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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- Date Issued: 2018
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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- Date Issued: 2018
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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- Date Issued: 2018
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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- Date Issued: 2018
Young men’s talk about menstruation and hegemonic masculinity in the South African context: a discursive analysis
- Authors: Glover, Jonathan M
- 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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- Date Issued: 2018