A clear, compassionate guide to your safe abortion options in South Africa
Facing an unplanned or unwanted pregnancy is one of the most personal experiences a woman can go through. At Marie Stopes South Africa, we believe that every woman deserves accurate information, non-judgmental care, and the freedom to make the choice that is right for her, on her own terms.
If you’ve decided to have a safe abortion, your next step is understanding your options. In South Africa, there are two medically approved abortion methods: a medical abortion and a surgical abortion. Both are safe, effective, and legal. The right option for you will depend on how far along your pregnancy is, your health, your lifestyle, and your personal preferences.
This guide explains both procedures clearly so you can walk into your consultation feeling informed and empowered.
First: Know Your Rights
Before we explore the two types of abortion, it’s worth knowing where you stand legally. Under the Choice on Termination of Pregnancy Act, abortion is legal in South Africa up to 20 weeks of pregnancy. If you are less than 12 weeks pregnant, you have the right to request a safe abortion without needing to provide any reason. After 12 weeks, a doctor must confirm that specific criteria are met.
The most important thing to remember: you have a right to safe, legal abortion care. Do not use unverified abortion pills ordered online or services advertised on street poles – these are illegal and potentially life-threatening. Always access abortion services through a certified provider like Marie Stopes South Africa.
What is a Medical Abortion?
A medical abortion – sometimes called an abortion pill – uses medication to end a pregnancy. It does not involve any surgical instruments or procedures. At Marie Stopes South Africa, a medical abortion is available for pregnancies up to 9 weeks from the first day of your last menstrual period.
How does it work?
A medical abortion uses a combination of two medications:
Mifepristone: This is the first pill, taken at the clinic. It blocks progesterone – the hormone your body needs to sustain a pregnancy. Without it, the pregnancy cannot continue.
Misoprostol: Taken 24 to 48 hours after the first pill, this medication causes the uterus to contract and expel the pregnancy. This part of the process takes place at home.
After taking the medication, you will experience cramping and bleeding – similar to a heavy period – as your body passes the pregnancy. This process is complete within a few hours to a couple of days for most women.
What are the benefits of a medical abortion?
- No surgical instruments or anaesthesia required
- The process is completed in the privacy of your own home
- Feels more ‘natural’, similar to a miscarriage
- Available via telemedicine for women in remote areas
- Can be the right choice for women who prefer a non-invasive option
What should I expect?
Most women experience cramping, bleeding, and the passage of clots. Some may feel nausea, vomiting, or diarrhoea. These side effects are normal and are caused by the medication. Pain relief is usually recommended, and our medical team will advise you on what to take.
A follow-up appointment or remote check-in is important to confirm the abortion is complete. In rare cases (about 2–5%), a second round of medication or a follow-up procedure may be needed.
Important note on breastfeeding:
If you are currently breastfeeding, you will need to pause breastfeeding during a medical abortion, as the medication can pass into breast milk. A surgical abortion may be a better option in this case – speak to our team for personalised guidance.
A New Way to Access Medical Abortion: Telemedicine
You no longer need to visit a clinic to access a safe, legal medical abortion. Marie Stopes South Africa offers a telemedicine abortion service – a discreet, professional consultation by phone or online, followed by your abortion medication being delivered directly to your door.
This service has been a life-changing development for many South African women, particularly those who:
- Live far from a Marie Stopes centre or in a rural or remote area
- Have limited transport or cannot easily take time off work
- Want complete privacy and prefer to manage the process from home
- Feel anxious about visiting a clinic in person
How does the telemedicine process work?
The process is straightforward and fully confidential:
- Book your consultation – Contact Marie Stopes via phone or our website for your telephonic appointment.
- Speak to a qualified nurse or doctor – During your consultation, a healthcare professional will confirm your gestational age, review your medical history, and ensure a medical abortion is the right and safe option for you.
- Receive your medication – If appropriate, your abortion tablets will be discreetly packaged and delivered to your chosen address.
- Take your medication at home – Your nurse will guide you through exactly what to expect, what to take for pain, and what signs to watch for.
- Follow-up check-in – After completing the process, you’ll have a follow-up call to confirm everything went as expected and that you’re recovering well.
Is it safe?
Yes – when accessed through a registered provider like Marie Stopes South Africa, telemedicine abortion is a safe and clinically sound option. The medications used are approved by the South African Health Products Regulatory Authority (SAHPRA) and are on the World Health Organization’s list of essential medicines.
Please note: telemedicine is only suitable for pregnancies up to 9 weeks. If you are unsure of your gestational age, our team can advise you on how to confirm this before your consultation.
What is a Surgical Abortion?
A surgical abortion is a safe, minor in-clinic procedure performed by a trained nurse or doctor to remove the contents of the uterus. It is the most common abortion method used globally, and it is performed at Marie Stopes South Africa centres by compassionate, experienced medical professionals.
Surgical abortion can be performed from early pregnancy up to 20 weeks of gestation, making it the only option available to women who are more than 9 weeks pregnant.
How does it work?
The most common surgical abortion method is Manual Vacuum Aspiration (MVA) or Electric Vacuum Aspiration (EVA), which uses gentle suction to empty the uterus. In later-stage pregnancies (second trimester), a Dilation and Evacuation (D&E) procedure is performed, which is more involved and requires a doctor.
The procedure is typically performed under conscious sedation (a light sleep-like state) or a local anaesthetic, meaning you are comfortable and feel minimal pain. The procedure itself usually takes between 5 and 15 minutes. Most women go home the same day.
What are the benefits of a surgical abortion?
- Single in-clinic visit – it’s over quickly
- Very high success rate with low complication rates, especially in the first trimester
- Medical staff present throughout for immediate care and support
- Available throughout all trimesters (up to 20 weeks)
- Suitable for breastfeeding women
- Contraception can be started on the same day as the procedure
What should I expect?
After the procedure, you may experience some cramping, light bleeding, and emotional feelings – all completely normal. You will rest in the recovery area for a short while before being discharged. Our team will provide you with aftercare instructions and support.
A follow-up appointment is recommended to make sure you are healing well and to discuss ongoing contraception if needed.
Medical vs. Surgical Abortion: A Quick Comparison
Gestational limit: Medical abortion is available up to 9 weeks. Surgical abortion is available up to 20 weeks.
Where it happens: Medical abortion is partly at the clinic and partly at home. A surgical abortion takes place entirely at the clinic.
How long it takes: A medical abortion unfolds over 1–3 days. A surgical abortion is a same-day procedure, typically 5–15 minutes.
Pain/discomfort: Medical abortion involves cramping similar to a heavy period. Surgical abortion is performed under sedation or local anaesthetic for your comfort.
Success rate: Both methods have high success rates. Surgical abortion has a slightly lower risk of needing a repeat procedure.
Breastfeeding: Medical abortion requires a pause in breastfeeding. Surgical abortion is safe for breastfeeding mothers.
Privacy: Medical abortion can be completed at home with greater privacy. Surgical abortion requires a clinic visit.
Which Option is Right for You?
There is no single ‘best’ abortion method, only what is safest and most suitable for you. Your decision will be guided by:
- How many weeks pregnant you are
- Your personal comfort with each process
- Your health history and any medical conditions
- Whether you are breastfeeding
- How much privacy you need
- Whether you prefer to be at home or have clinic support throughout
Our nurses and doctors at Marie Stopes South Africa will always discuss both options with you honestly and without judgement. We will never pressure you or try to change your decision. Our only goal is to ensure you receive the safest, most appropriate care for your individual circumstances.
Post-Abortion Care: What Comes Next
Regardless of which method you choose, taking care of yourself after an abortion is important. You may experience a range of physical and emotional responses in the days and weeks that follow, and all of them are valid.
At Marie Stopes, we offer:
- Post-abortion contraception counselling and same-day contraceptive options, including the pill, injectable contraceptives, or an IUD
- Follow-up care to confirm the procedure is complete
- Emotional support and referrals to counselling if needed
Your fertility returns quickly after an abortion – often within weeks – so starting contraception promptly is important if you want to avoid another unintended pregnancy.
Ready to Take the Next Step?
If you are considering an abortion or simply want to understand your options, we are here for you. Marie Stopes South Africa has centres across six provinces – including Johannesburg, Cape Town, Durban, and Pretoria – staffed by trained, non-judgmental healthcare professionals who are on your side.
You can reach us by:
- Calling or WhatsApp: 060 094 9173
- Toll-free: 0800 11 77 85
- Booking online at www.mariestopes.org.za
You deserve safe, quality care, and you deserve to make this decision on your own terms. We are here whenever you are ready.
This article is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider for guidance specific to your situation.