Emergency abortion in South Africa: Legal access, implementation, and the role of sexual violence

Rape has historically been used as a weapon of war, inflicting profound physical, psychological and social harm on survivors while destabilising communities. The intersection of conflict-related sexual violence and restricted access to abortion care exacerbates the suffering of survivors, particularly in addressing unwanted pregnancies, stigma and long-term health consequences. Despite international legal frameworks such as the Geneva Conventions and the Convention on the Elimination of All Forms of Discrimination Against Women (CEDAW) recognising the importance of comprehensive reproductive health care, including abortion, significant gaps in implementation persist, leaving survivors without the necessary care. This article concludes that abortion as emergency health care is critical for addressing the needs of survivors, ensuring their rights to dignity, autonomy and health. In South Africa, constitutional provisions, supported by the Choice on Termination of Pregnancy Act (CTOP Act) and the National Health Act (NHA), provide a robust legal framework that mandates access to emergency abortion care, even in cases of conscientious objection. Placing these findings in a broader context, this article underscores the importance of integrating legal, ethical and medical guidelines to operationalise emergency abortion care effectively. Strengthening healthcare systems through practitioner training, advocacy, and the removal of systemic barriers is essential to upholding survivors’ rights. These insights have broader implications for global efforts to provide equitable and rights-based reproductive health care in humanitarian and conflict settings.