Women's Health Research Unit, University of Cape Town, Anzio Road, 7925 Observatory, Cape Town, South Africa.
Reprod Health. 2021 Oct 26;18(1):211. doi: 10.1186/s12978-021-01262-0.
South Africa has a liberal abortion law, yet denial of care is not uncommon, usually due to a woman being beyond the legal gestational age limit for abortion care at that facility. For women successfully obtaining care, time from last menstrual period to confirmation of pregnancy is significantly longer among those having an abortion later in the second trimester compared to earlier gestations. This study explores women's experiences with recognition and confirmation of unintended pregnancy, their understanding of fertile periods within the menstrual cycle as well as healthcare providers' and policy makers' ideas for public sector strategies to facilitate prompt confirmation of pregnancy.
We recruited participants from July through September 2017, at an urban non-governmental organization (NGO) sexual and reproductive health (SRH) facility and two public sector hospitals, all providing abortion care into the second trimester. We conducted in-depth interviews and group discussions with 40 women to elicit information regarding pregnancy recognition and confirmation as well as fertility awareness. In addition, 5 providers at these same facilities and 2 provincial policy makers were interviewed. Data were analysed using thematic analysis.
Uncertainties regarding pregnancy signs and symptoms greatly impacted on recognition of pregnancy status. Women often mentioned that others, including family, friends, partners or colleagues noticed pregnancy signs and prompted them to take action. Several women were unaware of the fertility window and earliest timing for accurate pregnancy testing. Health care providers and policy makers called for strategies to raise awareness regarding risk and signs of pregnancy and for pregnancy tests to be made more readily accessible.
Early recognition of unintended pregnancy in this setting is frustrated by poor understanding and awareness of fertility and pregnancy signs and symptoms, compounded by a distrust of commercially available pregnancy tests. Improving community awareness around risk and early signs of pregnancy and having free tests readily available may help women confirm their pregnancy status promptly.
南非拥有宽松的堕胎法，但拒绝提供堕胎服务的情况并不少见，通常是因为在该医疗机构，女性的妊娠时间超过了法律规定的堕胎护理的最晚期限。对于成功获得堕胎服务的女性来说，从上次月经到确认怀孕的时间，在妊娠中期后期堕胎的女性比早期妊娠的女性要长得多。本研究探讨了女性对意外怀孕的认识和确认的经历，她们对月经周期内可育期的理解，以及医疗保健提供者和政策制定者对促进及时确认怀孕的公共部门策略的想法。
我们于 2017 年 7 月至 9 月，在一家城市非政府组织（NGO）性健康和生殖健康（SRH）机构以及两家提供堕胎护理的公立医院招募参与者。我们对 40 名妇女进行了深入访谈和小组讨论，以了解有关怀孕识别和确认以及生育意识的信息。此外，我们还对这些相同设施的 5 名提供者和 2 名省级政策制定者进行了访谈。使用主题分析对数据进行分析。
对怀孕迹象和症状的不确定性极大地影响了对怀孕状况的认识。女性经常提到，包括家人、朋友、伴侣或同事在内的其他人注意到了怀孕迹象，并促使她们采取行动。一些女性不知道生育窗口和最早进行准确妊娠测试的时间。医疗保健提供者和政策制定者呼吁采取策略，提高对怀孕风险和迹象的认识，并使妊娠测试更容易获得。
在这种情况下，由于对生育和怀孕迹象和症状的理解和认识不足，以及对商业上可用的妊娠测试的不信任，意外怀孕的早期识别受到了阻碍。提高社区对风险和怀孕早期迹象的认识，并使免费测试易于获得，可能有助于女性及时确认其怀孕状况。
