resolve.

In the countries where abortion laws are more liberal, the cost of a legal abortion tends to be on the lower end of the spectrum; however, while termination is permitted in every Southern African country (except Angola), it is only permitted without strict restrictions (except for gestational-age limits) in South Africa.

Cost of Abortion by Country

In South Africa, a 2017 study by PlOS ONE found that the average cost for a first-trimester medical abortion, which is the most popular method chosen by women, was US$63.91 . In-clinic abortions, on the other hand, were reported to have an average cost of US$69.60. A 2018 study, also conducted by PlOS ONE, found that on average, the cost of a second-trimester medical abortion ranged between US$298.03 and US$375.31, depending on the method chosen. In-clinic abortions had an average cost of US$91.17.

A 2019 News24 article, however, reported that prices at Marie Stopes (an organization that provides abortion services and information) started at R800, which would presently be US$48.31. It seems that abortion prices in the country vary significantly depending on the facility providing the abortion services, as well as the gestation of the pregnancy. This variation in costs can be dangerous. In fact, according to the International Women’s Health Coalition, South Africa has faced numerous situations where unskilled practitioners, claiming to be qualified, have performed termination procedures for as little as US$6.50. These procedures are not advised as their methods often lead to health complications; however, because many women are not aware of where to acquire accurate information on safe abortion services, they opt for these procedures.

Because of the liberal abortion laws in South Africa, services and accurate information can be accessed easily if you know where to look. Marie Stopes is a trusted organization that provides information on abortion costs that are specific to its different centers across South Africa. The Marie Stopes website contains all of these resources.

In Namibia, information about termination costs is much less accessible. The strict laws and social stigma around termination have resulted in a scarcity of internet resources with detailed information about abortion costs. The cost of a medical abortion can be anywhere between US$20 and US$60, according to How To Use, a Women First Digital platform, while surgical abortions vary more, depending on the institution providing the service.

As Namibian law has strict stipulations on who can provide and receive abortion services, the safest way to receive accurate information would be to contact a facility, such as the Namibian Planned Parenthood Association (NAPPA), or visit safe2choose and speak to one of our counselors. We offer referrals and information for those seeking safe abortions, wherever they are. NAPPA provides center-specific information through its website. Otherwise, outside of these organizational channels, legal termination information online can be quite inconclusive.

In Botswana and Zambia, How To Use reports that a medical abortion normally costs between US$20 and US$60, while the cost of a surgical abortion depends on the provider. A 2018 study by PLOS ONE reported that post-surgical abortion care in Botswana costs, on average, US$83. However, this information pertains to care provided to women after receiving an illegal abortion.

Like Namibia, information on abortion in Botswana is hard to come by because of strict restrictions on who can access and receive abortions. However, the Botswana Family Welfare Association (BOFWA) website provides further information on the legal abortion services available in the country.

In Zambia, post-abortion care costs, on average, US$81, according to a 2018 study in the Research Health Master journal. The Planned Parenthood Association of Zambia (PPAZ) provides information, contacts, and resources on safe termination through its website.

At the higher end of the cost spectrum, a 2012 Pambazuka News article reported that legal abortions in Zimbabwe can cost up to US$350 (12). Aside from the cost being high and the laws around abortion being very strict, termination is also heavily stigmatized in the country. These factors have resulted in unsafe abortions becoming very common. Up to 70,000 are performed every year and many are performed by unskilled practitioners, resulting in health complications.

Nevertheless, there is still accessible information for those seeking legal and safe terminations within the country. Marie Stopes International provides abortion services in Zimbabwe and information on the procedures and costs can be found on their website. Our counselors also have information on abortion providers in Zimbabwe and can be contacted through live chat at safe2choose.org

In Mozambique, The Associação Moçambicana para Desenvolvimento da Família (AMODEFA) was established in the 1980s for the provision of family planning and reproductive and sexual health services. The organization provides information on the costs and procedures available for termination in the country through its website.

In Angola, abortion is not legal under any conditions. There is still a strong stigma around termination; however, according to a 2018 Elsevier journal study, this stigma has not stopped abortions from occurring; rather, it has led to procedures remaining unsafe.

Overall, abortion is still strongly stigmatized in all of Southern Africa. This has resulted in the most accessible resources usually being legally and medically risky for women. Regardless, there are organizations women can turn to that are working within the regions to make sure that safe procedures are available.

 


Sources:

[1] “Abortion in Africa Fact Sheet.” Guttmacher Institute, 2018, www.guttmacher.org/sites/default/files/factsheet/ib_aww-africa.pdf. Accessed December 2020.

[1] Lince-Deroche, N, et al. “The costs and cost effectiveness of providing first-trimester, medical and surgical safe abortion services in KwaZulu-Natal Province, South Africa.” PLOS ONE, 2017, doi.org/10.1371/journal.pone.0174615. Accessed December 2020.

[1] Lince-Deroche, N, et al. “The costs and cost effectiveness of providing second-trimester medical and surgical safe abortion services in Western Cape Province, South Africa.” PLOS ONE, 2018, doi.org/10.1371/journal.pone.0197485. Accessed December 2020.

[1] “Everything you need to know about safe abortions in South Africa in 2020.” News24, 2019, www.news24.com/parent/fertility/faqs/everything-you-need-to-know-about-safe-abortions-in-south-africa-in-2019-20191210. Accessed December 2020.

[1] “The High Cost of Legal Abortion in South Africa.” International Women’s Health Coalition, 2016, iwhc.org/2016/07/high-cost-legal-abortion-south-africa/. Accessed December 2020.

[1] “Women’s clinic near me.” Marie Stopes South Africa, mariestopes.org.za/our-centres/. Accessed December 2020.