Springtime booklet 5

exploring your options for an unplanned pregnancy

W hen faced with an unplanned pregnancy, the decisions you need to make may seem overwhelming. Your emotions are pulling you in different directions, one person is telling you to do this, and someone else is saying don't do that.
Perhaps you haven't told anyone. Well, this booklet is designed to help you make the best decision. Find a quiet place somewhere and go through each of your options slowly and thoughtfully before making a decision.
Before reading any further, it is important to realise that we are not trying to make your decision for you, but rather our intention is that this booklet will help you make an informed decision.
There are essentially four options available to you: Foster Care or Place of Safety As you look at the choices, know that each option is difficult in its own way. Each choice has short-term and long-term consequences. For you to make the best quality decision, look carefully at each option, and honestly try to imagine the effects that the decision will have.
The long-term consequences of deciding to parent your child
are fairly obvious: Parenting is a full time commitment.
Financially, there is another member of the family to support.
It may mean sleepless nights, less time for yourself, taking time off work, and maybe even delaying your career or studies. Parenting is not only cute baby clothes and cuddling. Yet with all that, there is the incredible joy of being a parent. It is a great privilege to be responsible for another life. Watching your child grow up and getting to know them is an exciting and wonderful opportunity! Marriage or single parenting?If you are not yet married, there is the decision to make of whether you want to get married, or be a single parent. Being a single parent is not easy by any means. Not only will you be acting as both mom and dad, but you will also have a job, career or studies to think of; plus keeping house. It may not be ideal, but there are people who can help you out, like day-care centres or domestic helpers. It is very possible! Remember, too, that it is really the first couple of years that will be the toughest – after that, when your child is at school during the day, it will be easier for you to be away at work.
Getting married is a serious decision, and should not be undertaken lightly. However, marriage does provide a secure environment for a child to grow up in, as well as a solid foundation on which to build a family. With both parents at home your child can benefit from the different qualities and roles they play in nurturing and shaping their identity. As a parent you can also benefit from sharing the responsibilities of looking after a baby and raising It is important to note that getting married because you feel you have to, is not advisable. Making a marriage last requires that both husband and wife are prepared to commit to making it work. These are some questions you need to consider: Are you both prepared to work at making your marriage succeed? What are your reasons for getting married? Were you planning to get married before you fell pregnant? The father's roleWhether or not you are married, the father is legally responsible to support your child financially for 21 years. If he refuses to pay maintenance there are legal steps you can take to ensure that he does.

If he denies that he is the father of your baby, you will need to go for paternity tests to prove the identity of the father. These tests, which are conducted at a pathologist, can be done after the birth of your baby.
The father cannot decide for you what you should do – he cannot decide on parenting or abortion. Although it is a good idea for him to be as involved in the decision-making process as possible, this decision is ultimately yours to make.
Regardless of what he wants you to do, he is still legally responsible to provide for his child.
Help available for youFor mothers and families with no or a very low income, a monthly grant for child support can be obtained from the Department of Social Development, and free medical help is available at any of the local state clinics and hospitals. Also, any of the Africa Cares for Life affiliated crisis pregnancy centres will assist you in any way we can (for example: with counselling, clothing and baby accessories).
Safe housesPerhaps you feel that you cannot stay at home if you are pregnant as it may be dangerous or unstable for you and your baby. If so, there are safe houses where you can stay for the months during your pregnancy. You will receive confidential care and support, and there may be an opportunity to learn new skills. You may be required to help out with household tasks such as cleaning, cooking and general housekeeping. (Speak to a counsellor at a crisis pregnancy centre for more information). TimingMaybe you feel that it is simply not the right time to be pregnant. All the structures may not be in place in your life. You may feel like you need more money, a new job, or that you need to finish your studies. There may never be a ‘perfect time', but if in your heart you want this child, then that desire will manage to overcome all the obstacles in your life. It may seem impossible now, but you can make it work.
Make sure that you explore all your options before deciding that it is the wrong time. For example many schools and universities are open to making arrangements with you so that you can continue your studies.
If you are still at school, the school may not legally expel you, although you will need to follow their rules and policies about pregnant learners, such as staying at home when you begin to show. Even then, you should be able to keep up with the rest of the class by working at home and may even write your exams at the end of the year.
At work, check with your employer about what the policy is regarding maternity leave, or whether or not any possible promotion might be affected by your taking maternity leave.
Telling your parents or familyTelling your parents or family that you are pregnant can be a terrifying prospect. In fact, this fear may make you seriously consider not going through with the pregnancy. This is a real and very valid concern. In all honesty, it must be said that when parents are first told, they are often very angry! They may shout and scream, and tell you that they are disappointed and ashamed of you. Some parents even go to the extreme of telling their children to leave But they nearly always come around! It is usually shock, and a sense that they as parents have failed, that causes them to react in anger and frustration. Once the shock has subsided, the anger usually goes too, and they step back into supporting and loving you.
Remember that no matter how hard it may be, it is ultimately you, and not your parents, that have to live with your decision.
If you feel forced into doing something that you do not want to do, it is very likely that you will begin to resent your parents. By not telling your parents, you may find that you begin a life of secrecy and dishonesty to cover up the abortion or adoption.
This can be stressful and harmful to your relationships.
If you don't feel you can tell your parents, try to find a sister, an aunt, a cousin or another family member who will support and help you.
• How do you think your parents will react if they find out one day that you were pregnant and never told them? • How will that affect your relationship with them? • Do you feel pushed into doing • If so, how will you feel afterwards about being forced into something you do not want to do? • Are you sure about the regulations at school or work? (Abortion is also called termination of pregnancy or T.O.P. for short)
Legally, anyone can chose termination as long as they are
less than 12 weeks pregnant. If you are between 12 and 20
weeks you can have an abortion if: • You are pregnant due to rape or incest; • Your baby is malformed; • Your pregnancy will harm your life or health in any way, be it physically, emotionally, economically or socially.
Terminations after twenty weeks can be done only in extreme cases when the baby is seriously malformed, or the mother's life is at risk.
What happens during an abortion?When done in proper, legal, medical facilities (and not in a back-street clinic) the termination procedure is fairly safe physically – depending on the methods used and the expertise But like any medical procedure there is a risk that something may go wrong. Some women have found the abortion procedure relatively painless, while many others have experienced extreme pain, severe cramps and bleeding (both before and after the actual procedure). The processThere are various ways that an abortion can be performed.
Listed here are the most common ways. Be sure to ask what procedure will be done so that you have a clear idea of exactly what will be happening, as this will help you to process and cope with the experience. Depending on the clinic, either a local anaesthetic (where you are awake) or a general anaesthetic (where you are asleep) may be used during the procedure. If you suffer from any medical problems, ask your doctor how this will affect the The morning-after pillTaken up to 72 hours after sex, this either prevents the egg from being fertilised or rejects the fertilised egg from being implanted in the womb. If the egg has been fertilised and is prevented from growing in the womb, this is, in effect, an early abortion.
Misoprostol and RU486 (Mifepristone)Pills such as Misoprostol or RU486 can be taken orally to terminate the pregnancy. Misoprostol is cheaper than RU486 and so is used more widely in the public health system. Very simply what happens is that the pills deplete the lining of the uterus cutting off the blood and oxygen supply to the foetus, which then causes labour to be induced. Women who are nearly at 12 weeks may see the foetus if they abort in the toilet or on a pad. Aside from cramps and heavy bleeding; nausea and diarrhoea are common side effects. A D&C is then done to complete the procedure and ensure that the uterus is empty.
Suction AbortionThis is currently the most common method. This method is done before the 12th week of pregnancy. During the procedure, the neck of the womb is gently opened; a thin, plastic tube is inserted into the womb and the foetus's body is removed using a suction device. Some clinics use a small pump-like instrument as opposed to a vacuum tube.
D&C (dilation and curettage) and D&E (dilation andevacuation)In a D&C (from 6-12 weeks) the neck of the womb is opened and a sharp cutting instrument is used to empty the womb by

breaking the foetus into small parts that can then be removed.
A D&E (12-18 weeks) is very similar except that small forceps are now used.
Late AbortionsLater abortions, after 20 weeks, (e.g. hysterotomy and partial birth abortions) are done surgically or by induced labour. These are done only in rare cases where the mother's life is in danger or where there is severe foetal abnormality.
The after-effects of abortionOften abortion is seen as being the best solution to a frightening situation. There seem to be many advantages and women often feel that they will be able to carry on with their lives as before. The reasons may all be true, but an abortion may not be the quick-fix it appears to be, as there are long-term consequences which need to be Physical effects of terminationFor a short while afterwards, bleeding may occur. In a small percentage of women infections follow which may result in not being able to have any more children. The majority of women, however, will be able to have more children, but there is a greater likelihood that something may go wrong in future pregnancies (e.g. miscarriages, stillbirths, unusual birth positions and premature births).
Studies are also being conducted on the link between abortion and breast cancer, which may be the result of an abortion unnaturally disturbing and interrupting the hormonal processes that occur during pregnancy. After an abortion, the breast, which prepares to produce milk, is left with extra cells that may become cancerous.
The emotional effects of abortionIt is surprising how few people know or even talk about the emotional consequences of abortion, yet the majority of women will experience these emotions at some point.
For most women the abortion has been a secret, and if some close friends and family do know, they may not understand how to react or how to help. The woman may also be experiencing mixed feelings and so, not knowing what to do or who to turn to, pushes her emotions down and tries to simply get on with her life. These buried emotions and hidden pain can lead to a condition, which is called Post Abortion Stress (also known as Post Abortion Syndrome).
Post Abortion Stress is characterised by feelings of: • Guilt with thoughts of "I killed my baby".
• Depression, ranging from feeling weepy to even contemplating suicide. • Regret, thinking "I wish I hadn't done it". • Anger, directed at the father, your family, God, yourself, or anyone connected to the abortion decision. • Apathy and just not caring or feeling positive about life.
• Hopelessness.
• An inability to make decisions. • A drop in self-worth, believing "I am a bad person". • Nightmares and flashbacks to the abortion are common, and some people may sense a baby • Disturbances in sleeping patterns, eating habits and • Crying for no apparent reason.
• Withdrawing from people.
• Avoiding babies.
These are all characteristics of Post Abortion Stress.
Basically this is a time when many questions seem to haunt you: "What if I hadn't gone through with it?" "What if I had told my parents?" "Would it have been a little boy or girl?" "What would my baby look like?" "Would it have worked out?" Having mentioned all these symptoms, it is important to understand that Post Abortion Stress does not normally set in immediately after the abortion. Usually the initial emotion is one of relief – "life can carry on as usual".
These emotions may emerge after several years (on average 5-7 years), perhaps when you fall pregnant later on, or when you see little children walking in the street, or the anniversary of the abortion or the would-be birthday of your baby may Maybe a television programme or magazine article will bring the emotions to the surface. It could be anything at any time.
Spiritual considerationsWhen thinking about having an abortion it is important to consider your spiritual beliefs and faith. Does having an abortion go against your fundamental beliefs? How will your faith be affected by this decision? What does God think about abortion? At the core of who you are lie the beliefs you hold about where you come from, where you are going, what you know to be true and what is of ultimate value. It is vital that the decisions you make do not contradict who you are and what you believe to be fundamentally true. If they do, you are essentially hurting yourself, and guilt and regret will be felt that much more deeply.
HealingThe healing process involves grieving your loss and coming to terms with the decision that you have made. This is a time of working through the guilt, sadness, anger and fear surrounding the abortion experience, as well as grieving the loss of your baby. Maybe you believe that while you are pregnant you are not carrying a baby yet. The fact of the matter is that if you waited nine months there would be a baby, regardless of when you believe it becomes a person. This is the loss you will need to grieve.
It is also a loss that came about because of a decision that you made. So overcoming a sense of guilt and making peace with yourself plays a major part in the healing process.

Aside from forgiving yourself, healing also involves forgiving all the other people who were either directly or indirectly involved. This may include the father, your family, friends, the doctor or counsellor. Where abortion has gone against your belief in God, finding forgiveness from Him is vital to your healing.
An important thing to remember after having had a termination is to deal with your emotions as they surface.
In this way you will avoid the build-up of hidden painful emotions that rise to the surface one day. Dealing with your emotions on a day-to-day basis will, in a sense, lessen the impact of Post Abortion Stress, as it is easier and healthier to deal with current emotions than a whole lot of ignored emotions from the past. So, on the days you feel sad, cry. On the days you feel angry, express it in a healthy way. Work through your emotions and do not stop in the middle of your depression without moving There is healing. The healing process will be painful, but keep in mind that this pain is healthy, as you will need to go back to the place of hurt in order to truly deal with the experience! A good idea to help you work through your emotions is to keep a journal. You will be able to see how far you have come and where you are still going. It is a great comfort to express those hidden parts of you, and writing it down helps you to On the other hand do not try to deal with this all on your own, find someone you can talk to and who will walk the road of healing with you.
(See the contact details at the end of the booklet for the Africa Cares for Life crisis pregnancy centres around the country for In the wombAnother important aspect to consider when making your decision is to understand the development of the foetus in Medical research has shown the different stages of development. On the next two pages, there is a brief outline of the growth of the foetus at different weekly intervals:

Moment of conception: • Genetic identity is • Complete skeleton in place• Brain waves have been established (it is as if a photo has been taken of • Brain begins to control what the person will be organs and muscle • Hair colour, eye colour, likely adult height, and gender are • Teeth buds are formed • Finger nails begin to grow • Foundations of the brain, • 40 muscle sets are working spinal cord and nervous in connection with the system are in place • Heart starts beating • About the length of a thumb • Backbone and muscles are • Has set of unique finger • Arms, legs, eyes and ears • Can make a tiny fist • Has own blood cells 10 weeks:
• Stomach begins digesting • Can wrinkle its forehead • Five fingers can be seen

• Can swallow and smile 13 weeks:
• Fine hair starts to grow on • Kicks legs and does • It is possible to tell gender 11 weeks:
20 weeks:
• Urination occurs • Mother can feel • Muscle movements are more co-ordinated • Ears are working and can 12 weeks:
24 weeks:
• Sensitive to touch, heat, • Recognises mother's voice sound, discomfort • About 5.5cm long 28 weeks:
• All organs (except lungs) • Can breathe by itself if born • Would sneeze if some- 32 weeks:
thing were to touch its • Layer of fat develops under • Can grasp objects 40 weeks:
• Sleeps, awakens and exercises muscles images Life Issues Institute Impact on a couple's relationshipsBeing in a strong, solid relationship can be a great help in a crisis pregnancy as there is somebody to talk to, cry with and help you make decisions. Terminating a pregnancy can put severe strain on a relationship. In fact, most relationships do not survive an abortion. Mixed emotions, different opinions and confusion are often expressed through anger and frustration. Realise, before you do anything, that your relationship is going through a tough time and that the other person is experiencing as much pain as you are. Be patient and try to come to a place where you are both dealing with your emotions and not simply reacting to one another.
Men and abortionAlthough it is rarely spoken of, men are also greatly affected by abortion. In fact, many men will also experience Post- Abortion Stress. The most common emotions seen in men after an abortion are anger and an increase in risk-taking activities. A man's basic desire to provide for, and protect his family is destroyed in an abortion and this can lead to intense emotional stress. Like women, these emotions are generally denied, suppressed, ignored or expressed without an understanding of Men will generally experience similar post-abortion emotions and behaviours as women such as: guilt; depression; panic attacks; nightmares; suicidal thoughts; an increase in alcohol and drug abuse; they may become workaholics; be indecisive; display poor coping skills; and experience sexual dysfunction.
Before you fell pregnant, what did you think about abortion? • Was it something you were — • Does having an abortion go against something you believe • How do you think you will feel after the abortion? • Who could you tell who would be there for you when you need Many women think that they could never go through with
adoption. The emotional pain of bonding with a child for
nine months and then separating seems unbearable. Along with that there are the questions of "What would happen to my baby?"; "How could I live knowing that my child is somewhere, but I don't know where?"; "What if the adoptive family doesn't treat them well?" Yes, adoption is difficult. It is hard to carry a baby for nine months, give birth and then release your child to someone Also everyone would know that you are pregnant, unlike with an abortion. But despite all the difficulties and pain of choosing adoption, there are many positive aspects to making this decision.
You can carry on with your schooling, studies or career. There is no extra financial burden on you. If you are not ready, to have children, you don't have to feel forced into early parenting.
Yet you can know that another family that is ready can provide your baby with love, a home and opportunities to live a good life. You are also bringing happiness to the adoptive family through your child.
Adoption is accepting that you are not ready for motherhood, but you realise that you cannot undo what you have done and are prepared to take that hard step of responsibility. When you think about it, adoption and abortion are similar in many ways. In both options, you can carry on with your schooling, studies or career. There are no extra financial pressures of supporting another person. You don't need to become a parent before you are ready and neither choice is easy emotionally. Although adoption and abortion have many things in common, there are obvious differences as well. You need to weigh these up.
• A baby is born.
• No baby is born.
• You will be pregnant for • You won't be pregnant nine months and give for nine months, you won't give birth.
• It is likely people will • People may not know know you are pregnant.
that you were pregnant.
• You will remember • You will not remember giving birth, giving life.
giving life, only preventing a life from being born or taking a • You will not experience • At some point you will Post Abortion Stress, probably experience the although you will guilt, depression and likely experience other other emotions of Post emotions such as Abortion Stress.
loneliness and grief.
• If you choose an open • You will never know adoption, you will know about your child, and can even hold and name Some myths about adoptionMyth: If I love my child I could never choose adoption. It wouldbe better to raise the child myself.
Truth: If you love your child you will do what is best for yourchild, which may be releasing him or her to somebody better equipped to look after a child emotionally, socially, spiritually and financially.
Myth: I wouldn't be able to live with myself knowing that mychild was somewhere and I didn't know where.
Truth: You may experience grief, depression and lonelinesswhen thinking of your child in another home. You will feel the hurt and separation deeply, but you can know that your pain and loss have resulted in a good life and many opportunities for your baby that you may not have been able Myth: My child will be neglected or abused.
Truth: There is a very thorough process involved in selectingsuitable adoptive families, including home visits from a social worker. Also, in an open adoption you will be able to see for yourself how well the child is loved and cared for.
Myth: I would never know anything about my child.
Truth: As a birth parent you can decide how open or closedyou would like the adoption process to be. If you choose an open adoption you can have ongoing contact with the adoptive family and you child via the social worker. You can even hold the baby and personally hand them to the adoptive parent.
The process of adoptionChoosing adoption as the option you want to take involves working with a registered and accredited adoption social worker, who looks for appropriate adoptive families. There are different types of adoption plans that you can choose. These vary on their degree of "openness", which is simply how involved you, as the birth parent, are both before and after the birth of the baby. In a more open adoption plan you can have contact with the adoptive family through the social worker. If you prefer not to have any ongoing contact with the adoptive family, you can choose a closed adoption plan. You can be part of the adoption plan and even choose your own family from selected profiles. If you want you can hold and name your baby and personally hand the baby to the new parents. You will need to go to court and sign an agreement that you are placing your baby for adoption. You have sixty days after you have signed to change your mind and decide to keep your baby. It is only after those sixty days that the adoption becomes final and irreversible. There are no costs involved in the adoption process for you as the birthparents. The adoptive family will cover any costs. (Speak to a counsellor at a crisis pregnancy centre for moreinformation about the different adoption agencies.) • What are the positive aspects • Is this something you would • How do you feel about the differences between abortion and adoption? If you are still unsure whether you are ready to parent or not, you can choose to put your baby into a place of safety for a period of six weeks. After this, according to the Child Care Act, the social worker will place the child in a foster family if you are still undecided or unable to personally take care of your child.
Foster care is more long-term and your baby can stay there for up to two years. During this time you may visit the child and if your circumstances change, the child can be placed back in your care. After two years, the foster parents may apply to adopt the child as it would be best for the child to be part of a permanent family. Before the child will be placed back in your care or placed for adoption with the foster care parents, the social worker has to do a thorough investigation on which the court will make the final decision. Although this is also not an easy option for any of the people involved, it is an option for those people who need some time to establish themselves financially or emotionally. It also opens up opportunities for your baby's life. Are you in a really bad situation that could change over the next year or two that would enable you to parent your child? Making a decision Sometimes what we feel in our hearts can be very different to what is going on in our heads. Our circumstances can be pushing us to do one thing when deep down we would rather do something else. Often we make a decision rationally, using our heads. We analyse everything thoroughly and come up with the decision that makes the most sense. It is essential that you think carefully and thoroughly about each of the alternatives you can take, but do not exclude what you are feeling and what your heart is saying. Ask yourself, what are the circumstances and people in your life telling you to do? When you think about being a mother, what are the feelings you experience? Some choices that you make bring much pain in the short- term, yet the long-term consequences are much more positive and better to live with.
Likewise some decisions bring immediate ease, but long-term pain. Every choice that you make will have consequences that you alone will have to live with. The pressure from other people may be overwhelming, but the choice is yours.
The consequences are yours. It is a good idea to weigh up what you think is good and what you think is bad about each option.
When making an important decision, be careful of making assumptions about what the future will hold or how your circumstances will change before you have examined everything thoroughly. Try to imagine how your priorities may change over time. Will the decision you make now be one you regret making later in life because of changed priorities? Being pregnant may not be easy.
It may feel like completely the wrong time to be pregnant or have a baby.
People may know.
They may even talk about you.
You may think people in your church will judge you.
Your parents may be angry and disappointed, even to the point of throwing you out of the house.
Circumstances may be completely awful.
Your new job or promotion may seem to be on the line.
It may mean taking longer to finish studying.
But this is a decision that you alone can make.
Regardless of what people say or think, you are the one who has to live with your decision every hour of every day of every week of every month of every year for the rest of your life.
What is best for you and your baby? Africa Cares for Life is a network of over 60 crisis pregnancy centres in Southern Africa. These centres offer free counselling for unplanned pregnancies as well as for Post Abortion Stress. They can also refer you to adoption services and safe homes; or provide you with information and practical To find the crisis pregnancy centre in your city or an adoption service contact the Africa Cares for Life National Office: (031) 903-6093 or (046) 622-2752.
For more copies of the undecided booklet, contact the Africa Cares for Life National Office at the above number or email : [email protected].
This booklet may be photocopied or reproduced for

Source: http://www.lifelink.co.za/Themes/LifeLink/Content/undecided.pdf

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Int. J. Biol. Sci. 2005 1: 24-33 International Journal of Biological Sciences ISSN 1449-2288 www.biolsci.org 2005 1:24-33 ©2005 Ivyspring International Publisher. All rights reserved Research paper Diversity of endophytic fungal community of cacao Received: 2004.09.20 (Theobroma cacao L.) and biological control of Crinipellis

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Migraine Prophylactic Guideline Summary for Primary Care Physicians - Section IVTamara Pringsheim1, W. Jeptha Davenport1, Gordon Mackie2, Irene Worthington3, Michel Aubé4, Suzanne N. Christie5, Jonathan Gladstone6, Werner J. Becker1 on behalf of the Canadian Headache Society Prophylactic Guidelines Development Group