Adolescent pregnancy resolution with special reference to pre-abortion counselling

Evangelisti, Linda (2000-03)

Thesis (MA)--Stellenbosch University, 2000.

Thesis

ENGLISH ABSTRACT: An exploratory study of the extent and nature of adolescent pregnancy resolution and pre-abortion counselling was undertaken. Little research has been done on pre-abortion counselling in South Africa since the Choice of Termination of Pregnancy Act (92 of 1996) was passed in February 1997. This study emphasised pre-abortion counselling since this is a new field for most counsellors. A literature study was conducted on adolescent pregnancy, focussing on the factors and possible consequences of the choice to carry the pregnancy to term or to terminate it. Adolescents, more than adults, need assistance to make this decision. Crisis intervention was explored as a possible counselling model for pregnancy resolution and pre-abortion counselling. The preliminary investigation included interviews with social workers and nursing professionals in Mossel Bay. Nursing professionals were included in the study since they administer the pregnancy tests and are therefore the first professionals with whom the pregnant adolescent comes into contact. This investigation revealed that nurses, not social workers, do most of the preabortion counselling in Mossel Bay. The Choice on Termination of Pregnancy Act emphasises the importance of supplying pre and post-abortion counselling at the facility providing the termination of pregnancy. The Act also envisages this as primarily a medical concern, with the implication that nursing professionals should do the counselling. The role of professional counsellors such as social workers is not mentioned in the Act. The Act lays down that training will be provided to equip nursing professionals with necessary skills to render this service. The empirical study examined the training and skills of nursing professionals and social workers to determine whether they were adequately qualified to render these services. The respondents' attitude towards pregnant adolescents who choose abortion was also investigated, since this would influence their counselling skills. The investigation revealed that many of the nurses did not seem confident in their counselling although they felt that they were adequately qualified to counsel pregnant adolescents. The nurses explained that they did not feel that they had enough knowledge of the different options, especially foster care and adoption and therefore referred patients to a social worker or Options Pregnancy Centre (a volunteer based counselling centre). The social workers felt confident in counselling adolescents who decided to carry pregnancy to term. The counselling model used was crisis intervention, which is most appropriate for pre-abortion counselling as well. However they felt that they did not have enough information of abortion procedures and emotional consequences of abortion to counsel a pregnant adolescent requesting an abortion effectively. The study showed that respondents felt empathy and understanding for the adolescents' situation and the seriousness of the decision needing to be made. The study also found that social workers and nurses were willing to attend further training in order to improve their knowledge and their counselling skills. The training should therefore not focus on attitudes but simply on improving counselling skills. Training should focus on the nature of a crisis and the steps of crisis intervention.

AFRIKAANSE OPSOMMING: 'n Studie is gedoen om die aard en omvang insake die besluitneming ten opsigte van tienerswangerskappe en berading voor 'n aborsie te ondersoek. Sedert die Wet op Beëindiging van Swangerskap (92 van 1996) in Februarie, is weinig navorsing in Suid-Afrika gedoen oor berading voor 'n aborsie. Hierdie studie beklemtoon voorafgaande berading aangaande aborsie, aangesien dit 'n onbekende terrein vir baie beraders is. 'n Literatuurstudie oor tienerswangerskap is geloods met die fokus op faktore en moontlike gevolge van die keuse om die volle termyn van die swangerskap te voltooi of die beëindiging daarvan. Adolessente het meer ondersteuning nodig as volwassenes om so 'n keuse uit te oefen. Krisis-ingryping is ondersoek as 'n moontlike model vir die beslissing van 'n swangerskap en berading wat 'n aborsie voorafgaan. Met die voor-ondersoek is onderhoude met maatskaplike werkers en verpleegkundiges in Mosselbaai gevoer. Verpleegkundiges was deel van die studie aangesien hulle die eerste kundiges is met wie die swanger tiener in aanraking kom, omdat hulle die swangerskaptoetse uitvoer. Dié navorsing toon dat verpleegsters in Mosselbaai (nie maatskaplike werkers nie) grotendeels die berading voor 'n aborsie hanteer. Die Wet benadruk hoe belangrik dit is om beradingsdienste vir voor- en na-aborsie te voorsien by die plek waar die aborsie toegepas word. Dié Wet beskou dit ook primêr as 'n mediese aangeleentheid, gevolglik behoort verpleegkundiges die berading te doen. Daar word egter nie melding gemaak van die rol van professionele beraders soos maatskaplike werkers, in dié verband nie. Die Wet bepaal ook dat verpleegkundiges opleiding sal ontvang om hulle met vaardighede toe te rus om so 'n diens te lewer. Die opleiding en vaardighede van verpleegkundiges en maatskaplike werkers is dus getoets aan die hand van studies, gegrond op praktiese ervaring, om te bepaal of hulle bevoegd is om die dienste te lewer. Daar is ook ondersoek ingestel na die respondente se houding teenoor die swanger adolessent wat 'n aborsie verkies, aangesien hul vermoë om die berading te hanteer, beïnvloed kan word. Die ondersoek toon dat baie verpleegsters onseker voorgekom het tydens berading, hoewel hulle gevoel het dat hulle bekwaam is om swanger adolessente te adviseer. Hulle verklaar dat hulle nie genoeg kennis oor die verskillende opsies, veral pleegsorg en aanneming, gehad het nie, en dus pasiënte na 'n maatskaplike werker of Options Pregnancy Centre verwys het. Maatskaplike werkers het berading aan swanger adolessente wat die termyn van die swangerskap wou voltooi, met sekerheid hanteer. In die proses is krisis-ingryping uitgeoefen wat dan ook gepas is vir berading voor 'n aborsie. Die maatskaplike werkers het egter gevoel dat hulle nie genoeg inligting oor die aborsieproses en die emosionele gevolge daarvan gehad het om die swanger adolessent wat 'n aborsie verlang, effektief voor te lig nie. Die studie het getoon dat respondente die adolessent se situasie en die erns van die besluit wat gemaak moes word, met empatie en begrip hanteer het. Met die studie is ook bevind dat maatskaplike werkers en verpleegsters bereid was om verdere opleiding te ontvang en sodoende hul kennis en vaardighede te verbeter. Die opleiding moet dus nie op houdings fokus nie, maar eerder die ontwikkeling van vaardighede. Dit behoort te fokus op die aard van die krisis en die stappe van krisis-intervensie.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/51567
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