Conscientious objection and South African medical practitioners' constructions of termination of pregnancy and emergency contraception
- Authors: Chiwandire, Desire
- Date: 2015
- Subjects: Abortion -- South Africa , Abortion -- Moral and ethical aspects -- South Africa , Emergency contraceptives -- South Africa , Contraception -- Moral and ethical aspects -- South Africa , Medical personnel -- Attitudes -- South Africa , Patients -- Legal status, laws, etc. -- South Africa , Reproductive rights -- South Africa , Women's rights -- South Africa , Liberty of conscience
- Language: English
- Type: Thesis , Masters , MSocSc
- Identifier: vital:2888 , http://hdl.handle.net/10962/d1017863
- Description: 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.
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- Date Issued: 2015
Attitudes of midwives towards the implementation of choice on Termination of Pregnancy Act in the health facilities of the O.R. Tambo District
- Authors: Nohaji, Essinah Nosisi
- Date: 2012
- Subjects: Family planning -- South Africa -- Eastern Cape , Midwives -- Attitudes , Abortion -- South Africa , Pregnant women -- South Africa -- Eastern Cape
- Language: English
- Type: Thesis , Masters , MSc (Nursing Science)
- Identifier: vital:11893 , http://hdl.handle.net/10353/517 , Family planning -- South Africa -- Eastern Cape , Midwives -- Attitudes , Abortion -- South Africa , Pregnant women -- South Africa -- Eastern Cape
- Description: The focus of the study was to evaluate the attitudes of midwives towards the implementation of the Choice on Termination of Pregnancy Act in the O.R. Tambo District hospitals in the Eastern Cape. There was no provision for termination of pregnancy (TOP) for unplanned pregnancy until 1994 when the Choice on Termination of Pregnancy (CTOP) Act was introduced. This act allowed any pregnant woman to request TOP when she wished for TOP. The midwives could voluntarily undergo training in TOP services and the designated institutions started offering TOP services, but stopped at a later stage. This resulted in overcrowding in health institutions which continued rendering TOP services. The researcher posed one question to be answered as: What are the attitudes of the midwives who are employed by health institutions in the O.R. Tambo District in the Eastern Cape Province towards the implementation of the Choice on Termination of Pregnancy Act? The aim of the study was to evaluate the attitude of midwives towards the implementation of the CTOP Act in the O.R. Tambo District hospitals. The objective of this study was to determine the attitudes of these midwives towards the implementation of these services in the O.R. Tambo District in the Eastern Cape Province. A quantitative descriptive design was used in this study. The population consisted of 150 midwives from two hospitals in the O.R. Tambo District. The sample consisted of 75 midwives; 30 midwives from Hospital 1 and 45 midwives from Hospital 2. Random systemic sampling was used in selecting the participants. Data were collected using a questionnaire developed by the researcher and approved by the supervisor and the University of Fort Hare Ethics Committee. In the study, using a sample of (n = 75), the attitude on the implementation of CTOP scale had high reliability of 0.81. Data were analysed with the help of a statistician using Statistix 8.1 software for Windows. Approval to conduct the study was obtained from the University of Fort Hare Ethics Committee, Eastern Cape Department of Health and Hospital 1 and Hospital 2 before the study was conducted. The dignity of the participants was maintained by explaining v the topic of the research study, the aim and objectives of the study, the method to be used for data collection and the significance of the study. The participants were allowed to ask questions and the name and telephone of the supervisor were provided in case they needed some clarity. Voluntary, written informed consent was obtained before the interviews were conducted. Privacy, anonymity and confidentiality were ensured and maintained through all the stages of the research process. The finding of this study was that the midwives employed by the health institutions in O. R. Tambo District Municipality displayed positive responses in the majority (n=11/61.1%) of 18 items in the questionnaire. Since the midwives in this study demonstrated a positive attitude towards TOP, it was recommended that the reason for stopping the TOP services in the concerned institutions should be investigated. The following are also recommended: Compulsory training of midwives should include aspects of reproductive epidemiology, in particular, the epidemiology of unsafe abortions. Training in TOP services should continue, so that there will be adequate number of midwives to provide the TOP services, and consideration of special remuneration for TOP providers. Employment of managers trained in TOP and voluntary training of managers working in TOP sections should be considered so that they may provide effective support to TOP providers. Formation of support centres for TOP providers at Provincial and National levels. Education of the community in prevention of unwanted pregnancies by means of contraceptives and indications for a need to provide TOP services, to prevent victimisation of the TOP providers. Availability of a toll free number for reporting victimisation of the TOP providers.
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- Date Issued: 2012
Women's experience of abortion : a qualitative study
- Authors: Taylor, Gaye Lesley
- Date: 1998
- Subjects: Abortion , Abortion -- South Africa , Women -- Counseling of
- Language: English
- Type: Thesis , Masters , MSocSc
- Identifier: vital:708 , http://hdl.handle.net/10962/d1006522 , Abortion , Abortion -- South Africa , Women -- Counseling of
- Description: Abortion is an emotive topic that always raises strong feelings. The purpose of this study, however, is not to focus on the religious, political or moral questions surrounding abortion. Abortion is a reality and in South Africa, where it has only recently become legal, there is a need to have an understanding of the effects on women in order to provide counselling services. There is also a need to provide services for the many women who have had illegal terminations in the past. This study reviewed the most recent literature on the subject and the researcher takes the view that although the scientific literature states there is little long term psychological effect of abortion, the non-positivist literature which records women's experiences tells another story. Some of the problems with the scientific literature is that psychological effects are not defined and there may be political motivation for the study, ie. an attempt is made to prove that the health costs are not high for abortion because there is little long term effect. The researcher, however, feels this does a disservice to women who have had abortions because there is a failure to provide counselling services. Some members of the feminist movement also deserve criticism because in their haste to give women their rights they fail to allow a woman to thoroughly explore her options beforehand and to provide support services afterwards. The researcher, however, also identified a new theme in the literature which has been called a maturing of the feminist viewpoint that along with the right to abortion, women also have a right to the mixed feelings that go with making, what is for many, a very painful decision. There is a recognition that abortion is about loss and thus there is a corresponding need to acknowledge women's need to mourn and to provide services. The study does not include the experience of women who seek abortions for reasons of poverty. It also excludes the experience of women who have abortions as a result of rape, incest or harm to the foetus. It is a qualitative study and a non-probability sampling technique which comprised snowball and purposive methods was used to identify respondents. In-depth semi-structured interviews using a broad theme of questions were conducted with five respondents. The women were asked to tell the stories of their abortions: their and their partner's feelings before and after, how they decided and the actual experience. They were also asked to identify counselling requirements, what they found helpful and what would have helped. The literature and the findings support the researcher's view that women who find themselves with an unexpected pregnancy need an opportunity to objectively consider all their options, namely keeping the baby, adoption or abortion, and to have an objective counsellor assist them in vigorously considering these. If they decide on a termination they need to be given as much information as possible about the procedure and about how they are likely to feel. Afterwards counselling should be made available and women should be encouraged to use the service. They need to be assisted to explore all ways of coming to terms with it such as through dream work, dialogueing with the unborn child through a letter and for those with religious beliefs seeking absolution from the church. There is a great need for a Christian and other religious ministry in this regard. Self-help therapies such as support groups can also be helpful
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- Date Issued: 1998