Aim: The 1996 Choice on Termination of Pregnancy Act decriminalized abortion in South Africa and the South African Medicines Control Council in 2000 approved the dispensing of emergency contraceptive methods by pharmacists to women without a doctor's prescription. This legislation has been hailed as among the most progressive in the world with respect to women's reproductive justice. However the realisation of these rights in practice has not always met expectations in part due to medical practitioners' ethical objections to termination of pregnancy and the provision of related services. The aim of this study was to interpret the varying ways in which medical practitioners frame termination of pregnancy and emergency contraceptive services, their own professional identities and that of their patients/clients. Methods: Sample of 58 doctors and 59 pharmacists drawn from all nine provinces of South Africa. Data collected using an anonymous confidential internet-based self-administered questionnaire. Participants were randomly recruited from online listings of South African doctors and pharmacists practicing in both private and public sectors. Data were analysed using theoretically derived qualitative content analysis. Results: Participants drew on eight frames to justify their willingness or unwillingness to provide termination-of-pregnancy related services: the foetal life frame, the women's rights frame, the balancing frame, the social justice frame, the do no harm frame, the legal and professional obligation frame, the consequences frame and the moral absolutist frame. Conclusion: Health professionals' willingness or unwillingness to provide termination of pregnancy related services is highly dependent on how they frame or understand termination of pregnancy, and how they understand their own professional identities and those of their patients/clients.

The Choice on Termination of Pregnancy Act (CTOP Act 92 of 1996) is perhaps the most revolutionary piece of legislation internationally ever to have been promulgated to regulate abortion and as such women’s reproductive lives. Abortion research tends to focus on the experiences of women and thus cast abortion as solely a territory that represents women’s reproductive concerns and the power to choose to procreate. While the CTOP Act safeguards women’s right of choice and a form of determination relating to what happens to their bodies, it also fails to recognise or even make pronouncements about the role that a man plays in the choice to terminate a pregnancy as well as how abortion affects a man’s life. This therefore implies that legally, men do not have a stake to influencing the decision to terminate a pregnancy. This qualitative study was undertaken to explore how young unmarried males whose partners have undergone an abortion construct abortion and the meanings that they attach to the experience of abortion. Interviews were conducted and the data was analysed using discourse analysis. Some of the young men knew about the woman’s decision to have an abortion and others did not know. Common findings include a sense of helplessness due to feeling that the decision is ultimately that of the woman, anger for those who did not know about the decision to abort and a lack of forgiveness towards their partners. / Psychology / M. A. (Clinical Psychology)

Department of Public Health / MPH

The purpose of this research study is to determine the factors influencing reproductive health choices of women living with HIV attending primary health care services. The need for this research study is evident in that most women attending health care services at primary health care clinics, and who are HIV positive report unintended pregnancy. The study sought to provide answers to factors influencing their reproductive choices. A quantitative, descriptive and cross-sectional research study was used in this study. The sample consisted of 83 females between the ages of 18 and 40. The findings of the research study provided the researcher with adequate evidence on the factors influencing reproductive health choices of women living with HIV attending primary health care services. The approach to reproductive health services was still acceptable but needs to be improved. Moreover, the identified factors therefore influenced one’s perceptions on reproductive health decisions among HIV-infected women. / Health Studies / M.A. (Public Health)

Contraceptives are available free of charge throughout South Africa. Nevertheless the number of requests for termination of pregnancy (TOP) services continues to increase. This research investigated challenges preventing women from using contraceptives effectively. Structured interviews were conducted with 47 women who requested TOP services. Gender and financial issues posed challenges for some women to access contraceptives as well as their reported inability to access contraceptives. Most (85,5%) of the respondents used contraceptives. They discontinued using contraceptives because they experienced side-effects, necessitating them to request TOPs. Knowledge about, access to, nor the actual use of contraceptive enabled these women to prevent unwanted pregnancies. More effective counselling about the side-effects of contraceptives and enhanced accessibility of contraceptives during weekends and lunch breaks could enable more women to prevent unwanted pregnancies and reduce the number of requests for TOPs in the Gert Sibande District (Mpumalanga). / Health Studies / M.A. (Health Studies)

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)

Contraceptives are available free of charge throughout South Africa. Nevertheless the number of requests for termination of pregnancy (TOP) services continues to increase. This research investigated challenges preventing women from using contraceptives effectively. Structured interviews were conducted with 47 women who requested TOP services. Gender and financial issues posed challenges for some women to access contraceptives as well as their reported inability to access contraceptives. Most (85,5%) of the respondents used contraceptives. They discontinued using contraceptives because they experienced side-effects, necessitating them to request TOPs. Knowledge about, access to, nor the actual use of contraceptive enabled these women to prevent unwanted pregnancies. More effective counselling about the side-effects of contraceptives and enhanced accessibility of contraceptives during weekends and lunch breaks could enable more women to prevent unwanted pregnancies and reduce the number of requests for TOPs in the Gert Sibande District (Mpumalanga). / Health Studies / M.A. (Health Studies)