Di Caelers
9 August 2007
"HIV-positive pregnant women should routinely be offered the choice of abortion in the context of the serious challenge the pandemic presents to maternal health," says the Health Systems Trust.
It has responded with a submission after a Constitutional Court judgment which asked for increased public participation in the Choice on Termination of Pregnancy Amendment Act.
In response to the judgment, provincial governments are set to hold a series of provincial hearings around the country this month.
The purpose of the act was to help the health system provide better access to high-quality termination of pregnancy services, and research shows it has been "hugely successful" in achieving the objective.
"There has been a phenomenal 91% decrease in abortion-related maternal mortality and morbidity in the last three years," according to Health Systems Trust chief executive Dr Lilian Dudley.
However, while the trust recognised the success, Dudley said, it wanted to emphasise the challenge to maternal health presented by HIV/Aids.
"In addition to measures to prevent perinatal transmission, and to offer HIV-positive women high-quality antenatal and post-natal care, the option of voluntary abortion should be offered as part of the continuum of care for HIV/Aids," she said.
Presently, these services were not integrated, and HIV-positive pregnant women were not offered the choice to terminate unwanted pregnancies.
"Care must be taken to see that women are afforded an unreserved choice to terminate or continue their pregnancies," Dudley stressed.
The trust's suggestion is that the health system be transformed to "maintain and increase access" to safe abortion, and that high-quality abortion services form part of integrated sexual and reproductive health services, including HIV/Aids services.
It was also critical, Dudley said, that women were properly informed via community-based outreach, so that they were aware of measures that would increase their access to safe legal abortion.
By virtually eliminating abortion-related death and illness, safe abortion had decreased a particular burden on the health system in South Africa.
"But HIV/Aids presents another challenge in terms of maternal health," Dudley warned.
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