In 1996 the South African government legalised the termination of pregnancy (TOP) services, allowing women to choose to terminate unplanned pregnancies at designated facilities. Although TOP services are available, pregnant women continue to use illegal abortion services, with potentially life-risking consequences. The purpose of this study was to identify challenges encountered by women requesting TOP services, and to make recommendations for improved policies and practices, enabling more women in the North West Province (NWP) to access TOP services. This was a non-experimental, exploratory, descriptive and quantitative study. Structured interviews were conducted with 150 women who had used TOP services in phase 1, with 50 women who were unable to access TOP services in phase 2 and with 20 professional nurses providing TOP services in the NWP in phase 3. In phase 1, 96.0% (n=144) of the women needed transport to access TOP services, and 73.2% (n=109) indicated that nurses put women’s names on waiting lists, posing barriers to such access in the NWP. In phase 2, 92.0% (n=46) of these respondents had reportedly requested TOPs for the first time, but 89.0% (n=44) could not access TOP services. In phase 3, only 14 out of 19 designated facilities in the NWP, and only 20 nurses, provided TOP services during the study period. Out of the 20 interviewed nurses, 74.0% (n=14) regarded the Choice on Termination of Pregnancy Act, Act 92 of 1996 (CTOP Act) was being unclear requiring a revision. These professional nurses provided TOP services in NWP, by choice. Unless more facilities and more nurses can provide TOP services to the women of the NWP, these services will continue to remain inaccessible, necessitating the continued utilisation of illegal abortion services, in spite of the TOP Act’s prescriptions. It is also recommended that management will provide sufficient support and training opportunities for professional nurses working in TOP services in the NWP. / Health Studies / (D. Litt. et Phil. (Health Studies))

The aim of this study was to explore the psychological effects of termination of pregnancy by choice amongst adolescents within the ages of 18 to 21 years. Exploratory, contextual, qualitative design was used to determine the psychological effects of termination of pregnancy by choice amongst adolescents. Purposive sampling method as well as snowballing were used to select participants for the study. Data collection was done through in-depth, one-on-one, face-to-face interviews, using a semi-structured interview guide. The study highlighted that adolescents who seek abortion are unmarried and mostly still studying. The results revealed that adolescents experience mental ill health after termination of pregnancy due to feelings of guilt. All participants stated that abortion is murder of a life person and that it is a bad thing to do. The study revealed that counselling that is done before TOP focuses on the procedure of TOP. There is need for a holistic approach to counselling. As a guide, policy makers need to specify the mandatory counselling in the Choice on Termination of Pregnancy Act (Act No 92 of 1996). / Health Studies / M.A. (Nursing Science)

The thesis deal with the topic of induced abortion and euthanasia as the basic issue of the theme of process of dying and death. The theoretical part presents how an acceptation of death have been changing during the human history, deals with the concept of after-life in five world religions, presents how death is perceived in different life period, gives the analysis of abortion and euthanasia as an issue of ethics. The second part od the thesis is to serve as the background material to design lessons of ethics for the secondary schools according to the RWCT program (Reading and Writing Critical Thinking). The aim is to depict the topicality and importance of these issues that a disciple is not only to meet during the lesson, but also to be able to handle, to judge and to draw conclusions for his behaviour.

Thesis (MA)--Stellenbosch University, 2000. / ENGLISH ABSTRACT: An exploratory study of the extent and nature of adolescent pregnancy resolution and pre-abortion counselling was undertaken. Little research has been done on pre-abortion counselling in South Africa since the Choice of Termination of Pregnancy Act (92 of 1996) was passed in February 1997. This study emphasised pre-abortion counselling since this is a new field for most counsellors. A literature study was conducted on adolescent pregnancy, focussing on the factors and possible consequences of the choice to carry the pregnancy to term or to terminate it. Adolescents, more than adults, need assistance to make this decision. Crisis intervention was explored as a possible counselling model for pregnancy resolution and pre-abortion counselling. The preliminary investigation included interviews with social workers and nursing professionals in Mossel Bay. Nursing professionals were included in the study since they administer the pregnancy tests and are therefore the first professionals with whom the pregnant adolescent comes into contact. This investigation revealed that nurses, not social workers, do most of the preabortion counselling in Mossel Bay. The Choice on Termination of Pregnancy Act emphasises the importance of supplying pre and post-abortion counselling at the facility providing the termination of pregnancy. The Act also envisages this as primarily a medical concern, with the implication that nursing professionals should do the counselling. The role of professional counsellors such as social workers is not mentioned in the Act. The Act lays down that training will be provided to equip nursing professionals with necessary skills to render this service. The empirical study examined the training and skills of nursing professionals and social workers to determine whether they were adequately qualified to render these services. The respondents' attitude towards pregnant adolescents who choose abortion was also investigated, since this would influence their counselling skills. The investigation revealed that many of the nurses did not seem confident in their counselling although they felt that they were adequately qualified to counsel pregnant adolescents. The nurses explained that they did not feel that they had enough knowledge of the different options, especially foster care and adoption and therefore referred patients to a social worker or Options Pregnancy Centre (a volunteer based counselling centre). The social workers felt confident in counselling adolescents who decided to carry pregnancy to term. The counselling model used was crisis intervention, which is most appropriate for pre-abortion counselling as well. However they felt that they did not have enough information of abortion procedures and emotional consequences of abortion to counsel a pregnant adolescent requesting an abortion effectively. The study showed that respondents felt empathy and understanding for the adolescents' situation and the seriousness of the decision needing to be made. The study also found that social workers and nurses were willing to attend further training in order to improve their knowledge and their counselling skills. The training should therefore not focus on attitudes but simply on improving counselling skills. Training should focus on the nature of a crisis and the steps of crisis intervention. / AFRIKAANSE OPSOMMING: 'n Studie is gedoen om die aard en omvang insake die besluitneming ten opsigte van tienerswangerskappe en berading voor 'n aborsie te ondersoek. Sedert die Wet op Beëindiging van Swangerskap (92 van 1996) in Februarie, is weinig navorsing in Suid-Afrika gedoen oor berading voor 'n aborsie. Hierdie studie beklemtoon voorafgaande berading aangaande aborsie, aangesien dit 'n onbekende terrein vir baie beraders is. 'n Literatuurstudie oor tienerswangerskap is geloods met die fokus op faktore en moontlike gevolge van die keuse om die volle termyn van die swangerskap te voltooi of die beëindiging daarvan. Adolessente het meer ondersteuning nodig as volwassenes om so 'n keuse uit te oefen. Krisis-ingryping is ondersoek as 'n moontlike model vir die beslissing van 'n swangerskap en berading wat 'n aborsie voorafgaan. Met die voor-ondersoek is onderhoude met maatskaplike werkers en verpleegkundiges in Mosselbaai gevoer. Verpleegkundiges was deel van die studie aangesien hulle die eerste kundiges is met wie die swanger tiener in aanraking kom, omdat hulle die swangerskaptoetse uitvoer. Dié navorsing toon dat verpleegsters in Mosselbaai (nie maatskaplike werkers nie) grotendeels die berading voor 'n aborsie hanteer. Die Wet benadruk hoe belangrik dit is om beradingsdienste vir voor- en na-aborsie te voorsien by die plek waar die aborsie toegepas word. Dié Wet beskou dit ook primêr as 'n mediese aangeleentheid, gevolglik behoort verpleegkundiges die berading te doen. Daar word egter nie melding gemaak van die rol van professionele beraders soos maatskaplike werkers, in dié verband nie. Die Wet bepaal ook dat verpleegkundiges opleiding sal ontvang om hulle met vaardighede toe te rus om so 'n diens te lewer. Die opleiding en vaardighede van verpleegkundiges en maatskaplike werkers is dus getoets aan die hand van studies, gegrond op praktiese ervaring, om te bepaal of hulle bevoegd is om die dienste te lewer. Daar is ook ondersoek ingestel na die respondente se houding teenoor die swanger adolessent wat 'n aborsie verkies, aangesien hul vermoë om die berading te hanteer, beïnvloed kan word. Die ondersoek toon dat baie verpleegsters onseker voorgekom het tydens berading, hoewel hulle gevoel het dat hulle bekwaam is om swanger adolessente te adviseer. Hulle verklaar dat hulle nie genoeg kennis oor die verskillende opsies, veral pleegsorg en aanneming, gehad het nie, en dus pasiënte na 'n maatskaplike werker of Options Pregnancy Centre verwys het. Maatskaplike werkers het berading aan swanger adolessente wat die termyn van die swangerskap wou voltooi, met sekerheid hanteer. In die proses is krisis-ingryping uitgeoefen wat dan ook gepas is vir berading voor 'n aborsie. Die maatskaplike werkers het egter gevoel dat hulle nie genoeg inligting oor die aborsieproses en die emosionele gevolge daarvan gehad het om die swanger adolessent wat 'n aborsie verlang, effektief voor te lig nie. Die studie het getoon dat respondente die adolessent se situasie en die erns van die besluit wat gemaak moes word, met empatie en begrip hanteer het. Met die studie is ook bevind dat maatskaplike werkers en verpleegsters bereid was om verdere opleiding te ontvang en sodoende hul kennis en vaardighede te verbeter. Die opleiding moet dus nie op houdings fokus nie, maar eerder die ontwikkeling van vaardighede. Dit behoort te fokus op die aard van die krisis en die stappe van krisis-intervensie.

Syftet med denna studie har varit att generera kunskap om det samtida abortmotståndet i Sverige genom att undersöka samtida och svensk abortkritisk diskurs, samt hur diskursen framställer abort som fenomen. Empirin har bestått utav texter från två abortkritiska organisationer: ”Ja till livet” och ”Människorätt för ofödda”. Studiens teoretiska utgångspunkt har varit en Foucault-inspirerad diskursteori, och empirin har analyserats med hjälp av en diskursanalys. Resultaten visar att den samtida abortkritiska diskursen i Sverige innefattar ett centralt element inom vilket fostret definieras som ett ofött barn, och därigenom konstrueras fostret som en egen individ med ett essentiellt människovärde. Vidare framställs abort som mord, likväl som en oansvarig och moraliskt felaktig handling. Däremot framställs fullföljandet av en graviditet och sedermera att axla föräldraskapet som det främsta sättet att ta ansvar. Ytterligare resultat identifierar ett element där abortkritik definieras i termer av kvinnans bästa; ett element inom vilket abort konstrueras som skadligt för kvinnor, och kvinnor konstrueras som offer inför abort och aborttvång. Slutligen hävdar diskursen sanningsanspråk genom hänvisningar till vetenskaplig kunskap och moraliska övertygelser; och genom att framställa diskursens världsbild som objektiv sanning så utmanas den allmänna svenska diskursen. / The purpose of this study has been to generate knowledge regarding the contemporary anti-abortion movement in Sweden, by examining the contemporary anti-abortion discourse and it’s construction of abortion as a phenomenon. The empirics has included texts from two anti-abortion organisations: ”Ja till livet” and ”Människorätt för ofödda”. The study has relied on a theoretical base of discourse theory inspired by Foucault, and the empirics have been examined through a discourse analysis. The results shows that the contemporary anti-abortion discourse in Sweden relies on a central element where the feetus is referred to as an unborn child, and therefore constructed as a person with an essential human worth. Furthermore, abortion is presented as an act of murder, as well as irresponsible and morally wrong. The act of carrying the pregnancy to term and then caring for the child is however presented as the ultimate way to take responsibility. In addition to this, a ”pro-woman”-element constitutes the discourse; constructing abortion as harmful to women, and women as victims of both abortion and coercion. Finally, the discourse claims its veracity by referring to science and moral convictions, and by claiming its view of the world as objectively true, the popular discourse on abortion is challenged.

Chromosomal aberrations are common causes of abnormal development of fetuses leading to the birth of malformed indvidual or to the intrauterine death. Half of miscarriages in the first trimester and a third in the second trimester are caused by fetal chromosomal abnormalities, mainly aneuploidies. If fetus is abnormally developed, invasive prenatal cytogenetic diagnosis should be recommended. Positive cytogenetic finding can be reason for induced abortion till the end of 24th week of gestation. We investigated 81 miscarriages, 46 fetuses from induced abortions and 80 fetuses with abnormal development from ongoing pregnancies. G-banding analysis was used as the main method for investigating miscarriages. Genomic DNA isolated from abnormally developed fetuses was screened by array CGH technique. We found 43,75 % chromosomal abnormal miscarried fetuses, majority of them with numerical aberrations (91,4 %). In group of induced abortions, 25,71 % fetuses carried chromosomal abnormality. The lowest rate 11,67 % of chromosoal aberrations was detected in group of prenatally diagnosed fetuses from ongoing pregnancies. Array CGH detected submicroscopic aberrations in 13,41 % fetuses with ultrasound findings. All together 25,74 % microscopic and causal submicroscopic chromosomal abnormalities were found to be...

Made available in DSpace on 2016-04-26T20:26:32Z (GMT). No. of bitstreams: 1 Dissertacao Frediano Teodoro.pdf: 2187368 bytes, checksum: 975366d3781c6a80d572caa971ad12a8 (MD5) Previous issue date: 2005-05-17 / Conselho Nacional de Desenvolvimento Científico e Tecnológico / The amazing technological advances in prenatal exams have reintroduced discussions on the right to abortion. The possibility of observing the development of the fetus since its early stages and being able to detect possible abnormalities in advance creates a new legal scenario involving the possibility of ending pregnancy before its term that is, abortion when doctors verify the existence of malformation that can make life outside the womb impossible. Since the early 1990 s, hundreds of court decisions have authorized the early ending of pregnancy in view of a serious fetal abnormality, mainly in the cases of anencephaly. The defenders of this new type of abortion, the so-called eugenic abortion, allege that the elimination of the fetus should be authorized as it does not stand any chances of surviving. Some define it as a stillborn child, thus creating an analogy between anencephaly and brain death. Moreover, they say that submitting a woman to withstand pregnancy of an anencephalic child can be compared to submitting her to cruel or degrading treatment, as, at the end of the nine-month term the child will die, which means the mother will suffer unbearable distress. The purpose of this work is to alert the defenders of eugenic abortion that the abnormal fetus is a living being and eliminating it on the grounds that it shows physical characteristics that do not meet the parents expectations is a crime aggravated by motivation based on prejudice and, further, it is the first step towards the implementation of a eugenic, racist policy, leading to the purification of the human race, which has been repelled by the Brazilian Constitution. / Com o espantoso avanço tecnológico dos exames pré-natais, reacende a discussão em torno do direito ao aborto. A possibilidade de se observar o desenvolvimento do feto, desde os seus primeiros momentos, e diagnosticar antecipadamente eventuais anomalias, cria uma situação jurídica nova sobre a possibilidade de interrupção da gravidez leia-se aborto quando constatadas deformidades que tornem o feto incompatível com a vida extra-uterina. Desde o início da década de 1990, centenas de decisões judiciais autorizaram a interrupção da gravidez em razão de grave anomalia fetal, principalmente nos casos de anencefalia. Os defensores dessa nova modalidade de aborto, o aborto eugênico, alegam que a eliminação do feto deve ser autorizada, pois ele não tem a mínima chance de sobreviver. Alguns chegam a defini-lo como natimorto, criando uma analogia entre a anencefalia e a morte cerebral. Além disso, afirmam que submeter a mulher a uma gravidez de um filho anencéfalo seria o mesmo que submetê-la a um tratamento cruel ou degradante, pois, ao final dos nove meses, seu filho irá perecer, o que significaria um enorme tormento para ela. Este trabalho tem o objetivo de alertar os defensores do aborto eugênico que o feto anômalo é um ser vivo e eliminá-lo, pelo fato de apresentar características físicas aquém das desejadas pelos seus pais, além de ser um crime agravado pela motivação de cunho preconceituoso, é o primeiro passo para a implantação de uma política eugênica, racista, de purificação da raça humana, rechaçada pela Constituição Federal brasileira.

Made available in DSpace on 2016-01-26T12:51:34Z (GMT). No. of bitstreams: 1 danielaprudenteteixeiranunes_dissert.pdf: 2007548 bytes, checksum: 1b9b96cf5d50556af914f8157e7d26ec (MD5) Previous issue date: 2010-12-16 / Adenosine deaminase (ADA), an enzyme coded by ADA gene (20q13.11) acts in adenosine metabolism and it is involved in the modulation of the immune response. ADA gene G22A polymorphism originates two co-dominants alleles ADA*01 and ADA*02 and influences the level of ADA enzyme in the organism. Apparently it has a fundamental role in gestational maintenance. The ADA*02 allele has been associated as protector effect against recurrent spontaneous abortion (RSA) in European Caucasian women. Aim: To investigate if ADA gene G22A polymorphism is associated with occurrence of RSA in Brazilian women. Methods: After obtaining the written consent 311 women were selected to compose two groups: G1 with previous history of RSA (n=129) and G2 without previous history of RSA (n=182). Genomic DNA was isolated from peripheral blood using commercial kits. The PCR-RFLP method was used to identify ADA gene G22A polymorphism. p>0005 was considered statistically significant. Results: The frequencies of ADA*01;*01, ADA*01;*02 and ADA*02;*02 genotypes were similar in both groups (G1 and G2) with no statistically significance differences observed (p = 0,7170; x2 = 0,6653; GL = 2). ADA*01 and ADA*02 alleles frequencies were 95,6% and 4,4% in G1 group and 94,9% and 5,1% in G2 group, respectively (p = 0,8433; OR = 1,179; CI 95%: 0,5340 2.601). Conclusion: The results suggest that ADA alleles ADA*01 and ADA*02 are not associated with RSA. It xvi is possible that the reduction of ADA levels resulting from the presence of at least one ADA*02 allele do not have a role against abortion in Brazilian women. / Polimorfismo G22A do gene ADA e abortamento espontâneo recorrente: ausência de associação Introdução: A adenosina deaminase (ADA), uma enzima codificada pelo gene ADA (20q13.11), atua no metabolismo da adenosina e modula a resposta imune. O polimorfismo G22A deste gene origina os alelos co-dominantes ADA*01 e ADA*02 e influencia o nível de expressão da enzima ADA, que possui papel fundamental na manutenção da gestação. O alelo ADA*02 tem sido associado a um efeito protetor contra o abortamento espontâneo recorrente (AER) em mulheres caucasianas européias. Objetivo: Investigar se o polimorfismo G22A do gene ADA se associa à ocorrência de AER em brasileiras. Métodos: Após obtenção do Termo de Consentimento Livre e Esclarecido (Parecer CEP FAMERP 308/2008), 311 mulheres foram selecionadas para compor dois grupos: G1 com histórico de AER (N=129) e G2 sem histórico de AER (N=182). O DNA genômico foi extraído a partir de sangue periférico com o uso kit comercial. O polimorfismo G22A do gene ADA foi identificado com o uso do método PCR-RFLP. O valor p>0,005 foi considerado significante. Resultados: As frequências dos genótipos ADA*01;*01, ADA*01;*02 e ADA*02;*02 foram semelhantes entre os grupos e não apresentaram diferenças estatisticamente significantes (p = 0,7170; χ2 = 0,6653; GL = 2). As frequências dos alelos ADA*01 e ADA*02 em G1 foram iguais a 95,6% e 4,4%; em G2, 94,9% e 5,1%, respectivamente (p=0,8433; OR=1,179; IC 95%: 0,5340-2.601). Conclusões: Os resultados sugerem que xiv os alelos ADA*01 e ADA*02 do gene ADA não estão associados ao AER. É possível que a redução nos níveis da ADA resultantes do alelo ADA*02 não apresente um efeito protetor contra o AER em brasileiras.

The purpose of this study has been to find out if the Christian Democratic Party of Sweden have changed their policy in their fundamental questions of value. In order to do this, I have based my study upon the following two questions: 1. How did the Christian Democracy's view and politics look at the issue of abortion? 2. How did Christian Democracy's family policy and view of family look like? The reason for choosing these two issues – the Christian Democratic Party’s abortion stance and family policy – is because these two issues are the founding core of the ideology that is known as Christian democracy – family and dignity. In order to answer my questions, I have chosen to go through parliamentary bills at the website of the swedish parliament. There I found bills from the Christian Democratic Party in the issues of abortion and family between the years 1985 and 1998. I have chosen a qualitative method and with that method dived into the archives of the swedish parliament. The reason for chosing a qualitative method has been because that method relies on the possibility of reaching results by analyzing words rather than numbers, which is preferable as this study intends to analyze and interpret what Christian Democratic MPs have written in their parliamentary bills. With the qualitative method, I have gone through the motions and focused on writing about abortion legislation and the right to life when it comes to abortion, and staying in daycare versus children in home care when it comes to family policy. The study shows that the Christian Democratic Party of Sweden did infact radically change in some core issues like the abortion stance when, for example, they supported the abortion legislation. They have also increasingly come to focus on the abortion and pregnancy prevention work. The Christian Democratic family policy, however, has proved to be more consistent, although here too, some pragmatism has been shown, for example when it comes to testing the need for child allowance for certain groups.

<p>The overall aim of this thesis was to examine the adoption of emergency contraceptive pills (ECP) in Sweden. Two cross-sectional surveys and two quasi-experimental studies were used. Reasons for induced abortion, contraceptive practices and contraceptive failure were examined in a group of abortion applicants with a waiting-room questionnaire (I) and knowledge, use and practices of ECP were assessed with a postal questionnaire in a population-based sample of young women (II). One community-based information campaign was evaluated with a repeated postal questionnaire (III) and a school-based education intervention was evaluated with repeated class-room questionnaires (IV). Abortion applicants had inadequate contraceptive practices and a low use of ECP. One year after the deregulation of ECP women were highly aware of the method and preferred the pharmacy for the purchase of ECP. Correct knowledge and positive attitudes influenced the willingness to use ECP in the future. The information campaign was noticed by two-thirds of the women and there was an overall trend towards better knowledge, improved attitudes and increased use among all women at follow-up. The school-based intervention improved the students’ knowledge of, and attitudes to, ECP without jeopardizing condom use. The adoption of ECP in Sweden seems to have gone through the first stages of diffusion of an innovation, i.e., developement, dissemination, and adoption, and has reached the stage of implementation since the studies indicated a general awareness of more than 90%, an intention to use in case of need of more than 70%, and womens’ own experience of use of around 30%. The most cited information channels were media, friends and the local Youth Clinic. ECP is gradually becoming a more widely known, accepted and used contraceptive method in Sweden, but must be considered as being only one of many tools in the prevention of unintended pregnancies.</p>