The termination of pregnancies is increasing worldwide and is associated with profound physical and emotional changes, but at the same time support in the form of pre- and post-counselling, especially in the South African context, does not always take place. Many women are thus reliant on themselves to deal with the trauma without receiving professional help in order to cope. Coping refers to efforts to manage claims made on the individual and which are viewed as a demand that exceeds the resources of the person. Coping is increasingly seen as a form of self-regulation, indicating the ability to conduct, direct and monitor a flexible plan of behaviour, depending on changing circumstances. A self-regulating perspective on coping can be very valuable to understand how appropriate adjustments are made in response to the discrepancy between stated goals and actual behaviour. In spite of this, there is lack of available research data in relation to the termination of pregnancy. The purpose of this study was to explore coping strategies relating to the termination of pregnancy from a self-regulating perspective. An exploratory qualitative case study research design was used, comprising in-depth interviews with a convenience sample of two young women and who had chosen to terminate their pregnancies. Both participants terminated their unplanned pregnancies by means of vacuum aspiration within the first 12 weeks of pregnancy, without any post-abortion counselling. Both indicated that they were not yet ready to have children and that they would have been unable financially to care for the children. The interviews began with an open-ended question to get a general idea of the participants’ views on the termination of pregnancy, to establish how they coped with it, and to obtain insight into their subjective experience. Then, by using more structured questions, the focus shifted to their coping, specifically as a form of self-regulation. Thematic content analysis of the data was done independently by the researcher and a second experienced qualitative researcher. Results show that coping with the termination of a pregnancy is an extremely difficult process that is emotionally difficult to handle, and that both participants coped through social, emotional, cognitive and problem focused strategies, as well as by managing goals. In addition to this, one participant also made use of religion as a source to be able to cope. Particularly significant was the realisation that a self- regulating perspective contributed to the observation that there were clear differences in how these strategies were applied in the unique context of each case. It is shown that the way in which social support and interpersonal conflict is regulated, plays an important role in the coping process, especially because, in this study, it could be distinguished in terms of how the participants made cognitive and problem focused adjustments. Furthermore, it is indicated that both sometimes suppressed their emotions and at other times expressed them appropriately within the context of the stressor. The value of faith as an internal source, as well as the ability to create a synthesis between assimilation and accommodation, became apparent in one participant, and supports research in this regard. The conclusion is eached that a self-regulating perspective adds value to the understanding of coping with the termination of pregnancy, especially because it emphasises how coping is essentially a self-regulatory process, and not just a one- dimensional implementation strategy. Finally, some gaps were identified and recommendations made for further research. / Thesis (MSc (Research Psychology))--North-West University, Potchefstroom Campus, 2013

The termination of pregnancies is increasing worldwide and is associated with profound physical and emotional changes, but at the same time support in the form of pre- and post-counselling, especially in the South African context, does not always take place. Many women are thus reliant on themselves to deal with the trauma without receiving professional help in order to cope. Coping refers to efforts to manage claims made on the individual and which are viewed as a demand that exceeds the resources of the person. Coping is increasingly seen as a form of self-regulation, indicating the ability to conduct, direct and monitor a flexible plan of behaviour, depending on changing circumstances. A self-regulating perspective on coping can be very valuable to understand how appropriate adjustments are made in response to the discrepancy between stated goals and actual behaviour. In spite of this, there is lack of available research data in relation to the termination of pregnancy. The purpose of this study was to explore coping strategies relating to the termination of pregnancy from a self-regulating perspective. An exploratory qualitative case study research design was used, comprising in-depth interviews with a convenience sample of two young women and who had chosen to terminate their pregnancies. Both participants terminated their unplanned pregnancies by means of vacuum aspiration within the first 12 weeks of pregnancy, without any post-abortion counselling. Both indicated that they were not yet ready to have children and that they would have been unable financially to care for the children. The interviews began with an open-ended question to get a general idea of the participants’ views on the termination of pregnancy, to establish how they coped with it, and to obtain insight into their subjective experience. Then, by using more structured questions, the focus shifted to their coping, specifically as a form of self-regulation. Thematic content analysis of the data was done independently by the researcher and a second experienced qualitative researcher. Results show that coping with the termination of a pregnancy is an extremely difficult process that is emotionally difficult to handle, and that both participants coped through social, emotional, cognitive and problem focused strategies, as well as by managing goals. In addition to this, one participant also made use of religion as a source to be able to cope. Particularly significant was the realisation that a self- regulating perspective contributed to the observation that there were clear differences in how these strategies were applied in the unique context of each case. It is shown that the way in which social support and interpersonal conflict is regulated, plays an important role in the coping process, especially because, in this study, it could be distinguished in terms of how the participants made cognitive and problem focused adjustments. Furthermore, it is indicated that both sometimes suppressed their emotions and at other times expressed them appropriately within the context of the stressor. The value of faith as an internal source, as well as the ability to create a synthesis between assimilation and accommodation, became apparent in one participant, and supports research in this regard. The conclusion is eached that a self-regulating perspective adds value to the understanding of coping with the termination of pregnancy, especially because it emphasises how coping is essentially a self-regulatory process, and not just a one- dimensional implementation strategy. Finally, some gaps were identified and recommendations made for further research. / Thesis (MSc (Research Psychology))--North-West University, Potchefstroom Campus, 2013

The use of traditional medicine during pregnancy and childbirth is common among the Black traditional cultures of Southern Africa. Any pregnancy–related problem is believed to be somehow associated with dikgaba, a phenomenon that only indigenous healers are capable of managing. It is therefore crucial that the midwives and other health care professionals acknowledge the relevance of traditional medicine when dealing with clients who belong to black traditional societies of South Africa. The objective of the study was to explore and describe health practices related to dikgaba in pregnancy as well as to formulate recommendations for culturally congruent and safe midwifery care. In–depth individual interviews were conducted to collect data from ten participants known to be experts in kgaba remedies used during pregnancy and birth. These were traditional healers, traditional birth attendants and those with keen interest in traditional and cultural issues. Interviews were conducted in the participants’ homes for privacy, confidentiality and convenience. A naturalistic and phenomenological approach using contextual exploratory and descriptive research design was used to reach the aim of the study from the perspectives of Batswana in the North West province. The study revealed that an understanding of dikgaba and the related healing practices in pregnancy and childbirth is common. This clearly motivates for better understanding of traditional medicine by the midwives as it is relevant and justifiable. Recommendations are made to inform the transformation of the health–care delivery system, with specific reference to midwifery education, research and practice, in order to make health care acceptable and accessible to all. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

The use of traditional medicine during pregnancy and childbirth is common among the Black traditional cultures of Southern Africa. Any pregnancy–related problem is believed to be somehow associated with dikgaba, a phenomenon that only indigenous healers are capable of managing. It is therefore crucial that the midwives and other health care professionals acknowledge the relevance of traditional medicine when dealing with clients who belong to black traditional societies of South Africa. The objective of the study was to explore and describe health practices related to dikgaba in pregnancy as well as to formulate recommendations for culturally congruent and safe midwifery care. In–depth individual interviews were conducted to collect data from ten participants known to be experts in kgaba remedies used during pregnancy and birth. These were traditional healers, traditional birth attendants and those with keen interest in traditional and cultural issues. Interviews were conducted in the participants’ homes for privacy, confidentiality and convenience. A naturalistic and phenomenological approach using contextual exploratory and descriptive research design was used to reach the aim of the study from the perspectives of Batswana in the North West province. The study revealed that an understanding of dikgaba and the related healing practices in pregnancy and childbirth is common. This clearly motivates for better understanding of traditional medicine by the midwives as it is relevant and justifiable. Recommendations are made to inform the transformation of the health–care delivery system, with specific reference to midwifery education, research and practice, in order to make health care acceptable and accessible to all. / Thesis (M.Cur.)--North-West University, Potchefstroom Campus, 2011.

Pregnancy can be a very difficult time of transition for some women as they have to adapt, change and prepare for the role and responsibility that awaits them after their baby is born. This is especially challenging for first-time mothers as they experience higher levels of anxiety and uncertainty than more experienced mothers. From a fortogenic perspective, pregnancy can be viewed as a developmental opportunity for maturation and growth. With high levels of psychological well-being the new mother will be able achieve optimal functioning by being a sensitive and responsive and confident in her abilities to care for her new-born baby. There is substantial evidence to show that spirituality is strongly associated with psychological well-being, but the lived experiences of first-time mothers have not yet been explored. Therefore this study aims to explore a group of first-time mothers‟ experiences of meaningfulness during their third trimester of pregnancy by focusing on their spirituality. Qualitative research and a phenomenological design were used to gain in-depth understanding of the experiences of first-time mothers. The Mmogo-Method® and reflective journals were used as data-gathering techniques and visual and textual data were captured. The data were analysed by using thematic analysis (textual) and comparing the symbolic values (visual) with the research question. This group of first-time mothers expressed a very personal and intimate relationship with a Divine reality that they rely on and from it they derive a sense of meaningfulness. This sense of meaning stems from their belief that the Divine reality is the giver of life; they were given a responsibility to carry new life. Unconditional trust in the Divine reality makes them willing to surrender control of their lives and accept the responsibility they were given. They find meaning, which potentially has implications for higher levels of psychological well-being. The findings of this research provide the basis for developing interventions for mothers-to-be to make sense of their pregnancy by relying on their pre-existing spiritual frameworks. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2014

Pregnancy can be a very difficult time of transition for some women as they have to adapt, change and prepare for the role and responsibility that awaits them after their baby is born. This is especially challenging for first-time mothers as they experience higher levels of anxiety and uncertainty than more experienced mothers. From a fortogenic perspective, pregnancy can be viewed as a developmental opportunity for maturation and growth. With high levels of psychological well-being the new mother will be able achieve optimal functioning by being a sensitive and responsive and confident in her abilities to care for her new-born baby. There is substantial evidence to show that spirituality is strongly associated with psychological well-being, but the lived experiences of first-time mothers have not yet been explored. Therefore this study aims to explore a group of first-time mothers‟ experiences of meaningfulness during their third trimester of pregnancy by focusing on their spirituality. Qualitative research and a phenomenological design were used to gain in-depth understanding of the experiences of first-time mothers. The Mmogo-Method® and reflective journals were used as data-gathering techniques and visual and textual data were captured. The data were analysed by using thematic analysis (textual) and comparing the symbolic values (visual) with the research question. This group of first-time mothers expressed a very personal and intimate relationship with a Divine reality that they rely on and from it they derive a sense of meaningfulness. This sense of meaning stems from their belief that the Divine reality is the giver of life; they were given a responsibility to carry new life. Unconditional trust in the Divine reality makes them willing to surrender control of their lives and accept the responsibility they were given. They find meaning, which potentially has implications for higher levels of psychological well-being. The findings of this research provide the basis for developing interventions for mothers-to-be to make sense of their pregnancy by relying on their pre-existing spiritual frameworks. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2014

The health and wellbeing of pregnant women are considered to be an international priority by the World Health Organization (WHO). Even though pregnant women constitute a large part of the population globally and in South Africa, there is a lack of research regarding their psychological wellbeing. It is known that a psychologically well-functioning pregnant woman has the capacity to attach to her baby and to be an effective parent. The WHO places emphasis on the health of pregnant women not only because they are crucial to the survival and reproduction of humanity, but also because they are more vulnerable during pregnancy and need extra support. Pregnancy is associated with many physical and psychological changes and has a major impact on a woman’s life. Although there are challenges associated with pregnancy, it can also be a special experience of psychological and personal growth. Most previous studies have focused on the medical, biological, and pathological aspects of pregnancy. Although this research is important, it is crucial that psychological well-being during pregnancy is investigated in order to find ways to proactively strengthen it. Research showed that women whose psychological well-being is lacking are vulnerable and prone to developing mental disorders. A pregnant woman who is psychologically well is better equipped to form a healthy attachment with her baby, cope with her newfound parenthood, and is less likely to develop pregnancy-related mental illness. It is clear that the presence of meaningfulness in life leads to enhanced psychological well-being. This study is conducted from a psychofortological perspective and focuses on exploring and gaining a deeper understanding of first-time pregnant women’s experiences of meaningfulness during their pregnancy. A qualitative, phenomenological approach was used to gain a deep understanding of the women’s experience of meaningfulness. Reflexive journals and the Mmogo-method® were used to gather data. After a thematic analysis was done on the visual (the presentations and participant’s explanations thereof) and textual (reflexive journals) data a deeper understanding was gained of the participants’ experiences of meaningfulness during pregnancy. According to the data spirituality and relationships contributed most to their experience of meaningfulness during pregnancy. This study focused only on how meaningfulness was found in the participant’s various relationships during their pregnancy. The main relationships that were identified were with their husband, their unborn baby, and with their parents. A rich description of these relationships helped to deepen our understanding of the first-time pregnant women’s experience of meaningfulness. The findings from this study make a valuable contribution to the improved understanding of the concept meaningfulness in the specific life domain of relationships and in the context of pregnancy. This confirmed the structure of the Meaning Model of Wissing and Delle Fave (2014) and deepened our understanding of the ‘meaningfulness in life’ category. This understanding is valuable as it can be used proactively to develop programmes to enhance pregnant women’s psychological well-being. No previous research in this regard in the South African context specifically could be found. Literature indicated that there is a lack of research to better our understanding of meaningfulness in different life domains and contexts, especially from a psychofortological perspective. This study’s contribution is significant as it not only deepens our understanding of meaningfulness experienced during pregnancy and the role relationships play, but also because it can make a valuable contribution to informing, developing, and implementing intervention programmes to proactively enhance the psychological well-being of pregnant women in South Africa. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2015

The health and wellbeing of pregnant women are considered to be an international priority by the World Health Organization (WHO). Even though pregnant women constitute a large part of the population globally and in South Africa, there is a lack of research regarding their psychological wellbeing. It is known that a psychologically well-functioning pregnant woman has the capacity to attach to her baby and to be an effective parent. The WHO places emphasis on the health of pregnant women not only because they are crucial to the survival and reproduction of humanity, but also because they are more vulnerable during pregnancy and need extra support. Pregnancy is associated with many physical and psychological changes and has a major impact on a woman’s life. Although there are challenges associated with pregnancy, it can also be a special experience of psychological and personal growth. Most previous studies have focused on the medical, biological, and pathological aspects of pregnancy. Although this research is important, it is crucial that psychological well-being during pregnancy is investigated in order to find ways to proactively strengthen it. Research showed that women whose psychological well-being is lacking are vulnerable and prone to developing mental disorders. A pregnant woman who is psychologically well is better equipped to form a healthy attachment with her baby, cope with her newfound parenthood, and is less likely to develop pregnancy-related mental illness. It is clear that the presence of meaningfulness in life leads to enhanced psychological well-being. This study is conducted from a psychofortological perspective and focuses on exploring and gaining a deeper understanding of first-time pregnant women’s experiences of meaningfulness during their pregnancy. A qualitative, phenomenological approach was used to gain a deep understanding of the women’s experience of meaningfulness. Reflexive journals and the Mmogo-method® were used to gather data. After a thematic analysis was done on the visual (the presentations and participant’s explanations thereof) and textual (reflexive journals) data a deeper understanding was gained of the participants’ experiences of meaningfulness during pregnancy. According to the data spirituality and relationships contributed most to their experience of meaningfulness during pregnancy. This study focused only on how meaningfulness was found in the participant’s various relationships during their pregnancy. The main relationships that were identified were with their husband, their unborn baby, and with their parents. A rich description of these relationships helped to deepen our understanding of the first-time pregnant women’s experience of meaningfulness. The findings from this study make a valuable contribution to the improved understanding of the concept meaningfulness in the specific life domain of relationships and in the context of pregnancy. This confirmed the structure of the Meaning Model of Wissing and Delle Fave (2014) and deepened our understanding of the ‘meaningfulness in life’ category. This understanding is valuable as it can be used proactively to develop programmes to enhance pregnant women’s psychological well-being. No previous research in this regard in the South African context specifically could be found. Literature indicated that there is a lack of research to better our understanding of meaningfulness in different life domains and contexts, especially from a psychofortological perspective. This study’s contribution is significant as it not only deepens our understanding of meaningfulness experienced during pregnancy and the role relationships play, but also because it can make a valuable contribution to informing, developing, and implementing intervention programmes to proactively enhance the psychological well-being of pregnant women in South Africa. / MA (Research Psychology), North-West University, Potchefstroom Campus, 2015

Text in Afrikaans / Die effek van die klient-verpleegkundige-verhoudings op kliente se keuse en volgehoue gebruik van kontraseptiewe metodes het tot op hede baie min aandag geniet. Die doel van hierdie studie was 'n ondersoek na die ongetroude klient se persepsie van die verpleegkundige se houding. Die steekproef het bestaan uit 99 kliente (tussen die ouderdomme van 15 en 50 jaar) wat die betrokke reproduktiewegesondheidsklinieke in die Kaapse Metropool besoek het. Die eerste 20 kliente wat die kliniek besoek het, is genader om 'n vraelys in te vul. Hierdie studie toon 'n algehele positiwiteit, naamlik 58,3% teenoor die houding van geregistreerde verpleegkundiges. Die meerderheid van die kliente (88,0%) het aangedui dat hulle weer die kliniek sal besoek wat dus die kliente se tevredenheid toon. / The effect of the client-registered nurse relationship on clients' choice and continuous use of contraceptive methods has until now received very little attention. The purpose of this study was to explore unmarried clients' perception of the attitude of the registered nurse. The sample existed of 99 clients (between the ages of 15 and 50 years) who visited the relevant reproductive health clinics in the Cape Metropole. The first 20 clients who visited the clinic were approached to complete a questionnaire. This study shows an overall positivity of 58,3% with regard to the attitude of registered nurses. Most of the clients (88,0%) indicated that they would visit the clinic again, which indicate their satisfaction. / Health Studies / M.A. (Nursing Science)

Text in Afrikaans / Die effek van die klient-verpleegkundige-verhoudings op kliente se keuse en volgehoue gebruik van kontraseptiewe metodes het tot op hede baie min aandag geniet. Die doel van hierdie studie was 'n ondersoek na die ongetroude klient se persepsie van die verpleegkundige se houding. Die steekproef het bestaan uit 99 kliente (tussen die ouderdomme van 15 en 50 jaar) wat die betrokke reproduktiewegesondheidsklinieke in die Kaapse Metropool besoek het. Die eerste 20 kliente wat die kliniek besoek het, is genader om 'n vraelys in te vul. Hierdie studie toon 'n algehele positiwiteit, naamlik 58,3% teenoor die houding van geregistreerde verpleegkundiges. Die meerderheid van die kliente (88,0%) het aangedui dat hulle weer die kliniek sal besoek wat dus die kliente se tevredenheid toon. / The effect of the client-registered nurse relationship on clients' choice and continuous use of contraceptive methods has until now received very little attention. The purpose of this study was to explore unmarried clients' perception of the attitude of the registered nurse. The sample existed of 99 clients (between the ages of 15 and 50 years) who visited the relevant reproductive health clinics in the Cape Metropole. The first 20 clients who visited the clinic were approached to complete a questionnaire. This study shows an overall positivity of 58,3% with regard to the attitude of registered nurses. Most of the clients (88,0%) indicated that they would visit the clinic again, which indicate their satisfaction. / Health Studies / M.A. (Nursing Science)