Contraception
Free at public clinics, and from the age of 12 a child can obtain it without parental consent after proper advice.
Contraception is free at public clinics, including implants, injectables, IUDs and condoms, with adolescents able to consent from the age of 12. The Children's Act allows a child of 12 or older to obtain contraception without parental consent, provided they have been properly advised.
Key points
| Cost | Free or subsidised in public facilities |
|---|---|
| Methods | Condoms, pills, injectables, implants, IUDs and sterilisation |
| Emergency contraception | Available in pharmacies and public facilities |
| Spousal consent | Not legally required, though often requested in practice |
| Adolescents | Entitled to services; national policies increasingly explicit about this |
| Community distribution | Community health workers supply condoms and pills locally |
| Free at public facilities | Including injectables, implants and intrauterine devices |
| Implants | Rolled out nationally, with training gaps affecting removal |
In practice
- Ask specifically about removal when choosing an implant: removal capacity is the recognised weak point.
- Youth-friendly services exist at many clinics and reduce the risk of judgemental treatment.
Worth knowing
The law allows a 12-year-old to consent to contraception in her own right. Facilities that demand a parent are acting outside the Children's Act.
The general article: Contraception · Compare with another country
Abortion
Termination is available on request up to the 12th week, and on defined grounds thereafter.
The Choice on Termination of Pregnancy Act 1996 permits termination on request up to and including the 12th week; from 13 to 20 weeks on medical, social or economic grounds assessed with a practitioner; and after 20 weeks where there is serious risk to the woman or severe fetal abnormality.
Key points
| On request | Up to 12 weeks |
|---|---|
| 13 to 20 weeks | Risk to physical or mental health, social or economic circumstances, rape or incest, or fetal abnormality |
| After 20 weeks | Serious risk to the woman, or severe fetal malformation |
| Minors | A girl under 18 may consent herself; counselling is advised but not required |
| Providers | Designated public facilities and accredited NGOs; midwives and nurses may provide first-trimester care with training |
| CTOP Act | Choice on Termination of Pregnancy Act 1996, among the most permissive in Africa |
| No parental consent | A minor may consent herself, though counselling is encouraged |
| No spousal consent | Expressly not required |
| Designated facilities | Many designated facilities do not in fact provide the service |
In practice
- Go directly to a designated public facility or an accredited provider — no referral needed.
- Expect a dating assessment and counselling offer.
- Medication abortion is available early in pregnancy.
- Ask about contraception at the same visit.
- Call ahead to confirm the facility is actually providing terminations, not merely designated.
- If refused, ask to be referred: refusal without referral is a breach of the practitioner's duty.
Cost and coverage
Free in the public sector. Private and NGO providers charge fees, generally moderate.
Recent changes
The gap between the law and access is the recurring issue: only a portion of designated facilities actually provide services, and conscientious objection is widespread.
Where to go
- Designated public clinics and hospitals.
- Marie Stopes South Africa and accredited NGO providers.
- National Department of Health helplines for facility information.
Worth knowing
Illegal advertisements for cheap terminations are common in South African cities. They are dangerous and unlawful: use a designated facility or an accredited provider, where the service is free or affordable anyway. The gap between the law and provision is the central problem: designation on paper does not mean an available service, and unlawful providers advertise heavily.
The general article: Abortion · Compare with another country
Parents: a teenager’s first relationship
Children's legislation allows a child of twelve or older to obtain contraceptives and to consent to an HIV test on their own, and to consent to medical treatment where they are mature enough. Public clinics provide contraception and testing free of charge. The age of consent to sex is sixteen, with close-in-age provisions.
South Africa has the clearest statutory framework of any country covered here. The Children's Act allows a child of twelve or older to obtain contraceptives without parental consent, provided they are given proper advice, and to consent to medical treatment if they are mature enough to understand. The National Health Act adds a right to confidentiality. The gap is between the law, which is excellent, and clinic practice, where judgemental treatment deters young people.
Where to go
- Public clinic, free contraception and testing
- School health programme
- Childline South Africa, free and confidential
Frequently asked questions
From what age can a young person get contraception in South Africa?
Twelve. The Children's Act permits it without parental consent provided the young person receives proper medical advice, and the same Act allows consent to medical treatment from twelve where the child has sufficient maturity. Testing and counselling follow the same rule.
Is the consultation confidential?
Yes, the National Health Act protects it. In practice the difficulty is attitudes rather than law: young people report being questioned or lectured at clinics. Youth-friendly services and non-governmental clinics are often the more comfortable route.
The general article: Parents: a teenager’s first relationship · Compare with another country
Sexual orientation
The first constitution in the world to prohibit discrimination on grounds of sexual orientation, alongside high levels of violence.
The Constitution of 1996 was the first in the world to prohibit discrimination on grounds of sexual orientation, and the Civil Union Act of 2006 opened marriage. Equality courts provide an accessible route for discrimination claims. The gap is in enforcement rather than in law: violence, including sexual violence targeting lesbian women, remains high, and hate crimes legislation was enacted only recently.
South Africa's 1996 Constitution was the first in the world to prohibit discrimination on grounds of sexual orientation, and the Civil Union Act followed in 2006 after the Constitutional Court required it. The law is among the strongest anywhere. The gap between law and life is the country's defining feature here: violence, including so-called corrective rape in townships, remains a serious problem, and prosecution rates are poor.
Key points
| Constitution | Prohibits discrimination on grounds of sexual orientation since 1996 |
|---|---|
| Marriage | Open since 2006 under the Civil Union Act |
| Equality courts | Accessible route for discrimination claims, without a lawyer |
| Hate crimes | Dedicated legislation enacted recently |
| Adoption | Open to same-sex couples |
| Gender markers | Amendable under the Alteration of Sex Description Act |
| Violence | Remains high, particularly outside major urban centres |
In practice
- Equality courts sit in magistrates' courts and take claims without a lawyer or a fee.
- Report hate-motivated violence explicitly as such: it affects how the case is handled.
- Organisations provide shelter, counselling and case support in most provinces.
- Marriage officers may still object on religious grounds in some circumstances: call ahead.
Cost and coverage
Equality court claims are free and do not require a lawyer.
Recent changes
The hate crimes legislation was signed into law, creating specific offences covering sexual orientation and gender identity, and the conscientious objection clause for marriage officers was removed in 2020.
Where to go
- Equality courts, in every magistrates' court district.
- South African Human Rights Commission.
- Community organisations providing shelter and case support.
Worth knowing
The distance between constitutional protection and daily safety is the defining feature here. The legal remedies are genuinely accessible; the risk of violence is nonetheless real and geographically uneven.
Frequently asked questions
Can any official refuse to marry a same-sex couple?
Not since 2020. The Civil Union Act had allowed individual marriage officers to object on conscience grounds; an amendment removed that, and Home Affairs must ensure every office can solemnise. If you are turned away, ask for the office manager and record the refusal.
What protection exists against hate crime?
The Prevention and Combating of Hate Crimes and Hate Speech Act creates specific offences with sexual orientation and gender identity as listed grounds, giving prosecutors a designated charge rather than relying on ordinary assault. Reporting remains the weak point; support organisations can accompany you to a police station.
The general article: Sexual orientation · Compare with another country
Drugs and controlled substances
Private adult use and cultivation of cannabis are lawful following the Constitutional Court; dealing remains a serious offence.
The Drugs and Drug Trafficking Act 140 of 1992 governs controlled substances. In Minister of Justice v Prince (2018) the Constitutional Court held that the criminalisation of the private use, possession and cultivation of cannabis by an adult in a private place was unconstitutional. The Cannabis for Private Purposes Act 7 of 2024 was signed into law to give effect to that judgment.
The lawful space is private: an adult may use and grow cannabis in a private place. Dealing, public use and supply to a child remain offences.
The 2024 Act provides for the expungement of certain past convictions for possession and use.
Other substances remain fully prohibited, with dealing punishable by up to twenty-five years' imprisonment.
Driving under the influence of a drug is an offence under the National Road Traffic Act.
Key points
| Main statute | Drugs and Drug Trafficking Act 140 of 1992 |
|---|---|
| Cannabis | Private adult use, possession and cultivation lawful (Prince, 2018) |
| Implementing Act | Cannabis for Private Purposes Act 7 of 2024 |
| Dealing | Up to 25 years' imprisonment |
| Expungement | Provided for certain past cannabis convictions |
In practice
- Public treatment is available through provincial health departments and SANCA centres, at low cost or free.
- Private cultivation does not authorise sale: the commercial market remains unlawful.
- Nyaope, a heroin-based mixture, is the dominant concern in several provinces and is treated as a serious dependence requiring opioid substitution.
Cost and coverage
SANCA and provincial services charge on a sliding scale; many are free. Private rehabilitation is expensive.
Recent changes
The Cannabis for Private Purposes Act was signed in May 2024, translating the 2018 judgment into statutory quantities and rules.
Where to go
- SANCA, South African National Council on Alcoholism and Drug Dependence.
- Provincial substance abuse treatment centres.
- Poisons Information Helpline, 0861 555 777.
- Emergencies: 10177 or 112.
Worth knowing
The lawful space is strictly private and non-commercial. Public consumption, sale and supply to a minor all remain offences.
Frequently asked questions
Is cannabis legal in South Africa?
Private adult use, possession and cultivation are lawful; dealing and public use are not.
Can past convictions be cleared?
The 2024 Act provides for the expungement of certain past convictions for cannabis possession and use.
The general article: Drugs and controlled substances · Compare with another country
Alcohol and tobacco
Long-standing smoking restrictions, a stalled tobacco bill, and alcohol harm among the highest in the world.
South Africa restricted smoking in public places and banned tobacco advertising well ahead of most of the continent. A comprehensive tobacco bill covering plain packaging and vapes has been before Parliament for years without passing. Alcohol is the larger public health problem: consumption per drinker is among the highest in the world, and alcohol-related trauma occupies a large share of hospital admissions.
South Africa restricted indoor smoking early, in the late 1990s, and has not moved much since: the Tobacco Products and Electronic Delivery Systems Control Bill, which would introduce plain packaging and regulate vapes, has been before Parliament for years. Alcohol is the larger problem — South Africa has among the highest levels of alcohol-attributable harm in the world, driven by heavy episodic drinking rather than overall volume.
Key points
| Smoking restrictions | Indoor public places restricted since the late 1990s |
|---|---|
| Tobacco bill | Plain packaging and vape regulation pending before Parliament |
| Illicit tobacco | A very large share of the market |
| Alcohol harm | Consumption per drinker among the highest in the world |
| Trauma | Alcohol-related injury occupies a large share of emergency admissions |
| Quit services | National quitline and public clinic support |
In practice
- For alcohol, public clinics can refer to outpatient and inpatient programmes.
- Illicit cigarettes carry no quality control and fund organised crime.
Cost and coverage
Quitline and public clinic support are free; nicotine replacement is paid for.
Recent changes
The Tobacco Products and Electronic Delivery Systems Control Bill, providing for plain packaging, a ban on display at point of sale and regulation of vaping, is still before Parliament. A separate Liquor Amendment Bill has been pending for even longer.
Where to go
- National Council Against Smoking quitline.
- South African National Council on Alcoholism and Drug Dependence.
Worth knowing
Alcohol, not tobacco, is the dominant driver of preventable harm here. Screening in primary care is quick, free and rarely offered — ask for it.
Frequently asked questions
Are vapes regulated in South Africa?
Only through a 2021 excise tax; comprehensive regulation awaits the Tobacco Products and Electronic Delivery Systems Control Bill, which remains before Parliament. Until it passes, vapes are sold largely as ordinary consumer goods with no age restriction in national law.
Why is alcohol harm so high?
Because the pattern of drinking matters more than the amount: a smaller share of the population drinks, but those who do drink heavily in concentrated sessions. That drives trauma admissions and road deaths, which is why the temporary sales bans during the pandemic produced such visible falls in hospital cases.
The general article: Alcohol and tobacco · Compare with another country
General sources
- gov.za — official government portal
- South African Human Rights Commission — constitutional rights body