Abortion on request has been legal in South Africa since 1997. The Choice in Termination of Pregnancy Act of South Africa 1996 allows abortion on request up to 20 weeks’ gestation. Since it was introduced, 40 000 legal abortions have been performed annually. A national study in 1994 on morbidity associated with incomplete abortion (illegally induced and spontaneous miscarriage) assisted the act’s passage through parliament. We studied the impact of legislative change on morbidity and medical management by repeating the 1994 study of morbidity due to incomplete abortion among patients presenting to public hospitals in 2000.