A number of studies have attempted to describe and explain both the levels of and trend in support for abortion in the adult population and college students, yet there is a gap around abortion attitudes of adolescents. This quantitative study aims to examine the levels of knowledge and attitudes of abortion among male and female secondary school learners, to examine gender differences among the learners with regards to abortion attitudes and knowledge as well as to investigate the effect of religion in terms of abortion. A sample of 150 adolescent males and females from Grade 11 between the ages of 15 to 19 years old was chosen to be used in the study. This research study was conducted at a secondary school in a lower middle class suburb in Durban. The learners were required to complete a questionnaire measuring levels of knowledge (based on different components of the South African legislation regarding abortion, that is, the Choice on Termination of Pregnancy (CTOP) Act (1996); a rating scale of abortion attitudes (Esposito & Basow, 1995) and a short biographical component. The statistical programme SPSS 15.0 was used to analyze the data. The results show that the respondents' knowledge about South African legislation governing the act of abortion; varied, attitudes to abortion differed by gender, sexual status and the reasons for abortion. It was found that the older the person, the more positive their attitude towards the elective reasons for abortion. In this study, more positive attitudes towards abortion were prevalent in the Hindu sample as compared to the Christian sample. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2011.

A period of ten years has elapsed since the Choice on Termination of Pregnancy Act came into effect. Little has been done in South Africa to investigate public discourses concerning termination of pregnancy since the implementation of the Act. The social context and the quality of available support systems determine the outcome of the women’s feelings after the abortion. Knowledge about the social context is important, as it will help to understand the complexities and nuances of abortion. The aim of the research is to explore public discourses on Choice on Termination of Pregnancy (CTOP), and the potential implications of these discourses on the use of the CTOP service. The sample consisted of 23 black isiXhosa-speaking participants from the rural area of the Eastern Cape Province in South Africa. Four focus groups coming from different age groups (between the ages 18 and 52) with both men and women participated in the study. Fictitious vignettes that tap into two different scenarios regarding abortion based on women’s stories were used. Discourses that emerged from people’s text are explained, described and interpreted through a discourse analysis. Since the study was interested in public discourses it led to the discovery of 17 interpretative repertoires as follows: social stigma, abortion equated to murder, degradation of society, pregnancy as an irresponsible act, conditional acceptance, TOP in the context of marriage, future potentiality invested in the foetus, dehumanizing foetus into a clot, shared decision making responsibility, gender dynamics interpretative repertoire, negative post abortion consequences, the scolding versus the supportive nurse interpretative repertoire, alternatives interpretative repertoire, rights versus no responsibility interpretative repertoire, more knowledge needed, male and female or generational differentiation repertoire, and the positive effects repertoire. Abortion is opposed on religious and cultural grounds. TOP has been legalized in South Africa but with this a debate and conflicting views have arisen. These variations in people’s discourses may limit access to TOP for women who need the service.

MPH / Department of Public Health / See the attached abstract below

MCur / Department of Advanced Nursing Science / See the attached abstract below

Thesis (MPH.) -- University of Limpopo, 2022 / Background: Termination of pregnancy among young women is a public health issue, particularly in South Africa where high prevalence of pregnany terminations has lately been reported. It is estimated that 260000 terminations of pregnancy take place in South Africa every year. Studies in South Africa have reported that risk factors associated with termination of pregnancy such as financial problems, being poorly educated, being young, unemployed, dependent on parents, widowed or single and other relationship problems were most common. Approximately 1200 pregnancies were terminated in the District Hospital of Limpopo Province between 2017 and 2018. There is also an increased rate of unintended pregnancy among HIV positive women which suggest that women with HIV may be more likely to terminate pregnancy but chooses not to terminate due to fear of being judged. Therefore, the primary objective of this study was to investigate the risk factors associated with termination of pregnancy at a District Hospital in Limpopo Province. Methodology: A cross-sectional descriptive retrospective review study in which convenience sampling of the records of women who terminated pregnancies was used in this study. A self-constructed data extraction tool was used to extract the data from patients records. The tool covered variables such as the age of the women, educational status, marital status, year and month of termination of pregnancy, gestational age, parity, and gravidity, HIV status and circumstances leading to termination of pregnancy. Data analysis was done using the STATA statistical software version 12 for Windows (STATA Corporation, College Station, Texas). The independent t-test was used for variables having two categories as it assesses whether the difference between means of two groups are statistically significant. This test was performed at the 95% confidence level. The p-value of less than 0.05 in the study results was used for statistical significant difference in means between the categories which were investigated. vi Results: The mean age was 27.9 years (standard error [Std. Err.] =0.37) and majority of women who terminated pregnancies were in the age group 20 – 24 years, single and had a secondary educational level. There was a statistical significance difference between age groups and the gestational age, parity and gravidity at p=0.004 and p<0.001 respectively. The proportion of women who were at gestational age of 1 to 8 weeks decreased with increasing maternal age from 22.4% in age ≤20 years to 13% in age group 30 – 34 years. There was again a statistical significance difference (p<0.001) in relation to number of pregnancies that have each resulted in the birth of an infant capable of survival (parity) and similarly to gravida. The prevalence of HIV amongst women who terminated pregnancy in the current study was found to be 21.3% and the risk of women who terminated pregnancies being HIV positive increased significantly with age as older women (age 20 years and above) were 6.5 times more likely to be HIV positive as compared to younger ones (p<001). Low educational level, gestational age of more than 13 weeks and parity of 1 – 2 were significantly associated with termination of pregnancy. The association of gravida of women who terminated pregnancies and HIV revealed that women who were in their second or third pregnancies (gravida) while HIV positive were 3.9 times more likely to terminate pregnancies as compared to those who were first pregnancy (p<0.001). Marital status was not significantly associated with termination of pregnancy. Conclusion: Termination of pregnancies among adolescents and youth is a major public health issue and the findings of this study highlight the need to address the structural socio-economic drivers of family planning which results in high number of termination of pregnancy amongst the youth. Structural interventions, such as increasing contraceptive use which may be useful for reducing the burden of unplanned pregnancies. These findings suggest the need for targeted interventions for women of child-bearing age to access reproductive health interventions to prevent unintended pregnancies and the associated risk of termination.

Unintended and unwanted pregnancies are major reproductive health problems impacting negatively on women’s health globally. When faced with these pregnancies, many women choose termination of pregnancy (TOP) as their recourse. The purpose of the study was to explore and describe physical, psychological and social implications of TOP on the woman’s health. A qualitative and descriptive research design was used. The population comprised women who had TOP three months to one year before the study and were willing to participate in the study. A non-probability purposive sampling was used to select participants for the study. In-depth phenomenological interviews were used for data collection until data saturation was reached with 20 participants. The findings reveal that women had psychological, physical and social implications after TOP which impacted negatively on their health. Recommendations were made to improve the services of women choosing to terminate a pregnancy to lessen negative implications. / Health Studies / M.A. (Health Studies)

This study investigated factors contributing to adolescent mothers' non-utilisation of contraceptives in the Piet Retief (Mkhondo) area. Contraceptives, emergency contraceptives and termination of pregnancy services are available free of charge. Nevertheless the number of adolescent mothers continues to increase in this area. Structured questionnaires were completed by 107 adolescent mothers. Most respondents (70,0%) received no sex education prior to their pregnancies, and were not knowledgeable about contraceptives. Subsequent to the birth of their babies, only 59,81% used contraceptives, risking further pregnancies. Adolescents, from the age of 12, should receive sex education. Availability of contraceptives during weekends could help adolescents to postpone their pregnancies. Health education should be given to the mothers in the Piet Retief (Mkhondo) area so that they can provide more effective sex education (including contraception) to their daughters. / Health Studies / M.A. (Health Studies)

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 investigate sexual activity as well as contraceptive knowledge and use among termination of pregnancy (TOP) clients at Prince Mshiyeni Memorial Hospital’s TOP clinic in the province of KwaZulu-Natal (KZN). This was a non-experimental quantitative study in the form of a cross sectional study. Self-administered questionnaires were used for collecting data from 61 respondents selected non-randomly. The majority of the respondents were single young women between 18 and 27 years of age. Sexual intercourse frequency was mostly once a month (91.8%). Most were unemployed and dependent on government grants and had heard of both contraception in general and emergency contraception. Only 44 (78.6%) had used contraceptives before and the most frequently used method of contraception was the injection (36.6%). Despite the respondents having heard of contraception, the median score of the knowledge of contraception was only 16%. The distribution of knowledge was very wide, but on the whole the level of knowledge of contraception was very low / Health Studies / M.A. (Public Health)

This study investigated factors contributing to adolescent mothers' non-utilisation of contraceptives in the Piet Retief (Mkhondo) area. Contraceptives, emergency contraceptives and termination of pregnancy services are available free of charge. Nevertheless the number of adolescent mothers continues to increase in this area. Structured questionnaires were completed by 107 adolescent mothers. Most respondents (70,0%) received no sex education prior to their pregnancies, and were not knowledgeable about contraceptives. Subsequent to the birth of their babies, only 59,81% used contraceptives, risking further pregnancies. Adolescents, from the age of 12, should receive sex education. Availability of contraceptives during weekends could help adolescents to postpone their pregnancies. Health education should be given to the mothers in the Piet Retief (Mkhondo) area so that they can provide more effective sex education (including contraception) to their daughters. / Health Studies / M.A. (Health Studies)