A gestação, o parto e o puerpério são saberes especiais no universo da mulher, do parceiro, da família e de sua comunidade. A gestação pode gerar diversos sentimentos, tais como: o de surpresa, o de castigo, o de prêmio, o de motivação para continuar a viver, o de realização de um projeto antigo, o de competição em família, o de problema, o de estorvo, o de descuido ou de irresponsabilidade. Confirmada a gravidez, a mulher, o parceiro e os familiares podem vivenciar diferentes reações diante dessa novidade. A reação inicial depende do desejo e planejamento da gravidez (gestação), podendo ser desejada, planejada, ou acidental, não planejada e, até mesmo indesejada. Gravidez não planejada é toda a gestação que não foi programada pelo casal ou, pelo menos, pela mulher. A sua ocorrência tem impacto importante na oferta de cuidados de pré-natal, na orientação sobre aleitamento materno, no estado nutricional infantil e nas taxas de morbimortalidade materno-infantil. Embora pouco estudada, a gravidez não planejada representa risco aumentado de ansiedade e de depressão, sobretudo no período puerperal. Tendo em vista estes aspectos, o objetivo deste estudo foi compreender como as gestantes vivenciaram/experienciaram uma gravidez não planejada e suas consequências à vida familiar/conjugal. O estudo baseou-se na metodologia de análise de dados qualitativos, na análise destes dados, utilizou-se a abordagem metodológica do Discurso do Sujeito Coletivo (DSC), por meio do software Atlas.ti. A população em estudo foi constituída de gestantes em idade fértil, entre 18 e 49 anos de idade, pois essa faixa etária assegura maioridade às mulheres. Foi utilizada para organizar os dados verbais, entrevista semiestruturada, realizada com 11 gestantes. Partindo dos depoimentos das gestantes copiados no software, a análise dos discursos teve início com a identificação das expressões-chave, nas quais estão contidas as ideias centrais de cada discurso que foram escritas de forma breve e objetiva. Foi evidenciado que as gestantes apresentaram reações iniciais negativas com relação à descoberta da gravidez não planejada, vivenciaram conflitos, devido ao medo de enfrentar a família, o companheiro e os pais. Também ficou evidente que a gravidez não planejada tem como principal consequência a problemática nos níveis biopsicossociais. Evidenciaram altos níveis de ansiedade, estresse e depressão no decurso da gestação. Quanto aos métodos contraceptivos, a maioria estava em uso quando da descoberta da gravidez. Considera-se que este estudo ganha relevância pelo impacto que exerce sobre o bem-estar pessoal, familiar e socioeconômico das mulheres e seus companheiros, em virtude das possíveis gestações não planejadas / Pregnancy, childbirth and the postpartum period are special knowledge in the world of woman\'s partner, family and your community. Pregnancy can cause many feelings, such as: the surprise, the punishment, the premium, the motivation to continue living, the realization of an old design, the competition in the family, the problem of the hindrance, to carelessness or irresponsibility. Confirmed pregnancy, the woman, her partner and family members may experience different reactions to this news. The initial reaction depends on the planning and desire of pregnancy (gestation), and may be desired, planned or accidental, unplanned and even unwanted. Unplanned pregnancy is any pregnancy that was not planned by the couple, or at least the woman. Its occurrence has important impact on the provision of prenatal care, the guidance on breastfeeding, the nutritional status and rates of maternal and child morbidity and mortality. Although little studied, unplanned pregnancy is increased risk of anxiety and depression, especially in the postpartum period. Considering these aspects, the aim of this study was to understand how pregnant women experienced / experienced an unplanned pregnancy and its consequences for family life / marriage. The study was based on the methodology of qualitative data analysis, the analysis of these data, we used the methodological approach of the Collective Subject Discourse (CSD), using the software Atlas.ti. The study population consisted of pregnant women of childbearing age, between 18 and 49 years of age, because this age ensures age women. Was used to organize the verbal data, semi-structured interviews conducted with 11 pregnant women. Based on the testimonies of the women copied the software, discourse analysis began with the identification of key expressions, in which are contained the main ideas of a speech that was written briefly and objectively. It was shown that pregnant women had initial negative reactions regarding the discovery of unplanned pregnancy, experienced conflict due to fear of facing the family, spouse, and parents. It was also evident that unplanned pregnancy is mainly due to problematic levels biopsychosocial. Showed high levels of anxiety, stress and depression during pregnancy. As for contraception, the majority was in use when the discovery of the pregnancy. It is considered that this study becomes relevant for the impact it has on the well -being, family and socioeconomic status of women and their partners, because of possible unintended pregnancies

This study investigated the relationships among family environment, demographic measures, the decisions made by unintentionally pregnant adolescents regarding post-delivery plans (stay single, get married, adoption), and the certainty with which these decisions were made. The Information Sheet, Family Environment Scale (Moos & Moos, 1981), and Multiple Affect Adjective Check List (Zuckerman & Lubin, 1965a) were administered to 17 5 pregnant adolescents, ages 14 through 22, who intended to carry their pregnancies to term. Pearson product-moment correlations and multiple regression analyses were utilized to assess the relationships between family environment and certainty of decision and between family environment and negative affect. Greater uncertainty was associated with nonwhite racial status and living with both natural parents or mother only. Higher levels of negative affect were related to lower levels of perceived family cohesion, independence, expressiveness, and intellectualcultural orientation. The demographic variables of age, trimester of pregnancy, and family constellation were also found to be useful in predicting levels of negative affect. Subjects who were older, further along in their pregnancies, and living with both natural parents or mother only tended to report greater negative affect. Findings of greater uncertainty and negative affect associated with living with the natural mother are consistent with previous reports of disturbed mother-daughter relationships among this population. Discriminant analysis revealed that subjects choosing adoption were more likely to be older and to be white than those choosing to keep the child. They also tended to perceive higher levels of expressiveness and independence in their families. Comparisons between the present sample and "normal" families revealed differences which were statistically significant, but quite small in terms of raw score units. Indeed, these groups may be more similar than has often been assumed. The implications of these findings for the delivery of services and for future research efforts in this area were discussed. More intensive assessment of family functioning is needed. Based upon present results, further investigation of the family constellation variable is warranted.

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)

MPH / Department of Public Health / Unplanned pregnancy is a major medical, social and public health problem worldwide. This problem affects learners’ performance and leads to a high learner drop-out rate at schools. The purpose of this study was to investigate the factors influencing unplanned pregnancy among high school learners in the Collins Chabane Municipality, Limpopo Province, South Africa. A quantitative study using survey methods was used. A structured questionnaire was used to collect data. The total sample size was 362 female learners ranged between learners whose ages ranged between 16 and 24. Only female learners in the school were recruited to participate in the study. Validity and Reliability were ensured. Data were analyzed using SPSS version 25.0 program. Descriptive and inferential statistics were used to summarize and present the data. Permission to conduct the study was obtained from the Department of Education, Limpopo Province, the Malamulele Circuit and the Principal of the school. Informed consent was obtained from parents on behalf of female learners under 18 years of age. Confidentiality and anonymity was ensured. The study found that about 58.2% of adolescents had used contraceptives, while 64.1% indicated that they needed more information on contraceptive methods and their use. The study also found that about 71.8% of the respondents had abstained from sexual activities in order to avoid unplanned pregnancy. Unplanned pregnancies were found to be associated with ignorance of the consequences of sexual activities, information about sex from their peers and the power imbalance in sexual relationships between male and female adolescents. It is recommended that adolescents be given adequate information about contraceptives, addressing the advantages, disadvantages, side effects and how to manage their side effects. This would help mitigate against the negative attitudes that the adolescents have toward contraceptives owing to misinformation and misconceptions. In addition, school health nurses should use Information Education Communication (IEC) materials on family planning to increase awareness about family planning and to prevent unplanned pregnancies. The IEC materials should be in the most common languages of Limpopo Province, i.e. Sepedi, Xitsonga and Tshivenda for clear understanding of the content. / NRF

The aim of the study was to develop strategies to reduce the unmet need for modern contraception among agro-pastoral women. The objectives of the study were to determine the prevalence of unmet need for modern contraception, determine the factors associated with unmet need for modern contraception, and explore the barriers that hindered agro-pastoral women from using modern contraception. A mixed-method research design was used to conduct the study. Data were collected from agro-pastoral women and family planning service providers. Questionnaire and individual in-depth interviews were used to collect the data. The validity and reliability of the quantitative data and trustworthiness of the qualitative data were ensured. Use of standard data collection tools, employing method and data triangulation, and documenting all the procedures of data collection and analysis were among the ways employed to do so The quantitative data were analysed using simple descriptive statistics and multivariate logistic regression. Thematic analysis was employed to analyse the qualitative data. Ethical principles of research such as beneficence, justice, informed consent, respect for persons, privacy and confidentiality and scientific integrity were considered to conduct the study. The study revealed an unmet need of 29.2% (n=112) for modern contraception among agro-pastoral women. The unmet need for birth spacing constituted 21.1% (n=81), whereas the unmet need for birth limiting was 8.1% (n=31). The age of the women, the number of living children, knowledge of modern contraceptive methods, and knowledge of FP service centres were found to be associated with women‘s unmet need for modern contraception. Lack of time and money, lack of knowledge about modern contraception, and fear of side effects were the major individual-level barriers. There were also culture-related factors such as the need for many children that hindered agro-pastoral women from using modern contraception. Moreover, the study disclosed that religious unacceptability and husband‘s and relatives‘ opposition were also among the mentioned barriers. The quality of FP service provision in terms of the competence and behaviour of health service providers, unavailability and inaccessibility of FP service, were also indicated as barriers. The findings informed the development of strategies to reduce agro-pastoral women‘s unmet needs for modern contraception in Eastern Ethiopia. The study further recommended that the health bureaus of the region, zone and district collaborate in ensuring that agro-pastoral women realise the significance of the provision of accessible, equitable, quality modern contraception. It is also essential to equip health facilities with qualified health service providers and necessary facilities. Religious leaders should be involved in disseminating vital, relevant and empowering FP information. / Health Studies / Ph. D. (Public Health)

Background: One in ten people in the U.S. are affected by a substance use disorder (SUD), roughly one third of whom are women. Rates of unintended pregnancy are higher in this population than in the general public. Little is understood about how women with SUD use prescription contraception and think about pregnancy. Methods: By analyzing Medicaid claims data and conducting qualitative interviews with women with SUD, this doctoral thesis seeks to: 1) compare any use of and consistent, continued coverage by prescription contraceptives between women with and without SUD; 2) determine the extent to which SUD is associated with pregnancy, abortion, and adverse feto-maternal outcomes in women who use prescription contraception; and 3) explore facilitators of and barriers to contraceptive utilization by women with SUD, using qualitative interviews. Results: Compared to women without SUD, women with SUD are less likely to use any prescription contraceptive, particularly long-acting reversible methods. Among women who do use long-acting methods, SUD is associated with less continued, consistent coverage by a prescription contraceptive. Among women who use contraception, SUD is also associated with increased odds of abortion. When interviewed, women with SUD report fatalistic attitudes towards pregnancy planning, and have difficulty conceptualizing how susceptibility to pregnancy may change over time. Women with SUD also report that pregnancy has substantial impact on their drug treatment prospects. Conclusions: This study is the first to examine contraceptive utilization by women with SUD who are enrolled in Medicaid or state-subsidized insurance. Our study may help to inform clinical practice and policy development to improve the reproductive health and wellbeing of women with SUD.