Adolescent pregnancy resolution with special reference to pre-abortion counselling

[摘要] ENGLISH ABSTRACT:An exploratory study of the extent and nature of adolescent pregnancyresolution and pre-abortion counselling was undertaken. Little research hasbeen done on pre-abortion counselling in South Africa since the Choice ofTermination of Pregnancy Act (92 of 1996) was passed in February 1997. Thisstudy emphasised pre-abortion counselling since this is a new field for mostcounsellors.A literature study was conducted on adolescent pregnancy, focussing on thefactors and possible consequences of the choice to carry the pregnancy to termor to terminate it. Adolescents, more than adults, need assistance to make thisdecision. Crisis intervention was explored as a possible counselling model forpregnancy resolution and pre-abortion counselling.The preliminary investigation included interviews with social workers andnursing professionals in Mossel Bay. Nursing professionals were included inthe study since they administer the pregnancy tests and are therefore the firstprofessionals with whom the pregnant adolescent comes into contact. Thisinvestigation revealed that nurses, not social workers, do most of the preabortioncounselling in Mossel Bay. The Choice on Termination of PregnancyAct emphasises the importance of supplying pre and post-abortion counsellingat the facility providing the termination of pregnancy. The Act also envisagesthis as primarily a medical concern, with the implication that nursingprofessionals should do the counselling. The role of professional counsellorssuch as social workers is not mentioned in the Act. The Act lays down thattraining will be provided to equip nursing professionals with necessary skills torender this service.The empirical study examined the training and skills of nursing professionalsand social workers to determine whether they were adequately qualified torender these services. The respondents' attitude towards pregnant adolescentswho choose abortion was also investigated, since this would influence theircounselling skills.The investigation revealed that many of the nurses did not seem confident intheir counselling although they felt that they were adequately qualified tocounsel pregnant adolescents. The nurses explained that they did not feel thatthey had enough knowledge of the different options, especially foster care andadoption and therefore referred patients to a social worker or OptionsPregnancy Centre (a volunteer based counselling centre).The social workers felt confident in counselling adolescents who decided tocarry pregnancy to term. The counselling model used was crisis intervention,which is most appropriate for pre-abortion counselling as well. However theyfelt that they did not have enough information of abortion procedures andemotional consequences of abortion to counsel a pregnant adolescentrequesting an abortion effectively.The study showed that respondents felt empathy and understanding for theadolescents' situation and the seriousness of the decision needing to be made.The study also found that social workers and nurses were willing to attendfurther training in order to improve their knowledge and their counselling skills.The training should therefore not focus on attitudes but simply on improvingcounselling skills. Training should focus on the nature of a crisis and the stepsof crisis intervention.

[发布机构] Stellenbosch University