Termination of Pregnancy (TOP) | Western Cape Government

Termination of Pregnancy (TOP)


The Choice on Termination of Pregnancy Act No. 92 of 1996 gives all women the right to a free abortion (termination of pregnancy) at a government hospital or clinic during the first 12 weeks of pregnancy.

According to the Act, the procedure can also be performed from the 13th week up to the 20th week of the pregnancy if the medical practitioner, after consultation with the pregnant woman, believes that: 

  • The continued pregnancy poses a risk of injury to the woman’s physical or mental health.
  • That there is a substantial risk that the foetus would suffer from a severe physical or mental abnormality.
  • If the pregnancy resulted from rape or incest.
  • If the continued pregnancy would significantly affect the social or economic circumstances of the woman.

After the 20th week of pregnancy if a medical practitioner after consultation with a registered midwife believes that the continued pregnancy:

  • would endanger the woman’s life.
  • Would result in a severe malformation of the foetus.
  • Would pose a risk of injury to the foetus.

Women of all ages have the right to terminate a pregnancy and should never be denied the service because of their age. While it’s advisable for minors under the age of 18 to be accompanied by a trusted adult (a parent, aunt or teacher) for support, provisions will be made for girls who are not accompanied by an adult.

Abortion methods A couple holding hands.

If you're considering going for an abortion, speak to a nursing practitioner about the safest methods available to you.

Medical Abortions
Medical abortions use medication (pills or tablets) only. A patient will take 2 different medicines to end the pregnancy. The patient will take the1st tablet (1 Mifepristone tablet) at the clinic or hospital, and the other tablets (4 Misoprostol tablets) are taken 1 to 2 days later at home. Within 4 to 6 hours of taking the second tablet, pain and bleeding will follow, then loss of pregnancy. A woman may experience symptoms similar to a miscarriage. This option is available to women who are 4 to 9 weeks pregnant and is administered by a registered nurse or Midwife, as well as women who are 10 to 13 weeks pregnant where it will be administered by a medical doctor. 

Surgical Abortions
Surgical abortions are performed by registered nurses (up to 12 weeks of pregnancy) or doctors (from 12 to 20 weeks) who conduct a same-day procedure in a clinic or hospital. Women who choose this procedure will be given tablets that will soften the mouth of the womb, after which the procedure will be done. The woman will be able to go home after a couple of hours once her vital signs are normal. She’ll receive pain medication to help her cope with contradictions, a patient information leaflet that help her identify any danger signs, and a preferred contraceptive method because fertility can return as soon as 8 days after the procedure.

Where can you have a safe abortion?

Government hospitals, designated private doctors and gynaecologists, and non-profit providers such as the Marie Stopes centres in the Western Cape, offer safe and legal termination of pregnancy.

To have a free abortion, the request must be made at a primary healthcare clinic, where the pregnancy will be confirmed, counselling provided, an appointment made, and a referral letter is given to a facility where the procedure can be performed.

Not all health workers are willing to be involved in this service, but they are obligated by law to inform the client of her rights and must refer the client to a health worker or facility, where she can get the service at one of these Western Cape Health Facilities.

Women are advised to go for safe, legal abortions rather than "backstreet" abortions that are likely to endanger their health and their lives. 


VIDEO: Terminating a pregnancy


How can you access the service? 

Dr talking to a-female patient.

If you're a first-time visitor to a health facility, you'll be asked to complete a form and a folder will be opened.

You will need the following:

  • Your referral letter (if relevant).
  • Any medication you are taking.
  • Your clinic/hospital card if you have previously registered at the facility.

You must sign an informed consent form giving permission for the abortion to be done.

Note: Health workers who are unwilling to give the service for any reason must refer you to a colleague who is willing to do so; or to the appropriate health care facility near you with a referral letter and a booking.

Also see:

  1. Avoiding Illegal / Unsafe Abortions
  2. Contraception (Family Planning) for emergency contraception
  3. Termination of Pregnancy (ToP): Policy, Guidelines and Protocols  
Provided At: These facility categories:
Provided by:
Government Body: (Western Cape Government)

TOP is free of charge at primary healthcare facilities and when referred up the line. Ambulance services are free of charge for women who have an abortion. 

The content on this page was last updated on 15 February 2023