It is a novel experience for a woman to enter into motherhood. While she may have some familiarity with basic methods of childcare, the experience of caring for her own child is a new one. Becoming a mother elicits a transformation for a woman, from a „self as a self‟ to a „self as a mother‟. When the pregnancy is unplanned, this transformation may be particularly complicated. This study explored this transformation by focusing on the stressors and supports mothers reported during pregnancy and in early motherhood, for women whose pregnancies had been unintended. The study utilized a psychoanalytic perspective, particularly object relations theory (ORT), to understand how the mother‟s object relations have been influenced by her perceptions and her stress levels, in her transition into motherhood. A qualitative approach was adopted in this study, so that the researcher could gain a “rich” description of the participants‟ experiences of pregnancy and motherhood. Five mothers, whose eldest was four years or younger and who had not intended to conceive, participated in focus groups and individual interviews. The data gained was analysed by means of thematic analysis, which brought about a list of perceived stressors and support factors. These stressors were categorized and discussed in relation to child-specific factors, factors specific to parenthood, environmental factors, and factors specific to the unintended nature of the pregnancy. The perceived supports included psychosocial support, allomaternal support, financial support, and information. / Thesis (M.A.)-University of KwaZulu-Natal, Pietermaritzburg, 2010.

Thesis (Mnutr)--University of Stellenbosch, 2003. / ENGLISH ABSTRACT: Pregnancy and growth have been found to have a detrimental effect on the micronutrient status of adolescent girls. Dietary studies in adolescents have shown serious shortfalls in their dietary iron and folate intake. The competition for nutrients between the fetus and a pregnant adolescent may carry the risk of complications such as intrauterine growth retardation, pre-eclampsia, both maternal and fetal intrapartum mortality, the increased risk of birth injuries and low birth weight. The aim of the study was to assess the nutritional status of rural black, pregnant teenagers attending the antenatal clinic at Siloam Hospital in the Limpopo Province, with special emphasis on iron and folic acid intake, and evaluation of the newborn babies in terms of weight status and neural tube defects. The nutritional status was determined in 40 pregnant and 40 non-pregnant adolescent girls. The pregnant girls were selected during their first visit to the antenatal clinic, and the non-pregnant girls were selected from nearby schools. The demographic and dietary history questionnaires were used to collect information from the subjects. The dietary intake of the subjects was collected by the completion of a pre-tested quantified food frequency questionnaire. The anthropometric questionnaire was used to get information from the pregnant adolescents and the control group. The infant anthropometric measurements questionnaire provided information on the infant and the outcome of birth. Blood was collected from the pregnant adolescent girls and the control subjects. Anaemia was observed in 57.5% of the pregnant and 27.5% of the non-pregnant adolescents (haemoglobin <Il g/dl and <12 g/dl, respectively). The prevalence of low serum ferritin « 12 ug/L) and low transferrin saturation « 16%) was high in both the pregnant (30% and 60% respectively) and the non-pregnant adolescents (17% and 72.5% respectively). Iron deficiency was observed in 45% of the pregnant girls and 35% of the control subjects. The prevalence of iron deficiency anaemia in the pregnant girls (30%) and the control subjects (22.5%) was high. Low red blood cell folate in pregnant and non-pregnant girls was uncommon. Low serum vitamin BI2 was common in most of the pregnant girls. Analysis of the quantitative food frequency questionnaire (QFFQ) that was completed for 80 of the pregnant and non-pregnant girls showed that 55% had low dietary iron intakes «67% of the RDA) (p = 0.7307). Forty-five percent of the pregnant girls reported taking iron supplements. The QFFQ showed 20% of pregnant girls with low intake of folate (p = 0.0577). Forty-five percent of pregnant girls also reported taking folate supplements. Anthropometric measurements of pregnant girls and their dietary intake could not be correlated to the birth outcome. The social profile of the subjects did not seem to influence their iron and folate status and the outcome of pregnancy. The findings in this study showed that pregnant adolescents appeared to be similar to the non-pregnant adolescent girls socio-economically, anthropometric and nutritionally. We recommend that educational programmes targeted at adolescents and teenagers in the Siloam area should reach girls that could potentially fall pregnant. An educational programme must include: reproductive needs (avoidance of sex or safe sex); nutritional needs, especially targeted at improving nutritional status to meet future reproductive needs; early booking at the antenatal clinic and effective supplementation during pregnancy. The need to improve the dietary and nutrient intake of the adolescent girls should be addressed within the current framework of the Integrated Nutrition Programme (!NP). A food fortification programme with essential micronutrients such as iron, folic acid, zinc and Vitamin A to improve the micronutrient status should be promoted among the adolescent girls. / AFRIKAANSE OPSOMMING: Daar is bevind dat swangerskap en groei 'n nadelige effek het op die mikronutriëntstatus van vroulike adolessente. Dieetstudies in adolessente het ernstige tekortkominge in dieetyster- en folaatinnames getoon. Die kompetisie vir nutriente tussen die fetus en die swanger adolessent kan verantwoordelik wees vir komplikasies soos intra-uterine groeivertraging, preeklampsie, verhoogde mortaliteit van beide moeder en baba tydens kraam, 'n verhoogde risiko vir geboortebeserings en lae geboortegewig. Die doel van die studie was om die effek van voedingstatus by swart, swanger tieners by die voorgeboortekliniek in Siloam Hospital in die Limpopo-provinsie te bepaal, met spesifieke verwysing na die yster- en foliensuurinname, asook die evaluering van die pasgebore babas in terme van gewig en neurale buis defekte. Die voedingstatus van 40 swanger en 40 nie-swanger adolessente meisies IS bepaal. Die swanger meisies is ewekansig geselekteer gedurende die eerste besoek aan die voorgeboortekliniek , en die nie-swanger meisies is geselekteer by nabygeleë skole. Die demografiese en dieetgeskiedenisvraelyste is gebruik om inligting van die proefpersone in te samel. Voorafgetoetste gekwantifiseerde voedselfrekwensie vraelyste is gebruik om die voedselinname van proefpersone te bepaal. Antropometriese vraelyste is gebruik om antropometriese inligting van die swanger adolessente en die kontrole groep. Die antropometriese vraelys vir babas is gebruik om inligting ten opsigte van die baba aan te teken asook die verloop van die swangerskap. Bloedmonsters is van die swanger tieners en die kontrole groep ingesamel. Anemie is waargeneem by 57.5% van die swanger en 27.5% van die nie-swanger adolessente (hemoglobien <Il g/dl en <12 g/dl onderskeidelik). Die voorkoms van lae serum ferritien « 12 ugIL) en lae transferrienversadiging « 16%) was hoog by beide die swanger (30% en 60%) en die nie-swanger adolessente (17.5% en 72.5% onderskeidelik). Ystergebrek is in 45% van die swanger meisies en in 35% van die kontrole groep waargeneem. Die voorkoms van ystergebrekanemie in die swanger meisies (30%) en die kontrole groep (22.5%) was hoog. Lae rooibloedselfolaat by swanger en nie-swanger meisies is nie algemeen waargeneem nie. Lae serum vitamien B12 was algemeen by die meeste swanger meisies. Ontleding van die gekwantifiseerde voedselfrekwensievraelys (KVFV) wat vir 80 van die swanger en nie-swanger meisies voltooi is, het getoon dat 55% 'n lae dieetysterinname gehad het «67% van die ADT) (p=0.7307). Vyf-en- veertig persent van die swanger meisies het bevestig dat hulle ystersupplemente gebruik het. Die gekwantifiseerde voedselfrekwensievraelys (KVFV) het getoon dat 20% van die swanger meisies 'n lae folaatinname het (0.0577). Vyf-en-veertig persent van die swanger meisies het ook genoem dat hulle folaatsupplemente gebruik het. Die antropometriese metings van swanger meisies en dieetinname kon nie gekorreleer word met die verloop van die geboorte nie. Dit blyk dat die sosiale profiel van die meisies nie 'n effek op die yster- en folaatstatus en op die verloop van swangerskap gehad het nie. Die bevindinge van hierdie studie toon dat swanger en nie-swanger adolessente meisies sosio-ekonomies, antropometries en nutrisioneel dieselfde voorkom. Dit word aanbeveel dat voorligtingsprogramme vir adolessente en tieners in die Siloam-area meisies moet bereik wat moontlik swanger sal word. 'n Voorligtingprogram moet die volgende insluit: reproduktiewe behoeftes (vermyding van seks of veilige seks); voedingbehoeftes, veral geteiken om voedingstatus te verbeter om ten einde toekomstige voorplantingsbehoeftes te vervul; vroeë besoeke aan die voorgeboortekliniek en effektiewe supplementering gedurende swangerskap. Die behoefte om die dieet en nutriëntinname van adolessente meisies te verbeter moet binne die huidige raamwerk van die Geintegreerde Voedingsprogram aangespreek word. 'n Voedselfortfiseringsprogram met essensiële mikronutriënte soos yster, foliensuur, sink en vitamien A om die mikronutriëntstatus van adolessente meisies te verbeter, moet bevorder word.

Teenage pregnancy is an ever increasing dilemma in South Africa. Dealing effectively with pregnant teenagers is a continuous challenge for the health care providers particularly the nursing staff. The present study focuses on the reproductive health care services in a Gauteng province clinic and pregnant teenagers' experiences of their interaction with the nursing staff. Six pregnant teenagers were included in the study. Data consistied of the participants' narratives regarding the health care services provided by the nursing staff. Themes from the narratives were identified and explored according to a Social Constructionism stance within the Postmodernist paradigm. Factors found to affect the experiences of the pregnant teenagers included acceptance, respect, effective communication, privacy, trust and the dedication and professionalism of the nursing staff. / Psychology / M.A. (Clinical Psychology)

Text in Afrikaans / Summaries in English and Afrikaans / In an exploratory study variables influencing the intention to use contraceptives and contraceptive use of teenagers and the association between these variables were determined.A random quota sample consisting of 231 and 224 school boys and girls (14 - 18 years) were selected and the final investigating group were 315 sexually active teenagers. According to loglinear analyses the following variables showed a significant relationship with the intention to use contraceptives: attitudes towards the use of contraceptives, perceptions of accessibility and locus of control. Variables that showed a significant relationship with actual contraceptive use were gender, knowledge about reproduction and contraceptives, beliefs and attitudes towards the use of contraceptives, traditional values such as proving fertility before marriage and family size, perceptions of social approval of contraceptive use as well as perceptions of accessibility to contraceptives. An important conclusion was that an urgent need exists for effective sex education programmes and better access to contraceptives. / In 'n verkennende veldstudie is faktore wat verband hou met swart tienderjariges se intensie om kontraseptiewes te gebruik en werklike kontraseptiewe gebruik ge'identifiseer en die verhoudings tussen die faktore is bepaal. 'n Ewekansige kwotasteekproef van 231 en 224 plattelandse skoolseuns en meisies ( 14 - 18 jaar) is betrek en die finale ondersoekgroep was 315 seksueel aktiewe tienderjariges. Volgens logitmodelontledings het die volgende veranderlikes 'n beduidende verband getoon met die intensie om van kontraseptiewes gebruik te maak: houding teenoor die gebruik van kontraseptiewes, persepsies van toeganklikheid tot kontraseptiewes en lokus van beheer. Veranderlikes wat 'n beduidende verband getoon het met werklike kontraseptiewe gebruik was geslag, kennis oor menslike reproduksie en kontraseptiewes, menings en houdings oor die gebruik daarvan, tradisionele waardeor'ientasies soos die bewys van fertiliteit voor die huwelik en gesinsgrootte, persepsies van sosiale ondersteuning vir kontraseptiewe gebruik asook persepsies van toeganklikheid tot kontraseptiewes. 'n Belangrike gevolgtrekking was dat daar 'n dringende behoefte bestaan na effektiewe seksuele voorligtingsprogramme en grater toeganklikheid tot kontraseptiewes. / Psychology / M.A.(Psychology)

The issue of teenage motherhood has been a concern, globally, continentally and locally. The quantitative study assessed whether the pregnant teenagers were ready for motherhood. This report analysed the current positions of women whose first child was to be born when they were teenagers in the rural Eastern Cape setting. The structured questionnaires were given to 106 pregnant teenagers who visited the War Memorial clinic for pregnancy check-up and convenient sampling was used to select these respondents. The items of the questionnaire were divided into the following sub-topics: prenatal and postnatal challenges and roles and responsibilities of motherhood. The study found that most of the pregnant teenagers were aware of the prenatal and postnatal challenges but they were not ready to perform the roles and responsibilities associated with motherhood. The analysis of data was divided in terms of descriptive and inferential statistics. The binary regression model was used to assess the factors affecting the pregnant teenagers’ readiness for motherhood. The finding of this study indicated that most (about 79 percent) of the pregnant teenagers were not aware of the roles and responsibilities of motherhood In addition to being not ready to face the psycho-social challenges of motherhood. Hence they indicated low level of readiness to motherhood. The psycho-social theory of Erikson posited that children who had strong and intact psycho-social relationships with the caregivers might have a high possibility of acquiring their identity during adolescent stage and this will help them to interact both effectively and efficiently with their peers and the society at large. While those do had negative psycho-social development have a high chance of facing identity crisis/confusion. As a result, they might lead them to being victims of psycho-social interaction such as early pregnancy.

MPH / Department of Public Health

MA (Psychology) / Department of Psychology / In South Africa, today, teenage pregnancy is on the increase, resulting in social and public health problems. The Department of Health (2002) indicates that, nationally 16.4% of the teenagers become pregnant every month. The Department also states that 26.4% of Grade 8 learners, 13.4% Grade 9 learners, 12.6% Grade 12 and 13.3% Grade 11 learners, fall pregnant every month. Many of these teenage mothers are confronted with various health problem, for example, HIV/AIDS, psychological (for example, high stress) and social problems (for example, lack of parenting skills, neglect, poverty, and low educational attainment). These problems have far-reaching consequences on the mothers. For example, many teenage mothers drop-out of school, attempt to commit suicide, as well as take part in prostitution and robbery. Many are unemployed and this puts the welfare of their children at risk. This research study was qualitative in nature. The exploratory phenomenological design was used in this study to explore the experiences or challenges of teenage mothers on social support as pregnancy interferes with all aspects of their lives. For example, it jeopardises teenage mothers’ relationships with their parents who are the main source of support for the young mothers. If this relationship is broken, it reduces the chances of the young mother’s success. These factors contribute to an inadequate parent-child interaction and diminish the infant’s development. Support during pregnancy and after birth is vital for a teenage mother. If her future and mental health are to be bright, then she needs to have strong social support. Non- probability sampling methods were used, namely purposive and snowball sampling. Pre-testing was done with four teenage mothers who had the same background as those in the main study. Data were collected from six teenage mothers through semistructured face to face interviews which required teenage mothers to answer a set of predetermined questions. The question asked allowed probing and clarification of answers. A tape recorder was used and the language used was Tshivenda. All ethical issues were adhered to throughout the study. Interpretative Phenomenological Analysis (IPA) was used to analyse the collected data. The findings from the interviews were integrated to avoid repetition. From the analysed v data, the following themes emerged: Challenges experienced by teenage mothers; Support system for teenage mothers; and Coping strategies for teenage mothers. Analysis of data revealed that lack of social support for teenage mothers was a major problem and this was collaborated by literature. These findings revealed that teenage mothers experience many challenges compared to the support they get from significant others. In this study, the researcher found that doing field work with teenage mothers with low educational backgrounds is very challenging because they do not understand what research is all about. The researcher realised that there is more that South African needs to do to encourage people to support teenage mothers. Whilst the work done at Tshikuwi is appreciated, the researcher feels it is too little too late considering the number of teenage mothers who continue to lack support. The researcher recommends that teenage mothers who experience challenges should take the initiatives to start projects that will boost their confidence. Teachers who teach life science orientations should, in the meantime, focus on teaching learners about the consequences of not having support either from family or partners and communities.

This quantitative, explorative and descriptive survey attempted to determine factors that influence the adolescent pregnancy rate in the Greater Giyani Municipality. Data were gathered from adolescent girls attending four selected high schools. Non-probability convenient sample of 147 respondents was used with 100% return rate. Data was collected using a questionnaire which had a reliability of 0.65. Data were analysed using the SAS/Basic computer program, version 9.2. Findings indicated that 56.34% of respondents reported key psychosocial variables such as peer pressure and 58.90% of them changed values as contributory to high pregnancy rates. .Health services were reported as not freely available and relationships with nurses significantly cited as poor by 72.41% respondents with regard to maintenance of confidentiality. Recommendations were made to improve school health services, reproductive education and future research / Health Studies / M.A. (Health Studies)

This quantitative, explorative and descriptive survey attempted to determine factors that influence the adolescent pregnancy rate in the Greater Giyani Municipality. Data were gathered from adolescent girls attending four selected high schools. Non-probability convenient sample of 147 respondents was used with 100% return rate. Data was collected using a questionnaire which had a reliability of 0.65. Data were analysed using the SAS/Basic computer program, version 9.2. Findings indicated that 56.34% of respondents reported key psychosocial variables such as peer pressure and 58.90% of them changed values as contributory to high pregnancy rates. .Health services were reported as not freely available and relationships with nurses significantly cited as poor by 72.41% respondents with regard to maintenance of confidentiality. Recommendations were made to improve school health services, reproductive education and future research / Health Studies / M.A. (Health Studies)

PhDPH / Department of Public Health / There is a growing concern over the rising cases of adolescent pregnancy, drug and substance abuse, poor academic performance, violence, high school dropout rate and HIV/AIDS prevalence among secondary school students. The grounds of these problems are considered to be related to inadequate Life Orientation Education which should equip the learners with psychosocial competencies, but the ability to make informed decision, solve problems, think creatively and critically, communicate effectively, build healthy interpersonal relationships is lacking among the youths (Dash, 2018). The purpose of the study was to develop strategies to facilitate the implementation of existing Life orientation curriculum in secondary schools of Limpopo province, South Africa. An exploratory sequential design was used in this study. This research design had three stages. In the first stage (1a) the researcher collected and analysed quantitative data. Based on the quantitative results, the researcher will then engage a second stage (1b), the qualitative phase, to test and make the general view of the initial findings. This was followed by phase 3, which was the development of the coping strategies and validation of the strategies as outlined. Purposive sampling was employed to select two districts and then four circuits. Phase 1a identified factors influencing implementation of existing Life Orientation curriculum. Eight schools were selected using stratified random sampling. Simple random sampling was used to select 521 grade 10, 11 and 12 adolescent girls. Data was collected through a self-designed and self-administered questionnaire. Data was analysed descriptively using statistical software Stata/IC version 15.0. of the computer program. Validity and reliability were ensured. Phase 1b identified the predisposing, enabling, and reinforcing factors that can affect the behaviours, attitudes, and environmental factors contributing to the implementation of Life skills programmes in schools. A qualitative approach, and explorative, descriptive and contextual designs were applied. The population were all guardians and school teachers. Purposive sampling was used to select guardians for the focus groups discussions and teachers for in-depth interviews. Data analysis employed Tesch open coding method. Phase 2 was the development strategies to facilitate the implementation of existing LO programme in Limpopo province. Results from Structured Interviews, Focused group, Questionnaires were fused together with the use of the Precede Proceed Model. Phase 3 was to validate the developed strategies. The aim of validation was to collect and evaluate data, from the process design stage, the consistency and quality of the product or outcome of the strategies. The objectives to validate the strategies were to: determine the credibility of the strategies. The researcher used the non–experimental, intervention validation design to validated the credibility of the developed strategies. The developed strategies were given to the learners, guardians and Life Orientation teachers Vhembe and Mopani district. To collect data, the researcher used a checklist with 6 questions as outlined by Chin and Kramer (refer to table 6.4). Simple descriptive statistics was use where the data was summarized using the frequency distribution. / NRF