CHOICE ON TERMINATION OF PREGNANCY
CHOICE ON TERMINATION OF PREGNANCY
Place where termination of pregnancy may take place
(1) Termination of a pregnancy may take place only at a facility which –
(a) gives access to medical and nursing staff;
(b) gives access to an operating theatre;
(c) has appropriate surgical equipment;
(d) supplies drugs for intravenous and intramuscular injection;
(e) has emergency resuscitation equipment and access to an emergency referral centre or facility;
(f) gives access to appropriate transport should the need arise for emergency transfer;
(g) has facilities and equipment for clinical observation and access to in-patient facilities;
(h) has appropriate infection control measures;
(i) gives access to safe waste disposal infrastructure;
(j) has telephonic means of communication; and
(k) has been approved by the Member of the Executive Council by notice in the Gazette.
(2) The Member of the Executive Council may withdraw any approval granted in terms of subsection (1)(k).
(3) (a) Any health facility that has a 24-hour maternity service, and which complies with the requirements referred to in subsection (1)(a) to (j), may terminate pregnancies of up to and including 12 weeks without having to obtain the approval of the Member of the Executive Council.
(b) The person in charge of a health facility contemplated in paragraph (a) must notify the relevant Member of the Executive Council that the health facility has a 24-hour maternity service which complies with the requirements referred to in subsection (1)(a) to (j).
(4) The Member of the Executive Council shall once a year submit statistics of any approved facilities for that year to the Minister.
(5) Notwithstanding anything to the contrary in this Act, the Minister may perform any of the functions that the Member of the Executive Council may or must perform, if it is necessary to perform such function in order to achieve any of the objects of this Act.
Circumstances in which and conditions under which pregnancy may be terminated
(1) A pregnancy may be terminated-
(a) upon request of a woman during the first 12 weeks of the gestation period of her pregnancy;
(b) from the 13th up to and including the 20th week of the gestation period if a medical practitioner, after consultation with the pregnant woman, is of the opinion that-
(i) the continued pregnancy would pose a risk of injury to the woman's physical or mental health; or
(ii) there exists a substantial risk that the fetus would suffer from a severe physical or mental abnormality; or
(iii) the pregnancy resulted from rape or incest; or
(iv) the continued pregnancy would significantly affect the social or economic circumstances of the woman; or
(c) after the 20th week of the gestation period if a medical practitioner, after consultation with another medical practitioner or a registered midwife, is of the opinion that the continued pregnancy-
(i) would endanger the woman's life;
(ii) would result in a severe malformation of the fetus; or
(iii) would pose a risk of injury to the fetus.
(2) The termination of a pregnancy may only be carried out by a medical practitioner, except for a pregnancy referred to in subsection (1)(a), which may also be carried out by a registered midwife who has completed the prescribed training course.
The patient must be informed about her condition and its prognosis. Such disclosure usually serves to relieve anxiety.
Planned procedures must be explained in detail so that the woman can give informed consent, which must always be obtained before any type of treatment is undertaken, for example, hysterectomy, biopsy, laparoscopy.
Confidentiality must always be maintained, and information made available to the healthcare provider must not be made public without the patient's permission.
For example, a young woman requesting termination of pregnancy may wish to keep this a secret from her parents.
The nurse must ensure that the patient makes her choice without coercion, and that she receives the treatment she anticipates.
When dealing with issues related to the female reproductive system, privacy is vital
The patient has a right to respect, dignity, privacy, honesty, information, truth, fairness and treatment.
This must be provided during history taking, physical examination and any other activity performed by the healthcare provider, regardless of the patient's status, age or condition
He/she has to practise within the constitution of the country, observing the laws that gorven nursing practice, such as Choice on Termination of Pregnancy Act 92 of 1996 and also bear in mind the patients rights
In dealing with conditions related to the female reproductive system, it is important for the nurse to observe relevant and legal issues
(1) Subject to the provisions of subsections (4) and (5), the termination of a pregnancy may only take place with the informed consent of the pregnant woman.
(2) Notwithstanding any other law or the common law, but subject to the provisions of subsections (4) and (5), no consent other than that of the pregnant woman shall be required for the termination of a pregnancy.
(3) In the case of a pregnant minor, a medical practitioner or a registered midwife, as the case may be, shall advise such minor to consult with her parents, guardian, family members or friends before the pregnancy is terminated: Provided that the termination of the pregnancy shall not be denied because such minor chooses not to consult them.
(4) Subject to the provisions of subsection (5), in the case where a woman is-
(a) severely mentally disabled to such an extent that she is completely incapable of understanding and appreciating the nature or consequences of a termination of her pregnancy; or
(b) in a state of continuous unconsciousness and there is no reasonable prospect that she will regain consciousness in time to request and to consent to the termination of her pregnancy in terms of section 2,
Offences and penalties
(1) Any person who-
(a) is not a medical practitioner, or a registered midwife or registered nurse who has completed the prescribed training course, and who performs the termination of a pregnancy referred to in section 2(1)(a);
(b) is not a medical practitioner and who performs the termination of a pregnancy referred to in section 2(1)(b) or (c);
(c) prevents the lawful termination of a pregnancy or obstructs access to a facility for the termination of a pregnancy; or
(d) terminates a pregnancy or allows the termination of a pregnancy at a facility not approved in terms of section 3(1) or not contemplated in section 3(3)(a),
shall be guilty of an offence and liable on conviction to a fine or to imprisonment for a period not exceeding 10 years. (
The State shall promote the provision of non-mandatory and non-directive counselling, before and after the termination of a pregnancy.
Information concerning termination of pregnancy
A woman who in terms of section 2(1) requests a termination of pregnancy from a medical practitioner or a registered midwife, as the case may be, shall be informed of her rights under this Act by the person concerned