Women of child-bearing age sometimes fail to plan for pregnancies. Often they discover that they are pregnant and are not prepared or cannot afford to raise the child. Before 1996 there was no choice for women as regards pregnancies, all pregnancies must be carried to term and delivered except on health grounds and with stringent conditions. However after the TOP act was enacted in 1996, women were allowed a choice of TOP up to and including 20 weeks of pregnancy.<br /> <br /> Regardless of the availability of choice of TOP, some pregnant women still present late (after 12 weeks) for TOP when the risks of complications and costs are higher. Women who present late for TOP usually have to be admitted to a district or regional hospital and managed. The costs at such institutions are high. TOPs before 12 weeks (early TOP) are done in a primary health care (PHC) facility (TOP center) and no admission is required hence less cost. Complications of early TOP are also very mild and rare. In Lejweleputswa district there is only one TOP Center (Kopano TOP Clinic) and this serves both Lejweleputswa and the Northern Free State districts. Early TOPs (less than 12 weeks) are done and completed at this center. Late TOPs (above 12 weeks but not more than 20 weeks) are initiated at this TOP center and referred to district or regional hospitals nearest to the patient&rsquo / s home, in both districts for completion.<br /> <br /> Problems - An increasing number of women are seeking TOP service at late stages of pregnancies and the incidence of severe complications like severe bleeding, retained placenta, infection, amniotic fluid embolism, death etc, are increasing. The hospital&rsquo / s bed space and budget are stretched to the limit due to the influx of late term TOP to the hospitals. Lack of manpower, especially doctors, in these hospitals also create some problems, as the few doctors available have to attend to other ill patients as well. Sometimes bleeding TOP patients are transfused with blood and placed on a waiting list for theatre and this often increases the risk of complications. The emotional effect of late TOP on hospital staff (doctors and nurses) are enormous as the expelled fetus are much more developed than in early TOP where no fetus is seen at evacuation with simple Manual Vacuum Aspiration (MVA).<br />

Women of child-bearing age sometimes fail to plan for pregnancies. Often they discover that they are pregnant and are not prepared or cannot afford to raise the child. Before 1996 there was no choice for women as regards pregnancies, all pregnancies must be carried to term and delivered except on health grounds and with stringent conditions. However after the TOP act was enacted in 1996, women were allowed a choice of TOP up to and including 20 weeks of pregnancy.<br /> <br /> Regardless of the availability of choice of TOP, some pregnant women still present late (after 12 weeks) for TOP when the risks of complications and costs are higher. Women who present late for TOP usually have to be admitted to a district or regional hospital and managed. The costs at such institutions are high. TOPs before 12 weeks (early TOP) are done in a primary health care (PHC) facility (TOP center) and no admission is required hence less cost. Complications of early TOP are also very mild and rare. In Lejweleputswa district there is only one TOP Center (Kopano TOP Clinic) and this serves both Lejweleputswa and the Northern Free State districts. Early TOPs (less than 12 weeks) are done and completed at this center. Late TOPs (above 12 weeks but not more than 20 weeks) are initiated at this TOP center and referred to district or regional hospitals nearest to the patient&rsquo / s home, in both districts for completion.<br /> <br /> Problems - An increasing number of women are seeking TOP service at late stages of pregnancies and the incidence of severe complications like severe bleeding, retained placenta, infection, amniotic fluid embolism, death etc, are increasing. The hospital&rsquo / s bed space and budget are stretched to the limit due to the influx of late term TOP to the hospitals. Lack of manpower, especially doctors, in these hospitals also create some problems, as the few doctors available have to attend to other ill patients as well. Sometimes bleeding TOP patients are transfused with blood and placed on a waiting list for theatre and this often increases the risk of complications. The emotional effect of late TOP on hospital staff (doctors and nurses) are enormous as the expelled fetus are much more developed than in early TOP where no fetus is seen at evacuation with simple Manual Vacuum Aspiration (MVA).<br />

It is a novel experience for a woman to enter into motherhood. While she may have some familiarity with basic methods of childcare, the experience of caring for her own child is a new one. Becoming a mother elicits a transformation for a woman, from a „self as a self‟ to a „self as a mother‟. When the pregnancy is unplanned, this transformation may be particularly complicated. This study explored this transformation by focusing on the stressors and supports mothers reported during pregnancy and in early motherhood, for women whose pregnancies had been unintended. The study utilized a psychoanalytic perspective, particularly object relations theory (ORT), to understand how the mother‟s object relations have been influenced by her perceptions and her stress levels, in her transition into motherhood. A qualitative approach was adopted in this study, so that the researcher could gain a “rich” description of the participants‟ experiences of pregnancy and motherhood. Five mothers, whose eldest was four years or younger and who had not intended to conceive, participated in focus groups and individual interviews. The data gained was analysed by means of thematic analysis, which brought about a list of perceived stressors and support factors. These stressors were categorized and discussed in relation to child-specific factors, factors specific to parenthood, environmental factors, and factors specific to the unintended nature of the pregnancy. The perceived supports included psychosocial support, allomaternal support, financial support, and information. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2010.

Text in Afrikaans / Summaries in Afrikaans and English / Hierdie studie toon dat vroue wat vir terminasie van swangerskappe aanmeld, se behoeftes wyer as bloot die verwydering van die fetus strek. Die diversiteit van probleme, vra 'n beradingsbenadering wat holisties van aard is. Indien die sosiale, psigiese en spirituele behoeftes nie aangespreek word nie, het ons in die holistiese hantering gefaal. Die Department Huisartskunde waar ek werksaam is, beywer hom vir 'n holistiese benadering van die pasient. Hierdie benadering word ook deur die huidige SuidAfrikaanse Regering onderskryf. Die vrou met die ongewenste swangerskap het 'n behoefte om, behalwe die fisieke probleme, in totaliteit verstaan en gehoor te word. Sy smag na 'n berader wat saam met haar deur die kompleksiteit van die probleem kan dink en voel. Die holistiese benadering behels die fisieke sowel as die psigiese, maatskaplike en spirituele behoeftes. Die studie het te doen met 'n soeke na 'n beradingsbenadering wat in al die behoeftesvan die vrou sal voorsien. / This study demonstrates that the needs of women requesting a termination of pregnancy extend much further than the mere removal of the foetus. The diversity of problems demands a counselling approach that is holistic in nature. We will fail in this holistic management, should the social, psychological and spiritual needs not be addressed. The Department of Family Medicine where I am employed strives towards a holistic approach to the patient. This approach is also endorsed by the present South African Government. The woman with an unwanted pregnancy needs to be heard and understood in totality, over-and-above the physical problem. She yearns for a counsellor who can think and feel through the complexity of the problem together with her. The holistic approach includes the physical, as well as the psychological, social and spiritual aspects. The study involves a search for a counselling approach which provides for all these needs of the women. / Practical Theology / M.Th. (Praktiese Teologie - met spesialisering in Pastorale Terapie)

Text in Afrikaans / Summaries in Afrikaans and English / Hierdie studie toon dat vroue wat vir terminasie van swangerskappe aanmeld, se behoeftes wyer as bloot die verwydering van die fetus strek. Die diversiteit van probleme, vra 'n beradingsbenadering wat holisties van aard is. Indien die sosiale, psigiese en spirituele behoeftes nie aangespreek word nie, het ons in die holistiese hantering gefaal. Die Department Huisartskunde waar ek werksaam is, beywer hom vir 'n holistiese benadering van die pasient. Hierdie benadering word ook deur die huidige SuidAfrikaanse Regering onderskryf. Die vrou met die ongewenste swangerskap het 'n behoefte om, behalwe die fisieke probleme, in totaliteit verstaan en gehoor te word. Sy smag na 'n berader wat saam met haar deur die kompleksiteit van die probleem kan dink en voel. Die holistiese benadering behels die fisieke sowel as die psigiese, maatskaplike en spirituele behoeftes. Die studie het te doen met 'n soeke na 'n beradingsbenadering wat in al die behoeftesvan die vrou sal voorsien. / This study demonstrates that the needs of women requesting a termination of pregnancy extend much further than the mere removal of the foetus. The diversity of problems demands a counselling approach that is holistic in nature. We will fail in this holistic management, should the social, psychological and spiritual needs not be addressed. The Department of Family Medicine where I am employed strives towards a holistic approach to the patient. This approach is also endorsed by the present South African Government. The woman with an unwanted pregnancy needs to be heard and understood in totality, over-and-above the physical problem. She yearns for a counsellor who can think and feel through the complexity of the problem together with her. The holistic approach includes the physical, as well as the psychological, social and spiritual aspects. The study involves a search for a counselling approach which provides for all these needs of the women. / Philosophy, Practical and Systematic Theology / M.Th. (Praktiese Teologie - met spesialisering in Pastorale Terapie)

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)

Department of Public Health / MPH

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)

This study identified pregnancy-related challenges encountered by student nurses at SAMHS Nursing College, with an aim of identify factors contributing to student nurses' pregnancies as well as finding ways to deal and minimize the rate of the pregnancies amongst the student nurses. Thirty (30) structured interviews were conducted with student nurses who were pregnant and those who delivered their babies during the period 2002 to 2007. It has been revealed that ignorance is the major contributing factor for student nurses' pregnancies, 63% of the pregnancies were not planned, 52% of the respondents related their pregnancies to risk taking as they engaged in unprotected sex without the use of contraceptives, and thus it was concluded that student nurses are engaging themselves in risk behaviours and also engaging in unsafe sexual practices. The study also found that student nurses face physical, social, emotional as well as academic problems during pregnancy and after the delivery of their babies. Student nurses should be encouraged to use condoms and other methods of contraception, coupled with educating them on life skills, provision of recreational facilities; provision of counseling and support services may be the tool to minimise the unplanned pregnancies. / Health Studies / (M.A.(Public Health ))

This study identified pregnancy-related challenges encountered by student nurses at SAMHS Nursing College, with an aim of identify factors contributing to student nurses' pregnancies as well as finding ways to deal and minimize the rate of the pregnancies amongst the student nurses. Thirty (30) structured interviews were conducted with student nurses who were pregnant and those who delivered their babies during the period 2002 to 2007. It has been revealed that ignorance is the major contributing factor for student nurses' pregnancies, 63% of the pregnancies were not planned, 52% of the respondents related their pregnancies to risk taking as they engaged in unprotected sex without the use of contraceptives, and thus it was concluded that student nurses are engaging themselves in risk behaviours and also engaging in unsafe sexual practices. The study also found that student nurses face physical, social, emotional as well as academic problems during pregnancy and after the delivery of their babies. Student nurses should be encouraged to use condoms and other methods of contraception, coupled with educating them on life skills, provision of recreational facilities; provision of counseling and support services may be the tool to minimise the unplanned pregnancies. / Health Studies / (M.A.(Public Health ))