Ensuring women's right to choose: Exploring nurses' role in the Choice on Termination of Pregnancy Act

The 1996 Choice on Termination of Pregnancy Act (CTOPA) laid the foundation for South African women to exercise choice as well as their right to have control over their bodies. Nurses are the largest category of health care providers, and their centrality to improved health and health systems performance is undisputed. Yet, there is little documentation of the voices and experiences of nurses in broader health policy advocacy, development and implementation. In this Briefing, we use the concept of positive deviance to explore the views and experiences of nurses who were involved in various stages of the CTOPA between 1996 and 2010. The concept of positive deviance refers to "intentional behaviours that significantly depart from the norms of the referent group in honourable ways" (Spreitzer and Sonenstein, 2004: 828) and is in concert with feminist theory that challenges patriarchal gender norms and sexist behaviours in society. The main themes emerging from the in-depth interviews with these nurses are: political or gender and women's rights activism; wanting to make a difference; and commitment to nursing excellence. We conclude that without the involvement of nurses in the CTOPA implementation progress would have been minimal.