South African women’s experience of the decision, procedure and recovery from “feticide” and late termination of pregnancy due to the presence of severe fetal abnormality: women’s and health service providers’ perspectives
- Authors: Vorster, Angela Carol
- Date: 2023-10-13
- Subjects: Feticide , Abortion , Late-term abortion , Fetus Abnormalities , Psychological trauma , Grief , Pregnancy loss
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/432359 , vital:72864 , DOI 10.21504/10962/432359
- Description: Routine antenatal care, including sonography and genetic testing, assist healthcare providers in identifying the presence of severe fetal abnormality. In countries where it is legal, the option to abort such a pregnancy may be presented to the pregnant person. When abortion takes place after the thirteenth week of gestation, it is generally referred to as a late termination of pregnancy and may entail the induction of labour or caesarean section. In cases where termination of the pregnancy is decided upon, and the gestation is further than 21 weeks and six days, the feticide procedure is recommended in order to ensure stillbirth. The feticide procedure entails the injection of potassium chloride directly into the fetal heart in order to ensure fetal demise. Existing literature on “feticide” and late termination of pregnancy (LTOP) owing to fetal abnormalities mostly takes a medical or psychological perspective in researching these procedures. Within the South African context, there are very few studies on feticide and LTOP, with none of these studies (to date – 8 January 2023) taking a feminist approach. This paucity of research that takes into account power relations, structural inequality and factors that affect decision-making and choice is one of the reasons that this study was undertaken. The main research question focused on in this study is: What are South African women’s experiences of feticide and late termination of pregnancy due to the presence of severe fetal abnormality, as related by the women themselves and the health service providers who perform the procedure or provide care? The sub-questions that initially drove the study were: How do the women relate their experience of the process of coming to the decision, undergoing and recovering from the procedure, and how do health service providers relate the experiences of these women? The methodological and theoretical framework employed in this research was a Feminist Social Constructionist approach to Grounded Theory. This reflexive, subjectivist, feminist lens encouraged awareness of the influence of gender, race, class and other structural and systemic factors on women’s experiences within the two healthcare systems. Data collection entailed semi-structured interviews conducted with 12 women, who had undergone feticide and LTOP procedures between one and five years prior to the interviews, in either the public or private healthcare system in South Africa. Semi-structured interviews were also conducted with 13 healthcare providers. The providers included medical specialists and participants from the fields of clinical psychology, genetic counselling and nursing and were employed in public or private healthcare in South Africa. Data relevant to public healthcare users and providers were collected from one tertiary (academic) public healthcare hospital and data regarding private healthcare users and providers were collected from across South Africa. Women’s constructions of their experiences of feticide and LTOP included stark contrasts between public and private healthcare users in South Africa, as well as women experiencing “no choice” and their voices being ignored or silenced. Healthcare providers’ constructions were frequently contradictory, referring to women as having freedom of choice and their needs largely prioritised within the healthcare system, while the providers within the public healthcare system relayed their own frustrations and emotional burden due to systemic failures. Findings from women and providers’ constructions were synthesised into a theoretical understanding of women’s experiences of feticide and LTOP in South Africa, which is grounded in, and emergent from, the data. Women’s experiences of feticide and LTOP in South Africa were conceptualised by framing the three phases of these experiences, namely the decision-making phase (I), undergoing the procedures and in-hospital recovery (phase II) and the recovery phase (III). The most prominent themes emerging in these phases included the schism between the public and private healthcare systems in South Africa, the lack of real choice women experience, as well as the silencing of women and providers with regard to feticide and LTOP. Underlying the three phases, and directly influencing the three prominent themes affecting women’s experiences, were the underlying and insidious structural inequality that undermined reproductive justice with regard to women’s decision-making, experiences of and recovery from feticide and LTOP. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2023
- Full Text:
- Date Issued: 2023-10-13
- Authors: Vorster, Angela Carol
- Date: 2023-10-13
- Subjects: Feticide , Abortion , Late-term abortion , Fetus Abnormalities , Psychological trauma , Grief , Pregnancy loss
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/432359 , vital:72864 , DOI 10.21504/10962/432359
- Description: Routine antenatal care, including sonography and genetic testing, assist healthcare providers in identifying the presence of severe fetal abnormality. In countries where it is legal, the option to abort such a pregnancy may be presented to the pregnant person. When abortion takes place after the thirteenth week of gestation, it is generally referred to as a late termination of pregnancy and may entail the induction of labour or caesarean section. In cases where termination of the pregnancy is decided upon, and the gestation is further than 21 weeks and six days, the feticide procedure is recommended in order to ensure stillbirth. The feticide procedure entails the injection of potassium chloride directly into the fetal heart in order to ensure fetal demise. Existing literature on “feticide” and late termination of pregnancy (LTOP) owing to fetal abnormalities mostly takes a medical or psychological perspective in researching these procedures. Within the South African context, there are very few studies on feticide and LTOP, with none of these studies (to date – 8 January 2023) taking a feminist approach. This paucity of research that takes into account power relations, structural inequality and factors that affect decision-making and choice is one of the reasons that this study was undertaken. The main research question focused on in this study is: What are South African women’s experiences of feticide and late termination of pregnancy due to the presence of severe fetal abnormality, as related by the women themselves and the health service providers who perform the procedure or provide care? The sub-questions that initially drove the study were: How do the women relate their experience of the process of coming to the decision, undergoing and recovering from the procedure, and how do health service providers relate the experiences of these women? The methodological and theoretical framework employed in this research was a Feminist Social Constructionist approach to Grounded Theory. This reflexive, subjectivist, feminist lens encouraged awareness of the influence of gender, race, class and other structural and systemic factors on women’s experiences within the two healthcare systems. Data collection entailed semi-structured interviews conducted with 12 women, who had undergone feticide and LTOP procedures between one and five years prior to the interviews, in either the public or private healthcare system in South Africa. Semi-structured interviews were also conducted with 13 healthcare providers. The providers included medical specialists and participants from the fields of clinical psychology, genetic counselling and nursing and were employed in public or private healthcare in South Africa. Data relevant to public healthcare users and providers were collected from one tertiary (academic) public healthcare hospital and data regarding private healthcare users and providers were collected from across South Africa. Women’s constructions of their experiences of feticide and LTOP included stark contrasts between public and private healthcare users in South Africa, as well as women experiencing “no choice” and their voices being ignored or silenced. Healthcare providers’ constructions were frequently contradictory, referring to women as having freedom of choice and their needs largely prioritised within the healthcare system, while the providers within the public healthcare system relayed their own frustrations and emotional burden due to systemic failures. Findings from women and providers’ constructions were synthesised into a theoretical understanding of women’s experiences of feticide and LTOP in South Africa, which is grounded in, and emergent from, the data. Women’s experiences of feticide and LTOP in South Africa were conceptualised by framing the three phases of these experiences, namely the decision-making phase (I), undergoing the procedures and in-hospital recovery (phase II) and the recovery phase (III). The most prominent themes emerging in these phases included the schism between the public and private healthcare systems in South Africa, the lack of real choice women experience, as well as the silencing of women and providers with regard to feticide and LTOP. Underlying the three phases, and directly influencing the three prominent themes affecting women’s experiences, were the underlying and insidious structural inequality that undermined reproductive justice with regard to women’s decision-making, experiences of and recovery from feticide and LTOP. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2023
- Full Text:
- Date Issued: 2023-10-13
Experiences of pet loss in the South African context
- Authors: Lowen, Kathleen Louise
- Date: 2017
- Subjects: Pet loss -- Psychological aspects , Pet loss -- South Africa -- Case studies , Pets -- Death , Pet ownders -- Psychology , Human-animal relationships -- Psychological aspects , Grief
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/4326 , vital:20649
- Description: In this research the experience of pet loss in relation to the intensity of grief and the repression of that grief due to societal restrictions was studied in a South African sample of 12 pet owners who had experienced the loss of a pet within 24 months prior to the study. A pilot study was conducted in order to refine the semi-structured interview schedule. Participants were asked about their pets, their experience of pet loss in relation to their feelings before and after the loss and whether they felt they could openly grieve around friends and family. The findings indicated that the intensity of grief experienced by the participants was influenced both by the intensity of their Bond with the pet and the repression of their grief due to assumed social sanctions surrounding mourning the loss of a pet. The findings from the study clearly indicate the necessity for pet loss counselling, however it was clear that societal views surrounding pet loss are shifting, thus allowing pet owners to mourn their loss more openly with family and friends. This indicates a decrease in cases of disenfranchised and complicated grief. Furthermore the impact of pet loss necessitates the social legitimation and acknowledgment of the significance of pet loss in contemporary society as these relationships with pets are an increasingly prominent feature both within and as an alternative to familial systems.
- Full Text:
- Date Issued: 2017
- Authors: Lowen, Kathleen Louise
- Date: 2017
- Subjects: Pet loss -- Psychological aspects , Pet loss -- South Africa -- Case studies , Pets -- Death , Pet ownders -- Psychology , Human-animal relationships -- Psychological aspects , Grief
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/4326 , vital:20649
- Description: In this research the experience of pet loss in relation to the intensity of grief and the repression of that grief due to societal restrictions was studied in a South African sample of 12 pet owners who had experienced the loss of a pet within 24 months prior to the study. A pilot study was conducted in order to refine the semi-structured interview schedule. Participants were asked about their pets, their experience of pet loss in relation to their feelings before and after the loss and whether they felt they could openly grieve around friends and family. The findings indicated that the intensity of grief experienced by the participants was influenced both by the intensity of their Bond with the pet and the repression of their grief due to assumed social sanctions surrounding mourning the loss of a pet. The findings from the study clearly indicate the necessity for pet loss counselling, however it was clear that societal views surrounding pet loss are shifting, thus allowing pet owners to mourn their loss more openly with family and friends. This indicates a decrease in cases of disenfranchised and complicated grief. Furthermore the impact of pet loss necessitates the social legitimation and acknowledgment of the significance of pet loss in contemporary society as these relationships with pets are an increasingly prominent feature both within and as an alternative to familial systems.
- Full Text:
- Date Issued: 2017
"Giving voice" to the bereaved : family grief and resilience after a child has died
- Authors: Scheepers, Lucas Johannes
- Date: 2013
- Subjects: Bereavement -- Psychological aspects , Death -- Psychological aspects , Loss (Psychology) , Grief
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9977 , http://hdl.handle.net/10948/d1021096
- Description: This study investigated family grief and resilience following a child’s death. Representing 23 families, 35 bereaved parents completed biographical questionnaires, the Family Hardiness Index, and the Family Attachment and Changeability Index 8. Significant positive correlations were found between family hardiness and family adaptation, and between parents’ age and family hardiness. Using grounded theory, interviews allowed for the formulation of categories including grief, continuing bonds, external support, religion, and family hardiness. The study reveals the need for exploring unique experiences of families bereaved by children’s deaths and identifies family hardiness as a potential resilience factor for this population
- Full Text:
- Date Issued: 2013
- Authors: Scheepers, Lucas Johannes
- Date: 2013
- Subjects: Bereavement -- Psychological aspects , Death -- Psychological aspects , Loss (Psychology) , Grief
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:9977 , http://hdl.handle.net/10948/d1021096
- Description: This study investigated family grief and resilience following a child’s death. Representing 23 families, 35 bereaved parents completed biographical questionnaires, the Family Hardiness Index, and the Family Attachment and Changeability Index 8. Significant positive correlations were found between family hardiness and family adaptation, and between parents’ age and family hardiness. Using grounded theory, interviews allowed for the formulation of categories including grief, continuing bonds, external support, religion, and family hardiness. The study reveals the need for exploring unique experiences of families bereaved by children’s deaths and identifies family hardiness as a potential resilience factor for this population
- Full Text:
- Date Issued: 2013
A phenomenological explication of the experience of having one's bereavement denied by others
- Authors: Sennett, Margot Jane
- Date: 1988
- Subjects: Death -- Psychological aspects , Bereavement , Grief
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3108 , http://hdl.handle.net/10962/d1004527 , Death -- Psychological aspects , Bereavement , Grief
- Description: Bereavement is the natural human reaction to the death of a significant other. Often the experience of the bereaved person is denied expression in the social context. The aim of this thesis is to examine what it means to have one's bereavement denied by others. The relevant literature was reviewed. Theories which have both reflected and influenced the way the bereaved are perceived in contemporary western society have been discussed. The historical background to changing attitudes towards death was described and the reasons for the "denial of death" were examined . The narcissistic personality in particular was considered . Using the Phenomenological method, a question was formulated to elicit the lived structure of the experience being researched. This was asked of thirteen voluntary subjects who had experienced the denial of their bereavement by others. Five written answers (protocols) were chosen and explicated. The lived structure of the experience can be described as "a profound and fundamental distancing of the world of the bereaved from the world of others." The implications of this for the bereaved person, bereavement support groups, health care professionals, future research and society as a whole were then critically discussed .
- Full Text:
- Date Issued: 1988
- Authors: Sennett, Margot Jane
- Date: 1988
- Subjects: Death -- Psychological aspects , Bereavement , Grief
- Language: English
- Type: Thesis , Masters , MA
- Identifier: vital:3108 , http://hdl.handle.net/10962/d1004527 , Death -- Psychological aspects , Bereavement , Grief
- Description: Bereavement is the natural human reaction to the death of a significant other. Often the experience of the bereaved person is denied expression in the social context. The aim of this thesis is to examine what it means to have one's bereavement denied by others. The relevant literature was reviewed. Theories which have both reflected and influenced the way the bereaved are perceived in contemporary western society have been discussed. The historical background to changing attitudes towards death was described and the reasons for the "denial of death" were examined . The narcissistic personality in particular was considered . Using the Phenomenological method, a question was formulated to elicit the lived structure of the experience being researched. This was asked of thirteen voluntary subjects who had experienced the denial of their bereavement by others. Five written answers (protocols) were chosen and explicated. The lived structure of the experience can be described as "a profound and fundamental distancing of the world of the bereaved from the world of others." The implications of this for the bereaved person, bereavement support groups, health care professionals, future research and society as a whole were then critically discussed .
- Full Text:
- Date Issued: 1988
- «
- ‹
- 1
- ›
- »