An exploration of the reasons women give for choosing legal termination of pregnancy at Soshanguve Community Health Centre, Pretoria, South Africa

Abstract

Background: Termination of pregnancy (TOP) is one of the most commonly performed gynaecological procedures in the world and was legalised in South Africa in 1996 with the passing of the Choice on Termination of Pregnancy Act, 1996 (Act No. 29 of 1996). Utilisation of the TOP service increased significantly after the promulgation of the Act, to the extent that 7% of pregnant women in South Africa chose to terminate their pregnancies legally in 2012. Worldwide, women most commonly state their reasons for choosing TOP as a desire to stop or postpone childbearing. Although several international studies have been done in this regard, the reasons for women requesting legalised TOP in South Africa have not been explored in depth.Methods: A qualitative study using the case-study approach and involving one-on-one open interviews with participants was done at the TOP Clinic at Soshanguve Clinic 3 with the aim of gaining more insight into this issue.Results: The following themes emerged from the interviews: formal education not completed, financial difficulties, contraceptive failure, wrong timing, reasons relating to the existing family; and problems relating to the partner.Conclusion: This study also gave insight into the complex personal and social contexts within which women make the decision to terminate their pregnancy, and the thoughtfulness with which they make their decisions.

A qualitative exploration of the reasons and influencing factors for pregnancy termination among young women in Soweto, South Africa: a Socio-ecological perspective

“…Results from previous studies, such as an exploration amongst Australian women, support this complex and "thoughtful" nature of reproductive decision making (21). Previous quantitative and qualitative studies (21,36,37), including those from various African settings (12)(13)(14)20,26), similarly found that nancial factors, feeling unready for motherhood, not wanting (more) children, the threat of losing educational and employment opportunities, and partner-relationship problems were important reasons for terminating a pregnancy. While the impact of family dynamics has arisen in previous research (21,25), most emphasis tends to be on the impact of the partner.…”

“…Qualitative explorations of the decision-making process towards termination, while scarcer, seem to align on the complexity of women's decisions to terminate a pregnancy (19)(20)(21).…”

“…Reasons provided by women have included those that are more 'practical' ( nancial reasons, schooling opportunities), problems with pregnancy timing, and more existential reasons, such as not being ready to be a mother or stigma around pregnancy (19)(20)(21)(22)(23). In addition, existing evidence has pointed towards the importance of a social network in making the decision to terminate, with a particular focus on the partner (21,(24)(25)(26).…”

“…In addition, existing evidence has pointed towards the importance of a social network in making the decision to terminate, with a particular focus on the partner (21,(24)(25)(26). For example, a South African study that explored the reasons for only legal pregnancy terminations, identi ed "problems with partners" as one of the overarching reasons for choosing to terminate a pregnancy (20). In a more extreme example, one Kenyan study found that male partners were the main decision-makers around terminating pregnancies (25), emphasizing the need to explore women's agency in choosing for termination.…”