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)

Literature reveals that reproductive coercion is a major contributor to unwanted pregnancy and a factor that influences the choice to terminate pregnancy in many adolescents. Adolescents represent a population vulnerable to a number of physical and psychological problems. Purpose The overall aim of this thesis was to develop a model of self-forgiveness for women who terminated pregnancy in adolescence. Objectives The study objectives are aligned according to the phases of the study as follows: Phase 1: Desk review Explore what is already known about the topic and identify gaps. Phase 2: Lived experiences of participants about TOP Explore the lived experiences of participants who terminated pregnancy in adolescence. Phase 3: Development of a model Develop a model of self-forgiveness for women who terminated pregnancy in adolescence. The social-ecological model (Bronfenbrenner 1992), through which individuals are understood to influence and be influenced by people, organisations, institutions, societal norms, rules and beliefs with whom they interact, was followed. The model offered a holistic framework for exploring interrelationships related to TOP Methodology A qualitative approach based on Heidegger (1962) interpretive phenomenological approach was used. The study was conducted at a Health Care Centre in Tshwane Municipality, Gauteng Province, South Africa. The population consisted of women, 20-35 years old, who terminated pregnancy in adolescence. A purposive and snowball sampling techniques were used to recruit 30 participants who had terminated pregnancy in adolescence. An interview guide was used to solicit information from participants. Audiotaped interviews were held at the time, date and place agreed by participants. Colaizzi’s (1978) approach of data analysis was used. Results Five major themes emerged, with 17 sub-themes as transgressing one of nature’s strongest instincts: the mother’s protection of her young; unplanned pregnancy; intra-and interpersonal relationships; experience of caring by health care professionals and a need for counselling. A model of self-forgiveness for women who did TOP in adolescence, based on the components of self-condemnation and self-blame, cultural and spiritual, as well as reproductive coercion, was developed. Conclusion Participants carried the burden of shame and guilt of having terminated pregnancy in adolescence. The influence of culture and religion were the major contributing factors to women failing to forgive themselves after termination of pregnancy. A model of self-forgiveness is needed to allow those who terminated pregnancy in adolescence to move on with their life. / Health Studies / D. Litt. et Phil. (Health Studies)

Adolescents have become focal points of discussions and debates regarding sexuality and reproductive health matters. However, little research has been done particularly in South Africa to examine their knowledge concerning abortion and emergency contraception. Research indicates that a substantial proportion of adolescent pregnancies are unintended or unwanted. Abortion and emergency contraception are both time-sensitive services. Thus having accurate and comprehensive knowledge about both abortion and emergency contraception is pivotal, in the case of unintended or unwanted pregnancy or when engaging in unprotected sex or experiencing contraceptive failure that could lead to pregnancy. The 1994 International Conference on Population and Development (ICPD) defined reproductive health rights for both men and women as the right to "decide freely and responsibly the number, spacing and timing of their children and to have the information and means to do so" (p. 60). That is, men and women should "have the right to make decisions concerning their reproduction free of discrimination, violence and coercion" (ICPD, 1994, p.60). Based on these definitions, it is rather evident that comprehensive and accurate knowledge are at the core of one's ability to make an informed consent. This is confirmed by Adler's (1992, p. 289) definition of informed consent or choice "a) access to sufficient information b) understanding the information c) competence to evaluate potential consequences d) freedom to make a choice and e) the ability to make and express that choice". It is from this framework that this study emerged. The aim of this study was to examine adolescents' knowledge concerning abortion and emergency contraception. The participants were Grade 11 learners between the ages of 15-24 years from five different schools in the Buffalo City Municipality. A sample of 514 was achieved. Data were analysed using descriptive cross-tabulation, chi-square and qualitative methods where appropriate. The results revealed that most of the participants did not have sufficient accurate knowledge concerning the Choice on Termination of Pregnancy Act, consequences of legal abortion and emergency contraceptive pills to make informed decisions. Furthermore, data also revealed that the participants' schools playa role in their sexual activity, their knowledge about the Choice on Termination of Pregnancy Act and about emergency contraceptive pills. Although this method made it feasible for the researcher to make general assumptions, non-responses were one of the limitations of the study. Similar research in various municipalities/cities in and outside the Eastern Cape is recommended so as to increase further awareness concerning the level of knowledge that adolescents have about contraceptive pills particularly emergency contraceptive pills, the Choice on Termination of Pregnancy Act and abortion in general.