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.

Bakgrund: Avbrytande av graviditet innebär att fostret utförskaffas ur livmodern innan graviditetsvecka 22, spontant eller genom induktion. En inducerad abort kan ske medicinskt eller kirurgiskt. Cirka 56 miljoner aborter sker årligen i ett globalt perspektiv. Barnmorskan ska stödja kvinnan i abortvården samt verka för att ge jämställd och rättvis vård baserad på vetenskap och beprövad erfarenhet utifrån ett socialt-, ekonomiskt- och kulturellt perspektiv. Barnmorskan utvecklas i sin yrkesroll genom kunskap och erfarenhet. Syfte: Syftet med studien är att belysa kvinnors erfarenheter av medicinsk- eller kirurgisk abort i ett globalt perspektiv. Metod: Studien genomfördes som en metasyntes med kvalitativ ansats. Femton (15) vetenskapliga artiklar utgör resultatet. Resultat: Fyra huvudkategorier identifierades otillgänglighet och konsekvenser för kvinnan, ekonomiska faktorer, stigma samt autonomi. Resultatet visar att kvinnorna upplever att restriktiv lagstiftning skapar en stor oro och kan ge desperation. Detta kan innebära att många kvinnor söker sig till osäkra alternativ om tillgången på säker abortvård inte finns tillgänglig. Aborten hade negativa ekonomiska konsekvenser för kvinnorna. Att få bestämma över sin egen kropp och känslan av kontroll var en viktig del i abortbeslutet för kvinnan. Slutsats: Brist på ekonomiska tillgångar och stigma gör att många kvinnor söker sig till osäkra abortalternativ. Den enskilda kvinnan bör få ta beslut som rör hennes egen kropp och själv besluta om när hon önskar skaffa barn vilket innebär att tillgängligheten på säker abortvård måste öka. Klinisk tillämpbarhet: Studien kan användas för att ge ökad kunskap om kvinnors upplevelser och erfarenheter vilket kan leda till en mer tillgänglig abortvård för kvinnor i ett globalt perspektiv. / Background: Termination of pregnancy is when a fetus is removed from the uterus before pregnancy week 22, spontaneously or through induction. An induced abortion can be performed either medical or surgical. In a global perspective, each year around 56 million abortions are performed. The role of the Midwife in abortion care is to support the woman aiming to offer equal and equitable care based on proven experience and with a social-, economical- and cultural perspective. The professional skills of the midwife is developing through knowledge and experience. Objective: The aim of the study was to identify womens experiences of medical- or surgical abortion in a global perspective. Method: The study was conducted as a qualitative metasynthesis. Fifteen (15) scientific articles were included in the result. Result: Four main categories were identified inaccessibility and consequences for the woman, economical factors, stigma and autonomy. The result shows that the women experience that restrictive legislations makes women anxious and instill feelings of desperation. Many women are considering unsafe alternatives when safe abortion care isn’t accessible. The abortion had negative financial consequences for the women. To decide about their own body and having a feeling of control was an important part in the decision of abortion for the woman. Conclusion: Lack of financial assets and stigma means that many women seek unsafe abortion options. The individual woman should be able to make decisions concerning her own body and decide for herself when she wants to have children, which means that access to safe abortion care must increase. Clinical applicability: The study can be used to provide increased knowledge about womens experiences which can lead to a more accessible abortion care for women in a global perspective.