A DISSERTATION SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE MASTERS DEGREE IN (COMMUNITY WORK) IN THE SOCIAL WORK DEPARTMENT (FACULTY OF ARTS) AT THE UNIVERSITY OF ZULULAND, 2008. / The study investigated the effects of unplanned pregnancy on female students at the University of Zululand. The sample consisted of 22 female students whose ages range from 15-26+. Female students who are sexually active were more likely to use no contraceptives, which puts them at a high risk of unplanned pregnancy. Some are influenced by their partners regarding birth control or they forget to use contraceptives altogether. University students engage in sexual intercourse, generally with multiple partners. The University of Zululand female students are faced with the problem of unplanned pregnancies, which is very high. It has become imperative, therefore, to get some answers to the questions as to why some fall pregnant and say it was unplanned and some do not know who impregnated them. The researcher wanted to examine perceptions of the effects of unplanned pregnancy on female students; to examine long term or on-going effects that female students might experience after termination of pregnancy or miscarriage, and to investigate the level of knowledge related to contraceptives and other means of preventing unplanned pregnancy. The findings show that it is the young adults (15-19) years of age that are mostly affected by unplanned pregnancies. Racial group are the blacks, those who are not married, are mostly experiencing unplanned pregnancy. There are a few people who are using contraceptives; this also indicates that there is lot that needs to be done in educating people about the use of contraceptives.

MSc (Med), Epidemiology and Biostatistics, Faculty of Health Sciences, University of the Witwatersrand / Background: The knowledge of contraceptive use is high among men and women in South Africa. However, contraceptive prevalence rate is moderate and unplanned pregnancies are common. Understanding the determinants of contraceptive use and unplanned pregnancy will inform future interventions that aim to maintain consistent contraceptive use and reduce unplanned pregnancies. Aim: The study aims to describe factors associated with contraceptive use and unplanned pregnancy in the South African population. Methods: A secondary data analysis was carried out on data collected in a cross–sectional survey conducted in Potchefstroom, South Africa between August 2007 and March 2008.Results: Contraceptive prevalence was 69.5% and unplanned pregnancy was 59.7%. The risk factors for contraceptive use included woman’s employment status at the last pregnancy, woman’s partner employment status at the last pregnancy and number of miscarriages a woman had experienced. The risk factors for unplanned pregnancy included race, woman’s age , education level and employment status at last pregnancy, number of miscarriages, contraceptive use and partner’s employment status at last pregnancy. Conclusion: If the prevalence of unplanned pregnancies is to be reduced, policies and programmes need to address economic factors which were associated with both contraceptive use and unplanned pregnancy. Further study needs to be carried out as to the reasons behind why a woman with a previous history of a miscarriage is less likely to have an unplanned pregnancy yet she is less likely to be on contraception.

Submitted in fulfillment of the requirements for the degree Masters in Psychology in the Department of Psychology, Faculty of Arts at the University of Zululand, South Africa, 2012. / Unwanted pregnancy among young unmarried South African women still remains a challenge. It has been identified that young unmarried women who are living in rural areas are more vulnerable to unwanted pregnancy. Bronfenbrenner.s theory of systems has been used in the study. The participants were sourced from eMbobeni location, a rural area in Bizana in the Eastern Cape Province. The data was collected through focus group interviews and analysed through content analysis. Group interviews were tape recorded and transcribed. Group support was provided for the participants in the focus group. Through the study it has emerged that lack of knowledge about sexuality and the protection of oneself still remains a challenge. Factors contributing towards unwanted pregnancy among young unmarried women were identified as being lack of parental support; lack of knowledge and the stigma towards contraception; pressures from the partner; ignorance, carelessness and restrictions; and shift of responsibility. / National Research Foundation (NRF)

Submitted in partial fulfilment of the requirements of a Masters Degree in Clinical Psychology, 2005. / The purpose of this research is to describe the experiences of females who have undergone a termination of pregnancy. A phenomenological study was employed, in which each participant used in the research was interviewed in a single session. The sample consisted of six women who had terminated a pregnancy before. The results were presented in the form of an integrative text, which accounted for all the individual variations of the experiences of termination. The ages of women ranged from 17 to 42. All participants regarded the situation of an unplanned pregnancy as stressful. Most of them viewed having a child as a threat to their education, career or relationship with family. Although all of the participants thought some part of the procedure was more stressful than they anticipated, they all found ways to cope with differing levels of stress. All participants view themselves as coping well with the stressful life event.

In the United States, prominent racial/ethnic and socioeconomic disparities in rates of unintended pregnancy, abortion, and unintended births exist. Recent analysis suggests that Latinas are three times more likely to experience an unintended pregnancy than non-Latina white women. More than half of pregnancies among Latinas (53%) in the United States are unintended and have higher unintended births as they are less likely than black women to have an abortion. In addition, in 2006 the unintended pregnancy rate was highest among women aged 20-24. Little research has 0been conducted to understand unintended pregnancy particularly among young adult Latina women. The purpose of the study is to determine and understand the meaning of unintended pregnancy among Latina subpopulations and examine the perceived consequences and management of unintended pregnancy among Latina subpopulations. Between May 2012 and October 2012, twenty in-depth-interviews were conducted with U. S. born- Latinas between 18-25 years of age seeking a confirmation pregnancy test at clinics in which some provided abortion services. Latinas in the study's meaning of pregnancy came from their complicated life situations, and were facilitated by Latino cultural beliefs, such as fatalism, religiosity and familismo. Many held favorable and positive meanings of their unintended pregnancy, particularly those who continued their pregnancies to term. Consistent with several other studies, the act of deliberately trying to plan a pregnancy was foreign to many of these women, particularly because a pregnancy was something that should was not in their control and left up to God. Most of the Latinas in the study felt that women should not plan their pregnancies and doing so was going against fate and natural life course. Public health research overwhelmingly highlights the negative maternal and child health consequences of unintended, while many women in this study perceived the negative consequences of unintended pregnancy to be primarily emotional and social. The inquiry found stigma surrounding unintended pregnancy among Latinas in this study. More than half of the women in the study resorted to termination of their pregnancy and cited fears of family reaction, fears their partner would deny paternity or responsibility, and/or desires to continue schooling, community and societal attitudes toward an unintended pregnancy and religiosity, as influencing this decision. In addition, contributing to the stigma were the stereotypes of Latinas. Latinas decision to continue their pregnancies to term or have an abortion was provoked by diverse and interrelated factors. Although a few Latinas in the study stated their partner's had an influence on the pregnancy resolution decision, all Latina stated that ultimately they were in control over their pregnancy resolution decision. Even when Latinas partners did not agree with their decision, women still performed their intended pregnancy resolution decision. . Family planning services might benefit from intervention designs with the following features that address the cultural needs of this population; a) highlight/stress the importance and benefits of delaying a pregnancy, not discuss pregnancy planning which was found to be irrelevant to these women, b) incorporate and address cultural constructs such as familismo and fatalism as protective factors rather than risk factors, and c) link and discuss issues such as poverty, education, insurance, stigma, and mental health issues. Many women reported these factors as perceived consequences and influencing the management of an unintended pregnancy. Interventions may be aimed at improving provider communication with Latinas about prevention of unintended pregnancy as well their pregnancy resolution options. Future public health campaigns might benefit from incorporating promotores de salud who had similar experiences in curriculums already discussing reproductive health. Support groups and mental health counseling was suggested as needed among participants that terminated their pregnancies. Future research should continue to focus on the multiple levels of influence and the contribution they make on the meaning and consequences of unintended pregnancy. In addition, the role of cultural protective factors in strengthening families and communities merits further exploration. This study increased our understanding of what unintended pregnancy means in the Latino community, and explored it from a comprehensive, multi-dimensional, and structural perspective. Understanding these factors are important and first steps to addressing an issue that affects Latinas, their families, communities, and the nation-at large.

No description available.

Background: Despite a wide range of contraceptive options available in the United Kingdom, the unplanned pregnancy rate remains high. Contraceptive services are currently delivered by general practitioners, sexual health clinics and pharmacies, but there may be scope to expand the places that these are offered, and increase the options available within each service. Doing so could increase the uptake of contraceptive methods, particularly the most effective methods, and therefore reduce the unplanned pregnancy rate. Aim and objectives: Research in this thesis aimed to investigate novel delivery models of contraception. The research had two main areas of focus. Firstly the capacity of the pharmacy to deliver regular contraception was examined, in the context of existing literature, and then through a pilot study. After that the expansion of contraception care to maternity services was investigated, first in the literature and then using an observational study. Methods: In undertaking this thesis I used a variety of methods. Two patient surveys were employed to investigate patients’ perspectives on proposed novel methods of contraceptive delivery. A pilot study investigated the feasibility and acceptability of delivery of the contraceptive injection at the pharmacy. Quantitative results about the numbers of injections given were collected, as were patient questionnaires. Qualitative one-to-one interviews were conducted with participating pharmacists, these were recorded, transcribed and analysed. An observational study was also undertaken to assess routine delivery of insertion of intra-uterine contraception at the time of caesarean section. Patients were seen at six weeks following insertion, and contacted by telephone at three, six and 12 months about satisfaction and continuation of the method. Results: 220 women completed a questionnaire about attending the community pharmacy to receive a contraception injection. 33% of current non-users indicated that they would consider using this method if it was available at the pharmacy. 50 established users of the contraceptive injection participated in a pilot project receiving up to three injections from the community pharmacy. Only 48 injections of a possible 150 were delivered at the community pharmacy. Only 7 participants received all three injections at the pharmacy, and participants reported mixed experiences accessing the pharmacy. The practical obstacles around pharmacy engagement and the challenges of retaining participants were significant, and more research is necessary before proceeding with a randomised controlled trial. 250 women on a postnatal ward completed questionnaires about their pregnancy intentions. 96.7% were not planning a baby in the next year, but only 23.6% were planning on using the most effective methods of contraception. One in three respondents described themselves as likely to use either an implant or intra-uterine contraception if it could be inserted before they left the hospital. In an observational study, 120/877 women opted to have intra-uterine contraception inserted at the time of caesarean section. Continuation rates at 12 months were 84.8% of those contacted, and 92.6% were either ‘very’ or ‘fairly’ happy with their contraception. Conclusion: Although patients are receptive to contraception being delivered using novel service models, alternatives to current practice need careful investigation. Contraceptive injections at the community pharmacy are not necessarily more convenient for patients, and therefore may not increase uptake of this method. However, offering intrauterine contraception to patients at the time of caesarean section is highly acceptable to patients, and results in a substantial majority continuing this highly effective method. Robust and careful research using a range of methods can help to identify which innovative approaches to contraceptive delivery offer the most promise.

Background: Prevention of unplanned pregnancy is a crucial aspect of preventing mother-to-child HIV transmission (PMTCT). However, we have little understanding of how HIV status and antiretroviral therapy (ART) may influence pregnancy planning. There are few data on pregnancy planning in HIV-infected South African women, and no comparative data with HIV-uninfected women. Methods: We conducted a cross-sectional study of 2105 pregnant women (1512 HIV-infected; 593 HIV-uninfected) ages 18-44 making their first antenatal clinic visit at a primary-level health care facility in Gugulethu, Cape Town. All women completed structured questionnaires including the London Measure of Unplanned Pregnancy (LMUP), a 6-item scale that categorizes pregnancies into planned, ambivalent and unplanned. Analyses examined LMUP results across 4 groups of participants: HIV-infected established on ART; known HIV-infected but not currently on ART; newly diagnosed HIV-infected; and HIV-uninfected. Results: Overall, the mean age was 29 years (SD: 5.63), 43% of women were married or cohabiting and 20% were nulliparous. The LMUP performed well across all groups (Cronbach's α=0.84). Levels of unplanned pregnancy were higher in HIV-infected versus HIV-uninfected women (50% vs. 33%, p<0.001); and highest in women not on ART. Overall, 69% of women reported contraceptive use in the year before pregnancy; this was strongly associated with unplanned pregnancy (p<0.001). Compared to HIV-uninfected women, HIV-infected women had significantly higher odds of unplanned pregnancy, even after adjusting for age, parity and cohabiting status. The odds were greatest among women newly-diagnosed with HIV and previously diagnosed but not on ART (OR: 1.43; 95% CI: 1.05-1.94 and OR: 1.56; 95% CI: 1.13-2.15, respectively). Increased parity and age <24 years were also associated with unplanned pregnancy (OR 1.83; 95% CI: 1.24-2.74 and OR 1.42; 95% CI: 1.25- 1.60 respectively). Conclusions: These data indicate high levels of unplanned pregnancy in a high HIV prevalence setting, highlighting missed opportunities for family planning and counselling services for HIVpositive women. Possible explanations for the high level of unplanned pregnancy observed include contraceptive failure and/or misuse thereof. Therefore, women living with HIV require additional support to avoid unplanned, particularly those who are younger and have one or more children.

Purpose: Unintended pregnancies are often a burden to pregnant women and to the health care system. The rates of unintended pregnancies have decreased since the wide use of contraceptives has increased; however, young women, women with low income, and racial/ethnic minorities are more likely to use contraceptives inconsistently, which increases the risk of an unintended pregnancy. This risk could be reduced with the proper use of emergency contraceptives (ECs).Methods and Analysis: A cross-sectional study was conducted using the data from the female respondents of the 2002 Cycle 6 NSFG. Logistic regression was used to determine rates of use of ECs among different risk groups. A second analysis only including women who have had an abortion in the past 12 months was also conducted.Results: In the total study population, women over the age of 30 were more likely to never have used ECs, to not have used ECs in the past 12 months, and to not have received EC counseling in the past 12 months. Among those who have had an abortion, women aged 15-19 were less likely to have never received ECs. Those aged 15-19 and 30-34 were less likely to not receive EC counseling. Income level did not have a significant effect on use of EC services. For the whole study population, Hispanic women were significantly less like to not receive ECs in the past 12 months. Hispanic women were also less likely to not receive EC counseling in the past 12 months for the total study population and for those who have had an abortion.Discussion: Unintended pregnancies create burden for individuals as well as the public health infrastructure. ECs could help to prevent some of these unintended pregnancies. Age was the most significant and consistent predictor of use of EC services Further research should focus on evaluating the use of ECs specifically among those who have unprotected sex in order to more precisely evaluate the characteristics of women using and not using ECs. Further research into the barriers preventing women from accessing ECs is also necessary to increase use of ECs and prevent unintended pregnancies.

Diante da importância que a gravidez não planejada vem adquirindo no cenário mundial, apesar da melhoria nas tecnologias contraceptivas e ampliação do acesso aos serviços de saúde e métodos contraceptivos, faz-se necessário mensurar com maior precisão este fenômeno. Por esta razão, pesquisadores da área de saúde sexual e reprodutiva têm procurado desenvolver medidas que possam oferecer estimativas confiáveis de mulheres que vivenciam a gravidez não planejada. A maior parte dos instrumentos utilizados para mensurar a gravidez não planejada são unidimensionais e não levam em consideração a parceria, a intencionalidade ou o uso de métodos anticonceptivos de forma simultânea, aspecto não observado no London Measure of Unplanned Pregnancy (LMUP), desenvolvido no Reino Unido. Nesse contexto, este estudo transversal tem como objetivo traduzir e adaptar o instrumento LMUP para a língua portuguesa e validar suas propriedades, visando à sua utilização como instrumento de mensuração de gravidez não planejada no Brasil. A adaptação cultural e validação do LMUP foram realizadas conforme o método preconizado pela literatura. O cenário de estudo foram unidades da rede de Atenção Básica do município de Marília-SP. A população de estudo foi composta por 126 mulheres com idade 18 e 42 anos, usuárias dessas unidades, que procuraram a Unidade para confirmação do diagnóstico da gravidez por meio de um teste imunológico para gravidez cujo resultado foi positivo. Os resultados obtidos demonstraram que em relação às propriedades psicométricas, o instrumento apresenta um valor de apha de Cronbach de 0,75 para a escala total. A análise fatorial exploratória dos componentes principais do instrumento LMUP na versão Português aqui apresentada resultou em um único fator, que explicou 66,5% da variância total dos dados. As propriedades psicométricas do instrumento foram demonstradas e, portanto ele pode ser utilizado para mensurar a gravidez não planejada na população brasileira. / Facing the impact that unplanned pregnancy is acquiring world wide, despite the improvement in contraceptive technologies and increasing access to health services and contraceptive methods, it is necessary to measure this phenomenon more accurately. For this reason, researchers in the sexual and reproductive health field have sought to develop measures that can provide reliable estimates of women experiencing unplanned pregnancies. Most instruments used to measure the unplanned pregnancy are unidimensional and do not take into account the partnership, the intent or the use of contraceptive methods simultaneously, a not observed aspect at London Measure of Unplanned Pregnancy (LMUP), developed in the United Kingdom. Thus, this cross-sectional study is aimed to translate and adapt the instrument LMUP to Portuguese and validate its properties, aiming at its use as an instrument for measuring unintended pregnancy in Brazil. Cultural adaptation and validation of LMUP were done according to the method recommended by the literature. The scenery for the study was units of the network of Primary Care in Marília-SP. The studied population consisted of 126 women aged between 18 and 42 years, users of these units, who sought for this Unit to confirm the diagnosis of pregnancy by means of an immunological test for pregnancy and the result was positive. The results showed that in relation to psychometric properties, the instrument has a Cronbach\'s alpha value of 0.75 for the total scale. The factor analysis of the main components of the LMUP to the Portuguese version presented here has resulted in one factor, which explained 66.5% of the total variance of the data. The instrument\'s psychometric properties were demonstrated, and, therefore, it can be used to measure the unplanned pregnancy of the Brazilian population.