Thesis (M.S.)--University of Michigan, 1996.

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.

The aim of this African culturally based research is to establish whether a group of unmarried pregnant teenage girls experience rejection during their period of pregnancy as well as to determine whether they experienced rejection for whatever reason before falling pregnant. Seen in the context of the communal and person-centred life view as upheld by the African culture where respect for and well-being of the individual within the tribal and extended family structure is paramount, one would expect that unmarried girls finding themselves in a precarious situation such as premature pregnancy would experience understanding, acceptance and support. The research is quantitative as well as qualitative. The quantitative research focuses on 341 grade 11-leamers at seven secondary schools in the Free State Province of Education as well as in the Gauteng Department of Education. Questionnaires were presented with the aim of establishing the reason for teenage pregnancy; to research the thoughts, feelings and actions of the peer group toward pregnant teenage girls; to determine the presence of feelings of rejection of a group of pregnant teenage girls at the same schools; to determine the thoughts the girls have about themselves as well as about the future. On account of the fact that that the responses of the pregnant girls seemingly contradicted the responses given by the grade 11-peer group sample it was decided to supplement the quantitative research result with a qualitative research investigation by means of focus group interviews conducted with twelve willing to participate pregnant girls at two ofthe secondary schools who voluntarily agreed to participate. The research result indicates that although the pregnant girls did not experience rejection before falling pregnant they did however experience rejection after falling pregnant, especially from the peer group at school, educators, and certain sections of society. Although the parents of these girls were initially offended and reluctant, their attitude toward the pregnancy changed to include acceptance and even support. / M.A. Psychology, North-West University, Vaal Triangle Campus, 2010

The aim of this African culturally based research is to establish whether a group of unmarried pregnant teenage girls experience rejection during their period of pregnancy as well as to determine whether they experienced rejection for whatever reason before falling pregnant. Seen in the context of the communal and person-centred life view as upheld by the African culture where respect for and well-being of the individual within the tribal and extended family structure is paramount, one would expect that unmarried girls finding themselves in a precarious situation such as premature pregnancy would experience understanding, acceptance and support. The research is quantitative as well as qualitative. The quantitative research focuses on 341 grade 11-leamers at seven secondary schools in the Free State Province of Education as well as in the Gauteng Department of Education. Questionnaires were presented with the aim of establishing the reason for teenage pregnancy; to research the thoughts, feelings and actions of the peer group toward pregnant teenage girls; to determine the presence of feelings of rejection of a group of pregnant teenage girls at the same schools; to determine the thoughts the girls have about themselves as well as about the future. On account of the fact that that the responses of the pregnant girls seemingly contradicted the responses given by the grade 11-peer group sample it was decided to supplement the quantitative research result with a qualitative research investigation by means of focus group interviews conducted with twelve willing to participate pregnant girls at two ofthe secondary schools who voluntarily agreed to participate. The research result indicates that although the pregnant girls did not experience rejection before falling pregnant they did however experience rejection after falling pregnant, especially from the peer group at school, educators, and certain sections of society. Although the parents of these girls were initially offended and reluctant, their attitude toward the pregnancy changed to include acceptance and even support. / M.A. Psychology, North-West University, Vaal Triangle Campus, 2010