Today, SECTION27 and the Treatment Action Campaign (TAC) launch a new report exposing widespread failures in access to abortion services in the Eastern Cape and Limpopo. The report, Barriers to Abortion Services in the Eastern Cape and Limpopo: 2026, documents how systemic failures in the public healthcare system are denying women and girls access to safe and lawful abortion services, particularly in poor and rural communities.
Informed by comprehensive monitoring conducted across healthcare facilities in both provinces in 2024, and ongoing assistance provided to women seeking abortion in the provinces, the report identifies major barriers to accessing abortion services. These include the lack of operational abortion facilities, severe shortages of trained providers, long delays to access care, medicine shortages, inadequate equipment, dysfunctional referral systems and the arbitrary use of conscientious objection by healthcare workers.
The findings reveal an alarming shortage of second-trimester abortion services. Only three facilities provide second-trimester abortions in Limpopo, all located in Waterberg District. In the Eastern Cape, only two facilities provide second-trimester abortions in accordance with the law, both located in and around KuGompo. Dora Nginza is designated to provide the service but only provides second-trimester abortions in very limited circumstances. In Limpopo, researchers found that although 52 facilities are officially listed as designated abortion facilities, only 21 are operational and offer the service to women.
As a result, many women are forced to travel between 100 and 300 kilometres to access care, often only to be turned away due to provider shortages or suspended services. Delays can range from several weeks to months, pushing some women beyond the legal gestational limit for abortion services.
The report further documents unlawful and discriminatory treatment of women seeking abortions. Researchers observed women being humiliated, judged, and denied care by healthcare workers under the guise of conscientious objection. In some cases, healthcare workers refused to assist minors without third-party consent, despite the law clearly stating that no consent other than that of the pregnant person is required.
The report highlights the collapse of services at several facilities due to the failure to replace providers who retired, resigned or objected to providing care. More than 80% of facilities monitored had only one abortion provider, meaning services were suspended whenever that provider was absent.
Medicine shortages and inadequate infrastructure were identified as major contributors to delays in care. Several facilities reported shortages of mifepristone, while others lacked dedicated spaces, ultrasound machines and essential equipment required to provide services safely and efficiently. In some cases, the shortage of ultrasound machines resulted in women being referred to private facilities to obtain scans at their own cost, creating additional financial barriers to accessing care.
SECTION27 and TAC warn that these failures constitute violations of constitutional rights to healthcare, dignity, bodily integrity and equality. We are calling on the National Department of Health, the Eastern Cape Department of Health and the Limpopo Department of Health to urgently expand operational facilities, train and appoint additional providers, improve referral systems and address staffing and equipment shortages.
The full report is available here.
For media enquiries contact:
Pearl Nicodemus | nicodemus@section27.org.za | 082 298 2636
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