Academic literature on the topic 'Abortion – KwaZulu-Natal'

Abstract Background Informal street traders are exposed on a daily basis to traffic emissions and biomass fuel smoke containing a variety of pollutants. These exposures are likely to place the female traders at increased risk for adverse reproductive outcomes. Aim The aim of this study was to compare the reproductive outcomes among street traders exposed to pollutants from their work-related activities and traders without such exposure. Methods A cross-sectional study was conducted among 305 female traders selected from exposed and non-exposed areas within the Warwick Junction trading hub, located in Durban, South Africa. Validated reproductive questionnaires and clinical assessments were conducted on all participants. Adverse reproductive outcomes such as low birth weight, spontaneous abortions and infertility were assessed. Results The mean age of the traders was 43.6 years (SD:12.1), mostly single (63%) and worked in trading hub for an average of 14 years. There were 876 pregnancies reported in the total sample. Traders pregnant while working in this location accounted for 120 pregnancies There was an increased risk of exposed traders having a low birth weight infant as compared to non-exposed traders (OR = 3.7; CI: 1.8, 7.6). Exposed traders were also almost 3 times more likely to be infertile as compared to non-exposed traders (OR = 2.6; CI: 1.6, 4.3). Conclusions This study has demonstrated that female street traders working within a trading hub in KwaZulu-Natal, South Africa; exposed to occupational pollutants show an association with developing infertility and low birth weight infants. Recommendations to mitigate adverse exposures have been suggested which include short term safety interventions and better cooking practices and future long term policy interventions.

The number of women accessing Termination of Pregnancy Services has increased in South Africa over the last 15 years. Lieberman and Davis (1992), hold that a woman’s right to choose is embedded in the principles of social work that is self-determination, empowerment and dignity. It is a social workers responsibility to ensure that the options are available to the clients. If a client is unable to choose from an array of alternatives it is because social workers have failed to provide them with the necessary information, therefore there can be no self-determination. Women who receive health care from public facilities usually cannot afford health care from a private physician and the ability of women to make informed decisions is based on the degree of information that is made available to them. In this study the researcher looks at the road travelled in order to make the decision to terminate an unwanted pregnancy. The process of data collection was a comprehensive, intensive process. Underpinned by the ecosystems theory, the qualitative exploratory research design was used for this research.Data was obtained through interviews from a purposeful sample of sixteen young women that attended the TOP (Termination of Pregnancy) Clinic at the research site, ranging from the ages of 18 to 35 years. This approach allowed the researcher to understand the processes and persons involved in making this decision. The assumption underlying this study was that the decision to terminate a pregnancy is a difficult one and often made with little or no support, education or guidance. The outcome of this study confirmed this assumption. The findings revealed that young woman accessing TOP services often choose TOP in isolation with limited knowledge and support from significant others. Some women requesting TOP may not want counselling but do need it. The need for counselling is stronger for those with strong religious beliefs and those that have little or no support systems. Based on the outcome of the analysis, recommendations were made with regard to the need for holistic counselling to be an integral component in health services rendered to women, with unintended pregnancies. Counseling whilst optional should be made compulsory such that a person can cope with the physical and psychological effects of an unwanted pregnancy should they decide to terminate or keep the pregnancy.
Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2012.

Introduction: Despite the availability of contraceptives, some women still seek an induced abortion. If these women are known, they can be targeted for intensive contraceptive counseling. An accessible termination of pregnancy health facility can also be provided to those who still wish to have an abortion. Aim: To determine the characteristics of women having first trimester induced termination of pregnancy in Newcastle Provincial Hospital in Amajuba district. Methods: Quantitative retrospective chart review. Seven hundred and fifty eight women had an induced first trimester abortion between 1st January and 31st December 2008 at Newcastle Provincial Hospital. The medical records of 254 were systematically sampled and the data obtained from these medical records were analyzed descriptively. Results: Most women (75%) were aged between 20 and 34 years. The commonest age was 23 years while the mean age was 25.27 years. Two percent were less than 16 years of age. Ninety seven percent of the sample were of African race, 75.6% reported having at least one child alive, 93.3% were single, 70.1% of the women reside in Newcastle sub-district while 19.7% reside outside Amajuba district. Eighty nine percent of the women were not using any contraception before the pregnancy that was terminated. Four (1.6%) women had previously had a termination of pregnancy. Fifty eight percent of the women requested abortion between 9 and 12 weeks of gestation (commonest gestational age was 8 weeks). Seventy four percent of the women were self-referred. Ninety six percent of the women reported having an abortion because of socio-econornic reasons. Only 69.7% disclosed their intention to procure abortion to a second person. Every woman was counseled before her pregnancy was terminated. Conclusions: In our patient population, women who are more likely to have an induced first trimester abortion are: in their twenties; African; single; parous; sexually active and not using any contraceptive; residing in Newcastle sub-district and of poor socioeconomic status. These groups of women should be targeted for intensive contraceptive counseling. The proportion of women who are less than 16 years of age shows that statutory rape is still a challenge in South Africa and deserves more attention. Further study is needed to establish if the location of Newcastle Provincial Hospital is denying women living in other sub-districts in Amajuba (apart from Newcastle sub-district) the opportunity to procure an induced abortion. Such a study will thus guide the place where future termination of pregnancy services may be established in Amajuba.
Thesis (M.Med.)-University of KwaZulu-Natal, Durban, 2011.

Department of Advanced Nursing Science
PhDH
Background: Despite measures to curb unwanted pregnancies and to sustain and expand abortion services, a high number of complications and deaths still occur. The failure of these measures is evidenced by the high number of women who are admitted to the public hospitals of KwaZulu-Natal Province with complications from induced abortions. KwaZulu-Natal Department of Health has repositioned Family Planning to a key priority in its health program in order to improve the situation for women. However, in order to improve the situation, it is necessary to understand the underlying causes. This study sought to identify challenges that affect women's access to Post Abortion Care (PAC) services in KwaZulu-Natal Province, South Africa. It also sought to shed light on the challenges faced by those who render PAC services, as well as assess the skills of those workers as observed while they provided PAC services. After conducting the research on challenges related to access and rendering of post abortion care services, the researcher identified a need to develop guidelines for management of unsafe and induced abortion complications, with the aim to improve the life expectancy of women and prevent maternal deaths. Therefore, an outcome of the study was the development of a PAC management guideline. Purpose: The purpose of the study was two-fold: Phase 1: to explore the challenges faced by women when accessing PAC, and the health care workers who render PAC services, and to assess the PAC skills of the health care workers; Phase 2: to use the findings of Phase 1 to develop guidelines for post abortion care management at selected Hospitals of KwaZulu-Natal Province, South Africa. Methods: The design of the study was guided by the Andersen model of Health Care Utilization. The model focuses on the contextual factors - enabling factors, predisposing factors and need factors - that influence the individual's utilization of health care services. Five districts of KwaZulu-Natal Province, South Africa were selected for the study. A convergent parallel mixed method was used to collect and interpret the data. A qualitative study was used to explore perceptions and challenges of women when accessing PAC; this was carried out by means of in-depth interviews with 23 women who accessed PAC services. Five Focus Group Discussions (FGD) were carried out with 50 health care workers to explore the challenges they experienced when managing abortion complications. A quantitative approach was used for direct skills observation of 92 health care workers. Thematic analysis was used to analyse the qualitative data; descriptive statistics were used to analyse the quantitative data. Results: From the in-depth interview data, several main themes were identified. Women who accessed PAC identified a lack of facilities that offered PAC service, distance from the community to the hospital that provided PAC service, lack of transport, shortage of staff, unskilled staff, shortage of equipment, long waiting queues, stigma and discrimination as challenges associated with delay or avoidance of access to post abortion care services. The main themes raised by the health care providers were lack of support from the management, shortage of staff, lack of training, burnout, unavailability of the guidelines or protocols and shortage of equipment. The quality of PAC services was perceived as poor by both the women seeking care and the health care workers. The main concerns raised by the women were lack of respect, lack of privacy, sharing of bed and insufficient time with the health care provider. The results confirmed that guidelines are needed for the management of post abortion care services. The findings from the qualitative and quantitative parts of the study were used by an expert group to develop PAC management guidelines. The development of the guidelines was in accordance with the WHO models, PICOS & GRADES. The guidelines were validated by the group using a close-ended checklist, analysed with simple descriptive statistics. Conclusion: This study concludes that access to comprehensive quality post abortion care must be provided for all women at times of need. Quality PAC services should be rendered by skilled health care workers in a facility which is accessible and well equipped with functional equipments and updated guidelines. Recommendations: The study therefore recommends that measures should be taken to ensure the provision of quality PAC services. The PAC services should be accessible with the increased number of facilities, adequate trained health care workers with functional equipment and guidelines. Health care workers must receive training and management support to enhance quality PAC services. Privacy and respect must be maintained during provision of PAC services to ensure quality of care and increase demand. There must be continuous community awareness about PAC services which will encourage early-seeking behavior, and reduce fear of stigma and discrimination by the providers of PAC services before the complications arises. This study did not cover all the districts to identify the challenges on delaying PAC service. Therefore, this study recommends additional clinical, operations and community research which will give broader details and understanding on the challenges that cause delay for seeking immediate post abortion care services.
NRF

Abortion remains one of the most controversial sexual health topics and yet is a common experience for women around the world. Making sure that women are practicing safe abortions is integral to women’s sexual and reproductive health as well as their sexual rights. South Africa has one of the most progressive and liberal abortion laws in the world, yet women still face major barriers in accessing these services. Introducing medical abortion as another termination of pregnancy option could potentially save women’s lives, while reducing the number of unsafe abortions in South Africa. Medical abortion also contributes to fulfilling women’s sexual and reproductive rights, providing more choices to best suit their needs. In 2001, the South African Medicines Control Council (MCC) approved the use of mifepristone in conjunction with misoprostol for termination of pregnancy. Currently there is no formal national policy that allows for the provision of medical abortion in public health facilities, and the Department of Health is considering introducing it into the public sector. In order for any public health intervention to be successful it must be acceptable to potential clients and the context in which it is being implemented must be assessed. This study first looks at women’s attitudes toward abortion; following Eaton’s model of sexual behavior it examines the personal, proximal, and distal environments that influence reproductive decision-making, specifically regarding abortion. With this background information, the study then aims to assess women’s knowledge of medical abortion and whether or not they find it to be an acceptable method for the South African public health system and South African women. The findings suggest that there is a demand for medical abortion among this sample of women. The majority of women find medical abortion to be an acceptable method, and would choose it if they were ever faced with having to terminate a pregnancy. The overwhelming majority of women felt that medical abortion should be introduced into the public sector and efforts should be made to ensure that this method is affordable, accessible, and available for women in South Africa in order to expand their sexual and reproductive health rights.
Thesis (M.A.)-University of KwaZulu-Natal, Durban, 2010.

The aim of this study was to investigate sexual activity as well as contraceptive knowledge and use among termination of pregnancy (TOP) clients at Prince Mshiyeni Memorial Hospital’s TOP clinic in the province of KwaZulu-Natal (KZN). This was a non-experimental quantitative study in the form of a cross sectional study. Self-administered questionnaires were used for collecting data from 61 respondents selected non-randomly. The majority of the respondents were single young women between 18 and 27 years of age. Sexual intercourse frequency was mostly once a month (91.8%). Most were unemployed and dependent on government grants and had heard of both contraception in general and emergency contraception. Only 44 (78.6%) had used contraceptives before and the most frequently used method of contraception was the injection (36.6%). Despite the respondents having heard of contraception, the median score of the knowledge of contraception was only 16%. The distribution of knowledge was very wide, but on the whole the level of knowledge of contraception was very low
Health Studies
M.A. (Public Health)

Advances in technology and medicine have greatly impacted on religious thought and have contributed to a large extent in bringing to the fore questions regarding euthanasia, suicide and abortion. This has raised a plethora of questions regarding actions and consequent ethical choices. What impact this has had on the Durban Hindu regarding the interpretation and re-interpretation of scripture to accommodate euthanasia, suicide and abortion is examined in the background of karma and dharma. A cross-section of Durban Hindus consisting of lawyers, doctors, academics, schoolteachers, Hindu scholars, priests and housewives were interviewed. Their views on karma and dharma, to what extent these concepts underlie their thinking with respect to euthanasia, suicide and abortion and what influence classical views based on Hindu scripture as well as Western thinking have had on the contemporary Hindus of the Durban area, are examined. Consequently, karma and dharma are viewed from a hermeneutical perspective and examined in the light of the phenomenological approach. The key hermeneutical concepts of karma and dharma have been modified and re-interpreted to accommodate changing circumstances. The views expressed range from the extremely liberal to the ultra conservative. Although the subjects were not all familiar with Hindu scripture, the views expressed were similar to scripture. Many Hindus therefore are reasoning on traditional lines, although the basis of their reasoning has shifted from scripture. Ethics and morality are not the only underlying principles affecting the euthanasia, suicide and abortion debate: financial and social considerations are also important. Although euthanasia and abortion are strongly condemned by the conservative Hindu they are accepted on medical, social and utilitarian grounds.
Religious Studies and Arabic
D. Litt. et Phil. (Religious Studies)