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Coerced contraception? Mec's controversial approach to teenage pregnancy sparks outrage and concern

Coerced contraception? Mec's controversial approach to teenage pregnancy sparks outrage and concern
Khuselwa Dyantyi
By Khuselwa Dyantyi
29 Jan 2025
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The bodily autonomy of young women and girls is under threat as Gauteng health and wellness MEC Nomantu Nkomo-Ralehoko intends to make the contraceptive Implanon compulsory for pupils as long as their parents consent. This approach to addressing teenage pregnancy is misguided and unlawful.

On Thursday, 16 January an article was published in which Gauteng health MEC Nomantu Nkomo-Ralehoko was quoted saying that girl pupils in Gauteng will essentially be forced to get contraceptive implants in their arms, as long as their parents give consent. 

Such an approach to curbing teenage pregnancy is misguided and unlawful. What is particularly concerning and would amount to an egregious violation of constitutional rights, reminiscent of coerced and forced sterilisation, is the MEC’s decision to make the contraceptive Implanon, an implant, compulsory for pupils based only on parental consent and not the consent of the pupils.  

Any attempt to forcefully administer contraceptives to young women and girls undermines their constitutional rights to bodily integrity and autonomy and concurrently constitutes gender-based violence and common law assault. 

Teenage pregnancy is a serious issue in our society and initiatives aimed at addressing it should be supported. However, such initiatives must accord with and respect the Constitution and other laws aimed at protecting young women and girls.  

The law is clear 


The law is clear: the department cannot make any form of contraception compulsory for pupils, even with parental consent. 

The state has a constitutional duty to respect, protect, promote and fulfil the rights in the Bill of Rights, including individual’s right to make decisions regarding reproduction and the right to reproductive healthcare.  

The Children’s Act is explicit about this. For instance, section 134(2)(a) states that children aged 12 and above have the freedom to make reproductive choices and practise autonomy over their bodies. This permits a child aged 12 and older to consent to contraceptives and related healthcare guidance without requiring parental consent. Parental consent cannot substitute or override the consent of children aged 12 and older. In other words, the child’s consent is the only consent that matters. 

Section 134(3) goes further, saying that a child who obtains contraceptives or contraceptive advice in terms of the Act is entitled to confidentiality in that respect. This means that, if a minor seeks contraceptives or contraceptive advice without parental consent, his or her confidentiality should be respected.  

The MEC’s approach on this implant issue is regressive and unlawful as it unjustifiably interferes with young women and girls’ rights guaranteed in the Constitution and the Children’s Act.  

Moreover, another fact that the MEC seemingly ignores is that the right to reproductive choice incorporates the right to choose the type of contraceptive one uses and that this choice and variety may be medically necessary in certain instances. Women and girls should be able to access their preferred contraceptive within the variety of methods offered by the national reproductive health programme.  

The state has, however, consistently failed to offer the required variety of contraceptive choices. In a 2022 report, SECTION27, along with partner organisations, found that 40% of all medicine shortages in the country were contraceptives, and most of those shortages (76.3%) were of injectable contraceptives. 

A comprehensive plan  


The MEC’s statement, as quoted by IOL, that some teenage pregnancies are a result of children being “raped” and “that is why we [the health department] are coming with the Implanon that we [the health department] are inserting on the left arm of a child so that the child doesn’t have to take pills” is dangerous and very worrying. To assert that the solution to the rape of minors is forcibly inserting a long-acting hormonal contraceptive into them is both irrational and illogical. Of course, teenage pregnancies can be a result of rape, whether statutory or otherwise, but the solution to this problem is not for the state to perpetrate the child a second time by forcibly administering a contraceptive. 

Rather than such off-the-cuff and unlawful “solutions” to address teenage pregnancy effectively, we need a comprehensive socioeconomic plan developed by the departments of health and education, along with other stakeholders. The provision of comprehensive sexuality education, investment in employment schemes, small businesses, parental education and training, expanding access to abortion services, along with ensuring adolescent-friendly clinics and access to a variety of contraceptive options for pupils, including in schools, can all help to reduce teenage pregnancies. 

Such a plan must be developed and implemented in a manner that upholds constitutional rights and promotes the principles of autonomy, dignity and equality enshrined in the Constitution. 

Four steps to take 


These are difficult issues to address, but there is a way forward. In an open letter published this week and endorsed by, among others, the Sexual Reproductive Justice Coalition, the Soul City Institute and the Cancer Alliance, we outline four constructive steps that the MEC, working with a variety of stakeholders, can take to address teenage pregnancy more effectively. 

First, the MEC can drive the development of a comprehensive plan that prioritises access to information, education and healthcare services that respect the autonomy and confidentiality of young women and girls. 

Second, she can take steps to ensure that all young people have access to comprehensive sexuality education and information about sexual reproductive health rights. 

Third, the MEC can work with a variety of stakeholders to determine the best approach for introducing contraceptives in schools in a way that respects constitutional rights and promotes the principles of autonomy, dignity and equality enshrined in the Constitution. 

Finally, she can work with other government departments to address underlying socioeconomic factors such as child-headed households, poverty, gender-based violence and HIV that contribute to teenage pregnancy. DM

Dyantyi is with SECTION27. This opinion piece was adapted from an open letter from SECTION27 and other organisations addressed to MEC Nomantu Nkomo-Ralehoko. 

This opinion piece was first published by Spotlight – health journalism in the public interest. Sign up to the Spotlight newsletter.



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