Abortion is a highly controversial subject that has again come into the spotlight in South Africa due to the legalisation of abortion on demand in 1996. The results of various studies conducted since the Choice on Termination of Pregnancy Act 92 of 1996 was implemented, have indicated that abortion providers have met with a great deal of negativism and ostracism. This study focused on the implications of abortion work on nurses' social relationships with family, friends, colleagues and their communities. Recent literature was reviewed on the subject. The researcher however, found little information on this specific aspect of abortion. The study was conducted with abortion nurses from two government designated hospitals in the East London area responsible for abortion services. Thus, results cannot be generalised. This is a qualitative study that aimed at obtaining firsthand information regarding the personal experiences of abortion nurses. A non-probability sampling technique was used viz. criterion sampling. The Interview Guide Approach was used whereby in-depth, semi-structured interviewed were conducted with the guidance of a set of questions in the form of an Interview Schedule. The ten respondents were asked to share their recommendations as to possible measures that could address the challenges mentioned during their interviews. The researcher came to the conclusion that nurses' social relationships and lives are definitely impacted by abortion work. This impact is largely negative as the majority of respondents experience labelling, stigmatization and ostracism from family, friends, and their colleagues. Abortion nurses also experience a lack of social support, ambivalent feelings with regard to abortion, and a range of negative emotions ranging from stress and depression to frustration and anger. A number of repeat abortions are being done and there seems to be a general lack of contraception. The need exists for nurses to go to Value Clarification Workshops and also to get support in terms of compulsory, continuous, counselling. Separate wards should be set up for abortions whilst sex education should be included in school curriculums at both primary and secondary schools. Family planning and facts about the abortion process should also be included in these sex education programmes. Overall. the need exists for family planning initiatives to promote contraception and deter women from using abortion as a means of contraception. As this study reveals, conducting abortions has come at a great cost for the majority of nurses who lack social support and bear the brunt of anti-abortion sentiment expressed by significant others in their lives. The latter being the people who would normally be the one's they would turn to for help, counsel, support and assistance

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)

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)

The prevalence of and increase in unplanned pregnancies (UPs) and the termination of pregnancy (TOP) amongst tertiary students (TSs) have been found to have a detrimental impact on students, their significant others, and tertiary institutions. UPs amongst TSs have been mentioned as one of the factors contributing to the problem of high dropout rates, which calls for an investigation of this phenomenon and strategies to address it. Despite the need for support to TSs who find themselves in the predicament of an UP and/or TOP, a lacuna has been found with specific reference to practice guidelines from the ambit of social work to assist service providers (SPs) in the provision of psychosocial support services to the said students. To explore and describe the experiences, support, and support needs of TSs presenting with UPs and/or TOPs from the perspectives of these students and the SPs rendering services to them, as well as to gather suggestions from them to inform practice guidelines for psychosocial support, the qualitative research approach, designs, and methods of data collection were used to collect data from six TS- and 23 SP-participants that were purposively recruited. Presenting the findings against the backdrop of Schlossberg’s Transition Process Model (Schlossberg, 2011 & 1981), adopted as theoretical framework for the study, the following emerged: Experiencing an UP and/or TOP is a traumatic crisis event for TSs, which rings in a transition resulting in imminent and fundamental changes in their academic and social life, relationships, outlook on life, and self-image, as well as a smorgasbord of feelings and emotional reactions such as shock, denial, guilt, shame, loneliness, depression and anger following this event. The UP-crisis is arrested by deciding how to manage it (either through parenting, foster care, adoption, or TOP). This decision-making process is perceived as difficult with the formal and/or informal convoy of support, or lack thereof, having a decisive influence on the outcome of how the UP is managed. Apart from TS-participants’ appraisal of the support that they received in dealing with this life event, they articulated several support needs and suggestions for themselves and other TSs alike. The SPparticipants also offered several suggestions on how psychosocial support to a TS confronted with this phenomenon should be provided. The suggestions from both participant groups informed the practice guidelines to assist SPs in providing psychosocial support to TSs presenting with an UP and/or TOP. These guidelines focus specifically on how to establish a helping relationship with a TS presenting with the concern of an UP and/or a TOP, and how to assess and intervene in the situation, the self, the support, and the (coping) strategies surrounding the TS’s UP and/or TOP. In addition, recommendations for university policies on student pregnancies, social work practice, and further research were made. / Social Work / D. Phil. (Social Work)

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)

The legalising of abortion in many countries has given women the choice or right to decide to terminate pregnancy. The Choice on Termination of Pregnancy Act (Act No 92 of 1996) was promulgated in 1997. This legislation promotes reproductive rights including to choose between having an unwanted pregnancy terminated early, safely and legally. The legislation affects both the women who choose to terminate pregnancy and the staff involved in the termination of pregnancy (TOP) procedures. This exploratory, descriptive and contextual qualitative study was designed to gain insight into the experiences of registered nurses in the procedure for termination of pregnancy and to explore recommendations based on these experiences. The researcher adopted a phenomenological approach. Participants were drawn from registered nurses providing TOP services at Soshanguve Community Health Centre near Pretoria. Registered nurses have the right to refuse to participate in TOP, those that do provide the service are exposed to emotional and psychological trauma. / Health Studies / M.A.

The Choice on Termination of Pregnancy Act (CTOP Act 92 of 1996) is perhaps the most revolutionary piece of legislation internationally ever to have been promulgated to regulate abortion and as such women’s reproductive lives. Abortion research tends to focus on the experiences of women and thus cast abortion as solely a territory that represents women’s reproductive concerns and the power to choose to procreate. While the CTOP Act safeguards women’s right of choice and a form of determination relating to what happens to their bodies, it also fails to recognise or even make pronouncements about the role that a man plays in the choice to terminate a pregnancy as well as how abortion affects a man’s life. This therefore implies that legally, men do not have a stake to influencing the decision to terminate a pregnancy. This qualitative study was undertaken to explore how young unmarried males whose partners have undergone an abortion construct abortion and the meanings that they attach to the experience of abortion. Interviews were conducted and the data was analysed using discourse analysis. Some of the young men knew about the woman’s decision to have an abortion and others did not know. Common findings include a sense of helplessness due to feeling that the decision is ultimately that of the woman, anger for those who did not know about the decision to abort and a lack of forgiveness towards their partners. / Psychology / M.A. (Clinical Psychology)

Thesis (MPhil)--Stellenbosch University, 2003. / ENGLISH ABSTRACT: A democratic political system grants unimpaired opportunities for all citizens to have their preferences weighted equally in the conduct of government regardless of content or source. However, governments in democratic political systems frequently disregard public preference. But all governments, not only popular governments, are dependent on the 'will of the people' if the system is to remain viable. This study investigates the relationship between public opinion and public policy in South Africa, using the 1996 Choice on Termination of Pregnancy Act as case study, as it provides a practical example to illustrate this complex relationship. The study used a longitudinal approach to investigate shifts in public opinion over a period of five years, using secondary survey analysis. Attitudes towards abortion are cross-tabulated by demographic variables, religion, interest in politics and democratic norms. The study found that the most significant shifts in public opinion occurred within demographic groups previously discriminated against by the 1975 Abortion and Sterilisation Act. In 1994 South Africa emerged from a lengthy anti-apartheid struggle and human rights were of paramount importance to many South Africans. The restrictive abortion legislation of 1975 was vestige of discriminative apartheid legislation and was not in line with South Africa's exemplary 1996 Constitution. Consequently, progressive abortion legislation was ratified, amidst significant public indifference, in order to promote equal citizenship of women. It is argued that abortion constitutes a basic democratic right, in the context of reproductive health rights, and although South African citizens predominantly support a democratic political system, few made the ideological connection with abortion as a democratic right. Therefore, the study infers that the South African electorate is ill informed of the ideological norms surrounding democracy. The significance of this study is that it investigated abortion not as a legal or moral issue, but as a politicised issue in South Africa. The African National Congress (ANC) was strongly committed to advancing progressive abortion legislation in South Africa. The ANC elected to vote on a party platform on the proposed abortion bill. When a majority party, which holds 252 seats of 400 in the National Assembly, elects to vote as a block on proposed legislation, it is likely that the legislation will be passed into law. This conduct of the ANC raises fears that South Africa is a de facto one-party dominant state, where free and fair elections are held, but no rotation in office occurs. Both the 1994 and 1999 elections led to landslide victories for the ANC, and they are assured that the 2003 elections will yield the same result. It is extremely damaging to any democratic system when competition but no contestation occurs. Therefore, it becomes increasingly difficult to distinguish between state and party interests. The study concludes that in the case of progressive abortion legislation in South Africa, the people did not rule. It is the view of this study that the enactment of the Choice on Termination of Pregnancy Act did not represent democratic conduct. It illustrates that the Choice on Termination of Pregnancy Act was, by implication, "bulldozed" into law by the ANC. / AFRIKAANSE OPSOMMING: 'n Demokratiese politieke stelsel vergun gelyke geleenthede aan elke burger sodat hul voorkeure gelyk opgeweeg word in die optrede van 'n regering, ongeag die bron of konteks daarvan. Nogtans minag regerings gereeld openbare voorkeur. Nie slegs populêre regerings nie, maar alle regerings is afhanklik van volkswil, as slegs dan die stelsel lewensvatbaar sal bly. Hierdie studie ondersoek die verhouding tussen openbare mening en openbare beleid in Suid-Afrika. Die Wet op Keuse oor Beëindiging van Swangerskap van 1996 word gebruik, omdat dit 'n praktiese gevallestudie bied om hierdie komplekse verhouding te illustreer. Die studie maak gebruik van 'n langsdeursnee aanslag om die verandering van openbare mening oor vyf jaar te ondersoek en maak gebruik van sekondêre meningsopname vraelys analiese. Lewenshoudings oor aborsie is kruis getabuleer met demografiese veranderlikes, geloof, intriseerdheid in politiek en demokratiese grondregte. Daar is gevind dat die mees aanduidende veranderinge in openbare menings te vinde was in demografiese groepe waarteen gediskrimineer was deur die Wet op Vrugafdrywing en Sterilisasie van 1975. Suid-Afrika het in 1994 uit 'n wydlopende anti-apartheid stryd getree en mense-regte was van oorwegende belang vir die meeste Suid-Afrikaners. Die 1975 Wet op Vrugafdrywing en Sterilisasie was 'n bewys van diskriminerende apartheid wetgewing en was nie in lyn met Suid-Afrika se nuwe Grondwet nie. Dus is progressiewe aborsie wetgewing bekragtig, om vroue in Suid-Afrika gelyke burgerskap te gee, te midde van deurslaggewende openbare ontevredenheid. Die studie veronderstel dat aborsie 'n grondreg van demokrasie vorm, binne die konteks van reproduktiewe gesondheids-regte. Alhoewel Suid-Afrikaners 'n demokratiese politieke stelsel steun, het weinig die konneksie tussen aborsie en demokratiese ideologiese grondregte gemaak. Die studie maak dus die gevolgtrekking dat Suid-Afrikaners swak ingelig is in verband met die ideologiese grondregte van demokrasie. Die inhoudsbelang van hierdie studie is dat aborsie ondersoek word as 'n politieke vraagstuk en nie as morele of wetregtige vraagstuk nie. Die African National Congress (ANC) was sterk verbind tot die totstandbringing van progresiewe aborsie wetgewing in Suid-Afrika en het besluit om op 'n party-platform te stem in Parlement aangaande voorgestelde progressiewe aborsie wetgewing. Wanneer 'n meerderheidsparty, wat 252 setels van 400 in die parlement beslaan, besluit om as 'n blok te stem oor voorgestelde wetgewing, dit redelik seker is dat dié wetgewing bekragtig sal word. Hierdie gedrag van die ANC gee aanleiding tot vrese dat Suid Afrika 'n de facto een party dominante staat is, waar vry en regverdige verkiesings voorkom, maar geen afwisseling in ampstermyn nie. Dit is skadelik vir enige demokratiese stelsel wanneer kompetisie maar geen betwisting paasvind nie. Gevolglik word dit al hoe moeiliker om te onderskei tussen party-en staatsbelange. Die studie sluit af dat die publiek nie regeer het in hierdie geval nie. Dit is die siening van hierdie studie dat die bekragtiging van die Wet op Keuse oor die Beëindiging van Swangerskap van 1996 nie goeie demokratiese optrede weerspieël het nie en dat dit, by implikasie, deur die ANC deur middel van intimidasie bekragtig is.

The legalising of abortion in many countries has given women the choice or right to decide to terminate pregnancy. The Choice on Termination of Pregnancy Act (Act No 92 of 1996) was promulgated in 1997. This legislation promotes reproductive rights including to choose between having an unwanted pregnancy terminated early, safely and legally. The legislation affects both the women who choose to terminate pregnancy and the staff involved in the termination of pregnancy (TOP) procedures. This exploratory, descriptive and contextual qualitative study was designed to gain insight into the experiences of registered nurses in the procedure for termination of pregnancy and to explore recommendations based on these experiences. The researcher adopted a phenomenological approach. Participants were drawn from registered nurses providing TOP services at Soshanguve Community Health Centre near Pretoria. Registered nurses have the right to refuse to participate in TOP, those that do provide the service are exposed to emotional and psychological trauma. / Health Studies / M.A.