Thesis (MPH.) --University of Limpopo, 2015 / Background: There are a high number of teenagers seeking Termination of Pregnancy (TOP) at Maggys Hope Clinic in Polokwane Municipality in Capricorn District in Limpopo Province after the Termination of Pregnancy Act was passed in 1997. The numbers have doubled since the inception of the Children's Act no 38 of 2005 and the Sexual Offences Bill in 2008. The report by Stats SA and Department of education also indicated that the numbers have also doubled. Objective: The aim of the study was to determine the factors contributing to termination of pregnancies amongst teenagers at Maggys Hope Clinic in Polokwane Municipality, Limpopo Province. Methods: An exploratory, descriptive qualitative research design was used to identify and describe the factors contributing to termination of pregnancies among teenagers in Maggys Hope Clinic in Capricorn district Limpopo Province South Africa, in April 2014. Results: The results of the study revealed that CTOP legislation is one of the reasons why teenagers terminate. All the twenty participants indicated age and marital status as the motivation as the contributing factor. Looking at the age and educational level the most pushing factor is that thirteen of the participants are still at school. Eleven of the participants have no knowledge of contraceptives. This is a serious concern. Participants indicated that they had very little knowledge on reproductive health issues. The rest of the pushing factors are parental pressure, contraceptive failure, fear of parental disappointment and unpreparedness to raise a child as well. Conclusion: It can thus be concluded that teenage termination of pregnancies is a major health concern in South Africa, Africa and globally. Teenagers’ health is in danger due to engaging in unprotected sex banking on TOP as a solution. The study found that age and fear from dropping out of school, lack parental involvement in sexual matters, family economic status and marital status, including lack of knowledge and information on reproductive health issues, were the main factors contributing to termination of pregnancies among teenagers in Maggys Hope Clinic in Capricorn District, Limpopo Province.

acase@tulane.edu / Gendered social stigmas including those surrounding pregnancy, abortion, and adoption are pervasive, as it is estimated that a majority of women will experience one or more throughout their life course. Seeking to explore the social norms and mechanisms surrounding pregnancy and pregnancy-related choices in the demographic of elite private university students, the present study investigated how undergraduate students perceive pregnancy amongst their fellow unmarried undergraduate peers. Specifically, this study examined whether an undergraduate woman’s decision to have an abortion, carry to term and raise the child, or carry to term and place the child for adoption affects others’ perceptions of the woman herself. The findings are complex, as results suggest than an unmarried undergraduate woman may be judged differently depending on her pregnancy and her subsequent choices regarding that pregnancy, with the most extreme differences emerging between a woman who chooses carry to term and raise the child and a woman who chooses abortion. Furthermore, the results suggest that a pregnant undergraduate woman, regardless of whether she chooses to have an abortion or to carry to term, may face negative judgment from her peers. Whereas a woman who chooses to have an abortion is perceived as less moral and warm than a woman who chooses to raise her child, a woman who chooses to raise her child is perceived as having lower career aspirations than a woman who has an abortion. Moderation by abortion approval and religiosity were also examined. Findings are discussed in light of a stigma tradeoffs model. / 1 / Meagan E Magaldi

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Typescript (photocopy). Thesis submitted under title: Biochemical aspects of early pregnancy in the pig; but doctorate conferred to title: Biochemical aspects of early pregnancy in the sow Includes bibliographical references (leaves 178-205) and list of personal publications related to pig physiology (leaves vi-vii) Examines aspects of early pregnancy in pigs, aimed to identify determinants of the high level of embryonic mortality which occurs prior to implantation

The research literature suggests that clinicians fail to adequately use health education interventions that have been demonstrated to be effective. This thesis examines the use of smoking cessation education (SCE) by clinicians who care for pregnant women. It investigates the clinician, organisational and dissemination variables which impact on the provision of smoking cessation education in antenatal clinics. Individual behaviour change theory, organisational theory and diffusion theory are used to guide the design and analysis of the research. A series of cross-sectional studies are used to investigate the provision of SCE and the outcomes of dissemination of a tested SCE program. Data are collected from multiple sources and both qualitative and quantitative research methods are used. Studies 1 and 2 indicated there was a performance gap between the reported SCE practice of clinicians who provide care for pregnant women and the recommended guidelines for SCE practice. The primary modifiable barriers to the provision of SCE by clinicians were: low clinician self-efficacy with regard to SCE; inadequate smoking assessment; lack of hospital SCE policy; and inadequate training. To overcome these barriers a SCE program was disseminated to 23 hospital antenatal clinics in NSW. Prior to dissemination, the organisational context of the clinics was explored using qualitative methods to determine the potential barriers to dissemination and to recommend strategies to overcome these barriers (Study 3). The remaining Studies (4-6) describe the outcomes of program dissemination using two methods of dissemination (intensive and simple). Clinics were randomly allocated to the two dissemination methods. Studies 4 and 5 describe program adoption by clinic managers three months after the initial dissemination. Study 6 investigates the implementation and maintenance of the program by clinicians 18 months after dissemination. The final study also examines the effect of two methods of dissemination on the provision of SCE in antenatal clinics. Most managers adopted or partially adopted the new SCE program. The fidelity of program adoption was better when intensive dissemination methods were used and when managers had more positive perceptions of the program. Dissemination method did not affect the number of SCE interventions offered by clinics, but clinicians in the intensive dissemination group were more likely to use more intensive and effective forms of SCE intervention. Nevertheless, the program was poorly implemented and SCE was not systematically provided in clinics after dissemination. The organisational, individual and dissemination barriers to health education are described.

2v. : / Title page, contents and abstract only. The complete thesis in print form is available from the University Library. / Thesis (M.D. 1979) from the Dept. of Obstetrics and Gynaecology, University of Adelaide

Aims : The aims of the study were to describe the experiences of the midwives who were part of the first Australian CenteringPregnancy Pilot Study and to inform the future development of CenteringPregnancy. Background CenteringPregnancy is a model of group antenatal care that has evolved over the past two decades in North America. A pilot study that explored the feasibility of implementing CenteringPregnancy in Australia was undertaken in 2006-2008. I was the research midwife employed to coordinate this study and I explored the experiences of the midwives who were participants as the focus of my Master of Midwifery (Honours) research. Method : An Action Research approach was undertaken to study the implementation of CenteringPregnancy in Australia. This included a qualitative descriptive study to describe and explore the experiences of the midwives who were participants. The study was set in two hospital antenatal clinics and two outreach community health-care centres in southern Sydney. Eight midwives and three research team members formed the Action Research group. Data collected were primarily from focus groups and surveys and were analysed using simple descriptive statistics and thematic content analysis. Findings : CenteringPregnancy enabled midwives to develop relationships with the women in their groups and with their peers in the Action Research group. The group antenatal care model enhanced the development of relationships between midwives and women that were necessary for professional fulfilment and the appreciation of relationship-based care. The use of supportive organisational change, enabled by Action Research methods, facilitated midwives to develop new skills that were appropriate for the group care setting and in line with a strengths-based approach. Issues of low staffing rates, lack of available facilities for groups, time constraints, recruitment difficulties and resistance to change impacted on widespread implementation of CenteringPregnancy. Conclusions : The experience of the midwives who provided CenteringPregnancy care suggests that it is an appropriate model of care for the Australian midwifery context, particularly if organisational support and recruitment strategies and access to appropriate facilities are addressed. The midwives who undertook CenteringPregnancy engaged in a new way of working that enhanced their appreciation of relationship-based care and was positive to their job satisfaction. Implications for practice Effective ways to implement CenteringPregnancy models of care in Australia were identified in this study. These included a system of support for the midwives engaging in facilitating groups for the first time. It is important that organisations also develop other supportive strategies, including the provision of adequate group spaces, effective recruitment plans and positive support systems for change management. In the light of current evidence the development of continuity of care models which enhance the relationship between an individual women and her midwife, it is important to explore the effects of group care on this unique relationship.

Aims : The aims of the study were to describe the experiences of the midwives who were part of the first Australian CenteringPregnancy Pilot Study and to inform the future development of CenteringPregnancy. Background CenteringPregnancy is a model of group antenatal care that has evolved over the past two decades in North America. A pilot study that explored the feasibility of implementing CenteringPregnancy in Australia was undertaken in 2006-2008. I was the research midwife employed to coordinate this study and I explored the experiences of the midwives who were participants as the focus of my Master of Midwifery (Honours) research. Method : An Action Research approach was undertaken to study the implementation of CenteringPregnancy in Australia. This included a qualitative descriptive study to describe and explore the experiences of the midwives who were participants. The study was set in two hospital antenatal clinics and two outreach community health-care centres in southern Sydney. Eight midwives and three research team members formed the Action Research group. Data collected were primarily from focus groups and surveys and were analysed using simple descriptive statistics and thematic content analysis. Findings : CenteringPregnancy enabled midwives to develop relationships with the women in their groups and with their peers in the Action Research group. The group antenatal care model enhanced the development of relationships between midwives and women that were necessary for professional fulfilment and the appreciation of relationship-based care. The use of supportive organisational change, enabled by Action Research methods, facilitated midwives to develop new skills that were appropriate for the group care setting and in line with a strengths-based approach. Issues of low staffing rates, lack of available facilities for groups, time constraints, recruitment difficulties and resistance to change impacted on widespread implementation of CenteringPregnancy. Conclusions : The experience of the midwives who provided CenteringPregnancy care suggests that it is an appropriate model of care for the Australian midwifery context, particularly if organisational support and recruitment strategies and access to appropriate facilities are addressed. The midwives who undertook CenteringPregnancy engaged in a new way of working that enhanced their appreciation of relationship-based care and was positive to their job satisfaction. Implications for practice Effective ways to implement CenteringPregnancy models of care in Australia were identified in this study. These included a system of support for the midwives engaging in facilitating groups for the first time. It is important that organisations also develop other supportive strategies, including the provision of adequate group spaces, effective recruitment plans and positive support systems for change management. In the light of current evidence the development of continuity of care models which enhance the relationship between an individual women and her midwife, it is important to explore the effects of group care on this unique relationship.