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)

The Choice on Termination of Pregnancy Act (no 92 of 1996) was implemented during 1997. This study attempted to investigate professional nurses' attitudes towards rendering these services in the Carletonville area of South Africa. The research results, obtained from questionnaires completed by professional nurses, indicated that most professional nurses would prefer:  women to be at least 16 years of age to access these services  not to allow repeated terminations of pregnancy to the same women  to administer pills rather than to use vacuum aspirations  to work in these services by choice only  to have better equipment, more resources and more staff members in units offering these services  more support from their families, friends, managers and communities Some professional nurses experienced guilt, depression, anxiety and religious conflicts as a result of the nature of their work. / Health Studies / M.A. (Health Studies)

This dissertation deals with a theological-ethical evaluation of the Termination of Pregnancy Act of 1996 on the area of abortion on demand. It aims at empowering women and also solving the problem of backstreet abortion. Chapter one gives a brief introduction to the Termination of Pregnancy Act of 1996. Chapter two gives a historical background of abortion and the factors tbat eventually led to the Termination of Pregnancy Act of 1996. Chapter three focuses mainly on the teachings of the Roman Catholic Church on abortion. Issues relating to the value of human life are discussed in this chapter. Is~~es relating to the Termination of Pregnancy Act of 1996 and their theologicalethical in.Jplications are discussed in this chapter, i.e. chapter four. Empowering of women, sex education, instilling good moral values to the youth and also changing the pastoral attitude of churches towards sexuality can help to alleviate the problem of unwanted pregnancy. / Philosophy, Practical and Systematic Theology / M. Th. (Theological Ethics)

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)

Aim: The 1996 Choice on Termination of Pregnancy Act decriminalized abortion in South Africa and the South African Medicines Control Council in 2000 approved the dispensing of emergency contraceptive methods by pharmacists to women without a doctor's prescription. This legislation has been hailed as among the most progressive in the world with respect to women's reproductive justice. However the realisation of these rights in practice has not always met expectations in part due to medical practitioners' ethical objections to termination of pregnancy and the provision of related services. The aim of this study was to interpret the varying ways in which medical practitioners frame termination of pregnancy and emergency contraceptive services, their own professional identities and that of their patients/clients. Methods: Sample of 58 doctors and 59 pharmacists drawn from all nine provinces of South Africa. Data collected using an anonymous confidential internet-based self-administered questionnaire. Participants were randomly recruited from online listings of South African doctors and pharmacists practicing in both private and public sectors. Data were analysed using theoretically derived qualitative content analysis. Results: Participants drew on eight frames to justify their willingness or unwillingness to provide termination-of-pregnancy related services: the foetal life frame, the women's rights frame, the balancing frame, the social justice frame, the do no harm frame, the legal and professional obligation frame, the consequences frame and the moral absolutist frame. Conclusion: Health professionals' willingness or unwillingness to provide termination of pregnancy related services is highly dependent on how they frame or understand termination of pregnancy, and how they understand their own professional identities and those of their patients/clients.

Department of Public Health / MPH

The aim of this study was to describe the nurses‘ perception of termination of pregnancy and her perception of her conduct towards clients that request termination of pregnancy guided by Kings‘ Systems Approach and Goal Attainment Theory. A non-experimental quantitative descriptive correlational design was used. A non-probability purposive sampling method was used consisting of institutions in the Western Cape, available to participate in this study, which deliver termination of pregnancy services, gov ernment health care institutions (21) and Marie Stopes clinics (3). Non-probability convenience sampling was used consisting of registered nurses who are working in termination of pregnancy units in these facilities (N=82). Data were collected through the administration of a self-designed questionnaire. The main findings of the study indicate that respondents (personal system) appear to feel positive about the work they are doing. Formal improvement and development are however not utilised optimally. Regarding the interpersonal system, respondents also show a positive orientation to both the woman opting for termination of pregnancy and the foetus. The potential towards transaction and ultimately goal attainment reside within this system. The respondents are also positive about legislation, employers and policies (social system) relating to termination of pregnancy. This orientation creates a milieu that is conducive to transactions, interactions and goal attainment.The main recommendation is that three systems as proposed by King be continuously integrated within the termination of pregnancy setup through, amongst other measures: values clarification, management support, in service education, the inclusion of termination of pregnancy in undergraduate programmes, focus groups and the like. / Die doel van hierdie studie was om die verpleegkundige se persepsie van terminasie van swangerskap en haar persepsie van haar houding en gedrag teenoor kliёnte wat terminasie van swangerskap versoek, aan die hand van King se Sisteembenadering en Doelwitbereikingsteorie te ondersoek en te beskryf. `n Nie-eksperimentele kwantitatiewe beskrywende korrelasie navorsingsontwerp was gebruik. `n Nie-waarskynlike doelbewuste-steekproefneming van die staatsgesondheidsorg-instansies wat terminasie van swangerskapdienste aanbied, is geneem en wat beskikbaar vir hierdie studie was (21) asook die Marie Stopesdienste (3), in die Wes-Kaap. `n Nie-waarskynlike gerieflikheidsteekproefneming is van verpleegkundiges geneem wat swangerskappe in hierdie afdelings termineer of moet termineer (N=82). Data is met behulp van `n selfontwerpte vraelys ingesamel. Die hoofbevindings van die studie dui daarop dat respondente (persoonlike sisteem) positief voel oor hul werk. Formele ontwikkelingshulpbronne word egter nie optimaal deur die sisteem benut nie. Wat die interpersoonlike sisteem betref, toon respondente ook ‗n positiewe oriëntasie tot beide die vrou wat terminasie van swangerskap aanvra en die fetus. Die potensiaal tot transaksie-sluiting en uiteindelike doelwitbereiking is binne hierdie sisteem geleë. Die respondente is ook positief oor wetgewing en die werkgewer en beleid (sosiale siteem) ten opsigte van terminasie van swangerskap. Hierdie oriëntering laat ‗n milieu wat bevorderlik is vir transaksie-sluiting, interaksie en doelwitbereiking. Die hoofaanbeveling is dat voortdurend gepoog moet word na die integrasie van King se drie sisteme binne die terminasie van swangerskapafdelings deur onder meer: waarde-uitklaringswerkswinkels, ondersteuning van bestuur, indiensopleiding, die insluiting van terminasie van swangerskap in voorgraadse kurrikula, fokusgroepe en so meer. / Health Studies / D. Litt. et Phil. (Gesondheidstudies)

The Choice on Termination of Pregnancy Act (Act 92 of 1996) states that “reproductive rights must be guaranteed and reproductive health services must promote people’s rights to privacy and dignity”, but most communities seem to lack proper information about this legislative aspect. The purpose of the study was to explore the community’s perceptions regarding legal choice of termination of pregnancy in order to have a broader understanding how the community views termination of pregnancy, and whether they are able to access legal termination of pregnancy. An exploratory qualitative study was conducted. The exploratory and descriptive research assisted the researcher to have adequate time to explore and describe the community’s perceptions about termination of pregnancy. The researcher purposely selected participants who consult at a particular Tshwane hospital as most of this particular community members presents with complications of illegal abortions. Both men and women above 18 years had an opportunity to participate. Data was collected until saturation is reached. Thematic analysis was conducted. The findings reveal that the community still needs to be given more information about rights and laws surrounding termination of pregnancy. Recommendations were made to create more awareness and improve access. / Health Studies / M.A. (Health Studies)

The aim of this study was to describe the nurses‘ perception of termination of pregnancy and her perception of her conduct towards clients that request termination of pregnancy guided by Kings‘ Systems Approach and Goal Attainment Theory. A non-experimental quantitative descriptive correlational design was used. A non-probability purposive sampling method was used consisting of institutions in the Western Cape, available to participate in this study, which deliver termination of pregnancy services, gov ernment health care institutions (21) and Marie Stopes clinics (3). Non-probability convenience sampling was used consisting of registered nurses who are working in termination of pregnancy units in these facilities (N=82). Data were collected through the administration of a self-designed questionnaire. The main findings of the study indicate that respondents (personal system) appear to feel positive about the work they are doing. Formal improvement and development are however not utilised optimally. Regarding the interpersonal system, respondents also show a positive orientation to both the woman opting for termination of pregnancy and the foetus. The potential towards transaction and ultimately goal attainment reside within this system. The respondents are also positive about legislation, employers and policies (social system) relating to termination of pregnancy. This orientation creates a milieu that is conducive to transactions, interactions and goal attainment.The main recommendation is that three systems as proposed by King be continuously integrated within the termination of pregnancy setup through, amongst other measures: values clarification, management support, in service education, the inclusion of termination of pregnancy in undergraduate programmes, focus groups and the like. / Die doel van hierdie studie was om die verpleegkundige se persepsie van terminasie van swangerskap en haar persepsie van haar houding en gedrag teenoor kliёnte wat terminasie van swangerskap versoek, aan die hand van King se Sisteembenadering en Doelwitbereikingsteorie te ondersoek en te beskryf. `n Nie-eksperimentele kwantitatiewe beskrywende korrelasie navorsingsontwerp was gebruik. `n Nie-waarskynlike doelbewuste-steekproefneming van die staatsgesondheidsorg-instansies wat terminasie van swangerskapdienste aanbied, is geneem en wat beskikbaar vir hierdie studie was (21) asook die Marie Stopesdienste (3), in die Wes-Kaap. `n Nie-waarskynlike gerieflikheidsteekproefneming is van verpleegkundiges geneem wat swangerskappe in hierdie afdelings termineer of moet termineer (N=82). Data is met behulp van `n selfontwerpte vraelys ingesamel. Die hoofbevindings van die studie dui daarop dat respondente (persoonlike sisteem) positief voel oor hul werk. Formele ontwikkelingshulpbronne word egter nie optimaal deur die sisteem benut nie. Wat die interpersoonlike sisteem betref, toon respondente ook ‗n positiewe oriëntasie tot beide die vrou wat terminasie van swangerskap aanvra en die fetus. Die potensiaal tot transaksie-sluiting en uiteindelike doelwitbereiking is binne hierdie sisteem geleë. Die respondente is ook positief oor wetgewing en die werkgewer en beleid (sosiale siteem) ten opsigte van terminasie van swangerskap. Hierdie oriëntering laat ‗n milieu wat bevorderlik is vir transaksie-sluiting, interaksie en doelwitbereiking. Die hoofaanbeveling is dat voortdurend gepoog moet word na die integrasie van King se drie sisteme binne die terminasie van swangerskapafdelings deur onder meer: waarde-uitklaringswerkswinkels, ondersteuning van bestuur, indiensopleiding, die insluiting van terminasie van swangerskap in voorgraadse kurrikula, fokusgroepe en so meer. / Health Studies / D. Litt. et Phil. (Gesondheidstudies)

The South African government promulgated the Choice on Termination of pregnancy Act (CTOP Act, 92 of 1996). This was a dramatic declaration of intent unprecedented in the African continent and globally. This act changed the outlook of the practice of termination of pregnancy by ensuring that services play a critical role in the delivery of the service. This study, which is qualitative in nature, explored the experiences of Termination of Pregnancy service providers working in three designated public health institutions in the Limpopo Province. Interviews were conducted with six service providers to look at how they construct their practice of providing termination of pregnancy services. The information was analyzed and interpreted by means of a thematic analysis method. Major themes that emerged from the participants’ experiences centred on their relationship with family, colleagues, management, clients, and the community reflecting a sense of alienation and lack of adequate infrastructural support. Inadequate support has been found to greatly contribute to the loss of interest in the work around abortion. / Psychology / M. A. (Clinical Psychology)