Termination of Pregnancy (TOP)
Description General measures Referral DESCRIPTION Under the Choice of Termination of Pregnancy Act, 1996, as amended, a TOP may be carried out in the following circumstances: Women eligibility If gestation ≤ 12 weeks and 0 days: On request. If gestation 12 weeks and 1 day to 20 weeks and 0 days: If doctor is satisfied that: Pregnancy was from rape or incest, or There is a substantial risk that th
DESCRIPTION
Under the Choice of Termination of Pregnancy Act, 1996, as amended, a TOP may be carried out in the following circumstances:
Women eligibility
If gestation ≤ 12 weeks and 0 days:
- On request.
If gestation 12 weeks and 1 day to 20 weeks and 0 days:
If doctor is satisfied that:
- Pregnancy was from rape or incest, or
- There is a substantial risk that the foetus would suffer from a severe mental or physical abnormality, or
- The continued pregnancy would pose a risk to mother's physical or mental health, or
- Continued pregnancy will significantly affect the social or economic circumstances of the woman.
If gestation ≥ 20 weeks and 0 day:
- If the doctor after consulting with a second doctor or registered midwife or registered nurse is satisfied that continuing the pregnancy would endanger the mothers' life, pose a risk of injury to the foetus, or result in a severe foetal malformation.
Venue
Any facility that has a 24-hour maternity service can provide TOP service without specific designation - The Choice on Termination of Pregnancy Act, 1996 (as amended by Act 38 of 2004), expanded access to abortions, allows registered nurses, as well as registered midwives, to perform abortions up to the twelfth week of pregnancy.
Practitioner
If gestation ≤ 11 weeks and 6 days:
- Doctor, midwife or registered nurse with appropriate training.
If gestation ≥ 12 weeks and 0 day:
- Doctor is responsible for decision and prescription of medication. Registered nurse/midwife may administer medication according to prescription.
GENERAL MEASURES
- Pre- and post-termination counselling is essential.
- Consent for TOP and related procedures (e.g. laparotomy) may be given by minors. Minors are encouraged to consult parents or others, but parental consent is not mandatory.
- Consent of spouse/partner is not necessary.
- Offer contraception post TOP.
REFERRAL
- If service not available, refer to appropriate district or regional facility as soon as possible (within 2 weeks).
- If gestation ≥ 12 weeks and 0 day.
See: Management of termination of pregnancy at primary health care level: gestation up to 12 weeks and 0 days
Click here to access the pdf.
Standard Treatment Guidelines and Essential Medicines List for South Africa, Primary Healthcare, 2025-9_Version 1.0_26 March 2026
Chapter 6: Obstetrics and Gynaecology_6.3 Termination of pregnancy (TOP)