Although much research has been conducted on termination of pregnancy, there is a paucity of information regarding women’s sexuality after such a procedure, and in particular, how a woman understands her sexuality following a termination of pregnancy or what influences such an understanding. This research aimed to investigate how women understand their sexuality following a voluntary termination of pregnancy through the examination of the interaction between personal and broader social views on sexuality. Seven women who had undergone the procedure at two private termination clinics in Johannesburg were interviewed, using a semi-structured, open-ended interview schedule. The data was analysed according to thematic analytic methods. Based on the results, it was clear that the way in which women understand their sexuality following a termination of pregnancy is complex and multi-faceted. Particular themes emerged that were in line with the debates raised in the current literature. It became evident that these views were intricate and multi-faceted. Heteronormativity and heterosexuality proved particularly influential in how women understand their sexuality following a termination of pregnancy, and which further related to points raised throughout the literature. It was clear through the analysis that each theme could be seen to stand alone, or alternatively be represented through other themes and sub-themes.

Thesis (MA. (Clinical Psychology)) -- University of Limpopo, 2013 / The current study aimed at investigating the relationship between attitudes towards termination of pregnancy (TOP) and family structure and functioning, religiosity, and death anxiety. Participants of this study consisted of 330 school-going, adolescent, female participants aged 12 to 19 years. The results indicated that no relationship exists between attitudes towards TOP and the type of family structure from which an individual stems. The relationship between attitudes towards TOP and the Family Assessment Device (FAD) general family functioning scale did not reach statistical significance either. When attitudes towards TOP were correlated with the more specific family functioning subscales, the FAD problem-solving subscale was negatively associated with attitudes towards TOP. Additionally, the relationship between attitudes towards TOP and death anxiety was not statistically significant. However, analysis indicated that there is a statistically significant, negative relationship between attitudes towards TOP and intrinsic religiosity among school-going adolescents. Final analysis involved the regression of variables of FAD problem-solving and intrinsic religiosity on attitudes towards TOP. Both intrinsic religiosity and FAD problem-solving scores were predictors of attitudes towards TOP.

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.

Adolescent pregnancy is a concern worldwide and has risen at an alarming rate in South African societies. Many teenage pregnancies end up being aborted. Despite the availability of contraceptives free of charge in public institutions, unintended pregnancies among adolescents still persist. These unintended pregnancies result in a high rate of induced abortion, both safe and unsafe. The study was conducted to explore and describe the perceptions of adolescents regarding induced abortion in two public hospitals in East London, South Africa. This was a qualitative, phenomenological research study to explore the perceptions of adolescents regarding the induced abortion. Participants were purposively selected to participate in the study. Data were collected by means of individual interviews using interview guide in order to allow the participants to express their perceptions freely because of the sensitivity of the issue. Data were collected until saturation was reached. Saturation was reached after 24 participants were interviewed by the researcher. Data analysis used Tech’s (1990) steps as outlined by Creswell (2014:198). Themes, categories, and subcategories were identified following the data analysis. All adolescents admitted having consensual unprotected sex. Engagement in early sexual behaviour by the adolescents was evident as their sexual debut was between the ages of fifteen and sixteen years. Adolescents emphasised that they had abortions because they had no choice. Adolescents cited poor-socio economic status as their main reason for having abortions. Some findings were that adolescent men were against abortion and they had to be persuaded by their female counter parts. A recurrent factor in the results was the infrequent use of contraceptives, including condoms by the adolescents. This indicated that adolescents practised unsafe sex, with little or no regard for sexual transmitted diseases including Human Immune Deficiency Virus and Acquired Immune Deficiency Syndrome (HIV and AIDS). The results also indicated poor treatment by the nursing staff at the family planning clinics. This poor treatment resulted in adolescents not attending family planning clinics. This led to adolescents using abortion as the only method of contraception. Shortage of staff was a contributing factor to the poor treatment of adolescents in the family planning clinics. Adolescents cited that contraception at the clinics is not prioritised. The participants suggested that they should be reminded when to come to the clinic for family planning. Perceptions of reasons for adolescents choosing induced abortion ranges from psychosocial to socio-economic reasons. The knowledge of participants of what was happening to them and what they were doing seemed adequate. The perceptions of the adolescents regarding induced abortion were that abortion is wrong, against their morals as they are Christians; they use abortion because they have no choice due to their poor socio-economic status. The strategies to reduce the unintended pregnancy through the proper management of the contraception programmes, including the change in negative attitudes of health care providers in the family planning clinics could yield positive results.

Thesis (M.Dev.) --University of Limpopo, 2007 / The study sought to develop guidelines that are aimed at improving Termination of Pregnancy (TOP) services that are rendered by public hospital based midwives. The researcher applied a qualitative and descriptive design. The study targeted midwives in the Bohlabela District, which has three hospitals. A non-probability purposive sampling was used to 6 midwives who are currently conducting TOP services in the hospitals. Data collection was both in-depth and conducted in face-to-face interviews with each participant. The findings of the study were analyzed, categorized into sub-themes, and revealed that midwives who conduct TOP services experience the following challenges, namely: inadequate human resource, poor infrastructure, lack of equipments, poor management support, and lack of support from doctors. Based on the findings of the study, it is imperative that all hospitals be designated centres for TOP services, so as to reduce the workload in the few hospitals that currently are inundated. The infrastructure needs to be improved, information about TOP services to the public has to be disseminated through awareness campaigns, and scarce skills allowances must be introduced. In addition, more staff members need to be employed. The study further recommends that the TOP policy guideline be reviewed in terms of allowing other competent health professionals to perform TOP. Chapter two discusses the literature review regarding the challenges that affect midwives who conduct TOP. In this study, theresearch compares the practice of TOP by the developing and developed countries, looks at related to laws at on TOP; gives an overview of sterilization Act in South Africa; mentions the amendments of laws on TOP; considers other legal restrictions; presents mandatory counseling for TOP clients; focuses on religious, cultural and traditional beliefs. The researcher has consulted different literatures, journals articles and website on challenges that affect midwives in rendering TOP in Limpopo, South Africa and world wild. Chapter three presents research methodology that consists of research design; area of study; population; sampling method; data collection method and procedure; ensuring trust worthiness; and ethical consideration, to be followed by limitation of the study. Chapter deals with data analysis and interpretation. Chapter five presents the researcher’s conclusions and recommendations.

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)

Abortion is one of the issues that elicits relatively controversial debates around the globe. These debates revolve around the pro-life and pro-choice stances, moral and religious issues, backstreet abortion, the role of fathers in decision-making and constitutional issues, among others. Therefore, there is a variety of factors that may influence the way individuals perceive abortion. Race, religious affiliation, and religiosity have been found to play a role in determining the attitudes of individuals towards abortion. For instance, racial and religious differences in abortion attitudes among the South African public are reported (Patel, Ramgoon & Paruk, 2009; Rule, 2004). However, research on attitudes towards abortion demonstrates its complex nature and provides somewhat conflicting evidence. Varga (2002) makes the point that while it is important to understand both male and female perspectives on abortion, very little is known about boys‟ attitudes towards abortion, thus the motivation for this research study. Consequently, the aim of this study was to investigate the attitudes of young male learners towards abortion taking into consideration their race, religion and religiosity. Findings indicate that young male learners generally have high religiosity levels and show negative attitudes towards abortion across race and religion. The religious and racial differences in abortion attitudes of male learners were also explored and revealed significant differences amongst the groups, with the Islamic group obtaining the highest levels of abortion opposition for different reasons when compared to Africans and Hindus. In line with past research (Patel & Johns, 2009; Patel & Kooverjee, 2009; Patel & Myeni, 2008), these findings indicate that the higher the religiosity level, the more negative the attitudes towards abortion. / Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.

Abortion is a publicly contentious topic as it speaks to and draws on localized understandings of body politics, abortion beliefs, women’s role in society, the sanctity of life, and the role of the state. South Africa’s liberal abortion law has led to the removal of abortion restrictions at the macro-structural level. However, cultural and religious constraints at individual and community levels continue to exist as barriers to women’s access to safe abortion which may put women’s lives at risk. These constraints to safe abortion were explored through giving attention to the context of the participants so as to comprehend the nature of the resistance as well as to understand constructions and perceptions of abortion. This study used a combination of frameworks: the African epistemologies, Judith Butler’s performativity theory and Foucault’s notion of power. Data was collected through individual interviews and focus group conversations with women aged 25-40 in a rural Bushbuckridge area of South Africa and analyzed using Parker’s discourse analysis approach. The results of the study revealed competing and contradicting discourses which provide multiple voices and realities. It highlighted discourses that emanate from African traditional epistemologies that view abortion as a taboo that is punishable by draught and shortage of agricultural products, illness, infertility and contamination of the body, which require ritual performances to alleviate. Furthermore, the findings showed the complexities of sexual reproductive decisions by alluding to conditions of poverty; gender based violence, gendered power relations as well as economic inequality. The findings of this study challenge us to be open-minded and mindful of other realities as scholars, policy makers and advocates of change in order to bring about meaningful and acceptable context appropriate change. / Psychology / M.A. (Psychology: Research Consultation)

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)

Department of Advanced Nursing Science / PhDH / Background: Despite measures to curb unwanted pregnancies and to sustain and expand abortion services, a high number of complications and deaths still occur. The failure of these measures is evidenced by the high number of women who are admitted to the public hospitals of KwaZulu-Natal Province with complications from induced abortions. KwaZulu-Natal Department of Health has repositioned Family Planning to a key priority in its health program in order to improve the situation for women. However, in order to improve the situation, it is necessary to understand the underlying causes. This study sought to identify challenges that affect women's access to Post Abortion Care (PAC) services in KwaZulu-Natal Province, South Africa. It also sought to shed light on the challenges faced by those who render PAC services, as well as assess the skills of those workers as observed while they provided PAC services. After conducting the research on challenges related to access and rendering of post abortion care services, the researcher identified a need to develop guidelines for management of unsafe and induced abortion complications, with the aim to improve the life expectancy of women and prevent maternal deaths. Therefore, an outcome of the study was the development of a PAC management guideline. Purpose: The purpose of the study was two-fold: Phase 1: to explore the challenges faced by women when accessing PAC, and the health care workers who render PAC services, and to assess the PAC skills of the health care workers; Phase 2: to use the findings of Phase 1 to develop guidelines for post abortion care management at selected Hospitals of KwaZulu-Natal Province, South Africa. Methods: The design of the study was guided by the Andersen model of Health Care Utilization. The model focuses on the contextual factors - enabling factors, predisposing factors and need factors - that influence the individual's utilization of health care services. Five districts of KwaZulu-Natal Province, South Africa were selected for the study. A convergent parallel mixed method was used to collect and interpret the data. A qualitative study was used to explore perceptions and challenges of women when accessing PAC; this was carried out by means of in-depth interviews with 23 women who accessed PAC services. Five Focus Group Discussions (FGD) were carried out with 50 health care workers to explore the challenges they experienced when managing abortion complications. A quantitative approach was used for direct skills observation of 92 health care workers. Thematic analysis was used to analyse the qualitative data; descriptive statistics were used to analyse the quantitative data. Results: From the in-depth interview data, several main themes were identified. Women who accessed PAC identified a lack of facilities that offered PAC service, distance from the community to the hospital that provided PAC service, lack of transport, shortage of staff, unskilled staff, shortage of equipment, long waiting queues, stigma and discrimination as challenges associated with delay or avoidance of access to post abortion care services. The main themes raised by the health care providers were lack of support from the management, shortage of staff, lack of training, burnout, unavailability of the guidelines or protocols and shortage of equipment. The quality of PAC services was perceived as poor by both the women seeking care and the health care workers. The main concerns raised by the women were lack of respect, lack of privacy, sharing of bed and insufficient time with the health care provider. The results confirmed that guidelines are needed for the management of post abortion care services. The findings from the qualitative and quantitative parts of the study were used by an expert group to develop PAC management guidelines. The development of the guidelines was in accordance with the WHO models, PICOS & GRADES. The guidelines were validated by the group using a close-ended checklist, analysed with simple descriptive statistics. Conclusion: This study concludes that access to comprehensive quality post abortion care must be provided for all women at times of need. Quality PAC services should be rendered by skilled health care workers in a facility which is accessible and well equipped with functional equipments and updated guidelines. Recommendations: The study therefore recommends that measures should be taken to ensure the provision of quality PAC services. The PAC services should be accessible with the increased number of facilities, adequate trained health care workers with functional equipment and guidelines. Health care workers must receive training and management support to enhance quality PAC services. Privacy and respect must be maintained during provision of PAC services to ensure quality of care and increase demand. There must be continuous community awareness about PAC services which will encourage early-seeking behavior, and reduce fear of stigma and discrimination by the providers of PAC services before the complications arises. This study did not cover all the districts to identify the challenges on delaying PAC service. Therefore, this study recommends additional clinical, operations and community research which will give broader details and understanding on the challenges that cause delay for seeking immediate post abortion care services. / NRF