Abortion -- some practical and ethical considerations [editorial]

Abortions have been performed in many societies throughout the world for a long time. This continues with the proportion of legal and illegal abortions varying from country to country. Available statistics suggest that the annual abortion rate per 1000 women aged 15-44 years ranges from less than 20 in many countries to 40-70 in others. Abortion has been a subject of only limited debate in South Africa where the 1975 Abortion and Sterilization Act clearly defines five circumstances in which abortion can be legally performed. Legal abortion may be performed in South Africa when a pregnancy poses a serious threat to the womans life and health; when the pregnancy poses a serious threat of permanent damage to a womans mental health; where a serious risk exists that the child will be seriously irreparably handicapped; when the pregnancy is the result of alleged and reported rape or incest and such allegations are considered valid by two medical practitioners and are supported by a certificate from a magistrate that a complaint has been lodged; and where the pregnancy has resulted from unlawful carnal intercourse with a woman having a permanent mental handicap or defect. Many women however despite the legal status will request and procure an abortion regardless of societal approval. This paper was prepared by a multidisciplinary bioethics group to provide a synoptic overview of the scope of public and professional debate about abortion with a view to broaden the readers understanding of the extent to which unwanted pregnancies and their termination is a source of great distress to women and society as a whole and to propose debate. The text focuses upon pregnancy and the health of the mother and fetus with sections on abortion service and problems at Groote Schuur Hospital positions on abortions in the Western world current philosophical considerations and the need to make abortion law in South Africa less restrictive.