“How do you feel about the abortion?”: pre-termination of pregnancy counselling in the public health sector in the Eastern Cape
- Authors: Du Toit, Ryan Rudolph
- Date: 2023-10-13
- Subjects: Abortion counseling South Africa Eastern Cape , Conversation analysis , Discursive psychology , Public health South Africa , Reproductive justice , Abortion Psychological aspects
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/437238 , vital:73355 , DOI 10.21504/10962/437239
- Description: Pre-abortion counselling, as an aspect of abortion provision, has received growing research interest in various contexts. Much of the research has primarily focused on whether abortion counselling takes place, the experiences of women and/or counsellors (usually through retrospective interviews and surveys), and the content discussed during the counselling session (often policy regulated). Such research has proven vital to addressing the various reproductive issues facing women seeking an abortion worldwide. However, little research has focused on how pre-abortion counselling as an everyday institutional practice is conducted at a conversational level in the medical setting. By drawing on both conversation analysis and discursive psychology, this study explored how pre-abortion counselling was conducted in the public health sector in South Africa. The study involved recording the conversation during pre-abortion counselling and analysing it in terms of its content, in particular, the discourses drawn on by all parties involved, and its structure and delivery. The data were collected from three public hospitals in the Eastern Cape of South Africa and involved the audio recording of pre-abortion counselling sessions as part of abortion services. In total, 28 counselling sessions were recorded: 21 were individual sessions, and 7 were group counselling sessions. At two of the sites, counselling was conducted by registered midwives who worked at the hospital. At one site, an external Christian organisation volunteered trained counsellors to counsel women at the hospital free of charge. Using conversation analysis, counselling sessions were analysed in terms of the main projects. Seven key projects were identified: (1) Context setting, (2) History taking, (3) Establishing reason for abortion, (4) Presenting options, (5) Providing procedural information, (6) Obtaining verbal informed consent, and (7) Discussion of family planning. Each project is explored in terms of what discourses and subject positions featured when speakers were orienting to a specific project. This process highlighted how the conversational projects and their respective goals enable the deployment of certain problematic discourses and interactive/reflexive positionings. Discourse analysis revealed a clustering of discourses around two central themes. In the first clustering, the discourses were primarily used to discuss the (1) medically related issues underpinning the abortion procedure [medical discourse, responsibilization discourse, risk discourse, and discourse of support]. Talk using these discourses positioned women as patients needing medical intervention, responsibilised women for conceiving, playing an active role in their termination, and navigating all the psychological and physical risks “associated” with abortion. The discourse of support illustrates how support was spoken about in the interaction whereby patients were constructed as subjects who required support and nurses/counsellors as the ones who offered the support. In the second clustering, the discourses (2) focused on women and the foetus. These discourses [reproductive choice, religious, pronatalist, and foetal personhood discourses] positioned women as being responsible for making a choice regarding their pregnancy and the consequences that may result. In addition, a religious discourse coupled with a pronatalist discourse was used to construct the pregnancy and motherhood as desirable and part of “God’s plan”, whereas the foetus was spoken about as a “gift from God”. The foetal personhood discourse was used to construct the foetus as a living and functional human. This research provides evidence of how abortion counselling is problematic at various levels. At a practical level, there is a lack of standardisation in the delivery of abortion counselling (e.g., variation in key projects, where the counselling is mandated, time taken, nurse/counsellor training, content and format – group vs. individual counselling). At a discursive level, the use of certain discourses works to render the counselling directive through : (1) awfulizing abortion by providing misinformation about the abortion procedure, foetus and post-abortion psychological distress, (2) chastising and responsibilising women for conceiving, (3) constructing abortion as immoral, the ending of life and not in line with God’s plan, (4) constructing parenthood as the preferred choice, (5) delegitimising abortion as a resolution for pregnancy when compared to the other options (e.g., parenting or adoption), and finally (6) providing counselling that does not take into account the broader socio-political contexts. Recommendations for future research are put forward, and a call to move to a reparative justice framework is made by highlighting how it can be used to identify and understand reproductive injustices as they occur along four intersecting dimensions: (1) Individual material, (2) Collective material, (3) Individual symbolic, and (4) Collective symbolic. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2023
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Nurses’ experiences of an abortion counselling training course and their understandings of quality abortion services
- Authors: Mogonong, Laurah Carolina
- Date: 2023-03-30
- Subjects: Abortion counseling , Abortion Psychological aspects , Nurses Attitudes , Abortion services South Africa Eastern Cape , Grounded theory , Person-centered therapy
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/408862 , vital:70532
- Description: This research study focuses on nurses’ experiences of participating in an abortion counselling training programme in the Eastern Cape Province (E.C), using a grounded theory and symbolic interactionism framework. The study aims to investigate how participating in a women-centred abortion counselling training course offered through the Critical Studies in Sexualities and Reproduction research unit may modify or improve nurses’ practice of abortion counselling and understanding of quality abortion services. Through purposive sampling, nine research participants working as abortion providers in EC health care facilities were recruited. Research data were produced using discussions around prior abortion counselling experiences, a reflective activity, power point case presentations conducted within the counselling training, and semi-structured interviews conducted two months after the training with five of the providers. A grounded theory analysis was used to generate themes that highlighted different aspects that enabled or hindered access to quality abortion services. In accordance with prior research, it was revealed that nurses undergo abortion training but there is limited content on abortion counselling training. Findings from this study reveal the modifications of practice and understanding of quality abortion services of nurses who participated in the client-centred abortion counselling training course. Themes of change that emerged from the nurses’ experiences were rendering counselling services in a non- judgemental, non-directive way, being acknowledged and recognized for the services they offer as abortion providers, and accepting that abortion is a reproductive legal right that can be accessed whenever a woman in need of the service requests it. The findings of this research also indicate that, despite the controversy and stigma attached to providing abortion services, the participants were motivated to continue offering abortion services because they felt equipped since undergoing abortion counselling training. The training course improved reported abortion counselling practices, but systematic issues such as lack of managerial support, space for individual counselling and procedure equipment continue to undermine services. , Thesis (MA) -- Faculty of Humanities, Psychology, 2023
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Making the personal political: understanding the impacts of participation in an anti-rape protest for women who have experienced sexual violence
- Authors: Barker, Kim Elise
- Date: 2023-03-29
- Subjects: Sexual assault South Africa , Silent protest , Under-reporting , Sexual abuse victims Attiudes , Narrative inquiry (Research method) , Rape Psychological aspects
- Language: English
- Type: Academic theses , Doctoral theses , text
- Identifier: http://hdl.handle.net/10962/422590 , vital:71960 , DOI 10.21504/10962/422590
- Description: South Africa is recognised as a country with unusually high levels of rape and sexual violence. The majority of those who experience sexual violence do not acknowledge, disclose or report it, and do not access support. Many factors have been identified which can inhibit acknowledgement and disclosure. While silence is to be honoured as a chosen response, unwanted silencing is of concern. The annual Silent Protest at Rhodes University is a day-long anti-rape protest which draws attention to the attitudes and practices which silence victim-survivors, and enacts solidarity with victim-survivors of sexual violence. I conducted a three year “critically engaged, activist ethnography” with the community of Silent Protestors and organisers. My focus was on the stories that victim-survivors told about the impacts of participating in the protest. Changes in the research context allowed for a participatory action research cycle to be incorporated into the methodology. This offered an opportunity to implement and evaluate some changes suggested by my research contributors. My contributor’s narratives highlighted the ways in which as a society we position those who have been subjected to sexual violence in ways that are limited and limiting and which diminish victim-survivors’ sense of agency and value. This malignant positioning restricts the choices available to victim-survivors. The anticipation of being positioned in negative ways can inhibit victim-survivors from disclosing a violation and accessing care and justice. Participation in the Silent Protest seems to stand against some of the factors which inhibit acknowledgement and disclosure. Through their participation many women took up opportunities to share their story with at least one other person and to receive and offer care. Most described participation as having been beneficial and having helped them move towards living well again. The ways in which the Silent Protest positioned victim-survivors and the choices they were offered in relation to that positioning seemed to open up opportunities for thinking, feeling and acting in ways that they preferred. This suggests that interventions which mobilise both political resistance and mutual care hold promise for developing more accessible and effective services to those affected by sexual violence. , Thesis (PhD) -- Faculty of Humanities, Psychology, 2023
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Alcohol use among women attending antenatal care in Buffalo City, Eastern Cape
- Authors: Bredenkamp, Petrus Johannes
- Date: 2022-04-07
- Subjects: Uncatalogued
- Language: English
- Type: Master's thesis , text
- Identifier: http://hdl.handle.net/10962/234358 , vital:50188
- Description: Alcohol use during pregnancy is known to cause neurodevelopmental disorders in offspring, known as Fetal Alcohol Spectrum Disorders (FASD). High prevalence of FASD has been observed in certain parts South Africa, but many areas of the country remain unstudied, and factors contributing to drinking among pregnant women are poorly understood. This study surveyed 1099 women attending antenatal care at public primary healthcare facilities in the Buffalo City Metropolitan Area in the Eastern Cape. Data was collected using the Alcohol Use Identification Test, a 10-item self-report measure of drinking behaviour in isiXhosa, English, and Afrikaans. Factors associated with alcohol use, risky drinking, binge drinking, and hazardous/harmful drinking were identified using logistic regression. A minority of the sample reported alcohol use (64%). Among those reporting alcohol use, most reported occasional binge drinking (63%) and met criteria for risky drinking (59%) and hazardous/harmful drinking (52%). Living with a regular drinker was significantly associated with alcohol use (OR 1.98, 95% CI 1.51 – 2.58), risky drinking (OR 2.03, 95% CI 1.49 – 2.76), binge drinking (OR 2.21, 95% CI 1.64 – 2.97), and hazardous/harmful drinking (OR 2.0, 95% CI 1.41 – 2.99). However, women who were married/cohabiting were less likely to report alcohol use (OR .71, 95% CI .53 - .95). Experiencing intimate partner violence during the current pregnancy was associated with alcohol use (OR 2.42, 95% CI 1.38 – 4.27) and hazardous/harmful drinking (OR 2.62, 95% CI 1.32 – 5.22). In this study, women who identified as Coloured were more likely to report alcohol use than Women who identified as African (OR 2.74, 95% CI 1.4 – 5.36). These findings simultaneously provide evidence of problematic drinking among pregnant women in a previously understudied area and show that external factors affect women’s drinking behaviour during pregnancy. Interventions aimed at reducing the incidence of FASD should consider alcohol use by pregnant women in the context of their lived experiences. , Thesis (MA) -- Faculty of Humanities, Psychology, 2022
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Sexual socialisation: young adult women storying how sexual activities were discussed in South African cultural contexts
- Authors: Ludidi, Zizipho
- Date: 2022-04-07
- Subjects: Socialization South Africa , Sex Social aspects South Africa , Young women Socialization South Africa , Young women Sexual behavior South Africa , Culture , Memory , Narrative inquiry (Research method)
- Language: English
- Type: Academic theses , Master's theses , text
- Identifier: http://hdl.handle.net/10962/292737 , vital:57011
- Description: Epidemics such as HIV/AIDS, unplanned pregnancy, gender-based violence and homophobia, in South Africa, have focused research on how young people learn about sex. This research has often focused on young girls from risk-saturated areas, and specific agents of socialisation, where they might learn about sex, such as parents, life orientation at schools, peers, media, and traditional cultural approaches. Using a narrative theoretical framework, through memory work, this study explored how black young adult women friends – who were university students – experienced forms of sexual socialisation, through various communication in South African cultural contexts. Findings from the thematic narrative analysis that was conducted demonstrated that sexual socialisation is a complex life-long process. This takes place through a collision of contradictory messages, from different agents of socialisation, in different cultural contexts. Themes were identified and organised to tell an overall sexual socialisation story that progressed through time, moving from a stage of perceived innocent oblivion, mixed messages in primary and high school, “liberal” university stories and the current stage of reauthoring stories. , Thesis (MA) -- Faculty of Humanities, Psychology, 2022
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The narratives of women in South Africa who use social media to talk about gender-based violence
- Authors: Walton, Donica Jasmin
- Date: 2022-04-07
- Subjects: Women Violence against South Africa , Social media and society South Africa , Internet and activism South Africa , Discourse analysis, Narrative , Internet and women South Africa , Subject positions
- Language: English
- Type: Master's thesis , text
- Identifier: http://hdl.handle.net/10962/232590 , vital:50005
- Description: There has been research conducted, both globally and in South Africa, on social media activism against gender-based violence (GBV). However, most research on the topic is based on participants in other parts of the world. Not much has been published on Black, African women. More specifically, not much is known about how women in South Africa experience using social media to talk about GBV. This research project draws on critical feminism and a narrative-discursive approach to explore the narratives of women in South Africa who use social media to talk about GBV. This is done by identifying the discourses women draw on to construct narratives, the subject positions utilised within these discourses, and how “trouble” and “repair” features in the narratives and positioning of women. Twelve interviews were conducted with women who volunteered and fit the inclusion criteria. The analysis of data was presented in two parts. The first set of discourses (discourses of ‘efficacy’, ‘convenience’, and ‘education’) were focused on what the use of social media achieves irrespective of the topic being discussed. These discourses speak to the idea that social media is powerful and useful because of its reach, speed, immediacy, and ability to be used to educate and be educated. The second set of discourses (discourses of ‘community and solidarity’, ‘validation’, and ‘vulnerability’) were focused on what the use of social media does for the people participating. Women have found a community and solidarity, and their experiences and thoughts have been validated on social media. Overall, the women in this research project justified their use of social media for activism against GBV, and acknowledged the tension that exists because despite its potential, there are limitations. , Thesis (MSocSci) -- Faculty of Humanities, Psychology, 2022
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Constructions of United States government development funding in response to the global gag rule
- Authors: Molobela, Reabetswe Lee-Anne
- Date: 2020
- Subjects: Pro-choice movement -- South Africa , Abortion -- Law and legislation -- South Africa , Abortion -- Moral and ethical aspects -- South Africa , Abortion -- Psychological aspects , Reproductive rights -- South Africa , Economic assistance, American -- South Africa , Non-governmental organizations -- South Africa , Discourse analysis , Social constructionism , Global Gag Rule
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/148295 , vital:38727
- Description: Despite South Africa’s progressive abortion law, barriers to safe abortion are numerous and exist at both the macro and micro level. Barriers include abortion stigma, discrimination, strong moral judgements against abortion within society and conscientious objection among health care workers. Furthermore, women’s lack of knowledge regarding the legal status of abortion and the voluminous illegal advertisements of back street abortions undermines the legislation and promotes unsafe abortions. Sexual and reproductive health rights (SRHR) non-governmental organizations (NGOs) have served as a link between service and people by providing information about safe abortion to women, especially in rural areas and have received funding from various platforms including United States government. However, the United States government has established the global gag rule which forbids foreign non-governmental organizations receiving United States government funding from using United States government and non-United States funds for abortion related activities. The global gag rule has been reinstated and extended by the current United States president. As such the global gag rule is expected to have an adverse effect on sexual and reproductive health rights in South Africa and on Sexual and reproductive health rights non-governmental organizations. The aim of the study is to highlight the constructions and responses to the global gag rule by sexual and reproductive health rights non-government organization workers in the South African context. This study used semi-structured individual interviews to collect data through purposive and snowball sampling of 10 South African Sexual and reproductive health rights non-governmental organizations workers. The study is situated within the social constructionist framework with emphasis on Fairclough’s three aspects of the constructive effects of discourse as an analytic tool in conjunction with Braun and Clarke’s social constructionist thematic analysis. The results of the study reflect on participants’ construction of United States government as imposing conservative agendas and taking regressive steps towards Sexual and reproductive health rights, which have in turn invoked indirect and direct resistance from non-governmental organizations. Additionally, NGO workers have constructed subject positions that highlight the vulnerability of non-governmental organizations dependency on United States government 1funding as it destabilizes and fragments civil society organization while it compromises the effectiveness of non-governmental organizations in serving the needs of intended communities. United States government is also constructed as strengthening abortion stigma and strengthening barriers to safe abortion that already exist in the country.
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Discursive constructions of alcohol use and pregnancy among participants in intervention aimed at reducing Foetal Alcohol Spectrum Disorders
- Authors: Msomi, Nqobile Nomonde
- Date: 2020
- Subjects: Fetal alcohol spectrum disorders -- South Africa , Pregnancy -- Psychological aspects , Reproductive rights -- South Africa , Reproductive health -- South Africa
- Language: English
- Type: text , Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/140374 , vital:37883
- Description: South Africa’s socio-cultural and political history has had significant effects on maternal and reproductive health. The hazardous alcohol use patterns in the country have affected alcohol consumption during pregnancy. Antenatal exposure to alcohol may result in Foetal Alcohol Spectrum Disorders (FASD). The levels of FASD in particular areas of the country are the highest recorded in the world. Epidemiological studies have dominated pregnancy and FASD research in South Africa; however, recently critical scholarship seeking to contextualise the issue of drinking alcohol during pregnancy is emerging. This study forms part of a developmental/formative assessment of an alcohol and pregnancy intervention. Assessment is an important part of pilot interventions, and discourse is a key area of focus due to its constitutive role for the subjectivity of human beings and legitimation of institutional practices. Using a reproductive justice perspective and a Foucauldian approach to analysis, I identified five prominent discursive constructions of alcohol use during pregnancy produced during interviews with community educators. These interviews were conducted following training workshops with the community educators. Participants constructed their living environments as ‘wholly bad’ and ‘issue-ridden’ and positioned alcohol consumption as ‘a destroyer!’, ‘king’ and a social lubricant. They interpellated the foetus, the ‘FASD child’ and pregnant women into this context. They positioned themselves as transformed subjects able to effect change. The foetus was constructed as ‘vulnerable and important’, as opposed to the ‘defiled FASD child’. Pregnant women were constructed as ‘ignorant, preoccupied and unreceptive to knowledge’. These constructions hinged on so-called ‘scientific knowledge’ of biological processes in utero, demonstrating Foucault’s conception of the power/knowledge nexus and how its dynamics transforms knowledge of human beings. Whereas this ‘knowledge’ transformed alcohol consumption and the foetus into powerful and vulnerable subjects respectively, the circulating discourses had objectivising effects on pregnant women. The discourses of responsibilisation, the personification of the foetus, ‘the problem’ category of FASD, the discourse of difference, and the discourse of alcohol consumption as an entrenched practice were circulating around pregnant women. I suggest alterations to the identified constructions using principles of community psychology, the harm reduction model, a social model of disability and the reproductive justice perspective
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The digital rhetoric of addressing rape culture: “official” and “unofficial” arguments at Rhodes University
- Authors: Jones, Megaera
- Date: 2020
- Subjects: Rape in universities and colleges -- South Africa -- Makhanda , Universities and colleges -- Administration -- South Africa -- Makhanda , Communication in higher education - South Africa -- Makhanda
- Language: English
- Type: text , Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/142621 , vital:38096
- Description: South Africa is overwhelmed with high levels of sexual violence and institutions of higher education in South Africa are not exempt from this. How higher education stakeholders have responded to the call to address rape culture on campuses has been at the centre of much attention, especially publicly on online communicative spaces. Drawing on contemporary rhetorical theories, informed by a feminist poststructuralist perspective, this study sought to explore how constituents at Rhodes University were discussing how rape culture should (and should not be) addressed on campus. Using a rhetorical analysis, this study collected and analysed online public data from ‘official’ (institutionally sanctioned) and ‘unofficial’ (institutionally independent) communication platforms, following the 2016 rape culture student-led protest at Rhodes University. In analysing and interpreting the data from the ‘official’ sites, four major themes of discussion were evident. These rhetors argued that rape culture is a societal issue, requiring collective responsibility and effort in countering it, and that any approach to do so must abide by the bounds of the law. The University’s commitment, and continued investment to address rape culture on campus were repeatedly stated; as well as, the use of external ‘supportive’ messages that bolstered the reputation, efforts, and actions of the institution. On the ‘unofficial’ sites six broad patterns of discussion were evident. These ‘unofficial’ rhetors embodied the rape culture on campus, perceiving its effects as threatening to the physical body, which led to the adoption of the argument that rape culture needs to be ‘fought’ through physical action and support. Narrow law and order approaches were contested, and the need for a victim-centred approaches were prioritised. Additionally, doubt and suspicion were cast onto the institutional management/leadership, and the University (management/leadership body) were perceived as having ‘failed’ to address rape culture adequality. Considering this ‘failure’, a divisive rhetoric argued that the ‘fight’ against rape culture should continue, despite, and separate from, the institutional body. These findings revealed how the divisive positions these various stakeholders took created a volatile climate between University management/leadership, staff, and student. I argue that such division will continue to undermine any meaningful efforts to counter rape culture on the University campus; underscoring the difficulty, and ambiguity, that comes with attempting to address rape culture on higher education campuses. This necessitates how important it will be for scholars to research, and continue researching, the ways in which a rape culture, and the various approaches which attempt to counter it, are understood.
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An intracategorical intersectional framework for understanding ‘supportability’ in womxn’s narratives of their pregnancy
- Authors: Kalyanaraman, Yamini
- Date: 2019
- Subjects: Pregnancy -- Psychological aspects -- South Africa , Prenatal care -- South Africa , Pregnant women -- South Africa -- Psycology , Medical care -- South Africa -- Eastern Cape
- Language: English
- Type: text , Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/96647 , vital:31304
- Description: In South Africa, the current Maternal Mortality Ratio (MMR) is 135 per 100,000 live births, with a long way to go before it can achieve the Sustainable Development Goal (SDG) global target of under 70 per 100,000 live births by 2030. This research project focuses on the narratives of pregnant womxn in the Eastern Cape Province, using an intracategorical intersectional framework and Macleod’s ‘supportability’ model as a base. The study aims to locate womxn’s pregnancies within the interweaving biological, psychological, social, economic, cultural and political contexts within which they occur, while focusing specifically on the aspect of ‘supportability’. Through purposive sampling and snowballing methods, the research team recruited participants who were 18 years and older, in or past the second trimester of their pregnancy, and able to access antenatal care. Research data were produced using photo-elicitation techniques on 92 photographs and narratives from 32 interviews. An intersectional thematic analysis was used to generate themes, which highlighted different aspects that enabled or hindered pregnancy ‘supportability’. In accordance with prior research, it was revealed that womxn found emotional and tangible support the most beneficial. Findings from this study reveal the interconnectedness between a womxn’s personal (emotional, physical and cognitive) experiences of pregnancy, the micro-interactions of support (un)available from partners, family, friends, healthcare workers, workplaces and community members, and the macrostructures of socioeconomic policies, religiosity, cultural practices and healthcare systems. For example, gendered perceptions (a macro-structure) influence the instrumental support provided by partners (a micro-interaction), which impacts the womxn’s well-being (personal). Certain themes that emerged from the different narratives were: the importance of making available pregnancy-related information to the womxn; a desire for non-judgement and acceptance of their pregnancies within their community; and the need for adequate communication in microinteractions. The findings of this research also indicate that, despite the financial tensions inherent in each womxn’s life, the participants were driven by overarching hopes for their child’s future.
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Colloquial terms used in young adults’ talk about sexual practices, sexual subjectivities and sexual desires’
- Authors: Robertson, Cassandra Ann
- Date: 2019
- Subjects: Youth -- Sexual behavior , Sex in popular culture , Communication and sex , Language and sex
- Language: English
- Type: text , Thesis , Masters , MSocSc
- Identifier: http://hdl.handle.net/10962/96551 , vital:31293
- Description: Much of the growth in sexualities‘ research has taken the form of large scale surveys, but there is also increased interest in qualitative approaches that provide useful insights into the experiential and subjective aspects of sexuality, and illuminate the social and cultural contexts shaping these experiences. The reason for this research is to provide a richer understanding of the language that young people employ when speaking about sexuality. This study examines young adults‘ talk about sexualities with a special focus on the way in which colloquial terms are deployed in this talk and through the presence of gendered and/or heteronormative assumptions. Data consisted of posts off a student-led social media site and the study design employed was a validity check group interview. The social media site allowed its followers to post anonymously about a range of sexualities related issues. Data were analysed thematically, using a deductive, critical, and post-structuralist approach with key insights drawn on from Michael Foucault, Adrienne Rich, Gayle Rubin, Judith Butler and Rosalind Gill. Three overarching themes emerged: young adults spoke to sexual practices, sexual subjectivities and sexual desires. A major focus of this talk is casual sex. This talk showed that there are attempts to undermine gendered and heteronormative power relations, for example, non-normative sexual experiences were not seen as deviant, although those who were engaging in monogamy and casual sex were constructed as deviant sexual subjects. Yet underpinning of these power relations still took place, for example, in the female missing discourse of desire, the internalisation of male sexual desires over female sexual desires and the sexual double standard. There was a clear divide between the sexual practices and sexual subjectivities that were considered to be good and bad. This research therefore has the potential to benefit sexuality interventions by bringing into sharp focus the actual experiences of young adults.
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Governing pregnancy in South Africa: political and health debate, policy and procedures
- Authors: Du Plessis, Ulandi
- Date: 2019
- Subjects: South Africa. Department of Health (1994- ) , Maternal health services -- South Africa , Mothers -- Mortality -- South Africa , Prenatal care -- South Africa , African mothers -- Mortality -- South Africa
- Language: English
- Type: text , Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/76552 , vital:30600
- Description: South Africa democratised in 1994. However, due to the discriminatory and segregationist character of the preceding regime, vast swathes of the country’s spaces and people entered the democratic period heavily deprived of essential government services. This was the case with health care in general, including maternal health care. There were also little to no national data available on maternal deaths, especially among the black population. One of the first tasks of the new National Department of Health (NDoH) was to target the high maternal mortality rate. The NDoH made maternal deaths notifiable by law and instituted auditing and information gathering systems in the health sector; health infrastructure was expanded exponentially, and maternal health care was made free. Despite this, the last 24 years have seen the maternal mortality escalate. The latest statistics show that between 1200 and 1300 women die in the South African public health sector each year during pregnancy and the puerperium. This puts the current institutional maternal mortality rate (MMR) at around 154/100 000 live births. The international target for ‘developing’ countries was to reduce the MMR rate by three quarters by 2015, which would have meant a reduction to 38/100 000 live births. The aim of this dissertation is to examine how the democratic South African government (influenced heavily by global health thinking) has laboured to reduce that statistic. I analyse, using Foucauldian discourse analysis, all relevant health and maternal health policies, procedural documents and reports produced by and for the NDoH in the last 24 years. I draw on Foucauldian concepts, specifically those related to Foucault’s work on governmentality. In this dissertation I introduce a new perspective towards the maternal health practices implemented in South Africa, practices that have generally remained unquestioned, been perceived as self-evident, and thus often escaping critical analysis. Through an analysis of the intended operation of the public antenatal clinic (within the larger institutional system) I show how ‘development’ has come to operate as a truth regime in South Africa – facilitating the introduction of liberal governmentality (including some advanced liberal practices) into public health service provision.
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Template ecological analsyis of the narratives of partner’s and family member’s of women who consumed alcohol in pregnancy
- Authors: Tsetse, Agrinette Nontozamo
- Date: 2019
- Subjects: Pregnant women -- Alcohol use -- Social aspects , Substance abuse in pregnancy , Fetus -- Effect of drugs on , Pregnancy -- Psychological aspects , Pregnant women -- Substance use , Substance abuse -- Social aspects , Ecological Systems Theory
- Language: English
- Type: text , Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/114905 , vital:34055
- Description: Although there is increasing research on alcohol in South Africa, most of this work has an epidemiological focus. Very little research has explored alcohol use during pregnancy specifically from the perspective of the woman’s partner or family member or focused on contextual risk factors beyond the pregnant woman. This information is important to ensure that interventions are formulated based on the social contexts within which drinking in pregnancy takes place and in guiding interventions that aim to prevent prenatal alcohol use, thereby preventing the occurrence of FASDs. This study was guided by Bronfenbrenner’s Ecological Systems Theory to understand partners’ and family members’ perspectives of prenatal exposure within the actual environments in which alcohol use takes place. According to this theory, an individual exists within layers of social relationships: the family, intimate partners, friendships, and healthcare workers (microsystems), interactions among these microsystems, for example, interaction between healthcare workers and intimate partner and family and social workers (mesosystem), accessibility of alcohol in the neighbourhoods (exosystems), religion, culture and society (macro-systems) and changes of the individual and socio-historical context (chronosystem). The data were collected using a biographic narrative interpretive method of interviewing. Thirteen narratives interviews were conducted with partners and family members in a disadvantaged community in Buffalo City, Eastern Cape Province. The interviews were analysed using Template Analysis within the Ecological Systems Theory to interrogate the stories of partners and family members. According to participants, some of the reasons women consumed alcohol in pregnancy are: drinking habits before pregnancy that were difficult to break in pregnancy; women drank during the first trimester of their pregnancy because of unplanned pregnancy; women continued drinking throughout their pregnancies to cope with the emotional upset caused by the trauma of rape and losing loved ones, stress, receiving HIV-diagnosis in pregnancy, intimate partner violence, infidelity, rejection and denial of pregnancy from partners. After birth, some women continued drinking. Consequently, their children were taken away from them by social workers and family members because the parents were unable to care for the child due to alcohol use. There was lack of compliance of shebeens with liquor regulations, heavy drinking, high rates of alcohol use in pregnancy, and easy accessibility of alcohol within this study community. Pregnant women used religious coping beliefs to cope with their circumstances such as changes in their health, relationships and finances. Drinking during pregnancy is a complex problem that stems from multiple social and structural issues and interventions should therefore not only focus on the individual, but also on social networks and communities.
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Women’s narratives about alcohol use during pregnancy: a narrative-discursive study
- Authors: Matebese, Sibongile
- Date: 2019
- Subjects: Pregnant women -- South Africa -- Social conditions , Pregnant women -- South Africa -- Alcohol use , Pregnant women -- South Africa -- Psychology
- Language: English
- Type: text , Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/95196 , vital:31126
- Description: While research has explored the risk factors that contribute to alcohol use during pregnancy among South African women, such studies have mostly been quantitative in nature. There is a growing body of research that contextualises and articulates the attitudes, beliefs, and underlying motivations that influence drinking during pregnancy. However, few qualitative studies explore the cultural, economic, familial, and social contexts within which drinking during pregnancy takes place. Studies which have explored these contexts have been conducted in other geographical regions such as Australia, Canada, New Zealand, and the United States but their findings are not generalisable to South Africa. Drawing on a feminist poststructuralist as well as a narrative-discursive approach including Foucault’s (1978) theory of power, this study sought to explore women’s narratives of the personal and interpersonal circumstances under which drinking during pregnancy takes place in terms of the discourses used to construct these narratives and the subject positions made available within these discourses. This allowed for the practice of alcohol use during pregnancy to be understood within the social and cultural narratives, practices, and discourses around pregnancy as well as gendered and social relations. Using the narrative interview method set out by Wengraf (2001), thirteen, unemployed ‘Black’ women from an area in the Eastern Cape were recruited and interviewed. Seven discourses emerged from the narratives namely, a discourse of ‘stress and coping’ ‘hegemonic masculinities’, ‘peer pressure’, ‘disablement and developmental delay’, ‘good mothering/appropriate pregnancies’, ‘culture’, and ‘religion’. These discourses informed the five narrative categories which emerged: narratives about the pregnancy, narratives about the drinking, narratives that justify/explain drinking, narratives that condemn the drinking, and narratives about the women knowing the effects of drinking during pregnancy. Within these narratives, the women mainly positioned themselves as dependent on alcohol during their pregnancies in order to cope with stress caused by various circumstances which were mainly centred on a lack of support from their partners, paternity denial, infidelity and unreliableness. As such, the women in this study mainly justified their drinking during pregnancy and in constructing this narrative, the ‘stress and coping’ discourse as well as the ‘male/masculine provider’ discourse were mainly drawn upon. In reflecting on this analysis, this study argues that alcohol use during pregnancy should be understood within the broader environmental and social context that makes a pregnancy challenging and/or difficult and thus necessitates drinking during pregnancy. Recommendations for future research include expanding the diversity of participants as well as interviewing healthcare providers and women who are currently pregnant, drinking, and part of an intervention aimed at addressing alcohol use during pregnancy so as to obtain a holistic understanding of engaging in this practice. The study makes key recommendations for interventions in practice to help work towards ensuring that the practice of alcohol use during pregnancy is not individualised, decontextualized, and stigmatised.
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Narrated experiences of the pre-termination of pregnancy counselling healthcare encounter in the Eastern Cape public health sector
- Authors: Mavuso, Jabulile Mary-Jane Jace
- Date: 2018
- Subjects: Abortion counseling -- South Africa -- Eastern Cape , Abortion -- Psychological aspects , Abortion -- Social aspects , Pro-choice movement -- South Africa -- Eastern Cape , Reproductive rights -- South Africa -- Eastern Cape , Women -- Sexual behavior -- South Africa -- Eastern Cape , Women -- South Africa -- Social conditions
- Language: English
- Type: text , Thesis , Doctoral , PhD
- Identifier: http://hdl.handle.net/10962/62928 , vital:28311
- Description: Research that has been conducted about experiences of pre-abortion counselling tends to investigate either womxn's1 or healthcare providers' experiences separately, with research on womxn's experiences of abortion and abortion counselling dominating this area of research. Although some of the studies on womxn's abortion experiences have explored womxn's experiences of interactions between themselves and healthcare providers, these aspects have been underreported. To my knowledge, research that also explores womxn's interactions among themselves in the waiting room has not been done. Furthermore, research that explores the pre-termination of pregnancy healthcare encounter, where womxn's and healthcare providers' experiences of waiting room interactions and of pre-abortion counselling practices are seen as interrelated, has not been conducted. Research that has been conducted among womxn's experiences show that womxn have varying experiences of pre-abortion counselling, with some finding it useful while other womxn have found it to be lacking in relevance to their specific situation or needs. Research conducted among healthcare providers also points to varying experiences, with some healthcare providers stratifying womxn's reasons for abortion according to the acceptability of the request. This study explores health service providers’ and womxn’s narrated experiences of the pre-termination of pregnancy healthcare encounter (waiting room interactions and pre-abortion counselling) in the Eastern Cape public health sector. An African feminist post-structural approach, which enables analysis of how discursive structures and power relations may underpin African womxn's experiences of oppression and resistance, was used. Fusing this approach with a narrative-discursive analysis, enabled an exploration of the discursive resources drawn upon and the power relations referred to by participants when constructing micro-narratives and accounts of their experiences of waiting room interactions and pre-abortion counselling practices. This fusion enabled an understanding of the micro (individual) and macro (social) and how they interact and come to bear on experiences of the pre-abortion counselling healthcare encounter. Womxn's micro-narratives and healthcare providers' accounts were compared for convergences and divergences in the pre-abortion counselling practices they described. The implications of these convergences and divergences and of the power relations referred to by participants for pre-abortion counselling service provision are discussed. The research referred to in this study were conducted in contexts where abortion is legal, although the conditions under which it may be accessed differ across and within contexts. This present study is contextualised by the Choice on Termination of Pregnancy Act No. 92 of 1996 which legalises abortion and stipulates that abortion counselling should be made available to womxn but should be non-mandatory and non-directive. Data were collected at three abortion facilities located in public hospitals in the Eastern Cape. Open-ended, semi-structured interviews were conducted with 30 womxn after they received pre-abortion counselling, and four healthcare providers involved in abortion service provision. Data were analysed using an extended narrative-discursive approach which entailed exploring patterns in and across participants' talk. These patterns took the form of discursive resources (discourses and the subject positions they made available, and canonical narratives), power relations, and micro-narratives and accounts of their experiences of pre-abortion counselling practices and waiting room interactions. Participants described the following pre-abortion counselling practices: information-giving practices, consent practices, administering of LARCs, a waiting period and third-party involvement. In describing these processes, participants drew on an awfulisation of abortion discourse, moralising discourses, pronatalist discourses, and liberal discourses to construct (micro-)narratives in which liberal, pastoral and authoritarian counselling practices and power relations were constructed and referred to. In their micro-narratives, most womxn described the counselling as informative, beneficial and healing whilst also describing shock, hurt, pain and distress at the various kinds of information they received. Healthcare providers drew on discourses and canonical narratives (such as the hero and personal testimony) to justify liberal, pastoral and authoritarian counselling practices which were underpinned by constructing abortion and unintended pregnancy as problematic. The pre-abortion counselling practices that were described were directive in two ways: the coercion of contraceptive uptake post-abortion, and information provision practices which effectively work to delegitimise and persuade womxn against abortion.
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Participation in the anti-sexual violence silent protest: a sexual citizenship perspective
- Authors: Chitiki, Elizabeth
- Date: 2018
- Subjects: Sex crimes Campus violence -- South Africa -- Prevention Rape victims -- Services for -- Political aspects -- South Africa Anti-rape movement Rape -- Case studies Sexual orientation
- Language: English
- Type: text , Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/62917 , vital:28310
- Description: There is a growing body of research on sexual citizenship that focuses attention on gender and which bridges the gap between public and private life in order to rethink citizenship from a feminist perspective. This is in contrast to understandings of citizenship that promote policies of sexual regulation and a heteronormative ideal of citizenship. My research takes the form of a qualitative case study. Using data from two focus group discussions, fifteen personal diaries, as well as social media posts, I analyse participation in the Silent Protest, an annual anti-rape protest, through the lens of sexual citizenship. I look at how participation in the protest promotes or inhibits inclusive and process-based understandings of sexual violence and sexualities issues. Data were analysed using thematic analysis and the results of the analysis are presented into two parts. The first part of the analysis discusses the politics of affect and witnessing as two processes through which allies’ understandings of sexual violence are shaped. The second part of analysis shows that the Silent Protest contributes to people’s knowledge and understandings of sexual violence in relation to sexualities in a range of ways. Examples of inclusive understandings are: (1) insights about rape in relation to gender and heteronormative inequalities, culture and patriarchal dominance; (2) understanding of critical sexual citizenship in relation to sexual violence; and (3) understanding of politics of recognition (the need for recognition of the importance of safe spaces for formal and informal support for victim-survivors and recognition of victim-survivors’ identities). However, some of the understandings are limited to emotion and affect dynamics. In some ways, therefore, the Silent Protest fails to promote understandings significant to inclusive citizenship, including understandings of entitlements to non-discriminatory sexual health care services and legal services.
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Policy responses to the sexual and reproductive health of queer youth in the global south: a systematic review
- Authors: Moore, Sarah-Ann
- Date: 2018
- Subjects: Sexual minorities -- Africa , Sexual minorities -- Asia , Sexual minorities -- Caribbean Area , Sexual health -- Developing countries , Reproductive health -- Developing countries , Reproductive health services -- Developing countries , Communication in reproductive health -- Developing countries , Sexual minorities -- Youth -- Developing countries , Medical policy -- Developing countries , Homophobia -- Developing countries
- Language: English
- Type: text , Thesis , Masters , MSocSc
- Identifier: http://hdl.handle.net/10962/63021 , vital:28355
- Description: Concerns surrounding youth sexual and reproduction health (SRH) are deeply embedded within systems of heteronormativity and ciscentrism. Resultantly, youth SRH is filtered through a lens of heterosexual and cisgender experience, rendering invisible the SRH needs of queer youth. Importantly, a failure to recognise queer experiences of SRH has implications for normative subject positions, which enjoy stronger institutional support and constitute legitimate ways of being. As such, the failure to recognise queer youth as health care subjects within policy has far reaching consequences for their sexual and reproductive health. Within this research, a sexual and reproductive justice (SRJ) framework is adopted as a backdrop for exploring policy documents related to youth SRH within selected global South countries in Africa, Asia, and the Caribbean. The final data set comprises of 1035 policy excerpts extracted from 152 policies across these three regions. Research takes the form of a systematic review utilising a deductive framing and positioning thematic analysis. Analysis identifies framings of youth SRH and explores the subject positions assigned to queer youth in relation to these identified framings, with the understanding that the manner in which youth SRH concerns are framed and queer youth are positioned within policies provides an important foundation for the implementation of SRH-related policy. Findings demonstrate that policy responses to youth SRH are most often framed in terms of a public health approach. As a result, dominant understandings of youth SRH serve to reduce youth sexuality to notions of infections and impact, which may speak to an overreliance on biomedical and population-level health models. Themes emerging within human rights framings demonstrate a presumption that rights are equally afforded to, and freely exercised by, all individuals once legally secured, failing to engage with the creation of enabling conditions to realise these rights. Although context and culture framings were by no means exhaustive examples of SRJ, they provide an interesting insight into how such SRJ concerns might be integrated into policy. Importantly, policy responses demonstrate a general pattern hypervisibility of men who have sex with men (MSM) standing in marked contrast to the invisibility of queer youth and other adult queer populations. Within policy extracts, both youth and „MSM‟ are positioned as particularly prone to poor SRH outcomes. By virtue of their inclusion within both populations, queer youth may be considered as especially at risk for, or vulnerable to, such outcomes. Relatedly, these populations (and by extension queer youth) are positioned as in need of correction, containment, and/or protection by those occupying „gatekeeping‟ positions (e.g. health care providers). The positioning of „MSM‟ solely within the context of HIV/AIDS serves to link same-sex sexualities (and at times gender non-conformity) with harmful consequences, suggesting that the positioning of queer youth could similarly serve to conflate their SRH needs with concerns around HIV/AIDS. Many of the subject positions deployed in policies serve to deny the potential for youth and „MSM‟ agency, strength, and resilience. Thus, queer youth subjects are unlikely to be positioned as empowered, autonomous, and agentic. Across both framing and positioning themes, a number of key shortcomings were observed. For the most part, policy responses fail to acknowledge the influence of social, economic, political, and cultural forces that may serve to hinder SRH outcomes according to particular contexts and the intersection of multiple and varied social identities. By obscuring these broader contextual factors and power relations, policy responses may serve to hold individual youth responsible for poor SRH outcomes. In failing to engage with the potential for diversity within youth populations, these populations are largely homogenised. Finally, the need for the creation of an enabling environment in order to secure sexual and reproductive health is largely unacknowledged within policy responses.
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Pregnant women’s construction of social support from their intimate partners during pregnancy
- Authors: Bottoman, Phathiswa Esona
- Date: 2018
- Subjects: Pregnant women -- South Africa -- Eastern Cape -- Relations with men Pregnancy -- Psychological aspects Pregnant women -- Social conditions
- Language: English
- Type: text , Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/62560 , vital:28207
- Description: There is a growing body of research aimed at understanding social support during pregnancy in South Africa. Pregnancy is constantly referred to as one of the challenging and stressful periods affecting women’s physical and psychological well-being. Various research studies on social support argue that social support is paramount at this stage. Research on social support indicates that having adequate and quality social support impacts on how pregnant women experience pregnancy. My interest in social support comes in the wake of absent fathers in South Africa and with the emerging trend of “new” fathers. Although there is a volume of research on social support, it tends to be realist. Using a social constructionist framework, I explore other ways of talking about social support in an attempt to expand the discourse around social support. I explore how pregnant women talk about social support during pregnancy from their intimate partners in the small rural municipality of Elundini, Eastern Cape, South Africa. Intimate partner support was limited to heterosexual partners regardless of their marital status. The sampling procedure followed a non-probability sampling method. Participants of the study were between 24 and 32 years old. Their gestational age ranged between five and eight months. Fourteen in-depth interviews using photo-elicitation were conducted with seven participants and were analysed using a social constructionist informed thematic analysis. The major theme that emerged from the analysis was partner involvement and absence during pregnancy. The analysis of results suggests that expectant father presence translates to social support. Participants constructed his presence as reassurance in the context of possible abandonment. Absence was constructed in different ways: participants constructed absence as unjust and unfair, absence and marriage, temporary absence in the form of cultural phenomenon of ukwaliswa/ukubukubazana, absence as normal but burdening to the pregnant women’s social network. Participants reported that social support from the expectant father affected pregnancy wantedness.
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Young men’s talk about menstruation and hegemonic masculinity in the South African context: a discursive analysis
- Authors: Glover, Jonathan
- Date: 2018
- Subjects: Menstruation -- Social aspects -- -- South Africa -- Eastern Cape , Hegemony -- South Africa -- Eastern Cape , Masculinity -- South Africa -- Eastern Cape , Sex role -- South Africa -- Eastern Cape , Men -- Attitudes , Men -- Psychology , Human body -- Social aspects -- South Africa -- Eastern Cape , Men's studies -- South Africa -- Eastern Cape
- Language: English
- Type: text , Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/60244 , vital:27758
- Description: Current research in the sub-Saharan and other resource poor contexts indicates the largely negative social constructions of menstruation and menstruating women. Young men have been shown to reproduce these negative constructions and reinforce the stigmatized status of menstruation in these contexts. To my knowledge no studies have examined the ways in which young men talk about menstruation and menstruating women in South Africa. In this research, I aimed to explore the ways in which young men (in a resource poor area in the Eastern Cape) talk about menstruation in with their male peers in a focus group context and how this talk serves to enable specific subject positions (both masculine and feminine) that may reproduce, comply with and resist constructions of hegemonic masculinity (as outlined in previous South African research). By drawing on Raewyn Connell’s influential framework of masculinities and augmenting this with Margaret Wetherell and Nigel Edley’s contributions, this research adds to the growing body of research on masculinities in the South African context. I utilized a discursive framework in which to understand the interpretative repertoires drawn on in everyday talk about menstruation and the specific subject positions made available by these. Purposive sampling was used to recruit a total of 37 participants from two former Department of Education and Training schools in the Eastern Cape. Participants were young ‘black’ men with a mean age of 18.3 In analyzing and interpreting the data two overarching patterns emerged. In the first, the participants discursively distanced themselves from menstruation (and femininity in general) in order to avoid possible marginalisation and subordination in relation to local hegemonic masculine ideals. In doing this, the participants drew on a number of interpretative repertoires including: a dualistic repertoire, a bad (versus ideal) femininity repertoire and an abject femininity repertoire, which assisted in creating numerous subject positions. These subject positions allowed the young men to align themselves closer to hegemonic masculine ideals, and create distance by positioning menstruating women as the ‘other’. In the second overarching pattern, menstruation was constructed as a threat to masculine identity; within this construction, the young men discursively negotiated the ideological dilemmas surrounding this ‘highly feminine’ topic in ways that bolstered their positions within the gender hierarchy. Overall, hegemonic masculinities in this context were discursively reproduced and complied with in the participants’ accounts.
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Sistering and sexual socialisation: a psychosocial study of Xhosa women’s ‘sex and reproduction talk’ with their sisters
- Authors: Ndabula, Yanela
- Date: 2017
- Language: English
- Type: Thesis , Masters , MA
- Identifier: http://hdl.handle.net/10962/35055 , vital:24313
- Description: While much work has been put into understanding parent-child talk about sex, less is known about how sisters discuss sex. Using a psychosocial framework, in this study, I explore how women report talking about sex and reproduction in their sister-sister relationships, the subject positions within the talk and how the talk restricts or shores up particular ways of ‘doing sex and reproduction’ in society. Moreover, I examine why these women emotionally invest in certain discourses over others in their sisterly sex talk. The psychosocial framework combines discursive psychology with a psychoanalytic approach to explore both ‘inner’ and ‘outer’ processes involved in sexual socialisation within sistering. Psychoanalytic concepts were used to ‘thicken’ the discursive reading of the text. Five isiXhosa-speaking, middle aged and working class women were the participants of the study. The Free Associated Narrative Interview was used to collect the data thus participants were encouraged to convey their experiences of sex talk and reproduction within their sisterly relationships with minimal interruptions from the interviewer. Analysis suggests that the women drew on two broad interpretative repertoires in order to construct their sisters as sexual subjects: a repertoire of secrecy, and a repertoire of responsibilisation and risk. Furthermore, sisterly sex talk was constructed as a complex interchange of shifting positions of openness and power due to two coinciding identities - that of mother and of peer taken up by the participants. A psychoanalytic reading of the data suggests an emotional investment in exemplifying responsibility. The participants experienced anxiety in negotiating a sexualised femininity and projected their sexual desire onto their sister to defend against anxiety in their talk; this enabled them to feel as though they were ‘doing’ sex better than their sisters.
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