Challenges encountered by women seeking termination of pregnancy services in the North West Province of South Africa (original) (raw)

2011, Journal of Physical Activity and Health

Abstract

In 1996 the South African government legalised the termination of pregnancy (TOP) services, allowing women to choose to terminate unplanned pregnancies at designated facilities. Although TOP services are available, pregnant women continue to use illegal abortion services, with potentially life-risking consequences. The purpose of this study was to identify challenges encountered by women requesting TOP services, and to make recommendations for improved policies and practices, enabling more women in the North West Province (NWP) to access TOP services. This was a non-experimental, exploratory, descriptive and quantitative study. Structured interviews were conducted with 150 women who had used TOP services in phase 1, with 50 women who were unable to access TOP services in phase 2 and with 20 professional nurses providing TOP services in the NWP in phase 3. In phase 1, 96.0% (n=144) of the women needed transport to access TOP services, and 73.2% (n=109) indicated that nurses put women's names on waiting lists, posing barriers to such access in the NWP. In phase 2, 92.0% (n=46) of these respondents had reportedly requested TOPs for the first time, but 89.0% (n=44) could not access TOP services. In phase 3, only 14 out of 19 designated facilities in the NWP, and only 20 nurses, provided TOP services during the study period. Out of the 20 interviewed nurses, 74.0% (n=14) regarded the Choice on Termination of Pregnancy Act, Act 92 of 1996 (CTOP Act) was being unclear requiring a revision. These professional nurses provided TOP services in NWP, by choice. Unless more facilities and more nurses can provide TOP services to the women of the NWP, these services will continue to remain inaccessible, necessitating the continued utilisation of illegal abortion services, in spite of the TOP Act's prescriptions. It is also recommended that management will provide sufficient support and training opportunities for professional nurses working in TOP services in the NWP. KEY CONCEPTS Reproductive health; TOP perceptions, nurses' attitudes towards TOPs; barriers to accessing TOP services; pre-and post-TOP counselling.

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References (126)

  1. SERVICES ...............................................................................................................................................
  2. 13 RESPONDENTS' OPINIONS AS TO WHO A WOMAN SHOULD CONSULT BEFORE TOP SERVICES ...............................................................................................................................................
  3. 14 IMPACT OF CULTURE AND RELIGIOUS BELIEFS AND MORAL VALUES ..........................................
  4. 15 CONFIDENTIALITY ..................................................................................................................................
  5. 16 SUMMARY ...............................................................................................................................................
  6. CHAPTER 6 Analysis and discussion of research results: Phase 3: Challenges encountered by nurses providing TOP services ......................................
  7. 1 INTRODUCTION ......................................................................................................................................
  8. 2 BIOGRAPHICAL DATA ............................................................................................................................
  9. 2.1 Age ...........................................................................................................................................................
  10. Gender......................................................................................................................................................
  11. 2.3 Population .................................................................................................................................................
  12. 2.4 Marital status ............................................................................................................................................
  13. 2.5 Religious affiliation ....................................................................................................................................
  14. 2.6 Registered midwives ................................................................................................................................
  15. 2.7 Number of grandchildren ..........................................................................................................................
  16. 2.8 Working in TOP services ..........................................................................................................................
  17. 9 Training received to perform TOP ............................................................................................................
  18. 2.10 Period of time of working in TOP services ................................................................................................
  19. 3 FEELINGS AND RELIGION .....................................................................................................................
  20. Respondents' sleeping pattern .................................................................................................................
  21. 4 RESPONDENTS' FEELINGS ABOUT THEIR INVOLVEMENT IN TOP SERVICES ...............................
  22. 5 RESPONDENTS' PERCEPTIONS AND OPINIONS ABOUT TOP SERVICES .......................................
  23. 5.1 Number of monthly TOPs performed at specific clinics ............................................................................
  24. 6 RESPONDENTS' PERCEPTIONS ABOUT WHO SHOULD RECEIVE TOP SERVICES ........................
  25. ABOUT TOPS ..........................................................................................................................................
  26. 8 RESPONDENTS' OPINIONS ON WHO SHOULD BE CONSULTED PRIOR TO USING TOP SERVICES ...............................................................................................................................................
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