Sample records for safe legal abortion

  1. Playing it Safe: Legal and Clandestine Abortions Among Adolescents in Ethiopia.

    PubMed

    Sully, Elizabeth; Dibaba, Yohannes; Fetters, Tamara; Blades, Nakeisha; Bankole, Akinrinola

    2018-06-01

    The 2005 expansion of the Ethiopian abortion law provided minors access to legal abortions, yet little is known about abortion among adolescents. This paper estimates the incidence of legal and clandestine abortions and the severity of abortion-related complications among adolescent and nonadolescent women in Ethiopia in 2014. This paper uses data from three surveys: a Health Facility Survey (n = 822) to collect data on legal abortions and postabortion complications, a Health Professionals Survey (n = 82) to estimate the share of clandestine abortions that resulted in treated complications, and a Prospective Data Survey (n = 5,604) to collect data on abortion care clients. An age-specific variant of the Abortion Incidence Complications Method was used to estimate abortions by age-group. Adolescents have the lowest abortion rate among all women below age 35 (19.6 per 1,000 women). After adjusting for lower levels of sexual activity among adolescents however, we find that adolescents have the highest abortion rate among all age-groups. Adolescents also have the highest proportion (64%) of legal abortions compared with other age-groups. We find no differences in the severity of abortion-related complications between adolescent and nonadolescent women. We find no evidence that adolescents are more likely than older women to have clandestine abortions. However, the higher abortion and pregnancy rates among sexually active adolescents suggest that they face barriers in access to and use of contraceptive services. Further work is needed to address the persistence of clandestine abortions among adolescents in a context where safe and legal abortion is available. Copyright © 2018 The Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  2. Why Abortion is Illegal? Comparison of Legal and Illegal Abortion: A Critical Review.

    PubMed

    Huq, M E; Raihan, M J; Shirin, H; Chowdhury, S; Jahan, Y; Chowdhury, A S; Rahman, M M

    2017-10-01

    Abortion is the termination of pregnancy that occurs spontaneously or purposely. In the most developed world, abortion is legally allowed for women seeking safe termination of pregnancies. Particularly, when access to legal abortion is restricted, abortion is the resort to unsafe methods. The aim of this review is to necessitate safe abortion and to accentuate the consequences of illegal abortion in case of legal prohibition. We used Pubmed, MedLine and Scopus databases to review previous literatures of safe, unsafe, legal and illegal abortions. Research work and reports from organizations such as World Health Organization (WHO), World Bank (WB) and United Nations (UN) were included. Snowball sampling was used to obtain relevant journals. Abortion is conventional whether it is safe, unsafe, legal or illegal. The intention of the antiabortion policy was to reduce the number of abortions globally. However, instead of decreasing rates, evidences show significant increase in abortions. When abortion is legal, the preconditions to be ensured are availability, accessibility, affordability and acceptability for the safe abortion facilities. When abortion is illegal, risk reduction strategies are needed to decrease maternal morbidity and mortality. We can reduce abortion related morbidity and mortality, whether it is legal or illegal if we can ensure the appropriate access to health care, including abortion services, education on sexuality, access to contraceptives, post abortion care, and suitable interventions and liberalization of laws. The paper reviewed the Mexico City Policy and the US foreign aid strategies and highlighted the evidence based analysis for policy reform. The liberalized abortion law can save pregnant women from abortion related complications and death.

  3. Cost of abortions in Zambia: A comparison of safe abortion and post abortion care.

    PubMed

    Parmar, Divya; Leone, Tiziana; Coast, Ernestina; Murray, Susan Fairley; Hukin, Eleanor; Vwalika, Bellington

    2017-02-01

    Unsafe abortion is a significant but preventable cause of maternal mortality. Although induced abortion has been legal in Zambia since 1972, many women still face logistical, financial, social, and legal obstacles to access safe abortion services, and undergo unsafe abortion instead. This study provides the first estimates of costs of post abortion care (PAC) after an unsafe abortion and the cost of safe abortion in Zambia. In the absence of routinely collected data on abortions, we used multiple data sources: key informant interviews, medical records and hospital logbooks. We estimated the costs of providing safe abortion and PAC services at the University Teaching Hospital, Lusaka and then projected these costs to generate indicative cost estimates for Zambia. Due to unavailability of data on the actual number of safe abortions and PAC cases in Zambia, we used estimates from previous studies and from other similar countries, and checked the robustness of our estimates with sensitivity analyses. We found that PAC following an unsafe abortion can cost 2.5 times more than safe abortion care. The Zambian health system could save as much as US$0.4 million annually if those women currently treated for an unsafe abortion instead had a safe abortion.

  4. Denial of abortion in legal settings.

    PubMed

    Gerdts, Caitlin; DePiñeres, Teresa; Hajri, Selma; Harries, Jane; Hossain, Altaf; Puri, Mahesh; Vohra, Divya; Foster, Diana Greene

    2015-07-01

    Factors such as poverty, stigma, lack of knowledge about the legal status of abortion, and geographical distance from a provider may prevent women from accessing safe abortion services, even where abortion is legal. Data on the consequences of abortion denial outside of the US, however, are scarce. In this article we present data from studies among women seeking legal abortion services in four countries (Colombia, Nepal, South Africa and Tunisia) to assess sociodemographic characteristics of legal abortion seekers, as well as the frequency and reasons that women are denied abortion care. The proportion of women denied abortion services and the reasons for which they were denied varied widely by country. In Colombia, 2% of women surveyed did not receive the abortions they were seeking; in South Africa, 45% of women did not receive abortions on the day they were seeking abortion services. In both Tunisia and Nepal, 26% of women were denied their wanted abortions. The denial of legal abortion services may have serious consequences for women's health and wellbeing. Additional evidence on the risk factors for presenting later in pregnancy, predictors of seeking unsafe illegal abortion, and the health consequences of illegal abortion and childbirth after an unwanted pregnancy is needed. Such data would assist the development of programmes and policies aimed at increasing access to and utilisation of safe abortion services where abortion is legal, and harm reduction models for women who are unable to access legal abortion services. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  5. Legal rights to safe abortion: knowledge and attitude of women in North-West Ethiopia toward the current Ethiopian abortion law.

    PubMed

    Muzeyen, R; Ayichiluhm, M; Manyazewal, T

    2017-07-01

    high-impact interventions that would trigger women to understand and exercise their legal rights to safe abortion and other reproductive health securities. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  6. Ensuring Access to Safe, Legal Abortion in an Increasingly Complex Regulatory Environment.

    PubMed

    Paul, Maureen; Norton, Mary E

    2016-07-01

    Restrictions on access to abortion in the United States have reached proportions unprecedented since the nationwide legalization of abortion in 1973. Although some restrictions aim to discourage women from having abortions, many others impede access by affecting the timeliness, affordability, or availability of services. Evidence indicates that these restrictions do not increase abortion safety; rather, they create logistic barriers for women seeking abortion, and they have the greatest effect on women with the fewest resources. In this commentary, we recall the important role that obstetrician-gynecologists (ob-gyns) have played, both before and after Roe v. Wade, in facilitating access to safe abortion care. Using the literature on abortion safety and access as a foundation, we propose several practical ideas about what we as ob-gyns can do to address the current threat to abortion access, whether or not we provide abortion services in practice. We hope that this commentary will encourage discourse within our profession and prompt other suggestions. As ob-gyns who are dedicated to addressing health disparities and promoting the health and well-being of our patients, we can make a difference.

  7. Abortion in a Progressive Legal Environment: The Need for Vigilance in Protecting and Promoting Access to Safe Abortion Services in South Africa

    PubMed Central

    Magwentshu, Makgoale

    2013-01-01

    The importance of South Africa as a model for reproductive self-determination in Africa cannot be underestimated. Abortion has been legal since 1996, and the country has some of the most developed government systems for the provision of abortion care on the continent. Yet in the same way opponents of abortion in the United States have whittled away at access with increased bureaucracy, South Africa faces similar assaults that leave women without safe care and threaten to turn back achievements made during the past 16 years. I explore the history of the law, subsequent legal challenges, and new threats to women’s access to abortion services, including service delivery issues that may influence the future of public health in the country. PMID:23327279

  8. Access to safe legal abortion in Malaysia: women's insights and health sector response.

    PubMed

    Low, Wah-Yun; Tong, Wen-Ting; Wong, Yut-Lin; Jegasothy, Ravindran; Choong, Sim-Poey

    2015-01-01

    Malaysia has an abortion law, which permits termination of pregnancy to save a woman's life and to preserve her physical and mental health (Penal Code Section 312, amended in 1989). However, lack of clear interpretation and understanding of the law results in women facing difficulties in accessing abortion information and services. Some health care providers were unaware of the legalities of abortion in Malaysia and influenced by their personal beliefs with regard to provision of abortion services. Accessibility to safer abortion techniques is also an issue. The development of the 2012 Guidelines on Termination of Pregnancy and Guidelines for Management of Sexual and Reproductive Health among Adolescents in Health Clinics by the Ministry of Health, Malaysia, is a step forward toward increasing women's accessibility to safe abortion services in Malaysia. This article provides an account of women's accessibility to abortion in Malaysia and the health sector response in addressing the barriers. © 2014 APJPH.

  9. Awareness of female students attending higher educational institutions toward legalization of safe abortion and associated factors, Harari Region, Eastern Ethiopia: a cross sectional study.

    PubMed

    Geleto, Ayele; Markos, Jote

    2015-03-17

    Unsafe abortion has been recognized as an important public health problem in the world. It accounts for 14% of all maternal deaths in sub-Saharan African countries. In Ethiopia, 32% of all maternal deaths are accounted to unsafe abortion. Taking the problem of unsafe abortion into consideration, the penal code of Ethiopia was amended in 2005, to permit safe abortion under a set of circumstances. However, lack of awareness on the revised penal code is a major barrier that hinders women to seek safe abortion. The aim of this study is to assess awareness of female students attending higher educational institutions toward legalization of safe abortion and associated factors in Harari region, eastern Ethiopia. Institution-based descriptive cross sectional study was conducted among 762 female students who are attending five higher educational institutions in Harari Region. Systematic sampling method was used to identify study participants from randomly selected colleges. Self administered structured questionnaire was used to collect data. Data were entered in to Epi Info version 6.04 and analyzed by SPSS version 17.0 statistical packages. Frequency, percentage and ratio were used to describe variables. Multivariable logistic regression analysis was done to control confounders and odds ratio with 95% confidence interval was used to identify factors associated with awareness of female students to legalization of abortion. 762 study participants completed the survey questionnaire making the response rate 90.2%. Only 272 (35.7%) of the respondents reported that they have good awareness about legalization of safe abortion. Studying other fields than health and medicine [AOR 0.48; 95%CI (0.23, 0.85)], being the only child for their family [AOR 0.28; 95%CI (0.13, 0.86)], having no boy friend [AOR 0.34; 95%CI (0.12, 0.74)], using family planning [AOR 0.50; 95%CI (0.13 and 0.86)], being 25 years or older [AOR 1.64; 95%CI (1.33, 2.80)] were significantly associated with awareness

  10. Safe abortion: WHO technical and policy guidance.

    PubMed

    Cook, R J; Dickens, B M; Horga, M

    2004-07-01

    In 2003, the World Health Organization published its well referenced handbook Safe Abortion: Technical and Policy Guidance for Health Systems to address the estimated almost 20 million induced abortions each year that are unsafe, imposing a burden of approximately 67 thousand deaths annually. It is a global injustice that 95% of unsafe abortions occur in developing countries. The focus of guidance is on abortion procedures that are lawful within the countries in which they occur, noting that in almost all countries, the law permits abortion to save a woman's life. The guidance treats unsafe abortion as a public health challenge, and responds to the problem through strategies concerning improved clinical care for women undergoing procedures, and the appropriate placement of necessary services. Legal and policy considerations are explored, and annexes present guidance to further reading, international consensus documents on safe abortion, and on manual vacuum aspiration and post-abortion contraception.

  11. Legalized abortion: a public health success story.

    PubMed

    Kelly, M

    1999-06-01

    60% of more than 2000 women surveyed by the Picker Institute who underwent induced abortion procedures rated the quality of their care as excellent. Another third reported their care as being either very good or good. The survey also found that the quality of abortion care is comparable to other outpatient surgery. However, the high quality of care women receive from abortion providers is lost in the hostile anti-abortion climate created by threatening protesters outside of clinics and the murder of 7 clinic workers and physicians who performed abortions. Abortion opponents fail to acknowledge that legal abortion is a medical procedure which protects women's health and saves their lives. Before abortion was legalized in the US, countless women were either rendered unable to reproduce or died from abortion-related complications. Efforts to outlaw abortion persist despite it being widely recognized by medical experts as one of the most safe medical procedures currently performed in the US. When state legislatures target abortion providers with unduly strict regulations, abortion becomes prohibitively expensive and difficult to obtain.

  12. The cost of postabortion care and legal abortion in Colombia.

    PubMed

    Prada, Elena; Maddow-Zimet, Isaac; Juarez, Fatima

    2013-09-01

    Although Colombia partially liberalized its abortion law in 2006, many abortions continue to occur outside the law and result in complications. Assessing the costs to the health care system of safe, legal abortions and of treating complications of unsafe, illegal abortions has important policy implications. The Post-Abortion Care Costing Methodology was used to produce estimates of direct and indirect costs of postabortion care and direct costs of legal abortions in Colombia. Data on estimated costs were obtained through structured interviews with key informants at a randomly selected sample of facilities that provide abortion-related care, including 25 public and private secondary and tertiary facilities and five primary-level private facilities that provide specialized reproductive health services. The median direct cost of treating a woman with abortion complications ranged from $44 to $141 (in U.S. dollars), representing an annual direct cost to the health system of about $14 million per year. A legal abortion at a secondary or tertiary facility was costly (medians, $213 and $189, respectively), in part because of the use of dilation and curettage, as well as because of administrative barriers. At specialized facilities, where manual vacuum aspiration and medication abortion are used, the median cost of provision was much lower ($45). Provision of postabortion care and legal abortion services at higher-level facilities results in unnecessarily high health care costs. These costs can be reduced significantly by providing services in a timely fashion at primary-level facilities and by using safe, noninvasive and less costly abortion methods.

  13. Abortion legalized: challenges ahead.

    PubMed

    Singh, M; Jha, R

    2007-01-01

    To see whether advocacy for abortion law and comprehensive abortion care (CAC) sites after legalization of abortion in Nepal is adequate among educated people (above school leaving certificate). 150 participants were assigned randomly who agreed to be in the survey and were given structured questionnaires to find out their perception of abortion and CAC sites. Majority know abortion is legalized and majority have positive attitude about legalization of abortion, however majority are not aware of abortion service in CAC sites and none knew the cost of abortion service. Proper and adequate advocacy of the new abortion law and CAC service is essential.

  14. Rape as a legal indication for abortion: implications and consequences of the medical examination requirement.

    PubMed

    Teklehaimanot, K I; Smith, C Hord

    2004-01-01

    A number of countries adopt abortion laws recognizing rape as a legal ground for access to safe abortion service. As rape is a crime, these abortion laws carry with them criminal and health care elements that in turn result in the involvement of legal and medical expertise. The most common objective of the laws should be providing safe abortion services to women survivors of rape. Depending on purposes of a given abortion law, the laws usually require women to undergo a medical examination to qualify for a legal abortion. Some abortion laws are so vague as to result in uncertainties regarding the steps health personnel must follow in conducting medical examination. Another group of abortion laws do not leave room for regulation and remain too rigid to respond to changing socio-economic circumstances. Still others require medical examination as a prerequisite for abortion. As a result, a number of abortion laws remain on the books. The paper attempts to analyze legal and practical issues related to medical examination in rape cases.

  15. Did Legalized Abortion Lower Crime?

    ERIC Educational Resources Information Center

    Joyce, Ted

    2004-01-01

    Changes in homicide and arrest rates were compared among cohorts born before and after legalization of abortion and those who were unexposed to legalized abortion. It was found that legalized abortion improved the lives of many women as they could avoid unwanted births.

  16. Implementation of legal abortion in Nepal: a model for rapid scale-up of high-quality care

    PubMed Central

    2012-01-01

    Unsafe abortion's significant contribution to maternal mortality and morbidity was a critical factor leading to liberalization of Nepal's restrictive abortion law in 2002. Careful, comprehensive planning among a range of multisectoral stakeholders, led by Nepal's Ministry of Health and Population, enabled the country subsequently to introduce and scale up safe abortion services in a remarkably short timeframe. This paper examines factors that contributed to rapid, successful implementation of legal abortion in this mountainous republic, including deliberate attention to the key areas of policy, health system capacity, equipment and supplies, and information dissemination. Important elements of this successful model of scaling up safe legal abortion include: the pre-existence of postabortion care services, through which health-care providers were already familiar with the main clinical technique for safe abortion; government leadership in coordinating complementary contributions from a wide range of public- and private-sector actors; reliance on public-health evidence in formulating policies governing abortion provision, which led to the embrace of medical abortion and authorization of midlevel providers as key strategies for decentralizing care; and integration of abortion care into existing Safe Motherhood and the broader health system. While challenges remain in ensuring that all Nepali women can readily exercise their legal right to early pregnancy termination, the national safe abortion program has already yielded strong positive results. Nepal's experience making high-quality abortion care widely accessible in a short period of time offers important lessons for other countries seeking to reduce maternal mortality and morbidity from unsafe abortion and to achieve Millennium Development Goals. PMID:22475782

  17. Quality of Care in a Safe-Abortion Hotline in Indonesia: Beyond Harm Reduction.

    PubMed

    Gerdts, Caitlin; Hudaya, Inna

    2016-11-01

    To examine services offered by safe-abortion hotlines in contexts in which abortion is legally restricted and to document the experiences of women contacting a safe-abortion hotline in Indonesia. We analyzed 1829 first-time contacts to a safe-abortion hotline in Indonesia as a part of routine service provision between January 1, 2012 and December 31, 2014. Nearly one third (29.9%) of initial contacts reported their age as between 18 and 24 years, and most (51.2%) reported being unmarried. When asked about their reason for calling the hotline, the majority of initial contacts stated that they were pregnant and not ready to have a child. More than one third reported gestational ages below 12 weeks, and nearly one fifth (18.3%) reported a gestation of 13 weeks or greater. These unique data provide a window of understanding into who contacts safe-abortion hotlines and why, and enable exploration of future directions for research on the role of safe-abortion hotlines in women's access to safe abortion. Public Health Implications. Safe-abortion hotlines should be evaluated not only for reducing harm but also for providing high-quality abortion care.

  18. [Safe illegal abortion would make an important contribution to decreasing maternal mortality and female suffering].

    PubMed

    Kleiverda, G

    2008-03-01

    Unsafe abortion is a major public health concern in many developing countries, contributing to a substantial proportion of maternal deaths. Increased legal access to abortion services is associated with improvement in mortality and morbidity. Safe illegal abortion by means of drugs is another possible way to prevent this unnecessary harm to women. The Dutch government, however, is now proposing legal changes that will diminish the access to medical abortion by general practitioners.

  19. Effects of abortion legalization in Nepal, 2001-2010.

    PubMed

    Henderson, Jillian T; Puri, Mahesh; Blum, Maya; Harper, Cynthia C; Rana, Ashma; Gurung, Geeta; Pradhan, Neelam; Regmi, Kiran; Malla, Kasturi; Sharma, Sudha; Grossman, Daniel; Bajracharya, Lata; Satyal, Indira; Acharya, Shridhar; Lamichhane, Prabhat; Darney, Philip D

    2013-01-01

    Abortion was legalized in Nepal in 2002, following advocacy efforts highlighting high maternal mortality from unsafe abortion. We sought to assess whether legalization led to reductions in the most serious maternal health consequences of unsafe abortion. We conducted retrospective medical chart review of all gynecological cases presenting at four large public referral hospitals in Nepal. For the years 2001-2010, all cases of spontaneous and induced abortion complications were identified, abstracted, and coded to classify cases of serious infection, injury, and systemic complications. We used segmented Poisson and ordinary logistic regression to test for trend and risks of serious complications for three time periods: before implementation (2001-2003), early implementation (2004-2006), and later implementation (2007-2010). 23,493 cases of abortion complications were identified. A significant downward trend in the proportion of serious infection, injury, and systemic complications was observed for the later implementation period, along with a decline in the risk of serious complications (OR 0.7, 95% CI 0.64, 0.85). Reductions in sepsis occurred sooner, during early implementation (OR 0.6, 95% CI 0.47, 0.75). Over the study period, health care use and the population of reproductive aged women increased. Total fertility also declined by nearly half, despite relatively low contraceptive prevalence. Greater numbers of women likely obtained abortions and sought hospital care for complications following legalization, yet we observed a significant decline in the rate of serious abortion morbidity. The liberalization of abortion policy in Nepal has benefited women's health, and likely contributes to falling maternal mortality in the country. The steepest decline was observed after expansion of the safe abortion program to include midlevel providers, second trimester training, and medication abortion, highlighting the importance of concerted efforts to improve access. Other

  20. Debate on the legalization of abortion in Zimbabwe.

    PubMed

    1994-01-01

    In Zimbabwe, where over 70,000 illegal abortions are performed each year and complications from clandestine abortion are a leading cause of maternal mortality, the abortion law debate has been re-opened. Under the present law, abortion is legal only to save the life of the mother and women who undergo illegal abortion face strict criminal sanctions. Timothy Stamps, the Minister of Health and Child Welfare, has stated, "The first rights of a child are to be desired, to be wanted, and to be planned." Dr. Illiff, of the University of Zimbabwe's Department of Obstetrics and Gynecology, has noted, "We cannot stop abortion. The choice is how safe it is." Illiff pointed out that urban Zimbabwe women run a 262 times greater risk of dying of abortion complications than their counterparts in the UK where abortion is legal. As the Women's Action Group has observed, men have dominated the current debate on abortion. The group has issued an appeal to women to enter into this debate that concerns their bodies to ensure that another law is not imposed on them. The group's appeal for action states: "We as Women's Action Group believe that every woman should decide what's right and what's wrong in her life. She and only she should be the master of her destiny. Her voice should be heard louder than anyone else's."

  1. Women's attitudes to safe-induced abortion in Iran: Findings from a pilot survey.

    PubMed

    Aghakhani, Nader; Cleary, Michelle; Zarei, Abbas; Lopez, Violeta

    2018-01-01

    To explore attitudes to safe-induced abortion among pregnant women in Iran. In Islamic teachings, abortion is generally forbidden. However in specific circumstances, abortion may be permitted and currently, in Iran, the law allows termination of pregnancy only if three specialist physicians confirm that the pregnancy outcome may be harmful for the mother during pregnancy or after birth. Pilot, descriptive survey. A 15-item structured questionnaire focusing on attitudes to safe-induced abortion was developed and pilot tested. Participants were pregnant women who were referred to the Legal Medical Centre (July-December 2015) to obtain permission for abortion. On obtaining their informed consent, the women were asked to respond to each item if they agreed (Yes) or disagreed (No). Only their age, education, employment, marital status and religion were obtained. Of the 80 survey participants referred for a safe-induced abortion, 90% were carrying foetuses with a diagnosed congenital malformation and 10% were experiencing complications of pregnancy that endangered their health. The majority of women (85%) perceived abortion to be dangerous to health; 86% indicated that partners should be involved in decision-making about abortion, while 83% believed that public health officials should have complete control of abortion law. There is a need to improve women's and couples' awareness and practice of effective contraceptive methods. Further research is needed to better understand the complex issues that lead to unintended pregnancies and abortions considering religious beliefs and cultural and legal contexts. © 2017 John Wiley & Sons Ltd.

  2. Anti-legal attitude toward abortion among abortion patients in the United States.

    PubMed

    Thomas, Rachel G; Norris, Alison H; Gallo, Maria F

    2017-11-01

    To measure the prevalence of believing that abortion should be illegal in all or most cases among women obtaining an abortion in the United States and to identify correlates of holding this belief. Study population was drawn from the nationally-representative 2008 Abortion Patient Survey. The primary outcome was having an anti-legal abortion attitude, defined as agreeing that abortion should be illegal in all or most cases. We assessed potential correlates in bivariable and multivariable analyses using weights to account for the complex sampling. A total of 4769 abortion patients completed the survey module containing the question on abortion legality, of which 4492 (94.2%) had non-missing data for the outcome. Overall, 4.1% of patients (N=183) reported an anti-legal abortion attitude. Correlates of having anti-legal attitude included being married, at <200% federal poverty level, fundamentalist, contraception non-use, no abortion history, perceiving the pregnancy with ambivalence or as unintended, and using misoprostol or another product on their own to bring back their period or end the pregnancy. Abortion patients who do not believe abortion should be legal appear to differ substantially from women who are more supportive of legality. Findings raise important questions about this subset of patients, including whether possible discordance between patient beliefs and behavior could influence their use of medical abortion or other products. Some abortion patients do not agree with abortion legality, and this subset could experience a degree of cognitive dissonance, which could influence the method by which they seek to abort. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Moving from legality to reality: how medical abortion methods were introduced with implementation science in Zambia.

    PubMed

    Fetters, Tamara; Samandari, Ghazaleh; Djemo, Patrick; Vwallika, Bellington; Mupeta, Stephen

    2017-02-16

    Although abortion is technically legal in Zambia, the reality is far more complicated. This study describes the process and results of galvanizing access to medical abortion where abortion has been legal for many years, but provision severely limited. It highlights the challenges and successes of scaling up abortion care using implementation science to document 2 years of implementation. An intervention between the Ministry of Health, University Teaching Hospital and the international organization Ipas, was established to introduce medical abortion and to address the lack of understanding and implementation of the country's abortion law. An implementation science model was used to evaluate effectiveness and glean lessons for other countries about bringing safe and legal abortion services to scale. The intervention involved the provision of Comprehensive Abortion Care services in 28 public health facilities in Zambia for a 2 year period, August 2009 to September 2011. The study focused on three main areas: building health worker capacity in public facilities and introducing medical abortion, working with pharmacists to provide improved information on medical abortion, and community engagement and mobilization to increase knowledge of abortion services and rights through stronger health system and community partnerships. After 2 years, 25 of 28 sites provided abortion services, caring for more than 13,000 women during the intervention. For the first time, abortion was decentralized, 19% of all abortion care was performed in health centers. At the end of the intervention, all providing facilities had managers supportive of continuing legal abortion services. When asked about the impact of medical abortion provision, a number of providers reported that medical abortion improved their ability to provide affordable safe abortion. In neighboring pharmacies only 19% of mystery clients visiting them were offered misoprostol for purchase at baseline, this increased to 47

  4. Access to safe abortion: progress and challenges since the 1994 International Conference on Population and Development (ICPD).

    PubMed

    Shah, Iqbal H; Åhman, Elisabeth; Ortayli, Nuriye

    2014-12-01

    The 1994 International Conference on Population and Development (ICPD) viewed access to safe abortion as imperative for public health. Globally, the number of induced abortions (safe and unsafe) per 1000 women aged 15-44 years declined from 35 in 1995 to 28 in 2008. The number of deaths due to unsafe abortion declined from 69,000 in 1990 to 47,000 in 2008, as safe and effective methods of abortion, including manual vacuum aspiration and medical abortion, became more widely available. During the same period, there was a slight increase in the number of countries where abortion is permitted on request, and 70 countries made grounds for abortion more liberal. Since ICPD, the decline in unsafe abortion was slower than that in safe abortion, and unsafe-abortion-related mortality continued to be a problem. Nearly all unsafe abortions and mortality occur in developing countries. While more must be done to ensure universal access to safe, acceptable and affordable contraception to reduce the need for abortion, this need will always exist. Information on grounds for safe abortion should be made widely available for women to access services to which they are legally entitled to. As recommended by ICPD, quality postabortion care including contraception counseling and provision should be available to all women, regardless of the legal grounds for abortion. The paper provides the evidence on unsafe abortion, a reproductive health issue that is entirely preventable but has been largely neglected or tarnished by emotional and contentious debates. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Access to safe abortion: building choices for women living with HIV and AIDS

    PubMed Central

    2011-01-01

    In many areas of the world where HIV prevalence is high, rates of unintended pregnancy and unsafe abortion have also been shown to be high. Of all pregnancies worldwide in 2008, 41% were reported as unintended or unplanned, and approximately 50% of these ended in abortion. Of the estimated 21.6 million unsafe abortions occurring worldwide in 2008 (around one in 10 pregnancies), approximately 21.2 million occurred in developing countries, often due to restrictive abortion laws and leading to an estimated 47,000 maternal deaths and untold numbers of women who will suffer long-term health consequences. Despite this context, little research has focused on decisions about and experiences of women living with HIV with regard to terminating a pregnancy, although this should form part of comprehensive promotion of sexual and reproductive health rights. In this paper, we explore the existing evidence related to global and country-specific barriers to safe abortion for all women, with an emphasis on research gaps around the right of women living with HIV to choose safe abortion services as an option for dealing with unwanted pregnancies. The main focus is on the situation for women living with HIV in Brazil, Namibia and South Africa as examples of three countries with different conditions regarding women's access to safe legal abortions: a very restrictive setting, a setting with several indications for legal abortion but non-implementation of the law, and a rather liberal setting. Similarities and differences are discussed, and we further outline global and country-specific barriers to safe abortion for all women, ending with recommendations for policy makers and researchers. PMID:22078463

  6. Safe abortion information hotlines: An effective strategy for increasing women's access to safe abortions in Latin America.

    PubMed

    Drovetta, Raquel Irene

    2015-05-01

    This paper describes the implementation of five Safe Abortion Information Hotlines (SAIH), a strategy developed by feminist collectives in a growing number of countries where abortion is legally restricted and unsafe. These hotlines have a range of goals and take different forms, but they all offer information by telephone to women about how to terminate a pregnancy using misoprostol. The paper is based on a qualitative study carried out in 2012-2014 of the structure, goals and experiences of hotlines in five Latin American countries: Argentina, Chile, Ecuador, Peru and Venezuela. The methodology included participatory observation of activities of the SAIH, and in-depth interviews with feminist activists who offer these services and with 14 women who used information provided by these hotlines to induce their own abortions. The findings are also based on a review of materials obtained from the five hotline collectives involved: documents and reports, social media posts, and details of public demonstrations and statements. These hotlines have had a positive impact on access to safe abortions for women whom they help. Providing these services requires knowledge and information skills, but little infrastructure. They have the potential to reduce the risk to women's health and lives of unsafe abortion, and should be promoted as part of public health policy, not only in Latin America but also other countries. Additionally, they promote women's autonomy and right to decide whether to continue or terminate a pregnancy. Copyright © 2015. Published by Elsevier Ltd.

  7. Evaluation of a multi-pronged intervention to improve access to safe abortion care in two districts in Jharkhand

    PubMed Central

    2014-01-01

    Background Despite the adoption of the Medical Termination of Pregnancy Act in 1972, access to safe abortion services remains limited in India. Awareness of the legality of abortion also remains low, leading many women to seek services outside the health system. Medical abortion (MA) is an option that has the potential to expand access to safe abortion services. A multi-pronged intervention covering a population of 161,000 in 253 villages in the Silli and Khunti blocks of Jharkhand was conducted between 2007 and 2009, seeking to improve medical abortion services and create awareness at the community level by providing information through community intermediaries and creating an enabling environment through a behavior change communication campaign. The study evaluates the changes in knowledge about abortion-related issues, changes in abortion care-seeking, and service utilization as a result of this intervention. Methods A baseline cross-sectional survey was conducted pre-intervention (n = 1,253) followed by an endline survey (n = 1,290) one year after the completion of the intervention phase. In addition, monitoring data from intervention facilities was collected monthly over the study period. Results Nearly 85% of respondents reported being exposed to safe abortion messaging as a result of the intervention. Awareness of the legality of abortion increased significantly from 19.7% to 57.6% for women, as did awareness of the specific conditions for which abortion is allowed. Results were similar for men. There was also a significant increase in the proportion of men and women who knew of a legal and safe provider and place from where abortion services could be obtained. Multivariate analysis showed positive associations between exposure to any component of the intervention and increased knowledge about legality and gestational age limits, however only interpersonal communication was associated with a significant increase in knowledge of where to obtain safe

  8. Evaluation of a multi-pronged intervention to improve access to safe abortion care in two districts in Jharkhand.

    PubMed

    Banerjee, Sushanta K; Andersen, Kathryn L; Baird, Traci L; Ganatra, Bela; Batra, Sangeeta; Warvadekar, Janardan

    2014-05-21

    Despite the adoption of the Medical Termination of Pregnancy Act in 1972, access to safe abortion services remains limited in India. Awareness of the legality of abortion also remains low, leading many women to seek services outside the health system. Medical abortion (MA) is an option that has the potential to expand access to safe abortion services. A multi-pronged intervention covering a population of 161,000 in 253 villages in the Silli and Khunti blocks of Jharkhand was conducted between 2007 and 2009, seeking to improve medical abortion services and create awareness at the community level by providing information through community intermediaries and creating an enabling environment through a behavior change communication campaign. The study evaluates the changes in knowledge about abortion-related issues, changes in abortion care-seeking, and service utilization as a result of this intervention. A baseline cross-sectional survey was conducted pre-intervention (n = 1,253) followed by an endline survey (n = 1,290) one year after the completion of the intervention phase. In addition, monitoring data from intervention facilities was collected monthly over the study period. Nearly 85% of respondents reported being exposed to safe abortion messaging as a result of the intervention. Awareness of the legality of abortion increased significantly from 19.7% to 57.6% for women, as did awareness of the specific conditions for which abortion is allowed. Results were similar for men. There was also a significant increase in the proportion of men and women who knew of a legal and safe provider and place from where abortion services could be obtained. Multivariate analysis showed positive associations between exposure to any component of the intervention and increased knowledge about legality and gestational age limits, however only interpersonal communication was associated with a significant increase in knowledge of where to obtain safe services (OR 4.8, SE 0

  9. Expansion of Safe Abortion Services in Nepal Through Auxiliary Nurse‐Midwife Provision of Medical Abortion, 2011‐2013

    PubMed Central

    Basnett, Indira; Shrestha, Dirgha Raj; Shrestha, Meena Kumari; Shah, Mukta; Aryal, Shilu

    2016-01-01

    Introduction The termination of unwanted pregnancies up to 12 weeks’ gestation became legal in Nepal in 2002. Many interventions have taken place to expand access to comprehensive abortion care services. However, comprehensive abortion care services remain out of reach for women in rural and remote areas. This article describes a training and support strategy to train auxiliary nurse‐midwives (ANMs), already certified as skilled birth attendants, as medical abortion providers and expand geographic access to safe abortion care to the community level in Nepal. Methods This was a descriptive program evaluation. Sites and trainees were selected using standardized assessment tools to determine minimum facility requirements and willingness to provide medical abortion after training. Training was evaluated via posttests and observational checklists. Service statistics were collected through the government's facility logbook for safe abortion services (HMIS‐11). Results By the end of June 2014, medical abortion service had been expanded to 25 districts through 463 listed ANMs at 290 listed primary‐level facilities and served 25,187 women. Providers report a high level of confidence in their medical abortion skills and considerable clinical knowledge and capacity in medical abortion. Discussion The Nepali experience demonstrates that safe induced abortion care can be provided by ANMs, even in remote primary‐level health facilities. Post‐training support for providers is critical in helping ANMs handle potential barriers to medical abortion service provision and build lasting capacity in medical abortion. PMID:26860072

  10. Medical abortion and manual vacuum aspiration for legal abortion protect women's health and reduce costs to the health system: findings from Colombia.

    PubMed

    Rodriguez, Maria Isabel; Mendoza, Willis Simancas; Guerra-Palacio, Camilo; Guzman, Nelson Alvis; Tolosa, Jorge E

    2015-02-01

    The majority of abortions in Colombia continue to take place outside the formal health system under a range of conditions, with the majority of women obtaining misoprostol from a thriving black market for the drug and self-administering the medication. We conducted a cost analysis to compare the costs to the health system of three approaches to the provision of abortion care in Colombia: post-abortion care for complications of unsafe abortions, and for legal abortions in a health facility, misoprostol-only medical abortion and vacuum aspiration abortion. Hospital billing records from three institutions, two large maternity hospitals and one specialist reproductive health clinic, were analysed for procedure and complication rates, and costs by diagnosis. The majority of visits (94%) were to the two hospitals for post-abortion care; the other 6% were for legal abortions. Only one minor complication was found among the women having legal abortions, a complication rate of less than 1%. Among the women presenting for post-abortion care, 5% had complications during their treatment, mainly from infection or haemorrhage. Legal abortions were associated not only with far fewer complications for women, but also lower costs for the health system than for post-abortion care. We calculated based on our findings that for every 1,000 women receiving post-abortion care instead of a legal abortion within the health system, 16 women experienced avoidable complications, and the health system spent US $48,000 managing them. Increasing women's access to safe abortion care would not only reduce complications for women, but would also be a cost-saving strategy for the health system. Copyright © 2015 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  11. Opening a door to safe abortion: international perspectives on medical abortifacient use.

    PubMed

    Pollack, A E; Pine, R N

    2000-01-01

    International experience compels us to revisit how we define and assess the safety and efficacy of medical abortifacients such as misoprostol. In some countries where safe abortion is neither accessible nor legal, even unsupervised, off-protocol use of misoprostol can provide women with a means to safely terminate pregnancy. This is due primarily to misoprostol-induced uterine contractions that cause bleeding, which in turn provides access to existing reasonable quality health services that would otherwise be unavailable. Several studies have suggested that an increase in the underground use of misoprostol in Brazil has already reduced serious complications from unsafe abortion. Thus, the availability of medical abortifacients combined with strengthened postabortion care services can legitimately be considered a public health success in countries in which safe abortion services do not exist and law reform is unlikely.

  12. Effects of Abortion Legalization in Nepal, 2001–2010

    PubMed Central

    Henderson, Jillian T.; Puri, Mahesh; Blum, Maya; Harper, Cynthia C.; Rana, Ashma; Gurung, Geeta; Pradhan, Neelam; Regmi, Kiran; Malla, Kasturi; Sharma, Sudha; Grossman, Daniel; Bajracharya, Lata; Satyal, Indira; Acharya, Shridhar; Lamichhane, Prabhat; Darney, Philip D.

    2013-01-01

    Background Abortion was legalized in Nepal in 2002, following advocacy efforts highlighting high maternal mortality from unsafe abortion. We sought to assess whether legalization led to reductions in the most serious maternal health consequences of unsafe abortion. Methods We conducted retrospective medical chart review of all gynecological cases presenting at four large public referral hospitals in Nepal. For the years 2001–2010, all cases of spontaneous and induced abortion complications were identified, abstracted, and coded to classify cases of serious infection, injury, and systemic complications. We used segmented Poisson and ordinary logistic regression to test for trend and risks of serious complications for three time periods: before implementation (2001–2003), early implementation (2004–2006), and later implementation (2007–2010). Results 23,493 cases of abortion complications were identified. A significant downward trend in the proportion of serious infection, injury, and systemic complications was observed for the later implementation period, along with a decline in the risk of serious complications (OR 0.7, 95% CI 0.64, 0.85). Reductions in sepsis occurred sooner, during early implementation (OR 0.6, 95% CI 0.47, 0.75). Conclusion Over the study period, health care use and the population of reproductive aged women increased. Total fertility also declined by nearly half, despite relatively low contraceptive prevalence. Greater numbers of women likely obtained abortions and sought hospital care for complications following legalization, yet we observed a significant decline in the rate of serious abortion morbidity. The liberalization of abortion policy in Nepal has benefited women’s health, and likely contributes to falling maternal mortality in the country. The steepest decline was observed after expansion of the safe abortion program to include midlevel providers, second trimester training, and medication abortion, highlighting the importance

  13. Eliminating the high abortion related complications and deaths in Cameroon: the restrictive legal atmosphere on abortions is no acceptable excuse.

    PubMed

    Bain, Luchuo Engelbert; Kongnyuy, Eugene Justine

    2018-05-24

    The abortion law in Cameroon is highly restrictive. The law permits induced abortions only when the woman's life is at risk, to preserve her physical and mental health, and on grounds of rape or incest. Unsafe abortions remain rampant with however rare reported cases of persecution, even when these abortions are proven to have been carried out illegally. Available public health interventions are cheap and feasible (Misoprostol and Manual Vacuum Aspiration in post abortion care, modern contraception, post-abortion counseling), and must be implemented to reduce unacceptably high maternal mortality rates in the country which still stand at as high as 596/100.000. Changes in the legal status of abortions might take a long time to come by. Albeit, advocacy efforts must be reinforced to render the law more liberal to permit women to seek safe abortion services. The frequency of abortions, generally clandestine, in this restrictive legal atmosphere has adverse economic, health and social justice implications. We argue that a non-optimal or restrictive legal atmosphere is not an acceptable excuse to justify these high maternal deaths resulting from unsafe abortions, especially in Cameroon where unsafe abortions remain rampant. Implementing currently available, cheap and effective evidence based practice guidelines are possible in the country. Expansion and use of Manual Vacuum Aspiration kits in health care facilities, post-abortion misoprostol and carefully considering the content of post abortion counseling packages deserve keen attention. More large scale qualitative and quantitative studies nationwide to identify and act on context specific barriers to contraception use and abortion related stigma are urgently needed.

  14. [Abortion: towards worldwide legalization].

    PubMed

    1998-09-01

    A table showing the current status of abortion in the world based on two recent and detailed studies is presented. Countries are categorized according to whether they totally prohibit abortion, permit it to save the mother's life, permit it to preserve her physical health or mental health, permit it for maternal socioeconomic reasons, or provide it at the mother's request. The countries are grouped into 5 geographic areas: America and the Caribbean; Central Asia, Middle East, and North Africa; East and South Asia and the Pacific; Europe; sub-Saharan Africa. The trend toward liberalization of laws is clear. The development of abortion laws is moving in the direction of complete legalization, that is, the creation of health norms that facilitate abortion for all women, with guarantees of medical safety. There are still countries that move to restrict access to abortion, and in a few cases, such as Colombia and Poland, legalization and prohibition have alternated depending on the social and political circumstances of the moment. In the past 12 years, 28 countries liberalized their laws in some way, while 4 countries with close ties to the Vatican restricted or prohibited access.

  15. Unsafe abortion: the silent scourge.

    PubMed

    Grimes, David A

    2003-01-01

    An estimated 19 million unsafe abortions occur worldwide each year, resulting in the deaths of about 70,000 women. Legalization of abortion is a necessary but insufficient step toward improving women's health. Without skilled providers, adequate facilities and easy access, the promise of safe, legal abortion will remain unfulfilled, as in India and Zambia. Both suction curettage and pharmacological abortion are safe methods in early pregnancy; sharp curettage is inferior and should be abandoned. For later abortions, either dilation and evacuation or labour induction are appropriate. Hysterotomy should not be used. Timely and appropriate management of complications can reduce morbidity and prevent mortality. Treatment delays are dangerous, regardless of their origin. Misoprostol may reduce the risks of unsafe abortion by providing a safer alternative to traditional clandestine abortion methods. While the debate over abortion will continue, the public health record is settled: safe, legal, accessible abortion improves health.

  16. From unwanted pregnancy to safe abortion: Sharing information about abortion in Asia through animation.

    PubMed

    Krishnan, Shweta; Dalvie, Suchitra

    2015-05-01

    Although unsafe abortion continues to be a leading cause of maternal mortality in many countries in Asia, the right to safe abortion remains highly stigmatized across the region. The Asia Safe Abortion Partnership, a regional network advocating for safe abortion, produced an animated short film entitled From Unwanted Pregnancy to Safe Abortion to show in conferences, schools and meetings in order to share knowledge about the barriers to safe abortion in Asia and to facilitate conversations on the right to safe abortion. This paper describes the making of this film, its objectives, content, dissemination and how it has been used. Our experience highlights the advantages of using animated films in addressing highly politicized and sensitive issues like abortion. Animation helped to create powerful advocacy material that does not homogenize the experiences of women across a diverse region, and at the same time emphasize the need for joint activities that express solidarity. Copyright © 2015. Published by Elsevier Ltd.

  17. Barriers to safe abortion access: uterine rupture as complication of unsafe abortion in a Ugandan girl.

    PubMed

    Olson, Rose McKeon; Kamurari, Solomon

    2017-10-20

    A 15-year-old girl at 18 weeks gestation by the last menstrual period presented to a rural Ugandan healthcare facility for termination of her pregnancy as a result of rape by her uncle. Skilled healthcare workers at the facility refused to provide the abortion due to fear of legal repercussions. The patient subsequently obtained an unsafe abortion by vaginal insertion of local herbs and sharp objects. She developed profuse vaginal bleeding and haemorrhagic shock. She was found to have uterine rupture and emergent hysterectomy was performed. Young and poor women are at high risk of unplanned pregnancy and subsequent mortality during pregnancy and childbirth. Unsafe abortion is a leading and entirely preventable cause of maternal mortality worldwide. Multiple barriers restrict access to safe abortions including social and moral stigma, gender-based power imbalances, inadequate contraceptive use and sexual education, high cost and poor availability, and restrictive abortion laws. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. A review of evidence for safe abortion care.

    PubMed

    Kapp, Nathalie; Whyte, Patti; Tang, Jennifer; Jackson, Emily; Brahmi, Dalia

    2013-09-01

    The provision of safe abortion services to women who need them has the potential to drastically reduce or eliminate maternal deaths due to unsafe abortion. The World Health Organization recently updated its evidence-based guidance for safe and effective clinical practices using data from systematic reviews of the literature. Systematic reviews pertaining to the evidence for safe abortion services, from pre-abortion care, medical and surgical methods of abortion and post-abortion care were evaluated for relevant outcomes, primarily those relating to safety, effectiveness and women's preference. Sixteen systematic reviews were identified and evaluated. The available evidence does not support the use of pre-abortion ultrasound to increase safety. Routine use of cervical preparation with osmotic dilators, mifepristone or misoprostol after 14 weeks gestation reduces complications; at early gestational ages, surgical abortions have very few complications. Prophylactic antibiotics result in lower rates of post-surgical abortion infection. Pain medication such as non-steroidal anti-inflammatories should be offered to women undergoing abortion procedures; acetaminophen, however, is not effective in reducing pain. Women who are eligible should be offered a choice between surgical (vacuum aspiration or dilation and evacuation) and medical methods (mifepristone and misoprostol) of abortion when possible. Modern methods of contraception can be safely initiated immediately following abortion procedures. Evidence-based guidelines assist health care providers and policymakers to utilize the best data available to provide safe abortion care and prevent the millions of deaths and disabilities that result from unsafe abortion. Copyright © 2013 Elsevier Inc. All rights reserved.

  19. Legalized abortion in Japan.

    PubMed

    Hart, T M

    1967-10-01

    The enactment of the Eugenic Protection Act in Japan was followed by many changes. The population explosion was stemmed, the birth rate was halved, and while the marriage rate remained steady the divorce rate declined. The annual total of abortions increased until 1955 and then slowly declined. The highest incidence of abortions in families is in the 30 to 34 age group when there are four children in the family. As elsewhere abortion in advanced stages of pregnancy is associated with high morbidity and mortality. There is little consensus as to the number of criminal abortions. Reasons for criminal abortions can be found in the legal restrictions concerning abortion: Licensing of the abortionist, certification of hospitals, taxation of operations and the requirement that abortion be reported. Other factors are price competition and the patient's desire for secrecy. Contraception is relatively ineffective as a birth control method in Japan. Oral contraceptives are not yet government approved. In 1958 alone 1.1 per cent of married women were sterilized and the incidence of sterilization was increasing.

  20. Maintaining access to safe abortion and reducing sex ratio imbalances in Asia.

    PubMed

    Ganatra, Bela

    2008-05-01

    High sex ratios at birth (108 boys to 100 girls or higher) are seen in China, Taiwan, South Korea and parts of India and Viet Nam. The imbalance is the result of son preference, accentuated by declining fertility. Prenatal sex detection with ultrasound followed by second trimester abortion is one of the ways sex selection manifests itself, but it is not the causative factor. Advocates and governments seeking to reverse this imbalance have largely prohibited sex detection tests and/or sex selective abortion, assuming these measures would reverse the trend. Such policies have been difficult to enforce and have met with only limited success. At the same time, such policies are starting to have adverse effects on the already limited access to safe and legal second trimester abortion for reasons other than sex selection. Moreover, the sex selection issue is being used as a platform for anti-abortion rhetoric by certain groups. Maintaining access to safe abortion and achieving a decline in high sex ratios are both important goals. Both are possible if the focus shifts to addressing the conditions that drive son preference.

  1. "Without this program, women can lose their lives": migrant women's experiences with the Safe Abortion Referral Programme in Chiang Mai, Thailand.

    PubMed

    Tousaw, Ellen; La, Ra Khin; Arnott, Grady; Chinthakanan, Orawee; Foster, Angel M

    2017-11-01

    For displaced and migrant women in northern Thailand, access to health care is often limited, unwanted pregnancy is common, and unsafe abortion is a major contributor to maternal death and disability. Based on a pilot project and situational analysis research, in 2015 a multinational team introduced the Safe Abortion Referral Programme (SARP) in Chiang Mai, Thailand, to reduce the socio-linguistic, economic, documentation, and transportation barriers women from Burma face in accessing safe and legal abortion care in Thailand. Our qualitative study documented the experiences of women with unwanted pregnancies who accessed the SARP in order to inform programme improvement and expansion. We conducted 22 in-depth, in-person interviews and analysed them for content and themes using deductive and inductive techniques. Women were overwhelmingly positive about their experiences using the SARP. They reported lack of costs, friendly programme staff, accompaniment to and interpretation at the providing facility, and safety of services as key features. Financial and legal circumstances shaped access to the programme and women learned about the SARP through word-of-mouth and community workshops. After accessing the SARP and receiving support, women became community advocates for reproductive health. Efforts to expand the programme and raise awareness in migrant communities appear warranted. Our findings suggest that referral programmes for safe and legal abortion can be successful in settings with large displaced and migrant populations. Identifying ways to work within legal constraints to expand access to safe services has the potential to reduce harm from unsafe abortion even in humanitarian settings.

  2. [Legal secrecy: abortion in Puerto Rico from 1937 to 1970].

    PubMed

    Marchand-Arias, R E

    1998-03-01

    The essay discusses abortion in Puerto Rico from 1937 to 1970, concentrating in its legal status as well as its social practice. The research documents the contradictions between the legality of the procedure and a social practice characterized by secrecy. The essay discusses the role of the Clergy Consultation Service on Abortion in promoting the legal practice of absortion in Puerto Rico. It also discusses the ambivalent role of medical doctors who, despite being legally authorized to perform abortions to protect the life and health of women, refused to perform the procedure arguing abortion was illegal. The essay concludes with a brief discussion on perceptions of illegality regarding abortion, emphasizing the contradictions between the practice of abortion and that of sterilization in Puerto Rico.

  3. The impact of a liberalisation law on legally induced abortion hospitalisations.

    PubMed

    Gonçalves-Pinho, Manuel; Santos, João V; Costa, Antónia; Costa-Pereira, Altamiro; Freitas, Alberto

    2016-08-01

    Legal abortion based purely in maternal option without fetal/maternal pathology was liberalised in Portugal in 2007 and since then abortion rates have increased substantially. The aim of this paper was to study the impact of the liberalisation of abortion by maternal request on total legal abortion related hospitalisation trends. We considered hospitalisations of legal abortion (ICD-9-CM codes 635.x) with discharges from 2000 to 2014. Data was obtained from a Portuguese administrative database, which contains all registered public hospitalisations in mainland Portugal. Performed legal abortions during the same period were obtained from INE (National Statistics Institute). Hospitalisations per abortion were calculated by dividing the number of legal abortions hospitalisations per the number of legal abortions, mean ages, number of hospitalisations per age group, complications, admission type and length of stay were also analysed, throughout the study period. Hospitalisations rose during the study period, (from 618 episodes in 2000 to 1,259 in 2014, with a peak of 1,603 in 2010). Since the liberalisation law was passed there was a significant decrease in the number of hospitalisations per abortion: from 1.07 in 2000 to 0.11 in 2014 (p<0.001). Furthermore, the mean age maintained stable since liberalisation (30.8 years before 2007 and 31.0 after). Abortion related hospitalisations are more frequent in women aged 25-39. A significant decrease from the emergent to the scheduled type of admission occurred from 2000 to 2014 (from 83.5% to 56.7% of emergent admissions) (p<0.001). Complications remained stable between 2000 and 2014 and delayed or excessive haemorrhage was the most frequent (4.6%). Since the liberalisation, hospitalisations per abortion have decreased, reflecting the major impact that the liberalisation of legal abortion by maternal request had on abortion trends nationwide. Before the liberalisation, each abortion led to approximately one hospitalisation

  4. [Legal abortion in an Indian state].

    PubMed

    Baskara, N; Kanbargi, R

    1978-01-01

    The number of abortions in India increased steadily since 1972, the year in which it was legalized. This study examines the characteristics of abortion seekers in the state of Karnataka, which has a population of 29.3 million inhabitants. Data analyzed are about 8073 abortions done in the 35 hospitals authorized to perform the procedure; most of them are state hospitals, and some are private. In 1972 there were 721 abortions, compared to 5544 in 1974. 80% of these were performed in only 12 of the 35 hospitals. In average there were 13-14 abortions a month/hospital, and 8 abortions per doctor qualified to perform it. The majority of abortion seekers were between 30-34 in 1972, but between 25-29 in the following years; 92% were married; 46% had parity over 3, and 37% parity over 4. 84% were Hindu, 7% Muslim, and 9% Christian. Data suggested that the number of illiterate women seeking abortion is increasing. 84% of abortions were performed during the first trimester of pregnancy, mostly by curettage and vacuum aspiration. 13% were second trimester abortions done by saline solution or hysterotomy. The percentage of women accepting contraception after abortion was 33% in 1972 and only 36% in 1974. Tubal ligation seemed to be the preferred method, followed by insertion of IUD. There are still relatively few legal abortions performed in Karnataka; this is due partly to the fact that most hospitals are located in urban areas, and that it can be extremely difficult for a woman living in the countryside to reach it.

  5. Roundtable: Legal Abortion

    ERIC Educational Resources Information Center

    Guttmacher, Alan F.; And Others

    1971-01-01

    A roundtable discussion on legal abortion includes Dr. Alan F. Guttmacher, President of The Planned Parenthood Federation of America, Robert Hall, Associate Professor of Obstetrics and Gynecology at Columbia University College of Physicians and Surgeons, Christopher Tietze, a diretor of The Population Council, and Harriet Pilpel, a lawyer.…

  6. Legalization of abortion doubtful in Italy.

    PubMed

    1973-09-03

    A proposal to legalize abortion has been presented to the Italian parliament by Representative Loris Fortuna. Thus far, the bill has the whole-hearted support of only the Radical Party. The Vatican has already voiced its strong opposition to this legislation. "The proposal to legalize abortion, even in certain circumstances, must inevitably be met with resistance and refusal," said Father Concetti, the Vatican representative. Professor Emanuele Lauricella, secretary of the Italian Obstetrics and Gynecology Society, on the other hand, claimed that abortion should be permitted, not only when an immediate danger to the mother's life exists, but also when there are other, simpler health risks. The passage of the bill in the near future, however, is very doubtful.

  7. Legal abortion services in Brazil--a national study.

    PubMed

    Madeiro, Alberto Pereira; Diniz, Debora

    2016-02-01

    This article presents the results of a mixed methods study of 68 legal abortion services in Brazil. The services were analyzed in two stages. The first stage was a census, in which all the institutions were sent an electronic questionnaire about the organization of the legal abortion services. The second stage was conducted in a sample of 5 reference services, one for each region of the country. In this stage, a form was used to collect data about the women and the abortions in the medical records, and 82 interviews with health professionals were conducted. Thirty-seven of the services informed they performed legal abortions, and the services were inactive in 7 states. Police reports, forensic reports, and court orders were required by 14%, 8% and 8% of the services, respectively. Women who underwent abortions were predominantly aged 15-29, single and Catholic. Most abortions were performed until 14 weeks in the case of rape-related pregnancy, by means of manual vacuum aspiration. According to the health professionals, the main difficulties faced in the services are the low availability of physicians to perform abortions and the insufficient training of the staff. The data reveal a discrepancy between the legal provision and the reality of the services. The implementation of more services and the strengthening of the existing services available are necessary.

  8. Abortion in Iranian legal system: a review.

    PubMed

    Abbasi, Mahmoud; Shamsi Gooshki, Ehsan; Allahbedashti, Neda

    2014-02-01

    Abortion traditionally means, "to miscarry" and is still known as a problem which societies has been trying to reduce its rate by using legal means. Despite the pregnant women and fetuses have being historically supported; abortion was firstly criminalized in 1926 in Iran, 20 years after establishment of modern legal system. During next 53 years this situation changed dramatically, so in 1979, the time of Islamic Revolution, aborting fetuses before 12 weeks and therapeutic abortion (TA) during all the pregnancy length was legitimate, based on regulations that used medical justification. After 1979 the situation changed into a totally conservative and restrictive approach and new Islamic concepts as "Blood Money" and "Ensoulment" entered the legal debates around abortion. During the next 33 years, again a trend of decriminalization for the act of abortion has been continuing. Reduction of punishments and omitting retaliation for criminal abortions, recognizing fetal and maternal medical indications including some immunologic problems as legitimate reasons for aborting fetuses before 4 months and omitting the fathers' consent as a necessary condition for TA are among these changes. The start point for this decriminalization process was public and professional need, which was responded by religious government, firstly by issuing juristic rulings (Fatwas) as a non-official way, followed by ratification of "Therapeutic Abortion Act" (TAA) and other regulations as an official pathway. Here, we have reviewed this trend of decriminalization, the role of public and professional request in initiating such process and the rule-based language of TAA.

  9. "Sometimes they used to whisper in our ears": health care workers' perceptions of the effects of abortion legalization in Nepal.

    PubMed

    Puri, Mahesh; Lamichhane, Prabhat; Harken, Tabetha; Blum, Maya; Harper, Cynthia C; Darney, Philip D; Henderson, Jillian T

    2012-04-20

    Unsafe abortion has been a significant cause of maternal morbidity and mortality in Nepal. Since legalization in 2002, more than 1,200 providers have been trained and 487 sites have been certified for the provision of safe abortion services. Little is known about health care workers' views on abortion legalization, such as their perceptions of women seeking abortion and the implications of legalization for abortion-related health care. To complement a quantitative study of the health effects of abortion legalization in Nepal, we conducted 35 in-depth interviews with physicians, nurses, counsellors and hospital administrators involved in abortion care and post-abortion complication treatment services at four major government hospitals. Thematic analysis techniques were used to analyze the data. Overall, participants had positive views of abortion legalization - many believed the severity of abortion complications had declined, contributing to lower maternal mortality and morbidity in the country. A number of participants indicated that the proportion of women obtaining abortion services from approved health facilities was increasing; however, others noted an increase in the number of women using unregulated medicines for abortion, contributing to rising complications. Some providers held negative judgments about abortion patients, including their reasons for abortion. Unmarried women were subject to especially strong negative perceptions. A few of the health workers felt that the law change was encouraging unmarried sexual activity and carelessness around pregnancy prevention and abortion, and that repeat abortion was becoming a problem. Many providers believed that although patients were less fearful than before legalization, they remained hesitant to disclose a history of induced abortion for fear of judgment or mistreatment. Providers were generally positive about the implications of abortion legalization for the country and for women. A focus on family planning

  10. “Sometimes they used to whisper in our ears”: health care workers’ perceptions of the effects of abortion legalization in Nepal

    PubMed Central

    2012-01-01

    Background Unsafe abortion has been a significant cause of maternal morbidity and mortality in Nepal. Since legalization in 2002, more than 1,200 providers have been trained and 487 sites have been certified for the provision of safe abortion services. Little is known about health care workers’ views on abortion legalization, such as their perceptions of women seeking abortion and the implications of legalization for abortion-related health care. Methods To complement a quantitative study of the health effects of abortion legalization in Nepal, we conducted 35 in-depth interviews with physicians, nurses, counsellors and hospital administrators involved in abortion care and post-abortion complication treatment services at four major government hospitals. Thematic analysis techniques were used to analyze the data. Results Overall, participants had positive views of abortion legalization – many believed the severity of abortion complications had declined, contributing to lower maternal mortality and morbidity in the country. A number of participants indicated that the proportion of women obtaining abortion services from approved health facilities was increasing; however, others noted an increase in the number of women using unregulated medicines for abortion, contributing to rising complications. Some providers held negative judgments about abortion patients, including their reasons for abortion. Unmarried women were subject to especially strong negative perceptions. A few of the health workers felt that the law change was encouraging unmarried sexual activity and carelessness around pregnancy prevention and abortion, and that repeat abortion was becoming a problem. Many providers believed that although patients were less fearful than before legalization, they remained hesitant to disclose a history of induced abortion for fear of judgment or mistreatment. Conclusions Providers were generally positive about the implications of abortion legalization for the country

  11. Legal abortion in Peru: knowledge, attitudes and practices among a group of physician leaders.

    PubMed

    Pace, Lydia; Grossman, Daniel; Chávez, Susana; Távara, Luis; Lara, Diana; Guerrero-Vásquez, Rossina

    2006-01-01

    We sought to examine knowledge, attitudes and practices regarding legal abortion among a group of Peruvian physicians. A pre-conference survey was mailed to Peruvian physicians invited to a workshop on legal abortion. A post-conference survey was distributed following the event. Eighty-six percent of 35 respondents correctly indicated that abortion is legal in Peru when a pregnancy endangers a woman's life while less than 50% knew it is also legal when necessary to protect a woman's health. Knowledge about abortion techniques was lower for induced abortion than for management of incomplete abortions. Dilation and curettage was used more frequently than manual vacuum aspiration and medications. Half of physicians reported having performed a legal abortion. The vast majority of physicians surveyed thought legal indications for abortion should be expanded to include cases of rape or fetal malformations. Most considered their abortion training to be inadequate. They identified lack of training and administrative and professional support as barriers to legal abortion provision. Physicians surveyed were willing to provide legal abortions but lacked the knowledge, skills, and support to do so. Improved training of health professionals, increasing institutional support, and developing administrative and legal procedures to guide management of women seeking abortions could increase women's access to legal abortion services and diminish the occurrence of unsafe abortion in Peru.

  12. Why don't humanitarian organizations provide safe abortion services?

    PubMed

    McGinn, Therese; Casey, Sara E

    2016-01-01

    Although sexual and reproductive health services have become more available in humanitarian settings over the last decade, safe abortion services are still rarely provided. The authors' observations suggest that four reasons are typically given for this gap: 'There's no need'; 'Abortion is too complicated to provide in crises'; 'Donors don't fund abortion services'; and 'Abortion is illegal'. However, each of these reasons is based on false premises. Unsafe abortion is a major cause of maternal mortality globally, and the collapse of health systems in crises suggests it likely increases in humanitarian settings. Abortion procedures can be safely performed in health centers by mid-level providers without sophisticated equipment or supplies. Although US government aid does not fund abortion-related activities, other donors, including many European governments, do fund abortion services. In most countries, covering 99 % of the world's population, abortion is permitted under some circumstances; it is illegal without exception in only six countries. International law supports improved access to safe abortion. As none of the reasons often cited for not providing these services is valid, it is the responsibility of humanitarian NGOs to decide where they stand regarding their commitment to humanitarian standards and women's right to high quality and non-discriminatory health services. Providing safe abortion to women who become pregnant as a result of rape in war may be a more comfortable place for organizations to begin the discussion. Making safe abortion available will improve women's health and human rights and save lives.

  13. Abortion Legalization and Childbearing in Mexico.

    PubMed

    Gutiérrez Vázquez, Edith Y; Parrado, Emilio A

    2016-06-01

    In 2007 abortion was legalized in the Federal District of Mexico, making it the largest jurisdiction in Latin America, outside of Cuba, to allow women to have abortions on request during the first trimester of pregnancy. While the implications of the law for women's health and maternal mortality have been investigated, its potential association with fertility behavior has yet to be assessed. We examine metropolitan-area differences in overall and parity-specific childbearing, as well as the age pattern of childbearing between 2000 and 2010 to identify the contribution of abortion legalization to fertility in Mexico. Our statistical specification applies difference-in-difference regression methods that control for concomitant changes in other socioeconomic predictors of fertility to assess the differential influence of the law across age groups. In addition, we account for prior fertility levels and change to better separate the effect of the law from preceding trends. Overall, the evidence suggests a systematic association between abortion legalization and fertility. The law appears to have contributed to lower fertility in Mexico City compared to other metropolitan areas and prior trends. The influence is mostly visible among women aged 20-34 in connection with the transition to first and second child, with limited impact on teenage fertility. There is some evidence that its effect might be diffusing to the Greater Mexico City Metropolitan area. © 2016 The Population Council, Inc.

  14. [Legal and illegal abortion in Switzerland].

    PubMed

    Stamm, H

    1970-01-01

    Aspects of legal and illegal abortion in Switzerland are discussed. About 110,000 births, 25,000 therapeutic abortions (75% for psychiatric indications) and an estimated 50,000 illegal abortions occur annually in Switzerland. Although the mortality and morbidity of therapeutic aborti on are similar to those of normal births (1.4 per 1000 and 11%, respectively) the mortality and morbidity of criminal abortions are far greater (3 per 1000 and 73%, respectively). In the author's view, too strict an interpretatiok of Swiss abortion law (which permits abortion to avoid serious harm to the mother's health) does not take into account the severe and lasting emotional and psychological damage which may be caused by unwanted pregnancy, birth, and childraising. In the present social situation, the social and psychological support required by these women is not available; until it is, abortion is to be preferred.

  15. [Abortion and rights. Legal thinking about abortion].

    PubMed

    Perez Duarte, A E

    1991-01-01

    countries with decriminalization of abortion should also be assessed. Factors considered should include the true impunity of abortion, public health problems and socioeconomic problems generated by the state through criminalization of abortion, and the psychological and economic implications for women of the criminal status of abortion. Systems of decriminalization should be examined to decide which would be appropriate for Mexico. These systems include authorizing complete freedom of choice for the 1st trimester and permitting abortion only for specific indications. All penal codes in Mexico now use the system of abortion for specific indications. Few cases are accepted for legal pregnancy termination.

  16. A comparative study of induced abortions before and after legalization of abortions.

    PubMed

    Malhotra, S; Devi, P K

    1979-06-01

    Abortion was legalized in many states in India in April 1972. This study deals with 2 groups of patients admitted to P.G.I., Chadigarh, with problems of induced septic abortion. Group 1 consisted of 88 patients admitted during the 2 1/2 year period from 1 July 1969 to 31 December 1971, before the legalization of abortion. Group 2 consists of 133 patients admitted during the 2 1/2 year period from 1 July 1973 to 31 December 1975. 1 year after the new abortion law had been in force. Not only has there been an increase in the total number of patients, there has been an increase in the severity of infection. Evidently, the liberalization of the law has encouraged more patients to seek abortions and has encouraged more doctors, lacking proper qualifications, to perform them. The morbidity and mortality with induced septic abortion can only be reduced if enough public propaganda makes the people especially in rural areas conscious of the hazards of induced abortion by "dais" and unqualified personnel, simultaneously making them aware of the provision of law and facilities available at different centers. Meanwhile, the law against unskilled and untrained personnel should be rigorously enforced.

  17. The effect of abortion legalization on sexual behavior: evidence from sexually transmitted diseases.

    PubMed

    Klick, Jonathan; Stratmann, Thomas

    2003-06-01

    Unwanted pregnancy represents a major cost of sexual activity. When abortion was legalized in a number of states in 1969 and 1970 (and nationally in 1973), this cost was reduced. We predict that abortion legalization generated incentives leading to an increase in sexual activity, accompanied by an increase in sexually transmitted diseases (STDs). Using Centers for Disease Control data on the incidence of gonorrhea and syphilis by state, we test the hypothesis that abortion legalization led to an increase in sexually transmitted diseases. We find that gonorrhea and syphilis incidences are significantly and positively correlated with abortion legalization. Further, we find a divergence in STD rates among early legalizing states and late legalizing states starting in 1970 and a subsequent convergence after the Roe v. Wade decision, indicating that the relation between STDs and abortion is casual. Abortion legalization accounts for about one-fourth of the average disease incidence.

  18. The World Health Organization's safe abortion guidance document.

    PubMed

    Van Look, Paul F A; Cottingham, Jane

    2013-04-01

    We discuss the history of the World Health Organization's (WHO's) development of guidelines for governments on providing safe abortion services, which WHO published as Safe Abortion: Technical and Policy Guidance for Health Systems in 2003 and updated in 2012. We show how the recognition of the devastating impact of unsafe abortion on women's health and survival, the impetus of the International Conference on Population and Development and its five-year follow-up, and WHO's progressive leadership at the end of the century enabled the organization to elaborate guidance on providing safe abortion services. Guideline formulation involved extensive review of published evidence, an international technical expert meeting to review the draft document, and a protracted in-house review by senior WHO management.

  19. Abortion Incidence and Unintended Pregnancy in Nepal.

    PubMed

    Puri, Mahesh; Singh, Susheela; Sundaram, Aparna; Hussain, Rubina; Tamang, Anand; Crowell, Marjorie

    2016-12-01

    Although abortion has been legal under broad criteria in Nepal since 2002, a significant proportion of women continue to obtain illegal, unsafe abortions, and no national estimates exist of the incidence of safe and unsafe abortions. Data were collected in 2014 from a nationally representative sample of 386 facilities that provide legal abortions or postabortion care and a survey of 134 health professionals knowledgeable about abortion service provision. Facility caseloads and indirect estimation techniques were used to calculate the national and regional incidence of legal and illegal abortion. National and regional levels of abortion complications and unintended pregnancy were also estimated. In 2014, women in Nepal had 323,100 abortions, of which 137,000 were legal, and 63,200 women were treated for abortion complications. The abortion rate was 42 per 1,000 women aged 15-49, and the abortion ratio was 56 per 100 live births. The abortion rate in the Central region (59 per 1,000) was substantially higher than the national average. Overall, 50% of pregnancies were unintended, and the unintended pregnancy rate was 68 per 1,000 women of reproductive age. Despite legalization of abortion and expansion of services in Nepal, unsafe abortion is still common and exacts a heavy toll on women. Programs and policies to reduce rates of unintended pregnancy and unsafe abortion, increase access to high-quality contraceptive care and expand safe abortion services are warranted.

  20. Abortion Incidence and Unintended Pregnancy in Nepal

    PubMed Central

    Puri, Mahesh; Singh, Susheela; Sundaram, Aparna; Hussain, Rubina; Tamang, Anand; Crowell, Marjorie

    2017-01-01

    CONTEXT Although abortion has been legal under broad criteria in Nepal since 2002, a significant proportion of women continue to obtain illegal, unsafe abortions, and no national estimates exist of the incidence of safe and unsafe abortions. METHODS Data were collected in 2014 from a nationally representative sample of 386 facilities that provide legal abortions or postabortion care and a survey of 134 health professionals knowledgeable about abortion service provision. Facility caseloads and indirect estimation techniques were used to calculate the national and regional incidence of legal and illegal abortion. National and regional levels of abortion complications and unintended pregnancy were also estimated. RESULTS In 2014, women in Nepal had 323,100 abortions, of which 137,000 were legal, and 63,200 women were treated for abortion complications. The abortion rate was 42 per 1,000 women aged 15–49, and the abortion ratio was 56 per 100 live births. The abortion rate in the Central region (59 per 1,000) was substantially higher than the national average. Overall, 50% of pregnancies were unintended, and the unintended pregnancy rate was 68 per 1,000 women of reproductive age. CONCLUSIONS Despite legalization of abortion and expansion of services in Nepal, unsafe abortion is still common and exacts a heavy toll on women. Programs and policies to reduce rates of unintended pregnancy and unsafe abortion, increase access to high-quality contraceptive care and expand safe abortion services are warranted. PMID:28825899

  1. Access to safe and legal abortion for teenage women from deprived backgrounds in Hong Kong.

    PubMed

    Hung, Suet Lin

    2010-11-01

    This paper reports on a qualitative study in 2007-08 on the abortion experiences of teenage women from deprived backgrounds in Hong Kong. Twenty-nine young women aged 13-24 who had undergone one or more induced abortions in their teen years were interviewed and participated in group empowerment sessions. Ten were unemployed, four were students, the rest were employed on low pay in unskilled occupations. Abortion services are legal and available in public and private services, but they charge fees ranging from HK$310 to $10,000, and do abortions only up to 24 weeks of pregnancy. Many young women resort to poor quality illegal clinics and clinics in mainland China because the cost is lower, they do not wish to tell their parents, who would be asked for consent, and/or they want to protect their sex partners, who may be reported and prosecuted if the girl is under-age. There is a need to strengthen services for teenage women in Hong Kong, especially those who are pregnant and from deprived backgrounds. There is also a need for professionals who deliver adolescent health and social welfare services, and for society to rethink and re-examine its views and attitudes towards teenage pregnancy, sexuality and abortion. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  2. [Abortion in Colombia. Medical, legal and socioeconomic aspects].

    PubMed

    Umaña, A O

    1973-01-01

    Abortion is a social problem and criminal sanctions are very ineffective in limiting it and are seldom applied (133 legal actions vs. 65,600 cases of induced abortion in 1965). Abortion is a social disease, as are prostitution, juvenile delinquency, drug abuse, and so far has been an insoluble problem. Colombian laws should be modified to reflect reality. Sex education must be emphasized, because ignorance is one of the main causes of abortion. Leniency should be applied toward women who cooperate with the authorities in identifying the person who performed an abortion. Legalization of abortion and enforcement of strict laws against it are considered as possible solutions, but both are rejected. The former is regarded as morally unacceptable and as imposing an excessive burden on scarce health services, the latter as even worse, imposing an equivalent burden on the court system, without s olving either health or social problems. The best and probably only solution is to improve education in family planning, to promote knowledge and motivation to enable the population to make sound and responsible decisions.

  3. Abortion in Islamic countries--legal and religious aspects.

    PubMed

    Asman, Oren

    2004-01-01

    The debate over abortion is still controversial as ever. As one of every four people in the world is of the Muslim religion, it is important to learn more about the Islamic point of view toward this dilemma in medical ethics. The first part of this paper gives a general view of the sources of Islamic law and discusses modern developments in Islamic medical ethics regarding abortion. The second part focuses on the legal aspects of abortion in different Islamic states, dealing with the need to supply solutions to women who for different reasons wish to abort and at the same time enact laws that would not contradict Islamic principles. A study of three Muslim states (Egypt, Kuwait and Tunisia) demonstrates three different approaches toward legalizing abortion--a conservative approach, a more lenient approach, and a liberal one--all within Islamic oriented states. This leads to a conclusion that a more liberal attitude regarding abortion is possible in Islamic states, as long as traditional principles are taken into account.

  4. Abortion Legalization and Life-Cycle Fertility

    ERIC Educational Resources Information Center

    Ananat, Elizabeth Oltmans; Gruber, Jonathan; Levine, Phillip

    2007-01-01

    The early-1970s abortion legalization led to a significant drop in fertility. We investigate whether this decline represented a delay in births or a permanent reduction in fertility. We combine Census and Vital Statistics data to compare the lifetime fertility of women born in early-legalizing states, whose peak childbearing years occurred in the…

  5. Restricted access to abortion in the Republic of Ireland and Northern Ireland: exploring abortion tourism and barriers to legal reform.

    PubMed

    Bloomer, Fiona; O'Dowd, Kellie

    2014-01-01

    Access to abortion remains a controversial issue worldwide. In Ireland, both north and south, legal restrictions have resulted in thousands of women travelling to England and Wales and further afield to obtain abortions in the last decade alone, while others purchase the 'abortion pill' from Internet sources. This paper considers the socio-legal context in both jurisdictions, the data on those travelling to access abortion and the barriers to legal reform. It argues that moral conservatism in Ireland, north and south, has contributed to the restricted access to abortion, impacting on the experience of thousands of women, resulting in these individuals becoming 'abortion tourists'.

  6. Abortion legalization and childbearing in Mexico1

    PubMed Central

    Gutierrez Vazquez, Edith Y.; Parrado, Emilio A.

    2016-01-01

    In 2007 abortion was legalized in the Federal District of Mexico, making the largest jurisdiction in Latin America, outside of Cuba, to allow women to have abortions on request during the first trimester of pregnancy. While the implications of the law for women's health and maternal mortality have been investigated, its potential association with fertility behavior has yet to be assessed. In this paper, we examine metropolitan area differences in overall and parity-specific, as well as the age pattern of childbearing between 2000 and 2010 to more precisely isolate the contribution of abortion legalization to fertility in Mexico. Our statistical specification applies difference-in-difference regression methods that control for concomitant changes in other socioeconomic predictors of fertility to assess the differential influence of the law across age groups. In addition, we account for prior fertility levels and change to better separate the effect of the law from preceding trends. Overall, the evidence suggests a systematic association between abortion legalization and fertility. The law appears to have contributed to lower fertility in Mexico City compared to other metropolitan areas and prior trends, though the influence is mostly visible among women aged 20-34 in connection with the transition to first and second child with limited impact on teenage fertility. There is some evidence that its effect might be diffusing to the greater Mexico City metropolitan area. PMID:27285423

  7. ‘This Is Real Misery’: Experiences of Women Denied Legal Abortion in Tunisia

    PubMed Central

    Hajri, Selma; Raifman, Sarah; Gerdts, Caitlin; Baum, Sarah; Foster, Diana Greene

    2015-01-01

    Barriers to accessing legal abortion services in Tunisia are increasing, despite a liberal abortion law, and women are often denied wanted legal abortion services. In this paper, we seek to explore the reasons for abortion denial and whether these reasons had a legal or medical basis. We also identify barriers women faced in accessing abortion and make recommendations for improved access to quality abortion care. We recruited women immediately after they had been turned away from legal abortion services at two facilities in Tunis, Tunisia. Thirteen women consented to participate in qualitative interviews two months after they were turned away from the facility. Women were denied abortion care on the day they were recruited due to three main reasons: gestational age, health conditions, and logistical barriers. Nine women ultimately terminated their pregnancies at another facility, and four women carried to term. None of the women attempted illegal abortion services or self-induction. Further research is needed in order to assess abortion denial from the perspective of providers and medical staff. PMID:26684189

  8. Hong Kong: population: legalized abortion.

    PubMed

    Abortion was legalized in Hong Kong on February 17 when the Legislative Council, by a vote of 40 to 7, approved the controversial abortion bill. Passage of the measure immediately drew a reaction from Catholic Bishop John Baptist Wu who denounced it as against the principles of human rights. He said that unborn children, regardless of whether or not they had a suspected handicap, have the right to live. He said that: "If we ignore or deny this right, we discriminate against the weak and the helpless. Such discrimination against unborn children threatens our own humanity." Under the law, abortion is virtually allowed on demand for girls under 16 years old. It also permits abortion if 2 doctors render an opinion that the unborn child might be seriously handicapped. Prior to the enactment of the abortion law, termination of pregnancy was allowed in the Colony only if 2 doctors certified that a woman would risk serious injury or her life by continuing the pregnancy. In approving the legislation, the Council said abortion could also be available for victims of rape or incest, provided the offense is reported to the police within 3 months and there are medical grounds for an abortion. It stressed that the law will not permit termination of any pregnancy when it exceeds 24 weeks' duration.

  9. Characteristics of private abortion services in Mexico City after legalization.

    PubMed

    Schiavon, Raffaela; Collado, Maria Elena; Troncoso, Erika; Soto Sánchez, José Ezequiel; Zorrilla, Gabriela Otero; Palermo, Tia

    2010-11-01

    In 2007, first trimester abortion was legalized in Mexico City, and the public sector rapidly expanded its abortion services. In 2008, to obtain information on the effect of the law on private sector abortion services, we interviewed 135 physicians working in private clinics, located through an exhaustive search. A large majority of the clinics offered a range of reproductive health services, including abortions. Over 70% still used dilatation and curettage (D&C); less than a third offered vacuum aspiration or medical abortion. The average number of abortions per facility was only three per month; few reported more than 10 abortions monthly. More than 90% said they had been offering abortion services for less than 20 months. Many women are still accessing abortion services privately, despite the availability of free or low-cost services at public facilities. However, the continuing use of D&C, high fees (mean of $157-505), poor pain management practices, unnecessary use of ultrasound, general anaesthesia and overnight stays, indicate that private sector abortion services are expensive and far from optimal. Now that abortions are legal, these results highlight the need for private abortion providers to be trained in recommended abortion methods and quality of private abortion care improved. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  10. Patient characteristics and service trends following abortion legalization in Mexico City, 2007-10.

    PubMed

    Mondragón y Kalb, Manuel; Ahued Ortega, Armando; Morales Velazquez, Jorge; Díaz Olavarrieta, Claudia; Valencia Rodríguez, Jorge; Becker, Davida; García, Sandra G

    2011-09-01

    Legal abortion services have been available in public and private health facilities in Mexico City since April 2007 for pregnancies of up to 12 weeks gestation. As of January 2011, more than 50,000 procedures have been performed by Ministry of Health hospitals and clinics. We researched trends in service users' characteristics, types of procedures performed, post-procedure complications, repeat abortions, and postabortion uptake of contraception in 15 designated hospitals from April 2007 to March 2010. The trend in procedures has been toward more medication and manual vacuum aspiration abortions and fewer done through dilation and curettage. Percentages of post-procedure complications and repeat abortions remain low (2.3 and 0.9 percent, respectively). Uptake of postabortion contraception has increased over time; 85 percent of women selected a method in 2009-10, compared with 73 percent in 2007-08. Our findings indicate that the Ministry of Health's program provides safe services that contribute to the prevention of repeat unintended pregnancies.

  11. The World Health Organization’s Safe Abortion Guidance Document

    PubMed Central

    Van Look, Paul F. A.; Cottingham, Jane

    2013-01-01

    We discuss the history of the World Health Organization’s (WHO’s) development of guidelines for governments on providing safe abortion services, which WHO published as Safe Abortion: Technical and Policy Guidance for Health Systems in 2003 and updated in 2012. We show how the recognition of the devastating impact of unsafe abortion on women’s health and survival, the impetus of the International Conference on Population and Development and its five-year follow-up, and WHO’s progressive leadership at the end of the century enabled the organization to elaborate guidance on providing safe abortion services. Guideline formulation involved extensive review of published evidence, an international technical expert meeting to review the draft document, and a protracted in-house review by senior WHO management. PMID:23409886

  12. Shaping legal abortion provision in Ghana: using policy theory to understand provider-related obstacles to policy implementation

    PubMed Central

    2013-01-01

    Background Unsafe abortion is a major public health problem in Ghana; despite its liberal abortion law, access to safe, legal abortion in public health facilities is limited. Theory is often neglected as a tool for providing evidence to inform better practice; in this study we investigated the reasons for poor implementation of the policy in Ghana using Lipsky’s theory of street-level bureaucracy to better understand how providers shape and implement policy and how provider-level barriers might be overcome. Methods In-depth interviews were conducted with 43 health professionals of different levels (managers, obstetricians, midwives) at three hospitals in Accra, as well as staff from smaller and private sector facilities. Relevant policy and related documents were also analysed. Results Findings confirm that health providers’ views shape provision of safe-abortion services. Most prominently, providers experience conflicts between their religious and moral beliefs about the sanctity of (foetal) life and their duty to provide safe-abortion care. Obstetricians were more exposed to international debates, treaties, and safe-abortion practices and had better awareness of national research on the public health implications of unsafe abortions; these factors tempered their religious views. Midwives were more driven by fundamental religious values condemning abortion as sinful. In addition to personal views and dilemmas, ‘social pressures’ (perceived views of others concerning abortion) and the actions of facility managers affected providers’ decision to (openly) provide abortion services. In order to achieve a workable balance between these pressures and duties, providers use their ‘discretion’ in deciding if and when to provide abortion services, and develop ‘coping mechanisms’ which impede implementation of abortion policy. Conclusions The application of theory confirmed its utility in a lower-middle income setting and expanded its scope by showing that

  13. Health system reform and safe abortion: a case study of Mongolia.

    PubMed

    Beck, Christina; Berry, Nicole S; Choijil, Semjidmaa

    2013-01-01

    Unsafe abortion serves as a marker of global inequity as it is concentrated in the developing world where the poorest and most vulnerable women live. While liberalisation of abortion law is essential to the reduction of unsafe abortion, a number of challenges exist beyond this important step. This paper investigates how popular health system reforms consonant with neoliberal agendas can challenge access to safe abortion. We use Mongolia, a country that has liberalised abortion law, yet, limited access to safe abortion, as a case study. Mongolia embraced market reforms in 1990 and subsequently reformed its health system. We document how common reforms in the areas of finance and regulation can compromise the safety of abortions as they foster challenges that include inconsistencies in service delivery that further foment health inequities, adoption of reproductive health programmes that are incompatible with the local sociocultural context, unregulated growth of the private sector and poor enforcement of standards and technical guidelines for safe abortion. We then discuss how this case study suggests the conversations that reproductive health policy-makers must have with those engineering health sector reform to ensure access to safe abortion in a liberalised environment.

  14. [Women's opinion on abortion legalization in a middle size county in southern Brazil].

    PubMed

    César, J A; Gomes, G; Horta, B L; de Oliveira, A K; Saraiva, A K; Pardo, D O; Silva, L M; Rodghiero, C L; Gross, M R

    1997-12-01

    Induced abortion is the main cause of maternal death in Brazil. Question of its legalization has been the subject of frequent discussion. In order to assess the influence of the variables affecting the opinion of women of reproductive age, a population-based systematic sample in the county of Rio Grande (Southern Brazil) was examined. Of a total of 1,456 interviews 30% endorsed the legalization, whatever the circumstances; this percentage was directly associated with age, schooling, family income and previous induced abortion (p < 0.01). Adjusted analysis using logistic regression showed a significant effect of schooling and previous induced abortion on favourable opinion. Schooling and previous induced abortion were the main determinants of women's favorable opinions regarding abortion legalization.

  15. Legal Change and Stigma in Surrogacy and Abortion.

    PubMed

    Robertson, John A

    2015-01-01

    Stigma marks both surrogacy and abortion. Legal change lessens stigma but may not remove it altogether. Post-legalization regulation may reinstall stigma by surrounding a legalized practice with barriers that make exercise of that right more difficult. As a result, law may reenact stigma even as it purports to take it away. © 2015 American Society of Law, Medicine & Ethics, Inc.

  16. [The consequences of the legalization of abortion within the Rostock area (GDR)].

    PubMed

    Mehlan, K H

    1974-11-04

    On March 9, 1972, the German Democratic Republic legalized abortion as one of the social and health policy measures with humanitarian goals to promote family life and improve living conditions. In evaluating the effect of the law, the development of fertility and frequency of abortion in Rostock District were studied for the years 1965 to 1973. In the first year after the new law went into effect, legal abortions increased about fivefold, which was expected; hospital abortions in 1973 decreased by about 40%. Compared to other Eastern European countries and to New York City, the frequency of abortion was still low. In the second year of the law, a further increase in abortions was not seen either in Rostock or the GDR as a whole. More women decided to continue their pregnancies; the number of women on oral contraceptives increased from about 1 million at the beginning of 1972 to about 1.2 million at the beginning of 1973. In 1972, for every 1000 women of reproductive age, there were 33 legal abortions in Rostock District; in the same period, for every 100 live births, there were 56 abortions.

  17. Nine demographic factors and their relationship to attitudes toward abortion legalization.

    PubMed

    Mileti, D S; Barnett, L D

    1972-03-01

    The 1967 Gallup Poll on attitudes toward abortion legislation taken for the Population Council was studied by multivariate analysis of 9 demographic factors: age, family income, occupation of household head, race, section of the country, sex, city size, education and religion. The poll was taken in two waves that totaled 6,065 cases (after weighting for a representative sample and elimination of "don't know" and "no answer" responses). The question asked for approval or disapproval of the legalization of abortion for the four "hard" reasons: mother's health, rape, incest, or expected child deformity. The analysis revealed that age, family income, occupation of household head, race, section of the country, and sex did not in themselves have an effect on attitudes towards abortion legalization, though they sometimes were an influence in combination with other variables. Significant statistical correlations were found between approval of abortion legalization and increasing city size and higher educational level. Abortion approval also increases along a religious scale from Jewish-Protestant-Catholic. The most significant theoretical conclusion of the study was that 6 of the 9 factors were not influential on abortion attitudes and the remaining 3 did not have strong predictive-explanatory power as expected. Re-examination of the causes of abortion attitudes is needed.

  18. A decade of progress providing safe abortion services in Ethiopia: results of national assessments in 2008 and 2014.

    PubMed

    Dibaba, Yohannes; Dijkerman, Sally; Fetters, Tamara; Moore, Ann; Gebreselassie, Hailemichael; Gebrehiwot, Yirgu; Benson, Janie

    2017-03-04

    Ethiopia has one of the highest maternal mortality ratios in the world (420 per 100,000 live births in 2013), and unsafe abortion continues to be one of the major causes. To reduce deaths and disabilities from unsafe abortion, Ethiopia liberalized its abortion law in 2005 to allow safe abortion under certain conditions. This study aimed to measure how availability and utilization of safe abortion services has changed in the last decade in Ethiopia. This paper draws on results from nationally representative health facility studies conducted in Ethiopia in 2008 and 2014. The data come from three sources at two points in time: 1) interviews with 335 health providers in 2008 and 822 health care providers in 2014, 2) review of facility logbooks, and 3) prospective data on 3092 women in 2008 and 5604 women in 2014 seeking treatment for abortion complications or induced abortion over a one month period. The Safe Abortion Care Model was used as a framework of analysis. There has been a rapid expansion of health facilities eligible to provide legal abortion services in Ethiopia since 2008. Between 2008 and 2014, the number of facilities reporting basic and comprehensive signal functions for abortion care increased. In 2014, access to basic abortion care services exceeded the recommended level of available facilities providing the service, increasing from 25 to 117%, with more than half of regions meeting the recommended level. Comprehensive abortion services increased from 20% of the recommended level in 2008 to 38% in 2014. Smaller regions and city administrations achieved or exceeded the recommended level of comprehensive service facilities, yet larger regions fall short. Between 2008 and 2014, the use of appropriate technology for conducting first and second trimester abortion and the provision of post abortion family planning has increased at the same time that abortion-related obstetric complications have decreased. Ten years after the change in abortion law, service

  19. Did abortion legalization reduce the number of unwanted children? Evidence from adoptions.

    PubMed

    Bitler, Marianne; Madeline, Zavodny

    2002-01-01

    The legalization of abortion in the United States led to well-known changes in reproductive behavior, but its effect on adoptions has not been investigated. Variation across states in the timing and extent of abortion legalization is used to identify the effects of changes in the legal status of abortion on adoption rates from 1961 to 1975. These effects are estimated in regression analyses that control for states' economic, demographic and political characteristics, as well as for health care availability within states. The rate of adoptions of children born to white women declined by 34-37% in states that repealed restrictive abortion laws before Roe v. Wade. The effect was concentrated among adoptions by petitioners not related to the child. Legal reforms resulting in small increases in access, such as in cases of rape and incest, were associated with a 15-18% decline in adoptions of children born to nonwhite women; however, this decline may have been due to other changes in the policy environment for such adoptions. Rates of adoption of children born to white women appear to have declined after Roe v. Wade, but this association is not statistically significant. The estimated effect of abortion legalization on adoption rates is sizable and can account for much of the decline in adoptions, particularly of children born to white women, during the early 1970s. These findings support previous studies' conclusions that abortion legalization led to a reduction in the number of "unwanted" children; such a reduction may have improved average infant health and children's living conditions.

  20. Youth often risk unsafe abortions.

    PubMed

    Barnett, B

    1993-10-01

    The topic of this article is the use of unsafe abortion for unwanted pregnancies among adolescents. The significance of unsafe abortion is identified as a high risk of serious health problems, such as infection, hemorrhage, infertility, and mortality, and as a strain on emergency room services. The World Health Organization estimates that at least 33% of all women seeking hospital care for abortion complications are aged under 20 years. 50 million abortions are estimated to be induced annually, of which 33% are illegal and almost 50% are performed outside the health care system. Complications are identified as occurring due to the procedure itself (perforation of the uterus, cervical lacerations, or hemorrhage) and due to incomplete abortion or introduction of bacteria into the uterus. Long-term complications include an increased risk of ectopic pregnancy, chronic pelvic infection, and infertility. Mortality from unsafe abortion is estimated at 1000/100,000 procedures. Safe abortion mortality is estimated at 0.6/100,000. When infertility results, some cultures ascribe an outcast status or marriages are prevented or prostitution is assured. The risk of complications is considered higher for adolescents. Adolescents tend to delay seeking an abortion, lack knowledge on where to go for a safe procedure, and delay seeking help for complications. Peer advice may be limited or inadequate knowledge. Five studies are cited that illustrate the impact of unsafe abortion on individuals and health care systems. Abortions may be desired due to fear of parental disapproval of the pregnancy, abandonment by the father, financial and emotional responsibilities of child rearing, expulsion from school, or inability to marry if the child is out of wedlock. Medical, legal, and social barriers may prevent women and girls from obtaining safe abortion. Parental permission is sometimes a requirement for safe abortion. Fears of judgmental or callous health personnel may be barriers to

  1. Public opinion on abortion in eight Mexican states amid opposition to legalization.

    PubMed

    Valencia Rodríguez, Jorge; Wilson, Kate S; Díaz Olavarrieta, Claudia; García, Sandra G; Sánchez Fuentes, Maria Luisa

    2011-09-01

    In opposition to Mexico City's legalization of first-trimester abortion, 17 Mexican states (53 percent) have introduced initiatives or reforms to ban abortion entirely, and other states have similar legislation pending. We conducted an opinion survey in eight states--four where constitutional amendments have already been approved and four with pending amendments. Using logistic regression analyses, we found that higher education, political party affiliation, and awareness of reforms/initiatives were significantly associated with support for the Mexico City law. Legal abortion was supported by a large proportion of respondents in cases of rape (45-70 percent), risk to a woman's life (55-71 percent), and risk to a woman's health (48-68 percent). A larger percentage of respondents favored the Mexico City law, which limits elective legal abortion to the first 12 weeks of gestation (32-54 percent), than elective abortion without regard to gestational limit (14-31 percent).

  2. Mortality and morbidity associated with legal abortions in Hungary, 1960-1973.

    PubMed Central

    Bognar, Z; Czeizel, A

    1976-01-01

    In Hungary, with 10 million inhabitants, the number of induced abortions in the 1960's first approached and then reached 200,000 cases annually. These data mean that the number of induced abortions has increased substantially compared with earlier decades. A qualitative change has also occurred, from criminal abortions to, in most cases, legally induced abortions performed in hospitals. On the basis of 32 deaths directly resulting from legal induced abortion in the first trimester during 1960-1972, maternal mortality is about 1.5 per 100,000 abortions in Hungary, the lowest rat observed until the present anywhere in the world. According to a special survey conducted in Budapest in 1966, the overall morbidity rate was 41.6 per 1,000 abortions of which 0.9 was due to perforations, 22.7 to post-abortal hemorrhages, and 18.0 to inflammatory complications, i.e., early post-abortal complications had to be reckoned with in every 25th case. Data in the present study suggest a correlation between induced abortions and the incidence of placenta previa, premature separation of the placenta, and premature births. PMID:937603

  3. Second trimester abortion laws globally: actuality, trends and recommendations.

    PubMed

    Boland, Reed

    2010-11-01

    There are important and compelling reasons why women have second trimester abortions, which constitute a significant percentage of all abortions performed. Laws vary widely around the world on the legality of these abortions. In many cases, they are quite restrictive. Indeed, the later in pregnancy an abortion is sought, the more restrictive the law tends to be. However, many laws say little about second trimester or later abortions. This article reviews the laws of the 191 countries around the world for which information is available and categorizes them by legal indications, which include preservation of the woman's life, health reasons, pregnancy due to sex offences, fetal impairment, socio-economic reasons and on request. Given that there are serious reasons why women have second trimester abortions, and that the laws in many countries do not make these abortions legally available, this paper makes recommendations on how laws and regulations can be changed in order better to respond to women's needs. While most countries may not decriminalise all abortions in the near future, especially second trimester abortions, less comprehensive legislative and regulatory reforms are possible. These include recommendations aimed at ensuring that abortions are carried out safely and as early as possible in pregnancy, and improving access to safe abortions by removing unnecessary legal and regulatory restrictions. Copyright © 2010 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  4. Experiencing abortion rights in India through issues of autonomy and legality: A few controversies.

    PubMed

    Patel, Tulsi

    2018-06-01

    Abortion laws in India, like other laws, are premised on the 1861 British Penal Code. The Medical Termination of Pregnancy Act was passed in 1971 to circumvent the criminality clause around abortion. Yet the law continues to render invisible women's right to choose. Legal procedures have often hindered in permitting abortion, resulting in the death of a mother or the foetus. Despite the latest techno-medical advances, the laws have remained stagnant or rather restrictive, complicated further by selective female foetus abortions. Legal resistance to abortion-seeking after 20 weeks gestation adversely affects women, depriving them of autonomy of choice. In this paper, raising important gender, health and ethical issues are illustrated through a recent legal case in India. Feminist campaigns against the legal mindset in India are emerging.

  5. Attitudes toward abortion in Zambia.

    PubMed

    Geary, Cynthia Waszak; Gebreselassie, Hailemichael; Awah, Paschal; Pearson, Erin

    2012-09-01

    Despite Zambia's relatively progressive abortion law, women continue to seek unsafe, illegal abortions. Four domains of abortion attitudes - support for legalization, immorality, rights, and access to services - were measured in 4 communities. A total of 668 people were interviewed. Associations among the 4 domains were inconsistent with expectations. The belief that abortion is immoral was widespread, but was not associated with lack of support for legalization. Instead, it was associated with belief that women need access to safe services. These findings suggest that increasing awareness about abortion law in Zambia may be important for encouraging more favorable attitudes. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  6. Latin American women’s experiences with medical abortion in settings where abortion is legally restricted

    PubMed Central

    2012-01-01

    Abortion is legally restricted in most of Latin America where 95% of the 4.4 million abortions performed annually are unsafe. Medical abortion (MA) refers to the use of a drug or a combination of drugs to terminate pregnancy. Mifepristone followed by misoprostol is the most effective and recommended regime. In settings where mifepristone is not available, misoprostol alone is used. Medical abortion has radically changed abortion practices worldwide, and particularly in legally restricted contexts. In Latin America women have been using misoprostol for self-induced home abortions for over two decades. This article summarizes the findings of a literature review on women’s experiences with medical abortion in Latin American countries where voluntary abortion is illegal. Women’s personal experiences with medical abortion are diverse and vary according to context, age, reproductive history, social and educational level, knowledge about medical abortion, and the physical, emotional, and social circumstances linked to the pregnancy. But most importantly, experiences are determined by whether or not women have the chance to access: 1) a medically supervised abortion in a clandestine clinic or 2) complete and accurate information on medical abortion. Other key factors are access to economic resources and emotional support. Women value the safety and effectiveness of MA as well as the privacy that it allows and the possibility of having their partner, a friend or a person of their choice nearby during the process. Women perceive MA as less painful, easier, safer, more practical, less expensive, more natural and less traumatic than other abortion methods. The fact that it is self-induced and that it avoids surgery are also pointed out as advantages. Main disadvantages identified by women are that MA is painful and takes time to complete. Other negatively evaluated aspects have to do with side effects, prolonged bleeding, the possibility that it might not be effective, and

  7. Current Legal Trends Regarding Abortions for Minors: A Dilemma for Counselors.

    ERIC Educational Resources Information Center

    Talbutt, Lou Culler

    1983-01-01

    Reviews court cases dealing with abortion and the counselor's legal responsibility to both the student and parents. Provides practical recommendations on abortion counseling with minors and suggests that counselors urge minors to discuss abortion plans with parents. Counselor should consider local mores and be knowledgeable about appropriate…

  8. Induced abortion.

    PubMed

    2017-06-01

    Abortion is common. Data on abortion rates are inexact but can be used to explore trends. Globally, the estimated rate in the period 2010-2014 was 35 abortions per 1000 women (aged 15-44 years), five points less than the rate of 40 for the period 1990-1994. Abortion laws vary around the world but are generally more restrictive in developing countries. Restrictive laws do not necessarily deter women from seeking abortion but often lead to unsafe practice with significant mortality and morbidity. While a legal framework for abortion is a prerequisite for availability, many laws, which are not evidence based, restrict availability and delay access. Abortion should be available in the interests of public health and any legal framework should be as permissive as possible in order to promote access. In the absence of legal access, harm reduction strategies are needed to reduce abortion-related mortality and morbidity. Abortion can be performed surgically (in the first trimester, by manual or electric vacuum aspiration) or with medication: both are safe and effective. Cervical priming facilitates surgery and reduces the risk of incomplete abortion. Diagnosis of incomplete abortion should be made on clinical grounds, not by ultrasound. Septic abortion is a common cause of maternal death almost always following unsafe abortion and thus largely preventable. While routine follow-up after abortion is unnecessary, all women should be offered a contraceptive method immediately after the abortion. This, together with improved education and other interventions, may succeed in reducing unintended pregnancy. © The Author 2017. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. Making abortions safe: a matter of good public health policy and practice.

    PubMed Central

    Berer, M.

    2000-01-01

    Globally, abortion mortality accounts for at least 13% of all maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing mortality and morbidity from abortion in countries where these remain high is a matter of good public health policy and medical practice, and constitutes an important part of safe motherhood initiatives. This article examines the changes in policy and health service provision required to make abortions safe. It is based on a wide-ranging review of published and unpublished sources. In order to be effective, public health measures must take into account the reasons why women have abortions, the kind of abortion services required and at what stages of pregnancy, the types of abortion service providers needed, and training, cost and counselling issues. The transition from unsafe to safe abortions demands the following: changes at national policy level; abortion training for service providers and the provision of services at the appropriate primary level health service delivery points; and ensuring that women access these services instead of those of untrained providers. Public awareness that abortion services are available is a crucial element of this transition, particularly among adolescent and single women, who tend to have less access to reproductive health services generally. PMID:10859852

  10. The interaction between legalization of abortion and contraception in Denmark.

    PubMed

    Matthiessen, P C

    1979-01-01

    Trends in fertility, abortion, and contraceptive practice in Denmark were analyzed, using previously compiled official statistics; the conclusion was drawn that easy access to abortion may contribute toward a decline in contraceptive practice depending on the level of contraceptive practice in the population and on the degree of confidence the population has in available contraceptive methods. In October 1973 Denmark passed a law permitting women to obtain free abortion on demand. The number of legal abortions increased from 16,500 in 1973 to 28,000 in 1975. This marked increase was not attributable to a decline in illegal abortion since that annual number had declined from 5,000 to 1,000 prior to the passage of the 1973 abortion on demand law. The increase in abortion observed from 1973-1975 was accompanied by a marked decrease in the number of oral contraceptive cycles sold. Annual sales decreased from 3.9 million cycles to 2.6 million. It was difficult to access the factors responsible for this decline. Although IUD insertions increased during this period, the increase could not adequately compensate for the reduction in oral contraceptive sales. The decline in oral contraceptive sales occurred at about the time the negative side effects associated with the pill received widespread news coverage. Some of the decline in pill usage was probably due to fear of side effects, but abortion availability also encouraged women to be more lax about taking the pill and encouraged them to rely on less effective methods of contraception. Tables provide data for Denmark in reference to: 1) number of legal abortions and the abortion rates for 1940-1977; 2) distribution of abortions by season, 1972-1977; 3) abortion rates by maternal age, 1971-1977; 4) oral contraceptive and IUD sales for 1977-1978; and 5) number of births and estimated number of abortions and conceptions, 1960-1975.

  11. Abortion Rights Legal Mobilization in the Peruvian Media, 1990-2015.

    PubMed

    Gianella, Camila

    2017-06-01

    State and non-state actors engaged in disputes to expand and limit abortion rights have engaged in legal mobilization-in other words, strategies using rights and law as a central tool for advancing contested political goals. Peru, like other Latin American countries, has experienced an increase in abortion rights legal mobilization in recent years, including litigation before national and international courts. This paper centers on societal legal mobilization, or the legal mobilization that occurs outside the legislative and judicial branches and that includes strategies promoted by the executive branch, political actors, and non-partisan organizations and individuals. It presents an analysis of op-ed articles published in two national newspapers, El Comercio and La República , between 1990 and 2015. The paper argues that the media is also an arena where legal mobilization takes place and is not just a space influenced by legal mobilization. Rather, the media's agenda operates independently of legal mobilization in the legislature and the courts, and it determines whether certain issues receive coverage and the way these issues are framed.

  12. The demographic argument in Soviet debates over the legalization of abortion in the 1920s.

    PubMed

    Solomon, S G

    1993-01-01

    Russia legalized abortion in 1920. State policy was pronatalist. Regional abortion commissions were established in order to monitor costs and maintain records. The physicians before the legal change were mainly against legalization. In 1923 the abortion rate was 2.91 abortions per live birth. A 1923 study by M. Karlin, M.D., found among 1362 women that the health risk to women of zero parity with an induced abortion was higher than giving birth. Public discussion of abortion was limited between 1921 and 1924. Russian physicians between 1925 and 1927 both publicly and privately discussed the problems; greater attention to demographic concerns occurred during the 1930s. The connection between abortion and the declining birth rate was established in a limited way in a May 1927 obstetricians' society meeting in Kiev, Ukraine. The albeit unreliable statistics appeared to confirm the decline in the birth rate due to increased numbers of abortions. The literature in the 1920s was devoted to the well-being of women as workers; abortion policy favored the interests of working women and was set up for prevention of unsafe illegal abortions. Russian demographers were more concerned with population movements. Surveys found that the profiled abortion client was indeed not destitute, but better off and married. Roesle, a German demographer, considered legal abortion beneficial in reducing maternal mortality, but he was criticized for obscuring abortions' impact on the birth rate. The debate in Russia was tangled in ideology. A comparison of abortion rates in Vienna and Moscow by a Viennese demographer Peller found similar rates regardless of legality. Peller further suggested that contraception had more to do with birth rates. Even though rural populations were hard hit by famine in 1931 and forced collectivization in 1929, increased rural abortions were blamed for the declining rural birth rates. The demographic argument against abortion became prominent again in 1931/32 after

  13. Post-abortion and induced abortion services in two public hospitals in Colombia.

    PubMed

    Darney, Blair G; Simancas-Mendoza, Willis; Edelman, Alison B; Guerra-Palacio, Camilo; Tolosa, Jorge E; Rodriguez, Maria I

    2014-07-01

    Until 2006, legal induced abortion was completely banned in Colombia. Few facilities are equipped or willing to offer abortion services; often adolescents experience even greater barriers of access in this context. We examined post abortion care (PAC) and legal induced abortion in two large public hospitals. We tested the association of hospital site, procedure type (manual vacuum aspiration vs. sharp curettage), and age (adolescents vs. women 20 years and over) with service type (PAC or legal induced abortion). Retrospective cohort study using 2010 billing data routinely collected for reimbursement (N=1353 procedures). We utilized descriptive statistics, multivariable logistic regression and predicted probabilities. Adolescents made up 22% of the overall sample (300/1353). Manual vacuum aspiration was used in one-third of cases (vs. sharp curettage). Adolescents had lower odds of documented PAC (vs. induced abortion) compared with women over age 20 (OR=0.42; 95% CI=0.21-0.86). The absolute difference of service type by age, however, is very small, controlling for hospital site and procedure type (.97 probability of PAC for adolescents compared with .99 for women 20 and over). Regardless of age, PAC via sharp curettage is the current standard in these two public hospitals. Both adolescents and women over 20 are in need of access to legal abortion services utilizing modern technologies in the public sector in Colombia. Documentation of abortion care is an essential first step to determining barriers to access and opportunities for quality improvement and better health outcomes for women. Following partial decriminalization of abortion in Colombia, in public hospitals nearly all abortion services are post-abortion care, not induced abortion. Sharp curettage is the dominant treatment for both adolescents and women over 20. Women seek care in the public sector for abortion, and must have access to safe, quality services. Copyright © 2014. Published by Elsevier Inc.

  14. Abortion Law and Policy Around the World

    PubMed Central

    2017-01-01

    Abstract The aim of this paper is to provide a panoramic view of laws and policies on abortion around the world, giving a range of country-based examples. It shows that the plethora of convoluted laws and restrictions surrounding abortion do not make any legal or public health sense. What makes abortion safe is simple and irrefutable—when it is available on the woman’s request and is universally affordable and accessible. From this perspective, few existing laws are fit for purpose. However, the road to law reform is long and difficult. In order to achieve the right to safe abortion, advocates will need to study the political, health system, legal, juridical, and socio-cultural realities surrounding existing law and policy in their countries, and decide what kind of law they want (if any). The biggest challenge is to determine what is possible to achieve, build a critical mass of support, and work together with legal experts, parliamentarians, health professionals, and women themselves to change the law—so that everyone with an unwanted pregnancy who seeks an abortion can have it, as early as possible and as late as necessary. PMID:28630538

  15. The Impact of Legalized Abortion on High School Graduation through Selection and Composition

    ERIC Educational Resources Information Center

    Whitaker, Stephan

    2011-01-01

    This analysis examines whether the legalization of abortion changed high school graduation rates among the children selected into birth. Unless women in all socio-economic circumstances sought abortions to the same extent, increased use of abortion must have changed the distribution of child development inputs. I find that higher abortion ratios…

  16. Destigmatising abortion: expanding community awareness of abortion as a reproductive health issue in Ghana.

    PubMed

    Lithur, Nana Oye

    2004-04-01

    Traditional and cultural values, social perceptions, religious teachings and criminalisation have facilitated stigmatisation of abortion in Ghana. Abortion is illegal in Ghana except in three instances. Though the law allows for performance of abortion in three circumstances, the Ghana reproductive health service policy did not have any induced legal abortion services component to cover the three exceptions until it was revised in 2003. The policy only had 'unsafe and post-abortion' care components, and abortions performed in health facilities operated by the Ghana Health Service were performed under this component. Though the policy has been revised, women and girls who need abortion services in Ghana more often resort to the backstreet dangerous methods and procedures. Criminalisation of abortion and those who perform abortions has contributed to unsafe abortion, the second leading cause of maternal deaths in Ghana. Most of these are performed outside the formal health service structures. Traditionally, abortion is perceived as a shameful act and the community may shun and give a woman who has caused anabortion derogatory names. Would provision of legal abortion services be culturally acceptable within a Ghanaian community? Yes, if they are made aware of the reproductive health benefits of providing safe abortion services. Three major strategies that would help to destigmatise abortion in the community are (1) the liberal interpretation of the three exceptions to the law on abortion; (2) expanding community awareness of its reproductive health benefits; and (3) improving and increasing access to legal abortion services within the formal health facilities.

  17. Exploring Legal Restrictions, Regulatory Reform, and Geographic Disparities in Abortion Access in Thailand.

    PubMed

    Arnott, Grady; Sheehy, Grace; Chinthakanan, Orawee; Foster, Angel M

    2017-06-01

    Despite decades of advocacy among Thai governmental and nongovernmental actors to remove abortion from the country's 1957 Criminal Code, this medically necessary service remains significantly legally restricted. In 2005, in the most recent regulatory reform to date, the Thai Medical Council established regulatory measures to allow a degree of physician interpretation within the confines of the existing law. Drawing on findings from a review of institutional policies and legislative materials, key informant interviews, and informal discussions with health service providers, government representatives, and nonprofit stakeholders, this article explores how legal reforms and health policies have shaped the abortion landscape in Thailand and influenced geographic disparities in availability and accessibility. Notwithstanding a strong medical community and the recent introduction of mifepristone for medication abortion (also known as medical abortion), the narrow interpretation of the regulatory criteria by physicians further entrenches these disparities. This article examines the causes of subnational disparities, focusing on the northern provinces and the western periphery of Thailand, and explores strategies to improve access to abortion in this legally restricted setting.

  18. Exploring Legal Restrictions, Regulatory Reform, and Geographic Disparities in Abortion Access in Thailand

    PubMed Central

    Arnott, Grady; Sheehy, Grace; Chinthakanan, Orawee; Foster, Angel M.

    2017-01-01

    Abstract Despite decades of advocacy among Thai governmental and nongovernmental actors to remove abortion from the country’s 1957 Criminal Code, this medically necessary service remains significantly legally restricted. In 2005, in the most recent regulatory reform to date, the Thai Medical Council established regulatory measures to allow a degree of physician interpretation within the confines of the existing law. Drawing on findings from a review of institutional policies and legislative materials, key informant interviews, and informal discussions with health service providers, government representatives, and nonprofit stakeholders, this article explores how legal reforms and health policies have shaped the abortion landscape in Thailand and influenced geographic disparities in availability and accessibility. Notwithstanding a strong medical community and the recent introduction of mifepristone for medication abortion (also known as medical abortion), the narrow interpretation of the regulatory criteria by physicians further entrenches these disparities. This article examines the causes of subnational disparities, focusing on the northern provinces and the western periphery of Thailand, and explores strategies to improve access to abortion in this legally restricted setting. PMID:28630551

  19. Abortion Rights Legal Mobilization in the Peruvian Media, 1990–2015

    PubMed Central

    Gianella, Camila

    2017-01-01

    Abstract State and non-state actors engaged in disputes to expand and limit abortion rights have engaged in legal mobilization—in other words, strategies using rights and law as a central tool for advancing contested political goals. Peru, like other Latin American countries, has experienced an increase in abortion rights legal mobilization in recent years, including litigation before national and international courts. This paper centers on societal legal mobilization, or the legal mobilization that occurs outside the legislative and judicial branches and that includes strategies promoted by the executive branch, political actors, and non-partisan organizations and individuals. It presents an analysis of op-ed articles published in two national newspapers, El Comercio and La República, between 1990 and 2015. The paper argues that the media is also an arena where legal mobilization takes place and is not just a space influenced by legal mobilization. Rather, the media’s agenda operates independently of legal mobilization in the legislature and the courts, and it determines whether certain issues receive coverage and the way these issues are framed. PMID:28630547

  20. Cohort Changes in Attitudes About Legalized Abortion.

    ERIC Educational Resources Information Center

    Cutler, Stephen J.; And Others

    Cohort changes in attitudes about the availability of legal abortions are traced over a 12-year period using data from seven national surveys. Contrary to the aging-conservatism hypothesis, trends in the direction of increasingly favorable attitudes between 1965 and 1973 and general stability thereafter characterize all cohorts. On this issue,…

  1. Doctors and Witches, Conscience and Violence: Abortion Provision on American Television.

    PubMed

    Sisson, Gretchen; Kimport, Katrina

    2016-12-01

    Popular entertainment may reflect and produce-as well as potentially contest-stigma regarding abortion provision. Knowledge of how providers are portrayed on-screen is needed to improve understanding of how depictions may contribute to the stigmatization of real providers. All abortion provision plotlines on American television from 2005 to 2014 were identified through Internet searches. Plotlines were assessed in their entirety and coded for genre, abortion provision space, provider characteristics, method and efficacy of provision, and occurrence of violence. Inductive content analysis was used to identify themes in how these features were depicted. Fifty-two plotlines involving abortion provision were identified on 40 television shows; a large majority of plotlines appeared in dramas, particularly in the subgenre of medical dramas. Medical spaces were depicted as normal and safe for abortion provision, and nonmedical spaces were often portrayed as remote and unsafe. Legal abortion care using medical methods was depicted as effective and safe, and legal providers were presented as compassionate, while providers operating outside of medical and legal authority were depicted as ineffective, dangerous and uncaring. Fictional providers were largely motivated by the belief that abortion provision is a necessary and moral service. Plotlines linked abortion provision to violence. The differing ways in which legal and illegal abortion are portrayed reveal potential consequences regarding real-world abortion provision, and suggest that representations situated in medical contexts may work to legitimate and destigmatize such provision. Copyright © 2016 by the Guttmacher Institute.

  2. Level of awareness about legalization of abortion in Nepal: a study at Nepal Medical College Teaching Hospital.

    PubMed

    Tuladhar, H; Risal, A

    2010-06-01

    World Health Organization (WHO) estimates that about 25.0% of all pregnancies worldwide end in induced abortion, approximately 50 million each year. More than half of these abortions are performed under unsafe conditions resulting in high maternal mortality ratio specially in developing countries like Nepal. Abortion was legalized under specified conditions in March 2002 in Nepal. But still a large proportion of population are unaware of the legalization and the conditions under which it is permitted. Legal reform alone cannot reduce abortion related deaths in our country. This study was undertaken with the main objective to study the level of awareness about legalization of abortion in women attending gyne out patients department of Nepal Medical College Teaching Hospital (NMCTH), which will give a baseline knowledge for further dissemination and advocacy about abortion law. Total 200 women participated in the study. Overall 133 (66.5%) women said they were aware of legalization of abortion in Nepal. Women of age group 20-34 years, urban residents, service holders, Brahmin/Chhetri caste and with higher education were more aware about it. Majority (92.0%) of the women received information from the media. Detail knowledge about legal conditions under which abortion can be performed specially in second trimester was found to be poor. Large proportion (71.0%) of the women were still unaware of the availability of comprehensive abortion care services at our hospital, which is being provided since last seven years. Public education and advocacy campaigns are crucial to create awareness about the new legislation and availability of services. Unless the advocacy and awareness campaign reaches women, they are not likely to benefit from the legal reform and services.

  3. Abortion: Still Unfinished Agenda in Nepal.

    PubMed

    Shrestha, Dirgha Raj; Regmi, Shibesh Chandra; Dangal, Ganesh

    2018-03-13

    Unsafe abortion is affecting a lot, in health, socio-economic and health care cost of many countries. Despite invention of simple technology and scientifically approved safe abortion methods, women and girls are still using unsafe abortion practices. Since 2002, Nepal has achieved remarkable progress in developing policies, guidelines, task shifting, training human resources and increasing access to services. However, more than half of abortion in Nepal are performed clandestinely by untrained or unapproved providers or induced by pregnant woman herself. Knowledge on legalization and availability of safe abortion service among women is still very poor. Stigma on abortion still persists among community people, service providers, managers, and policy makers. Access to safe abortion, especially in remote and rural areas, is still far behind as compared to their peers from urban areas. The existing law is not revised in the spirit of current Constitution of Nepal and rights-based approach. The existence of abortion stigma and the shifting of the government structure from unitary system to federalism in absence of a complete clarity on how the safe abortion service gets integrated into the local government structure might create challenge to sustain existing developments. There is, therefore, a need for all stakeholders to make a lot of efforts and allocate adequate resources to sustain current achievements and ensure improvements in creating a supportive social environment for women and girls so that they will be able to make informed decisions and access to safe abortion service in any circumstances.

  4. Pathways and consequences of unsafe abortion: a comparison among women with complications after induced and spontaneous abortions in Madhya Pradesh, India.

    PubMed

    Banerjee, Sushanta K; Andersen, Kathryn L; Warvadekar, Janardan

    2012-09-01

    This study aimed to understand women's pathways of seeking care for postabortion complications in Madhya Pradesh, India. The study recruited 786 women between July and November 2007. Data were collected on service provision, abortion-related complications, care-seeking behavior, knowledge about abortion legality and availability, methods used, symptoms, referral source, and out-of-pocket costs. Women seeking care for complications from induced abortion followed more complex pathways to treatment than women with complications of spontaneous abortion. More complex pathways were associated with higher out-of-pocket costs. Improving community awareness on legal aspects, safe abortion methods, and trained providers are necessary to reduce morbidity associated with unsafe abortion. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Realizing Abortion Rights at the Margins of Legality in Mexico.

    PubMed

    Singer, Elyse Ona

    2018-06-20

    I analyze the alternative tactics and logics of Las Fuertes, a feminist organization that has taken an "alegal" approach to realizing the human right to abortion in the conservative Mexican state of Guanajuato. Since a series of United Nations agreements throughout the 1990s enshrined reproductive rights as universal human rights, Mexican feminists have adopted the human rights platform as a lobbying tool to pressure the government to reform restrictive abortion laws. This strategy bore fruit in Mexico City, with passage of the historic 2007 abortion legalization. Las Fuertes has leveraged the human rights strategy differently - to justify the direct provision of local abortion accompaniment in a context of near-total abortion criminalization. By directly seizing abortion rights, rather than seeking to implement them through legalistic channels, Las Fuertes has effectively challenged Mexican reproductive governance in an adversarial political environment.

  6. [Historic, cultural, legal, psychosocial and educational aspects of induced abortion].

    PubMed

    Aguirre Zozaya, F; Iglesias, M; Reyes, R M; Iturralde, G; Martínez, M; Pineda Hernández, C

    1980-08-01

    The history of abortion is a very long one. Every people and nation used different and widely varied methods during the centuries to get rid of unwanted pregnancies. Unfortunately, in most instances, the great majority of these methods was equivalent to zero effectiveness, or, too often, to suicide. Legal aspects of induced abortion have changed considerably with the passing of time and according to countries; these days 36% of the world countries admit abortion on request, 24% for specific reasons only, 16% for medical reasons only, and 8% still consider it an illegal practice. In Mexico abortion is legal only when pregnancy would imply death of the mother, when it is the result of rape of minors, or when it is done on women with very serious mental pathology. Obviously abortion is not the solution to unwanted pregnancies; an improvement in the socioeconomic condition and in the quality of life of many people would be a much better, and more difficult, approach to the solution. Psychosocial factors of abortion involve concepts which are difficult to define, such as those of the wanted or of the unwanted child, and can cause problems which are very difficult to handle. Health education, and sex education in particular, should not only teach the fundamentals of reproduction, but respect and consideration for the phenomenon of procreation, and a strong sense of personal and social responsibility toward family planning.

  7. [Scientific evidence on the legalization of abortion in Mexico City].

    PubMed

    Gayón-Vera, Eduardo

    2010-03-01

    On April 24 2007, abortion before 12 weeks became legal in Mexico City. The arguments for this decision were: diminish the maternal morbidity and mortality, avoid a "severe health problem" and accomplish the women's physical, mental and social well being. To analyze the scientific evidences that support or reject this arguments. Retrospective study realized by bibliographic search of electronic data basis and Internet portals of interested groups. Mexico is considered by the World Health Organization, one of the countries in the world with low maternal mortality rates (<100/100,000 live births). The main causes are: preeclampsia-eclampsia, pregnancy related hemorrhage, complications of pregnancy, delivery and puerperium, and other causes (92.2 to 93.1%). In 2007, the Health Services of Mexico City reported 11 deaths (0.03% of the total maternal deaths) associated with "non-spontaneous abortion". In the hospitals of the Mexican Institute of Social Security, maternal deaths as consequence of induced abortions were, approximately, three every year. The evidences used as arguments in favor of abortion come from studies performed in Sub-Saharan African countries, which do not apply to Mexico. The scientific evidences show that induced abortion has important psychological sequels in women, a higher frequency of illegal drug abuse, alcoholism, child abuse, low birth weight in the following pregnancy, greater risk of subsequent miscarriage and greater mortality rate. There are no scientific evidences to support the arguments used for the legal approval of abortion in Mexico City.

  8. Advocacy for legal reform for safe abortion.

    PubMed

    Ashenafi, Meaza

    2004-04-01

    In Ethiopia, violation of women's reproductive rights is both a cause and a manifestation of women's disempowerment. Obstacles to full realisation of Ethiopian women's reproductive health and rights include the persistence of harmful traditional practices such as female genital mutilation, early marriage and abduction, as well as the disturbing prevalence of rape and HIV/AIDS. Unsafe abortion represents a particularly serious threat to women's health and lives. Ethiopia's status as a signatory to the Convention to Eliminate all Forms of Discrimination Against Women (CEDAW) and its constitutional guarantee of women's equality demand more aggressive action to eradicate such practices and inequities. After years of lobbying by women's organisations, parliamentarians are now reviewing a draft of the 1957 penal code, which includes numerous provisions addressing some of these practices and other conditions that underlie women's poor social and health status.

  9. A review of abortion laws in Western-European countries. A cross-national comparison of legal developments between 1960 and 2010.

    PubMed

    Levels, Mark; Sluiter, Roderick; Need, Ariana

    2014-10-01

    The extent to which women have had access to legal abortions has changed dramatically in Western-Europe between 1960 and 2010. In most countries, abortion laws developed from completely banning abortion to allowing its availability on request. Both the timing and the substance of the various legal developments differed dramatically between countries. Existing comparative studies on abortion laws in Western-European countries lack detail, usually focus either on first-trimester abortions or second trimester abortions, cover a limited time-span and are sometimes inconsistent with one another. Combining information from various primary and secondary sources, we show how and when the conditions for legally obtaining abortion during the entire gestation period in 20 major Western-European countries have changed between 1960 and 2010. We also construct a cross-nationally comparable classification of procedural barriers that limit abortion access. Our cross-national comparison shows that Western-Europe witnessed a general trend towards decreased restrictiveness of abortion laws. However, legal approaches to regulating abortion are highly different in detail. Abortion access remains limited, sometimes even in countries where abortion is legally available without restrictions relating to reasons. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  10. Postabortion contraception a decade after legalization of abortion in Nepal.

    PubMed

    Rocca, Corinne H; Puri, Mahesh; Harper, Cynthia C; Blum, Maya; Dulal, Bishnu; Henderson, Jillian T

    2014-08-01

    To assess the contraceptive information received and methods chosen, received, and used among women having abortions one decade after legalization of abortion in Nepal. We examined postabortion contraception with questionnaires at baseline and six months among women obtaining legal abortions (n=838) at four facilities in 2011. Multivariate regression analysis was used to measure factors associated with method information, choice, receipt, and use. One-third of participants received no information on effective methods, and 56% left facilities without a method. The majority of women who chose to use injectables and pills were able to do so (88% and 75%, respectively). However, only 44% of women choosing long-acting reversible contraceptives and 5% choosing sterilization had initiated use of the method by six months. Levels of contraceptive use after medical abortion were on par with those after aspiration abortion. Nulliparous women were far less likely than parous women to receive information and use methods. Women living without husbands or partners were also less likely to receive information and supplies, or to use methods. Improvements in postabortion counseling and provision are needed. Ensuring that women choosing long-acting and permanent contraceptive methods are able to obtain either them or interim methods is essential. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. New trends in therapeutic abortion in California. Complete legalization is imminent.

    PubMed

    Kummer, J M

    1969-12-01

    In 1967 California adopted updated therapeutic abortion laws which were more liberal than previous laws but which did not allow abortion for fetal indications nor for minor psychiatric reasons. Between November 8, 1967, and September 30, 1968, there were 4291 applicants for abortion in California. 91% of these were approved and 88% performed. Of the applications, 86% were for mental health, 6% for physical health, and 9% for rape or incest. 63% of the abortions were performed in the 9 bay area counties around San Francisco although only 23% of the states births occur in that area. The author feels that these liberalized laws will help to lead to the eventual legalization of abortion in California.

  12. Ethical and Legal Issues Regarding Selective Abortion of Fetuses with Down Syndrome.

    ERIC Educational Resources Information Center

    Glover, Noreen M.; Glover, Samuel J.

    1996-01-01

    Selective abortion of fetuses with Down syndrome is discussed in terms of abortion perspectives, genetic testing, legislation, and ethical principles. The ethical principles of autonomy, beneficence, nonmaleficence, fidelity, and justice are offered as guidelines for the examination of legal standards imposed by legislation. (Author/PB)

  13. Further Evidence that Legalized Abortion Lowered Crime: A Reply to Joyce

    ERIC Educational Resources Information Center

    Donohue, John J., III; Levitt, Steven D.

    2004-01-01

    Joyce's failure to uncover a negative relationship between crime and abortion was because of his decision to concentrate on a non-representative six-year period. Evidence supporting the claims that the crack-cocaine epidemic hit the high-abortion early-legalizing states earlier and more severely than other states of the U.S in 1970 is presented.

  14. The individual level cost of pregnancy termination in Zambia: a comparison of safe and unsafe abortion.

    PubMed

    Leone, Tiziana; Coast, Ernestina; Parmar, Divya; Vwalika, Bellington

    2016-09-01

    Zambia has one of the most liberal abortion laws in sub-Saharan Africa. However, rates of unsafe abortion remain high with negative health and economic consequences. Little is known about the economic burden on women of abortion care-seeking in low income countries. The majority of studies focus on direct costs (e.g. hospital fees). This article estimates the individual-level economic burden of safe and unsafe abortion care-seeking in Zambia, incorporating all indirect and direct costs. It uses data collected in 2013 from a tertiary hospital in Lusaka, (n = 112) with women who had an abortion. Three treatment routes are identified: (1) safe abortion at the hospital, (2) unsafe clandestine medical abortion initiated elsewhere with post-abortion care at the hospital and (3) unsafe abortion initiated elsewhere with post-abortion care at the hospital. Based on these three typologies, we use descriptive analysis and linear regression to estimate the costs for women of seeking safe and unsafe abortion and to establish whether the burden of abortion care-seeking costs is equally distributed across the sample. Around 39% of women had an unsafe abortion, incurring substantial economic costs before seeking post-abortion care. Adolescents and poorer women are more likely to use unsafe abortion. Unsafe abortion requiring post-abortion care costs women 27% more than a safe abortion. When accounting for uncertainty this figure increases dramatically. For safe and unsafe abortions, unofficial provider payments represent a major cost to women.This study demonstrates that despite a liberal legislation, Zambia still needs better dissemination of the law to women and providers and resources to ensure abortion service access. The policy implications of this study include: the role of pharmacists and mid-level providers in the provision of medical abortion services; increased access to contraception, especially for adolescents; and elimination of demands for unofficial provider

  15. Legal and Ethical Issues in Evaluating Abortion Services.

    ERIC Educational Resources Information Center

    Ferris, Lori E.

    2000-01-01

    Focuses on ethical and legal issues that arose in the evaluation of abortion services. Discusses the development of decision rules and tradeoffs in dealing with these issues to reach rational and objective decisions. Places the discussion in the context of balancing usefulness and propriety with respect to informed consent and privacy and makes…

  16. Decriminalization of abortion in Mexico City: the effects on women's reproductive rights.

    PubMed

    Becker, Davida; Díaz Olavarrieta, Claudia

    2013-04-01

    In April 2007, the Mexico City, Mexico, legislature passed landmark legislation decriminalizing elective abortion in the first 12 weeks of pregnancy. In Mexico City, safe abortion services are now available to women through the Mexico City Ministry of Health's free public sector legal abortion program and in the private sector, and more than 89 000 legal abortions have been performed. By contrast, abortion has continued to be restricted across the Mexican states (each state makes its own abortion laws), and there has been an antichoice backlash against the legislation in 16 states. Mexico City's abortion legislation is an important first step in improving reproductive rights, but unsafe abortions will only be eliminated if similar abortion legislation is adopted across the entire country.

  17. Perspectives on induced abortion among Palestinian women: religion, culture and access in the occupied Palestinian territories.

    PubMed

    Shahawy, Sarrah; Diamond, Megan B

    2018-03-01

    Induced abortion is an important public health issue in the occupied Palestinian territories (OPT), where it is illegal in most cases. This study was designed to elicit the views of Palestinian women on induced abortion given the unique religious, ethical and social challenges in the OPT. Sixty Palestinian women were interviewed on their perceptions of the religious implications, social consequences and accessibility of induced abortions in the OPT at Al-Makassed Islamic Charitable Hospital in East Jerusalem. Themes arising from the interviews included: the centrality of religion in affecting women's choices and views on abortion; the importance of community norms in regulating perspectives on elective abortion; and the impact of the unique medico-legal situation of the OPT on access to abortion under occupation. Limitations to safe abortion access included: legal restrictions; significant social consequences from the discovery of an abortion by one's community or family; and different levels of access to abortion depending on whether a woman lived in East Jerusalem, the West Bank, or Gaza. This knowledge should be incorporated to work towards a legal and medical framework in Palestine that would allow for safe abortions for women in need.

  18. Abortion Law and Policy Around the World: In Search of Decriminalization.

    PubMed

    Berer, Marge

    2017-06-01

    The aim of this paper is to provide a panoramic view of laws and policies on abortion around the world, giving a range of country-based examples. It shows that the plethora of convoluted laws and restrictions surrounding abortion do not make any legal or public health sense. What makes abortion safe is simple and irrefutable-when it is available on the woman's request and is universally affordable and accessible. From this perspective, few existing laws are fit for purpose. However, the road to law reform is long and difficult. In order to achieve the right to safe abortion, advocates will need to study the political, health system, legal, juridical, and socio-cultural realities surrounding existing law and policy in their countries, and decide what kind of law they want (if any). The biggest challenge is to determine what is possible to achieve, build a critical mass of support, and work together with legal experts, parliamentarians, health professionals, and women themselves to change the law-so that everyone with an unwanted pregnancy who seeks an abortion can have it, as early as possible and as late as necessary.

  19. Abortion, metaphysics and morality: a review of Francis Beckwith's defending life: a moral and legal case against abortion choice.

    PubMed

    Nobis, Nathan

    2011-06-01

    In Defending Life: A Moral and Legal Case Against Abortion Choice (2007) and an earlier article in this journal, "Defending Abortion Philosophically"(2006), Francis Beckwith argues that fetuses are, from conception, prima facie wrong to kill. His arguments are based on what he calls a "metaphysics of the human person" known as "The Substance View." I argue that Beckwith's metaphysics does not support his abortion ethic: Moral, not metaphysical, claims that are part of this Substance View are the foundation of the argument, and Beckwith inadequately defends these moral claims. Thus, Beckwith's arguments do not provide strong support for what he calls the "pro-life" view of abortion.

  20. Death after legally induced abortion. A comprehensive approach for determination of abortion-related deaths based on record linkage.

    PubMed Central

    Shelton, J D; Schoenbucher, A K

    1978-01-01

    The sources for determination of abortion-related deaths in Georgia are the cause of death listed on the death certificate and reports from informal reporting channels. Although Georgia residents 10-44 years of age obtained 19,877 induced abortions in 1975, no deaths related to abortion were found through these two usual sources. To determine the sensitivity of this system, all abortion certificates for 1975 were compared with all death certificates of Georgia females aged 10-44 who died in 1975 and the first 2 months of 1976. Based on the age and racial distribution of the women who received abortions, approximately 13 deaths (from all causes) would be expected to have subsequently occurred during the period of time studied. The authors found only 10. From national death-to-case rates for legal abortion, the expected number actually atrributable to abortion was 0.78 death. Of the 10 deaths, 2 were potentially related to the previous abortion, but a causal relationship to the preceding abortion was not clearly evident for any of the 10 deaths. The data, therefore, tend to support the assertion that no large numbers of deaths related to abortion are undiscovered and that current measurements of abortion mortality are accurate. Images p376-a PMID:684149

  1. Decriminalization of Abortion in Mexico City: The Effects on Women’s Reproductive Rights

    PubMed Central

    Díaz Olavarrieta, Claudia

    2013-01-01

    In April 2007, the Mexico City, Mexico, legislature passed landmark legislation decriminalizing elective abortion in the first 12 weeks of pregnancy. In Mexico City, safe abortion services are now available to women through the Mexico City Ministry of Health’s free public sector legal abortion program and in the private sector, and more than 89 000 legal abortions have been performed. By contrast, abortion has continued to be restricted across the Mexican states (each state makes its own abortion laws), and there has been an antichoice backlash against the legislation in 16 states. Mexico City’s abortion legislation is an important first step in improving reproductive rights, but unsafe abortions will only be eliminated if similar abortion legislation is adopted across the entire country. PMID:23409907

  2. [Between the stigma and the law: legal abortion in Mexico City].

    PubMed

    Lamas, Marta

    2014-01-01

    The present contribution is part of a research developed with qualitative social research methods. It offers part of the results attained in a study performed at a clinic belonging to Mexico City´s Government, and explores the effects on staff of the implementation of Legal Pregnancy Termination (ILE, for its initials in Spanish). The results highlights that, besides diminishing health risks in the women who abort, the use of misoprostol prompted assertive attitudes in many women, that reduced the negative effects produced by the stigma of abortion. It also acknowledges the persistence of stigma in the opinions of the health personnel. The empowering of the self-image of women who become subject to this procedure is due to the full exercise of their legal right.

  3. "These things are dangerous": Understanding induced abortion trajectories in urban Zambia.

    PubMed

    Coast, Ernestina; Murray, Susan F

    2016-03-01

    Unsafe abortion is a significant but preventable cause of global maternal mortality and morbidity. Zambia has among the most liberal abortion laws in sub-Saharan Africa, however this alone does not guarantee access to safe abortion, and 30% of maternal mortality is attributable to unsafe procedures. Too little is known about the pathways women take to reach abortion services in such resource-poor settings, or what informs care-seeking behaviours, barriers and delays. In-depth qualitative interviews were conducted in 2013 with 112 women who accessed abortion-related care in a Lusaka tertiary government hospital at some point in their pathway. The sample included women seeking safe abortion and also those receiving hospital care following unsafe abortion. We identified a typology of three care-seeking trajectories that ended in the use of hospital services: clinical abortion induced in hospital; clinical abortion initiated elsewhere, with post-abortion care in hospital; and non-clinical abortion initiated elsewhere, with post-abortion care in hospital. Framework analyses of 70 transcripts showed that trajectories to a termination of an unwanted pregnancy can be complex and iterative. Individuals may navigate private and public formal healthcare systems and consult unqualified providers, often trying multiple strategies. We found four major influences on which trajectory a woman followed, as well as the complexity and timing of her trajectory: i) the advice of trusted others ii) perceptions of risk iii) delays in care-seeking and receipt of services and iv) economic cost. Even though abortion is legal in Zambia, girls and women still take significant risks to terminate unwanted pregnancies. Levels of awareness about the legality of abortion and its provision remain low even in urban Zambia, especially among adolescents. Unofficial payments required by some providers can be a major barrier to safe care. Timely access to safe abortion services depends on chance rather

  4. Theorizing Time in Abortion Law and Human Rights.

    PubMed

    Erdman, Joanna N

    2017-06-01

    The legal regulation of abortion by gestational age, or length of pregnancy, is a relatively undertheorized dimension of abortion and human rights. Yet struggles over time in abortion law, and its competing representations and meanings, are ultimately struggles over ethical and political values, authority and power, the very stakes that human rights on abortion engage. This article focuses on three struggles over time in abortion and human rights law: those related to morality, health, and justice. With respect to morality, the article concludes that collective faith and trust should be placed in the moral judgment of those most affected by the passage of time in pregnancy and by later abortion-pregnant women. With respect to health, abortion law as health regulation should be evidence-based to counter the stigma of later abortion, which leads to overregulation and access barriers. With respect to justice, in recognizing that there will always be a need for abortion services later in pregnancy, such services should be safe, legal, and accessible without hardship or risk. At the same time, justice must address the structural conditions of women's capacity to make timely decisions about abortion, and to access abortion services early in pregnancy.

  5. The impact of legal abortion on marital and nonmarital fertility in upstate New York.

    PubMed

    Tu, E J; Herzfeld, P M

    1982-01-01

    Nonmarital fertility rates declined rapidly immediately after the legalization of abortion in upstate New York, but began to rise again in the mid-1970s concomitant with an increase in nonmarital abortion rates. The downward pressure exerted by abortion on nonmarital fertility is thus more than offset by other factors, among which are possible increases in sexual activity and less use of effective contraception.

  6. Second trimester abortions in India.

    PubMed

    Dalvie, Suchitra S

    2008-05-01

    This article gives an overview of what is known about second trimester abortions in India, including the reasons why women seek abortions in the second trimester, the influence of abortion law and policy, surgical and medical methods used, both safe and unsafe, availability of services, requirements for second trimester service delivery, and barriers women experience in accessing second trimester services. Based on personal experiences and personal communications from other doctors since 1993, when I began working as an abortion provider, the practical realities of second trimester abortion and case histories of women seeking second trimester abortion are also described. Recommendations include expanding the cadre of service providers to non-allopathic clinicians and trained nurses, introducing second trimester medical abortion into the public health system, replacing ethacridine lactate with mifepristone-misoprostol, values clarification among providers to challenge stigma and poor treatment of women seeking second trimester abortion, and raising awareness that abortion is legal in the second trimester and is mostly not requested for reasons of sex selection.

  7. Abortion: a history.

    PubMed

    Hovey, G

    1985-01-01

    labor, and greater consumerism. The legal history of abortion in the US illustrates dramatically that it was doctors, not women, who defined the morality surrounding abortion. Women continue to have to cope with the legacy of this fact. The seemingly benign 2-sphere family of the 19th century cut a deep wound in the human community. Men had public power and authority and were encouraged to be sexual. Women were offered the alternative of being powerful only as sexual beings who could thus enforce a domestic moral order. The legacy of the 2-sphere family continues, but much has changed. By 1973 pressure for reform had led 14 states to liberalize their existing abortin laws, and the US Supreme Court finally ruled that abortion is a private matter between a woman and her doctor. The current problem is that despite new laws and new attitudes toward women and abortion, male dominated and male defined institutions still determine what is possible. Women's right to abortion will never be safe and secure as long as this situation continues.

  8. Women's knowledge and attitudes surrounding abortion in Zambia: a cross-sectional survey across three provinces

    PubMed Central

    Cresswell, Jenny A; Schroeder, Rosalyn; Dennis, Mardieh; Owolabi, Onikepe; Vwalika, Bellington; Musheke, Maurice; Campbell, Oona; Filippi, Veronique

    2016-01-01

    Objectives In Zambia, despite a relatively liberal legal framework, there remains a substantial burden of unsafe abortion. Many women do not use skilled providers in a well-equipped setting, even where these are available. The aim of this study was to describe women's knowledge of the law relating to abortion and attitudes towards abortion in Zambia. Setting Community-based survey in Central, Copperbelt and Lusaka provinces. Participants 1484 women of reproductive age (15–44 years). Primary and secondary outcome measures Correct knowledge of the legal grounds for abortion, attitudes towards abortion services and the previous abortions of friends, family or other confidants. Descriptive statistics and multivariable logistic regression were used to analyse how knowledge and attitudes varied according to sociodemographic characteristics. Results Overall, just 16% (95% CI 11% to 21%) of women of reproductive age correctly identified the grounds for which abortion is legal. Only 40% (95% CI 32% to 45% of women of reproductive age knew that abortion was legally permitted in the extreme situation where the pregnancy threatens the life of the mother. Even in urban areas of Lusaka province, only 55% (95% CI 41% to 67%) of women knew that an abortion could legally take place to save the mother's life. Attitudes remain conservative. Women with correct knowledge of abortion law in Zambia tended to have more liberal attitudes towards abortion and access to safe abortion services. Neither correct knowledge of the law nor attitudes towards abortion were associated with knowing someone who previously had an induced abortion. Conclusions Poor knowledge and conservative attitudes are important obstacles to accessing safe abortion services. Changing knowledge and attitudes can be challenging for policymakers and public health practitioners alike. Zambia could draw on its previous experience in dealing with its large HIV epidemic to learn cross-cutting lessons in effective mass

  9. Trends in induced abortion during the 12 years since legalization in Norway.

    PubMed

    Skjeldestad, F E; Borgan, J K

    1994-01-01

    Data on 174,595 Norwegian women aged 15-44 who had an induced abortion between 1979 (when all abortions through 12 weeks of gestation were legalized) and 1990 reveals that the general abortion rate decreased by 12% among married women, while it remained unchanged among unmarried women. Unmarried women had higher abortion rates than did married women among all age-groups except teenagers, increasing from a difference of 11 abortions per 1,000 women in 1979-1981 to a difference of 13 per 1,000 in 1988-1990. Pregnancy terminations occurred at an earlier gestational age during the last three years of the study period, compared with the first three. Abortions beyond 12 gestational weeks, which require the approval of a hospital committee, decreased among unmarried women, while increasing somewhat among married women. A larger proportion of married women than unmarried women terminated pregnancies beyond 18 gestational weeks.

  10. Update on abortion policy.

    PubMed

    Conti, Jennifer A; Brant, Ashley R; Shumaker, Heather D; Reeves, Matthew F

    2016-12-01

    To review the status of antiabortion restrictions enacted over the last 5 years in the United States and their impact on abortion services. In recent years, there has been an alarming rise in the number of antiabortion laws enacted across the United States. In total, various states in the union enacted 334 abortion restrictions from 2011 to July 2016, accounting for 30% of all abortion restrictions since the legalization of abortion in 1973. Data confirm, however, that more liberal abortion laws do not increase the number of abortions, but instead greatly decrease the number of abortion-related deaths. Several countries including Romania, South Africa and Nepal have seen dramatic decreases in maternal mortality after liberalization of abortion laws, without an increase in the total number of abortions. In the United States, abortions are incredibly safe with very low rates of complications and a mortality rate of 0.7 per 100 000 women. With increasing abortion restrictions, maternal mortality in the United States can be expected to rise over the coming years, as has been observed in Texas recently. Liberalization of abortion laws saves women's lives. The rising number of antiabortion restrictions will ultimately harm women and their families.

  11. Queering abortion rights: notes from Argentina.

    PubMed

    Sutton, Barbara; Borland, Elizabeth

    2018-03-06

    In recent years, there have been calls in activist spaces to 'queer' abortion rights advocacy and to incorporate non-normative notions of gender identity and sexuality into abortion struggles and services. Argentina provides an interesting site in which to examine these developments, since there is a longstanding movement for abortion rights in a context of illegal abortion and a recent ground-breaking Gender Identity Law that recognises key trans rights. In this paper, we analyse public documents from the abortion rights movement's main coalition - the National Campaign for the Right to Legal, Safe and Free Abortion - alongside interviews with 19 Campaign activists to examine shifts and tensions in contemporary abortion rights activism. We trace the incorporation of trans-inclusive language into the newly proposed abortion rights bill and conclude by pointing to contextual factors that may limit or enhance the further queering of abortion rights.

  12. Investigation of the prevalence and causes and of legal abortion of teenage married mothers in Iran.

    PubMed

    Ghodrati, Fatemeh; Saadatmand, Narges; Gholamzadeh, Saeid; Akbarzadeh, Marzieh

    2018-02-05

    Background The therapeutic abortion law, in accordance with the fatwa issued by our Muslim jurisprudent approved by the parliament in 2005, has made major developments in dealing with cases of therapeutic abortions. Objective This study aimed at identifying the prevalence and causes of therapeutic abortion requests to the Legal Medicine Organization of Fars province, Shiraz, by pregnant teenager mothers. Methods This study was a retrospective, cross-sectional, descriptive survey. In this study, all documents related to therapeutic abortion requests from the Legal Medicine Organization of Fars province (southern Iran) from 2006 to 2013 were investigated. The total sample size included 1664, out of which 142 were teenagers. Sampling was carried out using Convenience method. Data were analyzed using SPSS statistical software, version 16, descriptive statistics and χ2. Results In this study, 142 mothers were under 20 years of age (8.5%). The prevalence of fetal abortion license requests was 110 (78.6%) and for maternal causes was 30 (21.4%). There was no significant statistical correlation between fetal causes in different years (p = 0.083). The most common causes of fetal abortion request were for thalassemia treatment in 78 cases (79.9%) followed by fetal malformations (20.9%); also, the most common maternal cause was thalassemia in 14 cases (51.9%) and depression in three cases (1.11%), respectively. Conclusion Our results showed that after approval of therapeutic abortion law, requests for therapeutic abortion due to fetal causes are extensively increasing. There is still a need for coordination of judicial, medical and legal authorities for prompt notification.

  13. The impact of legalized abortion on child health outcomes and abandonment. Evidence from Romania.

    PubMed

    Mitrut, Andreea; Wolff, François-Charles

    2011-12-01

    We use household survey data and a unique census of institutionalized children to analyze the impact of abortion legalization in Romania. We exploit the lift of the abortion ban in December 1989, when communist dictator Ceausescu and his regime were removed from power, to understand its impact on children's health at birth and during early childhood and whether the lift of the ban had an immediate impact on child abandonment. We find insignificant estimates for health at birth outcomes and anthropometric z-scores at age 4 and 5, except for the probability of low birth weight which is slightly higher for children born after abortion became legal. Additionally, our findings suggest that the lift of the ban had decreased the number of abandoned children. Copyright © 2011 Elsevier B.V. All rights reserved.

  14. Women's Awareness and Knowledge of Abortion Laws: A Systematic Review.

    PubMed

    Assifi, Anisa R; Berger, Blair; Tunçalp, Özge; Khosla, Rajat; Ganatra, Bela

    2016-01-01

    Incorrect knowledge of laws may affect how women enter the health system or seek services, and it likely contributes to the disconnect between official laws and practical applications of the laws that influence women's access to safe, legal abortion services. To provide a synthesis of evidence of women's awareness and knowledge of the legal status of abortion in their country, and the accuracy of women's knowledge on specific legal grounds and restrictions outlined in a country's abortion law. A systematic search was carried for articles published between 1980-2015. Quantitative, mixed-method data collection, and objectives related to women's awareness or knowledge of the abortion law was included. Full texts were assessed, and data extraction done by a single reviewer. Final inclusion for analysis was assessed by two reviewers. The results were synthesised into tables, using narrative synthesis. Of the original 3,126 articles, and 16 hand searched citations, 24 studies were included for analysis. Women's correct general awareness and knowledge of the legal status was less than 50% in nine studies. In six studies, knowledge of legalization/liberalisation ranged between 32.3%-68.2%. Correct knowledge of abortion on the grounds of rape ranged from 12.8%-98%, while in the case of incest, ranged from 9.8%-64.5%. Abortion on the grounds of fetal impairment and gestational limits, varied widely from 7%-94% and 0%-89.5% respectively. This systematic review synthesizes literature on women's awareness and knowledge of the abortion law in their own context. The findings show that correct general awareness and knowledge of the abortion law and legal grounds and restrictions amongst women was limited, even in countries where the laws were liberal. Thus, interventions to disseminate accurate information on the legal context are necessary.

  15. Theorizing Time in Abortion Law and Human Rights

    PubMed Central

    Erdman, Joanna N.

    2017-01-01

    Abstract The legal regulation of abortion by gestational age, or length of pregnancy, is a relatively undertheorized dimension of abortion and human rights. Yet struggles over time in abortion law, and its competing representations and meanings, are ultimately struggles over ethical and political values, authority and power, the very stakes that human rights on abortion engage. This article focuses on three struggles over time in abortion and human rights law: those related to morality, health, and justice. With respect to morality, the article concludes that collective faith and trust should be placed in the moral judgment of those most affected by the passage of time in pregnancy and by later abortion—pregnant women. With respect to health, abortion law as health regulation should be evidence-based to counter the stigma of later abortion, which leads to overregulation and access barriers. With respect to justice, in recognizing that there will always be a need for abortion services later in pregnancy, such services should be safe, legal, and accessible without hardship or risk. At the same time, justice must address the structural conditions of women’s capacity to make timely decisions about abortion, and to access abortion services early in pregnancy. PMID:28630539

  16. 'High profile health facilities can add to your trouble': Women, stigma and un/safe abortion in Kenya.

    PubMed

    Izugbara, Chimaraoke O; Egesa, Carolyne; Okelo, Rispah

    2015-09-01

    Public health discourses on safe abortion assume the term to be unambiguous. However, qualitative evidence elicited from Kenyan women treated for complications of unsafe abortion contrasted sharply with public health views of abortion safety. For these women, safe abortion implied pregnancy termination procedures and services that concealed their abortions, shielded them from the law, were cheap and identified through dependable social networks. Participants contested the notion that poor quality abortion procedures and providers are inherently dangerous, asserting them as key to women's preservation of a good self, management of stigma, and protection of their reputation, respect, social relationships, and livelihoods. Greater public health attention to the social dimensions of abortion safety is urgent. Copyright © 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

  17. Experiences and opinions of health-care professionals regarding legal abortion in Mexico City: a qualitative study.

    PubMed

    Contreras, Xipatl; van Dijk, Marieke G; Sanchez, Tahilin; Smith, Patricio Sanhueza

    2011-09-01

    This study examines the experiences and opinions of health-care professionals after the legalization of abortion in Mexico City in 2007. Sixty-four semistructured interviews were conducted between 1 December 2007 and 16 July 2008 with staff affiliated with abortion programs in 12 hospitals and 1 health center, including obstetricians/gynecologists, nurses, social workers, key decisionmakers at the Ministry of Health, and others. Findings suggest that program implementation was difficult because of the lack of personnel, space, and resources; a great number of conscientious objectors; and the enormous influx of women seeking services, which resulted in a work overload for participating professionals. The professionals interviewed indicate that the program improved significantly over time. They generally agree that legal abortion should be offered, despite serious concerns about repeat abortions. They recommend improving family planning campaigns and post-procedure contraceptive use, and they encourage the opening of primary health-care facilities dedicated to providing abortion services.

  18. Woman-centered research on access to safe abortion services and implications for behavioral change communication interventions: a cross-sectional study of women in Bihar and Jharkhand, India

    PubMed Central

    2012-01-01

    Background Unsafe abortion in India leads to significant morbidity and mortality. Abortion has been legal in India since 1971, and the availability of safe abortion services has increased. However, service availability has not led to a significant reduction in unsafe abortion. This study aimed to understand the gap between safe abortion availability and use of services in Bihar and Jharkhand, India by examining accessibility from the perspective of rural, Indian women. Methods Two-stage stratified random sampling was used to identify and enroll 1411 married women of reproductive age in four rural districts in Bihar and Jharkhand, India. Data were collected on women's socio-demographic characteristics; exposure to mass media and other information sources; and abortion-related knowledge, perceptions and practices. Multiple linear regression models were used to explore the association between knowledge and perceptions about abortion. Results Most women were poor, had never attended school, and had limited exposure to mass media. Instead, they relied on community health workers, family and friends for health information. Women who had knowledge about abortion, such as knowing an abortion method, were more likely to perceive that services are available (β = 0.079; p < 0.05) and have positive attitudes toward abortion (β = 0.070; p < 0.05). In addition, women who reported exposure to abortion messages were more likely to have favorable attitudes toward abortion (β = 0.182; p < 0.05). Conclusions Behavior change communication (BCC) interventions, which address negative perceptions by improving community knowledge about abortion and support local availability of safe abortion services, are needed to increase enabling resources for women and improve potential access to services. Implementing BCC interventions is challenging in settings such as Bihar and Jharkhand where women may be difficult to reach directly, but interventions can target individuals in the community to

  19. Woman-centered research on access to safe abortion services and implications for behavioral change communication interventions: a cross-sectional study of women in Bihar and Jharkhand, India.

    PubMed

    Banerjee, Sushanta K; Andersen, Kathryn L; Buchanan, Rebecca M; Warvadekar, Janardan

    2012-03-09

    Unsafe abortion in India leads to significant morbidity and mortality. Abortion has been legal in India since 1971, and the availability of safe abortion services has increased. However, service availability has not led to a significant reduction in unsafe abortion. This study aimed to understand the gap between safe abortion availability and use of services in Bihar and Jharkhand, India by examining accessibility from the perspective of rural, Indian women. Two-stage stratified random sampling was used to identify and enroll 1411 married women of reproductive age in four rural districts in Bihar and Jharkhand, India. Data were collected on women's socio-demographic characteristics; exposure to mass media and other information sources; and abortion-related knowledge, perceptions and practices. Multiple linear regression models were used to explore the association between knowledge and perceptions about abortion. Most women were poor, had never attended school, and had limited exposure to mass media. Instead, they relied on community health workers, family and friends for health information. Women who had knowledge about abortion, such as knowing an abortion method, were more likely to perceive that services are available (β = 0.079; p < 0.05) and have positive attitudes toward abortion (β = 0.070; p < 0.05). In addition, women who reported exposure to abortion messages were more likely to have favorable attitudes toward abortion (β = 0.182; p < 0.05). Behavior change communication (BCC) interventions, which address negative perceptions by improving community knowledge about abortion and support local availability of safe abortion services, are needed to increase enabling resources for women and improve potential access to services. Implementing BCC interventions is challenging in settings such as Bihar and Jharkhand where women may be difficult to reach directly, but interventions can target individuals in the community to transfer information to the women who

  20. Women’s Awareness and Knowledge of Abortion Laws: A Systematic Review

    PubMed Central

    Assifi, Anisa R.; Berger, Blair; Tunçalp, Özge; Khosla, Rajat; Ganatra, Bela

    2016-01-01

    Background Incorrect knowledge of laws may affect how women enter the health system or seek services, and it likely contributes to the disconnect between official laws and practical applications of the laws that influence women’s access to safe, legal abortion services. Objective To provide a synthesis of evidence of women’s awareness and knowledge of the legal status of abortion in their country, and the accuracy of women’s knowledge on specific legal grounds and restrictions outlined in a country’s abortion law. Methods A systematic search was carried for articles published between 1980–2015. Quantitative, mixed-method data collection, and objectives related to women’s awareness or knowledge of the abortion law was included. Full texts were assessed, and data extraction done by a single reviewer. Final inclusion for analysis was assessed by two reviewers. The results were synthesised into tables, using narrative synthesis. Results Of the original 3,126 articles, and 16 hand searched citations, 24 studies were included for analysis. Women’s correct general awareness and knowledge of the legal status was less than 50% in nine studies. In six studies, knowledge of legalization/liberalisation ranged between 32.3% - 68.2%. Correct knowledge of abortion on the grounds of rape ranged from 12.8% – 98%, while in the case of incest, ranged from 9.8% - 64.5%. Abortion on the grounds of fetal impairment and gestational limits, varied widely from 7% - 94% and 0% - 89.5% respectively. Conclusion This systematic review synthesizes literature on women’s awareness and knowledge of the abortion law in their own context. The findings show that correct general awareness and knowledge of the abortion law and legal grounds and restrictions amongst women was limited, even in countries where the laws were liberal. Thus, interventions to disseminate accurate information on the legal context are necessary. PMID:27010629

  1. "If a woman has even one daughter, I refuse to perform the abortion": Sex determination and safe abortion in India.

    PubMed

    Potdar, Pritam; Barua, Alka; Dalvie, Suchitra; Pawar, Anand

    2015-05-01

    In India, safe abortion services are sought mainly in the private sector for reasons of privacy, confidentiality, and the absence of delays and coercion to use contraception. In recent years, the declining sex ratio has received much attention, and implementation of the Pre-Conception and Pre-Natal Diagnostic Techniques (PCPNDT) Act (2003) has become stringent. However, rather than targeting sex determination, many inspection visits target abortion services. This has led to many private medical practitioners facing negative media publicity, defamation and criminal charges. As a result, they have started turning women away not only in the second trimester but also in the first. Samyak, a Pune-based, non-governmental organization, came across a number of cases of refusal of abortion services during its work and decided to explore the experiences of private medical practitioners with the regulatory mechanisms and what happened to the women. The study showed that as a fallout from the manner of implementation of the PCPNDT Act, safe abortion services were either difficult for women to access or outright denied to them. There is an urgent need to recognize this impact of the current regulatory environment, which is forcing women towards illegal and unsafe abortions. Copyright © 2015. Published by Elsevier Ltd.

  2. Study of fail-safe abort system for an actively cooled hypersonic aircraft, volume 2

    NASA Technical Reports Server (NTRS)

    Peeples, M. E.; Herring, R. L.

    1976-01-01

    Conceptual designs of a fail-safe abort system for hydrogen fueled actively cooled high speed aircraft are examined. The fail-safe concept depends on basically three factors: (1) a reliable method of detecting a failure or malfunction in the active cooling system, (2) the optimization of abort trajectories which minimize the descent heat load to the aircraft, and (3) fail-safe thermostructural concepts to minimize both the weight and the maximum temperature the structure will reach during descent. These factors are examined and promising approaches are evaluated based on weight, reliability, ease of manufacture and cost.

  3. Availability and distribution of safe abortion services in rural areas: a facility assessment study in Madhya Pradesh, India

    PubMed Central

    Chaturvedi, Sarika; Ali, Sayyed; Randive, Bharat; Sabde, Yogesh; Diwan, Vishal; De Costa, Ayesha

    2015-01-01

    Background Unsafe abortion contributes to a significant portion of maternal mortality in India. Access to safe abortion care is known to reduce maternal mortality. Availability and distribution of abortion care facilities can influence women's access to these services, especially in rural areas. Objectives To assess the availability and distribution of abortion care at facilities providing childbirth care in three districts of Madhya Pradesh (MP) province of India. Design Three socio demographically heterogeneous districts of MP were selected for this study. Facilities conducting at least 10 deliveries a month were surveyed to assess availability and provision of abortion services using UN signal functions for emergency obstetric care. Geographical Information System was used for visualisation of the distribution of facilities. Results The three districts had 99 facilities that conducted >10 deliveries a month: 74 in public and 25 in private sector. Overall, 48% of facilities reported an ability to provide safe surgical abortion service. Of public centres, 32% reported the ability compared to 100% among private centres while 18% of public centres and 77% of private centres had performed an abortion in the last 3 months. The availability of abortion services was higher at higher facility levels with better equipped and skilled personnel availability, in urban areas and in private sector facilities. Conclusions Findings showed that availability of safe abortion care is limited especially in rural areas. More emphasis on providing safe abortion services, particularly at primary care level, is important to more significantly dent maternal mortality in India. PMID:25797220

  4. Changes in Morbidity and Abortion Care in Ethiopia After Legal Reform: National Results from 2008 and 2014

    PubMed Central

    Gebrehiwot, Yirgu; Fetters, Tamara; Gebreselassie, Hailemichael; Moore, Ann; Hailemariam, Mengistu; Dibaba, Yohannes; Bankole, Akinrinola; Getachew, Yonas

    2017-01-01

    CONTEXT In Ethiopia, liberalization of the abortion law in 2005 led to changes in abortion services. It is important to examine how levels and types of abortion care—i.e., legal abortion and treatment of abortion complications—changed over time. METHODS Between December 2013 and May 2014, data were collected on symptoms, procedures and treatment from 5,604 women who sought abortion care at a sample of 439 public and private health facilities; the sample did not include lower-level private facilities—some of which provide abortion care—to maintain comparability with the sample from a 2008 study. These data were combined with monitoring data from 105,806 women treated in 74 nongovernmental organization facilities in 2013. Descriptive analyses were conducted and annual estimates were calculated to compare the numbers and types of abortion care services provided in 2008 and 2014. RESULTS The estimated annual number of women seeking a legal abortion in the types of facilities sampled increased from 158,000 in 2008 to 220,000 in 2014, and the estimated number presenting for postabortion care increased from 58,000 to 125,000. The proportion of abortion care provided in the public sector increased from 36% to 56% nationally. The proportion of women presenting for postabortion care who had severe complications rose from 7% to 11%, the share of all abortion procedures accounted for by medical abortion increased from 0% to 36%, and the proportion of abortion care provided by midlevel health workers increased from 48% to 83%. Most women received postabortion contraception. CONCLUSIONS Ethiopia has made substantial progress in expanding comprehensive abortion care; however, eradication of morbidity from unsafe abortion has not yet been achieved. PMID:28825903

  5. [Abortion and medical education in Mexico].

    PubMed

    de León-Aguirre, Deyanira González; Billings, Deborah L; Ramírez-Sánchez, Rubén

    2008-01-01

    Medical education in Mexico has significant deficiencies in the area of sexual and reproductive health and does not offer students the information needed for dealing with abortion as a relevant problem in the professional practice of medicine. Medical education does not offer options for the clinical training of future physicians in integrated models for abortion care, which include the use of safe and effective technologies as well as a range of services to respond to women's needs. These limitations are especially relevant in countries such as Mexico where unsafe abortion continues to be a significant public health problem. In addition, the legal context for abortion has begun to change during the current decade; therefore, the search for alternatives to incorporate a broad approach to abortion in medical school programs is a task that cannot be postponed.

  6. Medical students' attitudes and perceptions on abortion: a cross-sectional survey among medical interns in Maharastra, India.

    PubMed

    Sjöström, Susanne; Essén, Birgitta; Sydén, Filip; Gemzell-Danielsson, Kristina; Klingberg-Allvin, Marie

    2014-07-01

    Although abortion care has been an established routine since decades in India, 8% of maternal mortality is attributed to unsafe abortion. Increased knowledge and improved attitudes among health care providers have a potential to reduce barriers to safe abortion care by reducing stigma and reluctance to provide abortion. Previous research has shown that medical students' attitudes can predict whether they will perform abortions. The objective of our study was to explore attitudes toward abortion among medical interns in Maharastra, India. A cross-sectional survey was carried out among 1996 medical interns in Maharastra, India. Descriptive and analytical statistics were used to interpret the study instrument. Almost one quarter of the respondents considered abortion to be morally wrong, one fifth did not find abortions for unmarried women acceptable and one quarter falsely believed that a woman needs her partner or spouse's approval to have an abortion. Most participants agreed that unsafe abortion is a serious health problem in India. A majority of the respondents rated their knowledge of sexual and reproductive health as good, but only 13% had any clinical practice in abortion care services. Disallowing attitudes toward abortion and misconceptions about the legal regulations were common among the surveyed medical students. Knowledge and attitudes toward abortion among future physicians could be improved by amendments to the medical education, potentially increasing the number of future providers delivering safe and legal abortion services. Abortion is legal in India since decades, but maternal mortality due to unsafe abortions remains high. This survey of attitudes toward abortion among medical interns in Maharastra indicates that disallowing views prevail. Improved knowledge and clinical training can increase numbers of potential abortion providers, thus limit unsafe abortion. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. The incidence of abortion worldwide.

    PubMed

    Henshaw, S K; Singh, S; Haas, T

    1999-01-01

    Accurate measurement of induced abortion levels has proven difficult in many parts of the world. Health care workers and policymakers need information on the incidence of both legal and illegal induced abortion to provide the needed services and to reduce the negative impact of unsafe abortion on women's health. Numbers and rates of induced abortions were estimated from four sources: official statistics or other national data on legal abortions in 57 countries; estimates based on population surveys for two countries without official statistics; special studies for 10 countries where abortion is highly restricted; and worldwide and regional estimates of unsafe abortion from the World Health Organization. Approximately 26 million legal and 20 million illegal abortions were performed worldwide in 1995, resulting in a worldwide abortion rate of 35 per 1,000 women aged 15-44. Among the subregions of the world, Eastern Europe had the highest abortion rate (90 per 1,000) and Western Europe to the lowest rate (11 per 1,000). Among countries where abortion is legal without restriction as to reason, the highest abortion rate, 83 per 1,000, was reported for Vietnam and the lowest, seven per 1,000, for Belgium and the Netherlands. Abortion rates are no lower overall in areas where abortion is generally restricted by law (and where many abortions are performed under unsafe conditions) than in areas where abortion is legally permitted. Both developed and developing countries can have low abortion rates. Most countries, however, have moderate to high abortion rates, reflecting lower prevalence and effectiveness of contraceptive use. Stringent legal restrictions do not guarantee a low abortion rate.

  8. Why is a "Good Abortion Law" Not Enough? The Case of Estonia.

    PubMed

    Oja, Liiri

    2017-06-01

    There are various ways to critically discuss abortion. Constructing or finding the most suitable analytical framework-whether rooted in legal formalism, socio-legal considerations, or comparativism-always depends on the country of subject and whether the analysis is for litigation, advocacy, or more theoretical purposes. This paper offers a model for analyzing abortion in Estonia in order to connect it as a thought-provoking case study to the ongoing transnational abortion discussions. I set out by describing the Estonian Abortion Act as a "good abortion law": a regulation that guarantees in practice women's legal access to safe abortion. Despite this functioning law, I carve a space for criticism by expanding the conversation to the broader power relations and gender dynamics present in Estonian society. Accordingly, I explain the state of the Estonian feminist movement and gender research, the local legal community's minimal engagement with the reproductive rights discourse, and the lingering Soviet-era narratives of reproduction and health, which were not fully extinguished by the combination of human rights commitments and neoliberalism upon restoration of independence in the early 1990s. I consequently show that Estonia's liberal abortion regulation is not grounded in a sufficiently deep understanding of human rights-based approaches to reproductive health, therefore leaving the door open for micro-aggressions toward women and for conservative political winds to gain ground.

  9. Can community health workers play a greater role in increasing access to medical abortion services? A qualitative study.

    PubMed

    Gupta, Pallavi; Iyengar, Sharad D; Ganatra, Bela; Johnston, Heidi Bart; Iyengar, Kirti

    2017-05-25

    Despite being legally available in India since 1971, barriers to safe and legal abortion remain, and unsafe and/or illegal abortion continues to be a problem. Community health workers have been involved in improving access to health information and care for maternal and child health in resource poor settings, but their role in facilitating accurate information about and access to safe abortion has been relatively unexplored. A qualitative study was conducted in Rajasthan, India to study acceptability, perspectives and preferences of women and community health workers, regarding the involvement of community health workers in medical abortion referrals. In-depth interviews were conducted with 24 women seeking early medical abortion at legal abortion facilities or presenting at these facilities for a follow-up assessment after medical abortion. Ten community health workers who were trained to assess eligibility for early medical abortion and/or to assess whether women needed a follow-up visit after early medical abortion were also interviewed. The transcripts were coded using ATLAS-ti 7 (version 7.1.4) in the local language and reports were generated for all the codes, emerging themes were identified and the findings were analysed. Community health workers (CHWs) were willing to play a role in assessing eligibility for medical abortion and in identifying women who are in need of follow-up care after early medical abortion, when provided with appropriate training, regular supplies and job aids. Women however had apprehensions about contacting CHWs in relation to abortions. Important barriers that prevented women from seeking information and assistance from community health workers were fear of breach of confidentiality and a perception that they would be pressurised to undergo sterilisation. Our findings support a potential for greater role of CHWs in making safe abortion information and services accessible to women, while highlighting the need to address women

  10. On legalizing abortion: an open letter from Mexico's Christian Women's Collective.

    PubMed

    1993-01-01

    In Mexico City the Christian Women's Collective's open letter to the Catholic Church is a response to the Catholic bishops' threats of excommunication of lawmakers in Chiapas State, Mexico, who may have approved a bill legalizing abortion. The bishops maintain that God is a just and merciful God who loves women and suffers with them. The Collective cannot ignore the 2 million women, 1.72 million of whom are Catholics, who undergo illegal abortions annually in Mexico. They tend to be poor and in a union and to have large families. The Collective does not advocate abortion, but recognized that almost all women who have had an abortion were not at all happy to do so. Instead they suffer depression, solitude, shame, and pain. In addition to the moral punishment, these women are at high risk of dying (150,000-200,000 women die annually from illegal abortions). Economic circumstances, health problems, rape, and abandonment threaten their lives, so abortion is a last resort. The Collective maintains that the Catholic Church must understand that God empathized with women's pain, and in sending Jesus, has become one with humanity. The Church must seriously consider this sorrowful and very complex situation and reflect on the circumstances leading to abortion rather than condemn it. It must realize that by choosing abortion women want to avoid harm in those cases where pregnancy could cause death, avoid injustice when rape caused the pregnancy, or avoid giving birth to an infant that society or family cannot sustain. The present adverse and unjust situation contributing to unwanted pregnancy and illegal abortion is a social sin. The Catholic Church needs to build a new pastoral program with women at its center emphasizing sexuality, maternity, and contraception. Indeed, confronting the true social, moral, and political causes of abortion, and avoiding punishment, incarceration, or excommunication will resolve the issue.

  11. Is It Safe to Provide Abortion Pills over the Counter? A Study on Outcome Following Self-Medication with Abortion Pills

    PubMed Central

    Nivedita, K.

    2015-01-01

    Background: Medical abortion is a safe method of termination of pregnancy when performed as per guidelines with a success rate of 92-97 %. But self-administration of abortion pills is rampant throughout the country due to over the counter availability of these drugs and complications are not uncommon due to this practice. The society perceives unsupervised medical abortion as a very safe method of termination and women use this as a method of spacing. Aim of the Study: The aim of this study was to study the implications of self-administration of abortion pills by pregnant women. Materials and Methods: Retrospective observational study done in Sri Manakula Vinayagar Medical College & Hospital between the period of July 2013 to June2014. Case sheets were analysed to obtain data regarding self-administration of abortion pills and complications secondary to its administration. The following data were collected. Age, marital status, parity, duration of pregnancy as perceived by the women, confirmation of pregnancy, duration between pill intake and visit to hospital, whether any intervention done elsewhere, any known medical or surgical complications, Hb level on admission, whether patient was in shock, USG findings, evidence of sepsis, blood transfusion, treatment given and duration of hospital stay. Descriptive analysis of the collected data was done. Results: Among the 128 cases of abortion in the study period, 40 (31.25%) patients had self-administered abortion pills. Among these 40 patients 27.5% had consumed abortion pills after the approved time period of 63 days of which 17.5% had consumed pills after 12 weeks of gestation. The most common presentation was excessive bleeding (77.5%) Severe anaemia was found in 12.5% of the patients and 5% of patients presented with shock. The outcome was as follows : 62.5% of the patients were found to have incomplete abortion, 22.5% had failed abortion and 7.5% of patients had incomplete abortion with sepsis. Surgical evacuation

  12. Is It Safe to Provide Abortion Pills over the Counter? A Study on Outcome Following Self-Medication with Abortion Pills.

    PubMed

    Nivedita, K; Shanthini, Fatima

    2015-01-01

    Medical abortion is a safe method of termination of pregnancy when performed as per guidelines with a success rate of 92-97 %. But self-administration of abortion pills is rampant throughout the country due to over the counter availability of these drugs and complications are not uncommon due to this practice. The society perceives unsupervised medical abortion as a very safe method of termination and women use this as a method of spacing. The aim of this study was to study the implications of self-administration of abortion pills by pregnant women. Retrospective observational study done in Sri Manakula Vinayagar Medical College & Hospital between the period of July 2013 to June2014. Case sheets were analysed to obtain data regarding self-administration of abortion pills and complications secondary to its administration. The following data were collected. Age, marital status, parity, duration of pregnancy as perceived by the women, confirmation of pregnancy, duration between pill intake and visit to hospital, whether any intervention done elsewhere, any known medical or surgical complications, Hb level on admission, whether patient was in shock, USG findings, evidence of sepsis, blood transfusion, treatment given and duration of hospital stay. Descriptive analysis of the collected data was done. Among the 128 cases of abortion in the study period, 40 (31.25%) patients had self-administered abortion pills. Among these 40 patients 27.5% had consumed abortion pills after the approved time period of 63 days of which 17.5% had consumed pills after 12 weeks of gestation. The most common presentation was excessive bleeding (77.5%) Severe anaemia was found in 12.5% of the patients and 5% of patients presented with shock. The outcome was as follows : 62.5% of the patients were found to have incomplete abortion, 22.5% had failed abortion and 7.5% of patients had incomplete abortion with sepsis. Surgical evacuation was performed in 67.5% of the patients whereas 12.5% of the

  13. "I Am Ready and Willing to Provide the Service … Though My Religion Frowns on Abortion"-Ghanaian Midwives' Mixed Attitudes to Abortion Services: A Qualitative Study.

    PubMed

    Oppong-Darko, Prince; Amponsa-Achiano, Kwame; Darj, Elisabeth

    2017-12-04

    Unsafe abortion is a major preventable public health problem and contributes to high mortality among women. Ghana has ratified international conventions to prevent unwanted pregnancies and provide safe abortion services, legally authorizing midwives to provide induced abortion services in certain circumstances. The aim of the study was to understand midwives' readiness to be involved in legal induced abortions, should the law become less restricted in Ghana. A qualitative study design, with a topic guide for individual in-depth interviews of selected midwives, was adopted. The interviews were tape-recorded and analyzed using content analysis. Participants emphasized their willingness to reduce maternal mortalities, their experiences of maternal deaths, and their passion for the health of pregnant women. Knowledge of Ghana's abortion law was generally low. Different views were expressed regarding readiness to engage in abortion services. Some expressed it as being sinful and against their religion to assist in abortion care, whilst others felt it was good to save the lives of women. The midwives made it clear that unsafe abortions are common, stigmatizing and contributing to maternal mortality, issues that must be addressed. They made various suggestions to reduce this preventable tragedy.

  14. Why is a “Good Abortion Law” Not Enough? The Case of Estonia

    PubMed Central

    2017-01-01

    Abstract There are various ways to critically discuss abortion. Constructing or finding the most suitable analytical framework—whether rooted in legal formalism, socio-legal considerations, or comparativism—always depends on the country of subject and whether the analysis is for litigation, advocacy, or more theoretical purposes. This paper offers a model for analyzing abortion in Estonia in order to connect it as a thought-provoking case study to the ongoing transnational abortion discussions. I set out by describing the Estonian Abortion Act as a “good abortion law”: a regulation that guarantees in practice women’s legal access to safe abortion. Despite this functioning law, I carve a space for criticism by expanding the conversation to the broader power relations and gender dynamics present in Estonian society. Accordingly, I explain the state of the Estonian feminist movement and gender research, the local legal community’s minimal engagement with the reproductive rights discourse, and the lingering Soviet-era narratives of reproduction and health, which were not fully extinguished by the combination of human rights commitments and neoliberalism upon restoration of independence in the early 1990s. I consequently show that Estonia’s liberal abortion regulation is not grounded in a sufficiently deep understanding of human rights-based approaches to reproductive health, therefore leaving the door open for micro-aggressions toward women and for conservative political winds to gain ground. PMID:28630549

  15. Marital status and abortion among young women in Rupandehi, Nepal.

    PubMed

    Andersen, Kathryn L; Khanal, Ram Chandra; Teixeira, Alexandra; Neupane, Shailes; Sharma, Sharad; Acre, Valerie N; Gallo, Maria F

    2015-01-01

    Despite liberalization of the Nepal abortion law, young women continue to experience barriers to safe abortion services. We hypothesize that marital status may differentially impact such barriers, given the societal context of Nepal. We evaluated differences in reproductive knowledge and attitudes by marital status with a probability-based, cross-sectional survey of young women in Rupandehi district, Nepal. Participants (N = 600) were surveyed in 2012 on demographics, romantic experiences, media habits, reproductive information, and abortion knowledge and attitudes. We used logistic regression to assess differences by marital status, controlling for age. Participants, who comprised never-married (54%) and ever-married women (45%), reported good access to basic reproductive health and abortion information. Social desirability bias might have prevented reporting of premarital romantic and sexual activity given that participants reported more premarital activities for their friends than for themselves. Only 45% knew that abortion was legal, and fewer ever-married women were aware of abortion legality. Never-married women expected more negative responses from having an abortion than ever-married women. Findings highlight the need for providing sexual and reproductive health care information and services to young women regardless of marital status.

  16. Interrogating medical tourism: Ireland, abortion, and mobility rights.

    PubMed

    Gilmartin, Mary; White, Allen

    2011-01-01

    Medical tourism in Ireland, like in many Western states, is built around assumptions about individual agency, choice, possibility, and mobility. One specific form of medical tourism—the flow of women from Ireland traveling in order to secure an abortion—disrupts and contradicts these assumptions. One legacy of the bitter, contentious political and legal battles surrounding abortion in Ireland in the 1980s and 1990s has been securing the right of mobility for all pregnant Irish citizens to cross international borders to secure an abortion. However, these mobility rights are contingent upon nationality, social class, and race, and they have enabled successive Irish governments to avoid any responsibility for providing safe, legal, and affordable abortion services in Ireland. Nearly twenty years after the X case discussed here, the pregnant female body moving over international borders—entering and leaving the state—is still interpreted as problematic and threatening to the Irish state.

  17. Stigmatized by association: challenges for abortion service providers in Ghana.

    PubMed

    Aniteye, Patience; O'Brien, Beverley; Mayhew, Susannah H

    2016-09-10

    Unsafe abortion is an issue of public health concern and contributes significantly to maternal morbidity and mortality globally. Abortion evokes religious, moral, ethical, socio-cultural and medical concerns which mean it is highly stigmatized and this poses a threat to both providers and researchers. This study sought to explore challenges to providing safe abortion services from the perspective of health providers in Ghana. A descriptive qualitative study using in-depth interviews was conducted. The study was conducted in three (3) hospitals and five (5) health centres in the capital city in Ghana. Participants (n = 36) consisted of obstetrician/gynaecologists, nurse-midwives and pharmacists. Stigma affects provision of safe-abortion services in Ghana in a number of ways. The ambiguities in Ghanaian abortion law and lack of overt institutional support for practitioners increased reluctance to openly provide for fear of stigmatisation and legal threat. Negative provider attitudes that stigmatised women seeking abortion care were frequently driven by socio-cultural and religious norms that highly stigmatise abortion practice. Exposure to higher levels of education, including training overseas, seemed to result in more positive, less stigmatising views towards the need for safe abortion services. Nevertheless, physicians open to practicing abortion were still very concerned about stigma by association. Stigma constitutes an overarching impediment for abortion service provision. It affects health providers providing such services and even researchers who study the subject. Exposure to wider debate and education seem to influence attitudes and values clarification training may prove useful. Proper dissemination of existing guidelines and overt institutional support for provision of safe services also needs to be rolled out.

  18. Abortion surveillance--United States, 1992.

    PubMed

    Koonin, L M; Smith, J C; Ramick, M; Green, C A

    1996-05-03

    From 1980 through 1992, the number of legal induced abortions reported to the CDC remained stable, varying each year by < or = 5%. This report summarizes and reviews information reported to CDC regarding legal induced abortions obtained in the United States during 1992. This report also includes recently reported abortion-related deaths for 1988-1991 and an update on abortion-related deaths for 1985-1987. For each year since 1969, CDC has compiled abortion data received from 52 reporting areas (i.e., the 50 states, the District of Columbia, and New York City). In 1992, 1,359,145 abortions were reported--a 2.1% decrease from 1991. The abortion ratio was 335 legal induced abortions per 1,000 live births, and the abortion rate was 23 per 1,000 women 15-44 years of age. Women who were undergoing an abortion were more likely to be young, white, and unmarried; most had had no previous live births and were obtaining an abortion for the first time. More than half (51%) of all abortions were performed at or before the 8th week of gestation, and 87% were before the 13th week. Approximately 14% of abortions were performed at < or = 6 weeks of gestation, 15% were performed at 7 weeks of gestation, and 22% at 8 weeks of gestation. Younger women (i.e., women < or = 19 years of age) were more likely to obtain abortions later in pregnancy than were older women. Sixteen deaths in 1988, 12 deaths in 1989, and five deaths in 1990 were associated with legal induced abortion. The case-fatality rates for 1988, 1989, and 1990, respectively, were 1.2, 0.9, and 0.3 abortion-related deaths per 100,000 legal induced abortions. Since 1980, the number and rate of abortions have remained relatively stable, with only small year-to-year fluctuations of < or = 5%. However, since 1987, the abortion-to-live-birth ratio has declined; in 1992, the abortion ratio was the lowest recorded since 1977. More pregnant women have been opting to carry their pregnancies to term rather than choosing to have an

  19. Abortion surveillance--United States, 1998.

    PubMed

    Herndon, Joy; Strauss, Lilo T; Whitehead, Sara; Parker, Wilda Y; Bartlett, Linda; Zane, Suzanne

    2002-06-07

    In 1969, CDC began abortion surveillance to document the number and characteristics of women obtaining legal induced abortions, to monitor unintended pregnancy, and to assist efforts to identify and reduce preventable causes of morbidity and mortality associated with abortions. This report summarizes and reviews information reported to CDC regarding legal induced abortions obtained in the United States in 1998. For each year since 1969, CDC has compiled abortion data by occurrence. From 1973 to 1997, data were received from or estimated for 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. In 1998, CDC compiled abortion data from only 48 reporting areas; Alaska, California, New Hampshire, and Oklahoma did not report. In 1998, 884,273 legal induced abortions were reported to CDC, representing a 2% decrease from the 900,171 legal induced abortions reported by the same 48 reporting areas for 1997. The abortion ratio, defined as the number of abortions per 1,000 live births, was 264, compared with 274 in 1997 (for the same 48 areas); the abortion rate for these 48 areas was 17 per 1,000 women aged 15-44 years for both 1997 and 1998. The availability of information about characteristics of women who obtained an abortion in 1998 varied by state and by the number of states reporting each characteristic. The total number of legal induced abortions by state is reported by state of residence and state of occurrence; characteristics of women obtaining abortions in 1998 are reported by state of occurrence. Women undergoing an abortion were likely to be young (i.e., age < 25 years), white, and unmarried; slightly more than one half were obtaining an abortion for the first time. Of all abortions for which gestational age was reported, 56% were performed at < or = 8 weeks of gestation, and 88% were performed before 13 weeks. Overall, 19% of abortions were performed at the earliest weeks of gestation (< or = 6 weeks), 18% at 7 weeks

  20. Abortion surveillance--United States, 1999.

    PubMed

    Elam-Evans, Laurie D; Strauss, Lilo T; Herndon, Joy; Parker, Wilda Y; Whitehead, Sara; Berg, Cynthia J

    2002-11-29

    CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions and to monitor unintended pregnancy. This report summarizes and describes data reported to CDC regarding legal induced abortions obtained in the United States in 1999. For each year since 1969, CDC has compiled abortion data by state or area of occurrence. From 1973 through 1997, data were received from or estimated for 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. Beginning in 1998, CDC compiled abortion data from 48 reporting areas. Alaska, California, New Hampshire, and Oklahoma did not report, and data for these areas were not estimated. The availability of data regarding the characteristics of women who obtained an abortion in 1999 varied by state and by the number of states reporting each characteristic. The total number of legal induced abortions is reported by state of residence and also by state of occurrence for most areas; characteristics of women obtaining abortions in 1999 are reported by state of occurrence. A total of 861,789 legal induced abortions were reported to CDC for 1999, representing a 2.5% decrease from the 884,273 legal induced abortions reported by the same 48 reporting areas for 1998. The abortion ratio, defined as the number of abortions per 1,000 live births, was 256 in 1999, compared with 264 reported for 1998; the abortion rate for these 48 reporting areas was 17 per 1,000 women aged 15-44 years for 1999, the same as in 1997 and 1998. The highest percentages of abortions were reported for women aged < 25 years, women who were white, and unmarried women; slightly more than half were obtaining an abortion for the first time. Fifty-eight percent of all abortions for which gestational age was reported were performed at < or = 8 weeks of gestation, and 88% were performed before 13 weeks. From 1992 (when these data were first collected) through 1999, increases have

  1. Service provider perspectives on post-abortion contraception in Nepal.

    PubMed

    Wang, Lin-Fan; Puri, Mahesh; Rocca, Corinne H; Blum, Maya; Henderson, Jillian T

    2016-01-01

    The government of Nepal has articulated a commitment to the provision of post-abortion contraception since the implementation of a legal safe abortion policy in 2004. Despite this, gaps in services remain. This study examined the perspectives of abortion service providers and administrators regarding strengths and shortcomings of post-abortion contraceptive service provision. In-depth interviews were conducted with 24 abortion providers and administrators at four major health facilities that provide legal abortion in Nepal. Facility factors perceived to impact post-abortion contraceptive services included on-site availability of contraceptive supplies, dedicated and well-trained staff and adequate infrastructure. Cultural norms emerged as influencing contraceptive demand by patients, including method use being unacceptable for women whose husbands migrate and limited decision-making power among women. Service providers described their personal views on appropriate childbearing and the use of specific contraceptive methods that influenced counselling. Findings suggest that improvements to a facility's infrastructure and training to address provider biases and misinformation may improve post-abortion family planning uptake. Adapting services to be sensitive to cultural expectations and norms may help address some barriers to contraceptive use. More research is needed to determine how to best meet the contraceptive needs of women who have infrequent sexual activity or who may face stigma for using family planning, including adolescents, unmarried women and women whose husbands migrate.

  2. Attitudes of medical students to induced abortion.

    PubMed

    Buga, G A B

    2002-05-01

    Unsafe abortion causes 13% of maternal deaths worldwide. Safe abortion can only be offered under conditions where legislation has been passed for legal termination of unwanted pregnancy. Where such legislation exists, accessibility of safe abortion depends on the attitudes of doctors and other healthcare workers to induced abortion. Medical students as future doctors may have attitudes to abortion that will affect the provision of safe abortion. Little is known about the attitudes of South African medical students to abortion. To assess sexual practices and attitudes of medical students to induced abortion and to determine some of the factors that may influence these attitudes. A cross-sectional analytic study involving the self-administration of an anonymous questionnaire. The questionnaire was administered to medical students at a small, but growing, medical school situated in rural South Africa. Demographic data, sexual practices and attitudes to induced abortion. Two hundred and forty seven out of 300 (82.3%) medical students responded. Their mean age was 21.81 +/- 3.36 (SD) years, and 78.8% were Christians, 17.1% Hindus and 2.6% Muslims. Although 95% of the respondents were single, 68.6% were already sexually experienced, and their mean age at coitarche was 17.24+/-3.14 (SD) years. Although overall 61.2% of the respondents felt abortion is murder either at conception or later, the majority (87.2%) would perform or refer a woman for abortion under certain circumstances. These circumstances, in descending order of frequency, include: threat to mother's life (74.1%), in case of rape (62.3%), the baby is severely malformed (59.5%), threat to mother's mental health (53.8%) and parental incompetence (21.0%). Only 12.5% of respondents would perform or refer for abortion on demand, 12.8% would neither perform nor refer for abortion under any circumstances. Religious affiliation and service attendance significantly influenced some of these attitudes and beliefs

  3. Legal Issues Surrounding Safe Schools.

    ERIC Educational Resources Information Center

    Day, Reed B.

    This handbook provides an overview of legal issues pertaining to the safety of public schools. Following the introduction, chapter 2 describes the governance model and philosophy on which American education is based. Court decisions and federal and state legislation that mandate the right to a safe school are discussed in chapter 3. The fourth…

  4. Trends of abortion complications in a transition of abortion law revisions in Ethiopia.

    PubMed

    Gebrehiwot, Yirgu; Liabsuetrakul, Tippawan

    2009-03-01

    Evidence from developed countries has shown that abortion-related mortality and morbidity has decreased with the liberalization of the abortion law. This study aimed to assess the trend of hospital-based abortion complications during the transition of legalization in Ethiopia in May 2005. Medical records of women with abortion complications from 2003 to 2007 were reviewed (n = 773). Abortion and its complications with regard to legalization were described by rates and ratios, and predictors of fatal outcomes were analyzed by logistic regression. The overall and abortion-related maternal mortality ratios (AMMRs) showed a non-statistically significant downward trend over the 5-year period. However, the case fatality rate of abortion increased from 1.1% in 2003 to 3.6% in 2007. Late gestational age, history of interference and presenting after new abortion legislation passed have been found to be significant predictors of mortality. Decreased trends of abortion ratio and the AMMR were identified, but the severity of abortion complications and the case fatality rate increased during the transition of legal revision.

  5. Medical Students’ Attitudes toward Abortion Education: Malaysian Perspective

    PubMed Central

    Tey, Nai-peng; Yew, Siew-yong; Low, Wah-yun; Su’ut, Lela; Renjhen, Prachi; Huang, M. S. L.; Tong, Wen-ting; Lai, Siow-li

    2012-01-01

    Background Abortion is a serious public health issue, and it poses high risks to the health and life of women. Yet safe abortion services are not readily available because few doctors are trained to provide such services. Many doctors are unaware of laws pertaining to abortion. This article reports survey findings on Malaysian medical students’ attitudes toward abortion education and presents a case for including abortion education in medical schools. Methods and Results A survey on knowledge of and attitudes toward abortion among medical students was conducted in two public universities and a private university in Malaysia in 2011. A total of 1,060 students returned the completed questionnaires. The survey covered about 90% of medical students in Years 1, 3, and 5 in the three universities. About 90% of the students wanted more training on the general knowledge and legal aspects of abortion, and pre-and post-abortion counseling. Overall, 75.9% and 81.0% of the students were in favor of including in medical education the training on surgical abortion techniques and medical abortion, respectively. Only 2.4% and 1.7% were opposed to the inclusion of training of these two methods in the curriculum. The remaining respondents were neutral in their stand. Desire for more abortion education was associated with students’ pro-choice index, their intention to provide abortion services in future practice, and year of study. However, students’ attitudes toward abortion were not significantly associated with gender, type of university, or ethnicity. Conclusions Most students wanted more training on abortion. Some students also expressed their intention to provide abortion counseling and services in their future practice. Their desire for more training on abortion should be taken into account in the new curriculum. Abortion education is an important step towards making available safe abortion services to enable women to exercise their reproductive rights. PMID:23300600

  6. What are people looking for when they Google "self-abortion"?

    PubMed

    Jerman, Jenna; Onda, Tsuyoshi; Jones, Rachel K

    2018-06-01

    To examine the motivations and circumstances of individuals seeking information about self-abortion on the Internet. We identified 26 terms that we anticipated someone might use to find information about self-abortion on the internet. Users who entered these terms into the Google search engine were provided with a link to our survey via Google AdWords. We fielded the survey over a 32-day period; users were eligible if accessing the survey from a US-based device. We examined demographic characteristics of the sample, reasons for searching for information on self-abortion, knowledge of the legality of abortion and of nearby providers, and top performing keywords. Our Google AdWords campaign containing the survey link was shown approximately 210,000 times, and clicked 9,800 times; 1,235 respondents completed the survey. The vast majority of the sample was female (96%), and 41% were minors. Almost three-quarters (73%) indicated that they were searching for information because they were pregnant and did not or may not want to be. Eleven percent had ever attempted to self-abort. One-third of respondents did not know if abortion was legal in their state of residence, and knowledge of legality did not differ by age. There is interest in learning more about self-abortion on the Internet. Our findings suggest that, among those who participated in our survey, online searches for information on self-abortion may be driven by adolescents and young adults facing an unintended pregnancy. Young women, in particular, may have an unmet need for information about safe and accessible abortion options. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

  7. Consensus on abortion unlikely at U.N. conference, Gore says.

    PubMed

    1994-08-26

    US Vice President Al Gore is pessimistic about the likelihood of consensus on abortion and contraception at the 1994 World Population Conference given opposition on the part of the Vatican, governments of nations with large Roman Catholic populations, and Muslim fundamentalists. Although the Clinton Administration is advocating safe, legal abortion and accessible contraception, it does not intent to push for abortion rights in countries where the procedure is illegal. On the other hand, Gore has expressed confidence that the Cairo conference will forge a new approach to population and development based on improvements in women's status.

  8. The regulatory cliff edge between contraception and abortion: the legal and moral significance of implantation

    PubMed Central

    Sheldon, Sally

    2015-01-01

    In regulating the voluntary interruption of pregnancy, English law has accorded particular significance to two biological events. First, ‘viability’, the moment when a fetus is said to acquire the capacity for independent life, plays an important role in grounding restrictions on access to legal abortion later in pregnancy. Second, equally significantly but far less frequently discussed, ‘implantation’ marks the point in pregnancy from which abortion laws apply. This paper focuses on this earlier biological event. It suggests that an unquestioning reliance on implantation as marking an appropriate moment of transition between two radically different legal frameworks is deeply problematic and is rendered still less sustainable in the light of the development of new technologies that potentially operate shortly after the moment of implantation. PMID:26085334

  9. Religion and attitudes toward abortion and abortion policy in Brazil.

    PubMed

    Ogland, Curtis P; Verona, Ana Paula

    2011-01-01

    This study examines the association between religion and attitudes toward the practice of abortion and abortion policy in Brazil. Drawing upon data from the 2002 Brazilian Social Research Survey (BSRS), we test a number of hypotheses with regard to the role of religion on opposition to the practice of abortion and its legalization. Findings indicate that frequently attending Pentecostals demonstrate the strongest opposition to the practice of abortion and both frequently attending Pentecostals and Catholics demonstrate the strongest opposition to its legalization. Additional religious factors, such as a commitment to biblical literalism, were also found to be significantly associated with opposition to both abortion issues. Ultimately, the findings have implications for the future of public policy on abortion and other contentious social issues in Brazil.

  10. Induced abortion: incidence and trends worldwide from 1995 to 2008.

    PubMed

    Sedgh, Gilda; Singh, Susheela; Shah, Iqbal H; Ahman, Elisabeth; Henshaw, Stanley K; Bankole, Akinrinola

    2012-02-18

    Data of abortion incidence and trends are needed to monitor progress toward improvement of maternal health and access to family planning. To date, estimates of safe and unsafe abortion worldwide have only been made for 1995 and 2003. We used the standard WHO definition of unsafe abortions. Safe abortion estimates were based largely on official statistics and nationally representative surveys. Unsafe abortion estimates were based primarily on information from published studies, hospital records, and surveys of women. We used additional sources and systematic approaches to make corrections and projections as needed where data were misreported, incomplete, or from earlier years. We assessed trends in abortion incidence using rates developed for 1995, 2003, and 2008 with the same methodology. We used linear regression models to explore the association of the legal status of abortion with the abortion rate across subregions of the world in 2008. The global abortion rate was stable between 2003 and 2008, with rates of 29 and 28 abortions per 1000 women aged 15-44 years, respectively, following a period of decline from 35 abortions per 1000 women in 1995. The average annual percent change in the rate was nearly 2·4% between 1995 and 2003 and 0·3% between 2003 and 2008. Worldwide, 49% of abortions were unsafe in 2008, compared to 44% in 1995. About one in five pregnancies ended in abortion in 2008. The abortion rate was lower in subregions where more women live under liberal abortion laws (p<0·05). The substantial decline in the abortion rate observed earlier has stalled, and the proportion of all abortions that are unsafe has increased. Restrictive abortion laws are not associated with lower abortion rates. Measures to reduce the incidence of unintended pregnancy and unsafe abortion, including investments in family planning services and safe abortion care, are crucial steps toward achieving the Millennium Development Goals. UK Department for International Development

  11. Abortion in Europe, 1920-91: a public health perspective.

    PubMed

    David, H P

    1992-01-01

    This article grew out of a keynote address prepared for the conference, "From Abortion to Contraception: Public Health Approaches to Reducing Unwanted Pregnancy and Abortion Through Improved Family Planning Services," held in Tbilisi, Georgia, USSR in October 1990. The article reviews the legal, religious, and medical situation of induced abortion in Europe in historical perspective, and considers access to abortion services, attitudes of health professionals, abortion incidence, morbidity and mortality, the new antiprogestins, the characteristics of abortion seekers, late abortions, postabortion psychological reactions, effects of denied abortion, and repeat abortion. Special attention is focused on the changes occurring in Romania, Albania, and the former Soviet Union, plus the effects of the new conservatism elsewhere in the formerly socialist countries of central and eastern Europe, particularly Poland. Abortion is a social reality that can no more be legislated out of existence than the controversy surrounding it can be stilled. No matter how effective family planning services and practices become, there will always be a need for access to safe abortion services.

  12. Magnitude and risk factors of abortion among regular female students in Wolaita Sodo University, Ethiopia

    PubMed Central

    2014-01-01

    Background Induced abortion is one of the greatest human rights dilemmas of our time. Yet, abortion is a very common experience in every culture and society. According to the World Health Organization, Ethiopia had the fifth largest number of maternal deaths in 2005 and unsafe abortion was estimated to account for 32% of all maternal deaths in Ethiopia. Youth are disproportionately affected by the consequences of unsafe abortion. The objective of this study was, therefore, to determine the magnitude and identify factors associated with abortion among female Wolaita Sodo University students. Methods A descriptive, cross-sectional study was conducted in Wolaita Sodo University between May and June 2011. Data were collected from 493 randomly selected female students using structured and pre-tested questionnaires. Results The rate of abortion among students was found to be 65 per 1000 women, making it three fold the national rate of abortion for Ethiopia (23/1000 women aged 15–44). Virtually all of the abortions (96.9%) were induced and only half (16) were reported to be safe. Students with history of alcohol use, who are first-year and those enrolled in faculties with no post-Grade 10 Natural Science background had higher risk of abortion than their counterparts. About 23.7% reported sexual experience. Less than half of the respondents (44%) ever heard of emergency contraception and only 35.9% of those who are sexually experienced ever used condom. Conclusions High rate of abortion was detected among female Wolaita Sodo University students and half of the abortions took place/initiated under unsafe circumstances. Knowledge of students on legal and safe abortion services was found to be considerably poor. It is imperative that improved sexual health education, with focus on safe and legal abortion services is rendered and wider availability of Youth Friendly family planning services are realized in Universities and other places where young men and women congregate

  13. The power dynamics perpetuating unsafe abortion in Africa: a feminist perspective.

    PubMed

    Braam, Tamara; Hessini, Leila

    2004-04-01

    Tens of thousands of African women die every year because societies and governments either ignore the issue of unsafe abortion or actively refuse to address it. This paper explores the issue of abortion from a feminist perspective, centrally arguing that finding appropriate strategies to reclaim women's power at an individual and social level is a central lever for developing effective strategies to increase women's access to safe abortion services. The paper emphasises the central role of patriarchy in shaping the ways power plays itself out in individual relationships, and at social, economic and political levels. The ideology of male superiority denies abortion as an important issue of status and frames the morality, legality and socio-cultural attitudes towards abortion. Patriarchy sculpts unequal gender power relationships and takes power away from women in making decisions about their bodies. Other forms of power such as economic inequality, discourse and power within relationships are also explored. Recommended solutions to shifting the power dynamics around the issue include a combination of public health, rights-based, legal reform and social justice approaches.

  14. Abortion surveillance--United States, 2001.

    PubMed

    Strauss, Lilo T; Herndon, Joy; Chang, Jeani; Parker, Wilda Y; Levy, Deborah A; Bowens, Sonya B; Zane, Suzanne B; Berg, Cynthia J

    2004-11-26

    CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. This report summarizes and describes data voluntarily reported to CDC regarding legal induced abortions obtained in the United States in 2001. For each year since 1969, CDC has compiled abortion data by state or area of occurrence. During 1973-1997, data were received from or estimated for 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. In 1998 and 1999, CDC compiled abortion data from 48 reporting areas. Alaska, California, New Hampshire, and Oklahoma did not report, and data for these states were not estimated. In 2000 and 2001, Oklahoma again reported these data, increasing the number of reporting areas to 49. A total of 853,485 legal induced abortions were reported to CDC for 2001 from 49 reporting areas, representing a 0.5% decrease from the 857,475 legal induced abortions reported by the same 49 reporting areas for 2000. The abortion ratio, defined as the number of abortions per 1,000 live births, was 246 in 2001, compared with 245 reported for 2000. This represents a 0.4% increase in the abortion ratio. The abortion rate was 16 per 1,000 women aged 15-44 years for 2001, the same as for 2000. For both the 48 and 49 reporting areas, the abortion rate remained relatively constant during 1997-2001. The highest percentages of reported abortions were for women who were unmarried (82%), white (55%) and aged <25 years (52%). Of all abortions for which gestational age was reported, 59% were performed at < or =8 weeks' gestation and 88% at <13 weeks. From 1992 (when detailed data regarding early abortions were first collected) through 2001, steady increases have occurred in the percentage of abortions performed at < or =6 weeks' gestation. A limited number of abortions were obtained at >15 weeks' gestation, including 4.3% at 16-20 weeks and 1.4% at > or =21 weeks. A total of 35 reporting areas

  15. Study of a fail-safe abort system for an actively cooled hypersonic aircraft. Volume 1: Technical summary

    NASA Technical Reports Server (NTRS)

    Pirello, C. J.; Herring, R. L.

    1976-01-01

    Conceptual designs of a fail-safe abort system for hydrogen fueled actively cooled high speed aircraft are examined. The fail-safe concept depends on basically three factors: (1) a reliable method of detecting a failure or malfunction in the active cooling system, (2) the optimization of abort trajectories which minimize the descent heat load to the aircraft, and (3) fail-safe thermostructural concepts to minimize both the weight and the maximum temperature the structure will reach during descent. These factors are examined and promising approaches are evaluated based on weight, reliability, ease of manufacture and cost.

  16. Women’s experiences with unplanned pregnancy and abortion in Kenya: A qualitative study

    PubMed Central

    Ngui, Felistah Mbithe; Hall, Kelli Stidham; Gerdts, Caitlin

    2018-01-01

    Background Safe and legal abortions are rarely practiced in the public health sector in Kenya, and rates of maternal mortality and morbidity from unsafe abortion is high. Little is known about women’s experiences seeking and accessing abortion in informal settlements in Nairobi, Kenya. Methods Seven focus group discussions were conducted with a total of 71 women and girls recruited from an informal settlement in Nairobi. The interview guide explored participants’ perceptions of unplanned pregnancy, abortion, and access to sexual and reproductive health information in their community. Thematic analysis of the focus group transcripts was conducted using MAX QDA Release 12. Results Participants described a variety of factors that influence women’s experiences with abortion in their communities. According to participants, limited knowledge of sexual and reproductive health information and lack of access to contraception led to unplanned pregnancy among women in their community. Participants cited stigma and loss of opportunities that women with unplanned pregnancies face as the primary reasons why women seek abortions. Participants articulated stigma as the predominant barrier women in their communities face to safe abortion. Other barriers, which were often interrelated to stigma, included lack of education about safe methods of abortion, perceived illegality of abortion, as well as limited access to services, fear of mistreatment, and mistrust of health providers and facilities. Conclusions Women in informal settlements in Nairobi, Kenya face substantial barriers to regulating their fertility and lack access to safe abortion. Policy makers and reproductive health advocates should support programs that employ harm reduction strategies and increase women’s knowledge of and access to medication abortion outside the formal healthcare system. PMID:29370220

  17. Study of a fail-safe abort system for an actively cooled hypersonic aircraft: Computer program documentation

    NASA Technical Reports Server (NTRS)

    Haas, L. A., Sr.

    1976-01-01

    The Fail-Safe Abort System TEMPerature Analysis Program, (FASTEMP), user's manual is presented. This program was used to analyze fail-safe abort systems for an actively cooled hypersonic aircraft. FASTEMP analyzes the steady state or transient temperature response of a thermal model defined in rectangular, cylindrical, conical and/or spherical coordinate system. FASTEMP provides the user with a large selection of subroutines for heat transfer calculations. The various modes of heat transfer available from these subroutines are: heat storage, conduction, radiation, heat addition or generation, convection, and fluid flow.

  18. Abortion surveillance--United States, 2000.

    PubMed

    Elam-Evans, Laurie D; Strauss, Lilo T; Herndon, Joy; Parker, Wilda Y; Bowens, Sonya V; Zane, Suzanne; Berg, Cynthia J

    2003-11-28

    CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. This report summarizes and describes data reported to CDC regarding legal induced abortions obtained in the United States in 2000. For each year since 1969, CDC has compiled abortion data by state or area of occurrence. During 1973-1997, data were received from or estimated for 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. In 1998 and 1999, CDC compiled abortion data from 48 reporting areas. Alaska, California, New Hampshire, and Oklahoma did not report, and data for these areas were not estimated. In 2000, Oklahoma again reported these data, increasing the number of reporting areas to 49. A total of 857,475 legal induced abortions were reported to CDC for 2000 from 49 reporting areas, representing a 0.5% decrease from the 861,789 legal induced abortions reported by 48 reporting areas for 1999 and a 1.3% decrease for the same 48 reporting areas that reported in 1999. The abortion ratio, defined as the number of abortions per 1,000 live births, was 246 in 2000 (for the same 48 reporting areas as 1999), compared with 256 reported for 1999. This represents a 3.8% decline in the abortion ratio. The abortion rate (for the same 48 reporting areas as 1999) was 16 per 1,000 women aged 15-44 years for 2000. This was also a 3.8% decrease from the rate reported for procedures performed during 1997-1999 for the same 48 reporting areas. The highest percentages of reported abortions were for women aged <25 years (52%), women who were white (57%), and unmarried women (81%). Fifty-eight percent of all abortions for which gestational age was reported were performed at < or =8 weeks of gestation, and 88% were performed before 13 weeks. From 1992 (when detailed data regarding early abortions were first collected) through 2000, steady increases have occurred in the percentage of abortions performed at < or =6

  19. Legal abortion for mental health indications.

    PubMed

    Cook, R J; Ortega-Ortiz, A; Romans, S; Ross, L E

    2006-11-01

    Where legal systems allow therapeutic abortion to preserve women's mental health, practitioners often lack access to mental health professionals for making critical diagnoses or prognoses that pregnancy or childcare endangers patients' mental health. Practitioners themselves must then make clinical assessments of the impact on their patients of continued pregnancy or childcare. The law requires only that practitioners make assessments in good faith, and by credible criteria. Mental disorder includes psychological distress or mental suffering due to unwanted pregnancy and responsibility for childcare, or, for instance, anticipated serious fetal impairment. Account should be taken of factors that make patients vulnerable to distress, such as personal or family mental health history, factors that may precipitate mental distress, such as loss of personal relationships, and factors that may maintain distress, such as poor education and marginal social status. Some characteristics of patients may operate as both precipitating and maintaining factors, such as poverty and lack of social support.

  20. Abortion surveillance--United States, 2003.

    PubMed

    Strauss, Lilo T; Gamble, Sonya B; Parker, Wilda Y; Cook, Douglas A; Zane, Suzanne B; Hamdan, Saeed

    2006-11-24

    CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. This report summarizes and describes data voluntarily reported to CDC regarding legal induced abortions obtained in the United States in 2003. For each year since 1969, CDC has compiled abortion data by state or area of occurrence. During 1973-1997, data were received from or estimated for 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. In 1998 and 1999, CDC compiled abortion data from 48 reporting areas. Alaska, California, New Hampshire, and Oklahoma did not report, and data for these states were not estimated. During 2000-2002, Oklahoma again reported these data, increasing the number of reporting areas to 49, and for 2003, Alaska again reported and West Virginia did not, maintaining the number of reporting areas at 49. A total of 848,163 legal induced abortions were reported to CDC for 2003 from 49 reporting areas, representing a 0.7% decline from the 854,122 legal induced abortions reported by 49 reporting areas for 2002. The abortion ratio, defined as the number of abortions per 1,000 live births, was 241 in 2003, a decrease from the 246 in 2002. The abortion rate was 16 per 1,000 women aged 15-44 years for 2003, the same as for 2002. For the same 47 reporting areas, the abortion rate remained relatively constant during 1998-2003. During 2001-2002 (the most recent years for which data are available), 15 women died as a result of complications from known legal induced abortion. One death was associated with known illegal abortion. The highest percentages of reported abortions were for women who were unmarried (82%), white (55%), and aged <25 years (51%). Of all abortions for which gestational age was reported, 61% were performed at < or =8 weeks' gestation and 88% at <13 weeks. From 1992 (when detailed data regarding early abortions were first collected) through 2002, steady increases

  1. Abortion surveillance--United States, 2004.

    PubMed

    Strauss, Lilo T; Gamble, Sonya B; Parker, Wilda Y; Cook, Douglas A; Zane, Suzanne B; Hamdan, Saeed

    2007-11-23

    CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. This report summarizes and describes data voluntarily reported to CDC regarding legal induced abortions obtained in the United States in 2004. For each year since 1969, CDC has compiled abortion data by state or area of occurrence. During 1973-1997, data were received from or estimated for 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. In 1998 and 1999, CDC compiled abortion data from 48 reporting areas. Alaska, California, New Hampshire, and Oklahoma did not report, and data for these states were not estimated. During 2000-2002, Oklahoma again reported these data, increasing the number of reporting areas to 49; for 2003 and 2004, Alaska again reported and West Virginia did not, maintaining the number of reporting areas at 49. A total of 839,226 legal induced abortions were reported to CDC for 2004 from 49 reporting areas, representing a 1.1% decline from the 848,163 legal induced abortions reported by 49 reporting areas for 2003. The abortion ratio, defined as the number of abortions per 1,000 live births, was 238 in 2004, a decrease from the 241 in 2003. The abortion rate was 16 per 1,000 women aged 15-44 years for 2004, the same since 2000. For the same 47 reporting areas, the abortion rate remained relatively constant during 1998-2004. In 2003 (the most recent years for which data are available), 10 women died as a result of complications from known legal induced abortion. No death was associated with known illegal abortion. The highest percentages of reported abortions were for women who were known to be unmarried (80%), white (53%), and aged <25 years (50%). Of all abortions for which gestational age was reported, 61% were performed at < or =8 weeks' gestation and 88% at <13 weeks. From 1992 (when detailed data regarding early abortions were first collected) through 2004, steady

  2. Accompaniment of second-trimester abortions: the model of the feminist Socorrista network of Argentina.

    PubMed

    Zurbriggen, Ruth; Keefe-Oates, Brianna; Gerdts, Caitlin

    2018-02-01

    Legal restrictions on abortion access impact the safety and timing of abortion. Women affected by these laws face barriers to safe care that often result in abortion being delayed. Second-trimester abortion affects vulnerable groups of women disproportionately and is often more difficult to access. In Argentina, where abortion is legally restricted except in cases of rape or threat to the health of the woman, the Socorristas en Red, a feminist network, offers a model of accompaniment wherein they provide information and support to women seeking second-trimester abortions. This qualitative analysis aimed to understand Socorristas' experiences supporting women who have second-trimester medication abortion outside the formal health care system. We conducted 2 focus groups with 16 Socorristas in total to understand experiences accompanying women having second-trimester medication abortion who were at 14-24 weeks' gestational age. We performed a thematic analysis of the data and present key themes in this article. The Socorristas strived to ensure that women had the power of choice in every step of their abortion. These cases required more attention and logistical, legal and medical risks than first-trimester care. The Socorristas learned how to help women manage the possibility of these risks and were comfortable providing this support. They understood their work as activism through which they aim to destigmatize abortion and advocate against patriarchal systems denying the right to abortion. Socorrista groups have shown that they can provide supportive, women-centered accompaniment during second-trimester medication abortions outside the formal health care system in a setting where abortion access is legally restricted. Second-trimester self-use of medication abortion outside of the formal health system supported by feminist activist groups could provide an alternative model for second-trimester care worldwide. More research is needed to document the safety and

  3. Abortion and Islam: policies and practice in the Middle East and North Africa.

    PubMed

    Hessini, Leila

    2007-05-01

    This paper provides an overview of legal, religious, medical and social factors that serve to support or hinder women's access to safe abortion services in the 21 predominantly Muslim countries of the Middle East and North Africa (MENA) region, where one in ten pregnancies ends in abortion. Reform efforts, including progressive interpretations of Islam, have resulted in laws allowing for early abortion on request in two countries; six others permit abortion on health grounds and three more also allow abortion in cases of rape or fetal impairment. However, medical and social factors limit access to safe abortion services in all but Turkey and Tunisia. To address this situation, efforts are increasing in a few countries to introduce post-abortion care, document the magnitude of unsafe abortion and understand women's experience of unplanned pregnancy. Religious fatāwa have been issued allowing abortions in certain circumstances. An understanding of variations in Muslim beliefs and practices, and the interplay between politics, religion, history and reproductive rights is key to understanding abortion in different Muslim societies. More needs to be done to build on efforts to increase women's rights, engage community leaders, support progressive religious leaders and government officials and promote advocacy among health professionals.

  4. Abortion in late Imperial China: routine birth control or crisis intervention?

    PubMed

    Sommer, Matthew H

    2010-01-01

    In late imperial China, a number of purported methods of abortion were known; but who actually attempted abortion and under what circumstances? Some historians have suggested that abortion was used for routine birth control, which presupposes that known methods were safe, reliable, and readily available. This paper challenges the qualitative evidence on which those historians have relied, and presents new evidence from Qing legal sources and modern medical reports to argue that traditional methods of abortion (the most common being abortifacient drugs) were dangerous, unreliable, and often cost a great deal of money. Therefore, abortion in practice was an emergency intervention in a crisis: either a medical crisis, in which pregnancy threatened a woman's health, or a social crisis, in which pregnancy threatened to expose a woman's extramarital sexual relations. Moreover, abortion was not necessarily available even to women who wanted one.

  5. Clandestine abortions are not necessarily illegal.

    PubMed

    Cook, R J

    1991-01-01

    It is common to find the term illegal abortion misused. Often times this misuse is perpetrated by antiabortion advocates who wish to reinforce negative stereotypes and thus apply pressure on doctors to refrain from performing abortions. Until a practitioner is prosecuted and convicted of performing an abortion contrary to the law, the procedure should not be referred to as illegal. Instead the legally neutral term, abortion, should be used instead. This would better serve the interests of women's reproductive health. There is no legal system that makes abortion illegal in all circumstances. For example, abortion is often legal if the life of the mother in danger. This includes a perception on behalf of the practitioner that the women may be suicidal or attempt to terminate the pregnancy by herself. A practitioner performing an abortion in such circumstances is not doing so illegally. The use of the term illegal abortion ignores the fact that in criminal law one is presumed innocent until proven guilty. A prosecutor must prove 1st that an intervention was performed and 2nd that a criminal intent accompanied the intervention. It is this 2nd criterion that is often the hardest to prove, since the practitioner must only testify that the intervention was indicated by legally allowed circumstances to be innocent. The prosecutor must show bad faith in order to gain a justified conviction. Even abortion by unqualified practitioners may not be illegal if doctors refuse to perform the intervention because it is still indicated. Accurate description of abortions would clarify situations in which abortion can be legally provided.

  6. Abortion surveillance--United States, 2005.

    PubMed

    Gamble, Sonya B; Strauss, Lilo T; Parker, Wilda Y; Cook, Douglas A; Zane, Suzanne B; Hamdan, Saeed

    2008-11-28

    CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. This report summarizes and describes data voluntarily reported to CDC regarding legal induced abortions obtained in the United States in 2005. For each year since 1969, CDC has compiled abortion data by state or area of occurrence. Information is requested each year from all 50 states, New York City, and the District of Columbia. For 2005, data were received from 49 reporting areas: New York City, District of Columbia, and all states except California, Louisiana, and New Hampshire. For the purpose of trends analysis, data were evaluated from the 46 reporting areas that have been consistently reported since 1995. A total of 820,151 legal induced abortions were reported to CDC for 2005 from 49 reporting areas, the abortion ratio (number of abortions per 1,000 live births) was 233, and the abortion rate was 15 per 1,000 women aged 15--44 years. For the 46 reporting areas that have consistently reported since 1995, the abortion rate declined during 1995--2000 but has remained unchanged since 2000. For 2005, the highest percentages of reported abortions were for women who were known to be unmarried (81%), white (53%), and aged <25 years (50%). Of all abortions for which gestational age was reported, 62% were performed at abortions were first collected) through 2005, the percentage of abortions performed at abortions occurred at >15 weeks' gestation (3.7% at 16--20 weeks and 1.3% at >/=21 weeks). A total of 35 reporting areas submitted data stating that they performed and enumerated medical (nonsurgical) procedures, making up 9.9% of all known reported procedures from the 45 areas with adequate reporting on type of procedure. In 2004 (the most recent years for which data are available), seven women

  7. Abortion surveillance--United States, 2002.

    PubMed

    Strauss, Lilo T; Herndon, Joy; Chang, Jeani; Parker, Wilda Y; Bowens, Sonya V; Berg, Cynthia J

    2005-11-25

    CDC began abortion surveillance in 1969 to document the number and characteristics of women obtaining legal induced abortions. This report summarizes and describes data voluntarily reported to CDC regarding legal induced abortions obtained in the United States in 2002. For each year since 1969, CDC has compiled abortion data by state or area of occurrence. During 1973-1997, data were received from or estimated for 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. In 1998 and 1999, CDC compiled abortion data from 48 reporting areas. Alaska, California, New Hampshire, and Oklahoma did not report, and data for these states were not estimated. For 2000-2002, Oklahoma again reported these data, increasing the number of reporting areas to 49. A total of 854,122 legal induced abortions were reported to CDC for 2002 from 49 reporting areas, representing a 0.1% increase from the 853,485 legal induced abortions reported by the same 49 reporting areas for 2001. The abortion ratio, defined as the number of abortions per 1,000 live births, was 246 in 2002, the same as reported for 2001. The abortion rate was 16 per 1,000 women aged 15-44 years for 2002, the same as for 2001. For the same 48 reporting areas, the abortion rate remained relatively constant during 1997-2002. The highest percentages of reported abortions were for women who were unmarried (82%), white (55%), and aged <25 years (51%). Of all abortions for which gestational age was reported, 60% were performed at < or =8 weeks' gestation and 88% at <13 weeks. From 1992 (when detailed data regarding early abortions were first collected) through 2002, steady increases have occurred in the percentage of abortions performed at < or =6 weeks' gestation. A limited number of abortions was obtained at >15 weeks' gestation, including 4.1% at 16-20 weeks and 1.4% at > or =21 weeks. A total of 35 reporting areas submitted data stating that they performed and enumerated medical

  8. Complications of unsafe abortion in sub-Saharan Africa: a review.

    PubMed

    Benson, J; Nicholson, L A; Gaffikin, L; Kinoti, S N

    1996-06-01

    medications and procedures; and case studies on the provision of safe abortion services where legally allowed.

  9. [Use of contraception and reasons for choosing abortion among abortion applicants].

    PubMed

    Hansen, S K; Birkebaek, J S; Husfeldt, C; Munck, C B; Nøddebo, S M; Petersson, B H

    1996-10-07

    The object of this study was to describe a group of women applying for legal abortion in relation to their use of contraception and reasons for choosing an abortion. During a period of 13 months (1991-92) a questionnaire was distributed to women applying for legal abortion at Hillerød Hospital in Denmark. Three hundred and thirty-nine women participated. Fifty-nine percent of the women had become pregnant although they had used contraception. As seen in other studies, women still state demographic factors as their most important reasons for choosing an abortion. Women with two or more children do not want to have more children. Single women do not want children without being in a stable relationship. Furthermore occupation and education were frequently stated as important reasons for having an abortion. Economy and housing were not main reasons but contributory factors. Thirty percent of the women expressed ambivalence about the choice of abortion at the time when the abort was due.

  10. Abortion surveillance--United States, 1997.

    PubMed

    Koonin, L M; Strauss, L T; Chrisman, C E; Parker, W Y

    2000-12-08

    In 1969, CDC began abortion surveillance to document the number and characteristics of women obtaining legal induced abortions, to monitor unintended pregnancy, and to assist efforts to identify and reduce preventable causes of morbidity and mortality associated with abortions. This report summarizes and reviews information reported to CDC regarding legal induced abortions obtained in the United States in 1997. For each year since 1969, CDC has compiled abortion data by state where the abortion occurred. The data are received from 52 reporting areas in the United States: 50 states, the District of Columbia, and New York City. In 1997, a total of 1,186,039 legal abortions were reported to CDC, representing a 3% decrease from the number reported for 1996. The abortion ratio was 306 legal induced abortions per 1,000 live births, and since 1995, the abortion rate has remained at 20 per 1,000 women aged 15-44 years. The availability of information about characteristics of women who obtained an abortion in 1997 varied by state and by the number of states reporting each characteristic. The total number of legal induced abortions by state is reported by state of residence and state of occurrence; characteristics of women obtaining abortions in 1997 are reported by state of occurrence. Women who were undergoing an abortion were more likely to be young (i.e., aged < 25 years), white, and unmarried; approximately one half were obtaining an abortion for the first time. More than one half of all abortions for which gestational age was reported (55%) were performed at < or = 8 weeks of gestation, and 88% were performed before 13 weeks. Overall, 18% of abortions were performed at the earliest weeks of gestation (< or = 6 weeks), 18% at 7 weeks of gestation, and 20% at 8 weeks of gestation. From 1992 through 1997, increases have occurred in the percentage of abortions performed at the very early weeks of gestation. Few abortions were provided after 15 weeks of gestation--4% of

  11. Brazilian adolescents’ knowledge and beliefs about abortion methods: a school-based internet inquiry

    PubMed Central

    2014-01-01

    Background Internet surveys that draw from traditionally generated samples provide the unique conditions to engage adolescents in exploration of sensitive health topics. Methods We examined awareness of unwanted pregnancy, abortion behaviour, methods, and attitudes toward specific legal indications for abortion via a school-based internet survey among 378 adolescents aged 12–21 years in three Rio de Janeiro public schools. Results Forty-five percent knew peers who had undergone an abortion. Most students (66.0%) did not disclose abortion method knowledge. However, girls (aOR 4.2, 95% CI 2.4-7.2), those who had experienced their sexual debut (aOR1.76, 95% CI 1.1-3.0), and those attending a prestigious magnet school (aOR 2.7 95% CI 1.4-6.3) were more likely to report methods. Most abortion methods (79.3%) reported were ineffective, obsolete, and/or unsafe. Herbs (e.g. marijuana tea), over-the-counter medications, surgical procedures, foreign objects and blunt trauma were reported. Most techniques (85.2%) were perceived to be dangerous, including methods recommended by the World Health Organization. A majority (61.4%) supported Brazil’s existing law permitting abortion in the case of rape. There was no association between gender, age, sexual debut, parental education or socioeconomic status and attitudes toward legal abortion. However, students at the magnet school supported twice as many legal indications (2.7, SE.27) suggesting a likely role of peers and/or educators in shaping abortion views. Conclusions Abortion knowledge and attitudes are not driven simply by age, religion or class, but rather a complex interplay that includes both social spaces and gender. Prevention of abortion morbidity and mortality among adolescents requires comprehensive sexuality and reproductive health education that includes factual distinctions between safe and unsafe abortion methods. PMID:24521075

  12. Public funding for abortion where broadly legal.

    PubMed

    Grossman, Daniel; Grindlay, Kate; Burns, Bridgit

    2016-11-01

    The objective was to investigate public funding policies for abortion in countries with liberal or liberally interpreted laws (defined as permitting abortion for economic or social reasons or upon request). In May 2011-February 2012 and June 2013-December 2014, we researched online resources and conducted an email-based survey among reproductive health experts to determine countries' public funding policies for abortion. We categorized countries as follows: full funding for abortion (provided for free at government facilities, covered under state-funded health insurance); partial funding (partially covered by the government, covered for certain populations based on income or nonincome criteria, or less expensive in public facilities); funding for exceptional cases (rape/incest/fetal impairment, health/life of the woman or other limited cases) and no public funding. We obtained data for all 80 countries meeting inclusion criteria. Among the world's female population aged 15-49 in countries with liberal/liberally interpreted abortion laws, 46% lived in countries with full funding for abortion (34 countries), 41% lived in countries with partial funding (25 countries), and 13% lived in countries with no funding or funding for exceptional cases only (21 countries). Thirty-one of 40 high-income countries provided full funding for abortion (n=20) or partial funding (n=11); 28 of 40 low- to middle-income countries provided full (n=14) or partial funding for abortion (n=14). Of those countries that did not provide public funding for abortion, most provided full coverage of maternity care. Nearly half of countries with liberal/liberally interpreted abortion laws had public funding for abortion, including most countries that liberalized their abortion law in the past 20 years. Outliers remain, however, including among developed countries where access to abortion may be limited due to affordability. Since cost of services affects access, country policies regarding public

  13. [Criteria on the legalization of abortion].

    PubMed

    García-Romero, H; González-González, A; Galicia, J; Garcia-Barrios, C

    2000-01-01

    We revised ethical concepts related to abortion from the points of view of the mothers; life, health, and considerations are made concerning the embryo or fetus as a biological, ontological, moral, and potential person. Certain religious matters on abortion are described and commented on. Effects of abortion penalization in Mexico and the legislation in the Mexican states are examined, as well as the motives of depenalization in certain countries.

  14. Legal Knowledge as a Tool for Social Change: La Mesa por la Vida y la Salud de las Mujeres as an Expert on Colombian Abortion Law.

    PubMed

    González Vélez, Ana Cristina; Jaramillo, Isabel Cristina

    2017-06-01

    In May 2006, Colombia's Constitutional Court liberalized abortion, introducing three circumstances under which the procedure would not be considered a crime: (1) rape or incest; (2) a risk to the woman's health or life; and (3) fetal malformations incompatible with life. Immediately following the court's ruling, known as Sentence C-355, members of La Mesa por la Vida y Salud de las Mujeres (hereinafter La Mesa) began to mobilize to ensure the decision's implementation, bearing in mind the limited impact that the legal framework endorsed by the court has had in other countries in the region. We argue that La Mesa's strategy is an innovative one in the field of legal mobilization insofar as it presumes that law can be shaped not just by public officials and universities but also by social actors engaged in the creation and diffusion of legal knowledge. In this regard, La Mesa has become a legal expert on abortion by accumulating knowledge about the multiple legal rules affecting the practice of abortion and about the situations in which these rules are to be applied. In addition, by becoming a legal expert, La Mesa has been able to persuade health providers that they will not risk criminal prosecution or being fired if they perform abortions. We call this effect of legal mobilization a "pedagogical effect" insofar as it involves the production of expertise and appropriation of knowledge by health professionals. We conclude by discussing La Mesa's choice to become a legal expert on abortion as opposed to recruiting academics to do this work or encouraging women to produce and disseminate this knowledge.

  15. Reducing abortion-related mortality in South Asia: a review of constraints and a road map for change.

    PubMed

    Ganatra, Bela; Johnston, Heidi Bart

    2002-01-01

    South Asia (Bangladesh, India, Nepal, Pakistan, and Sri Lanka) is home to 28% of the world's people and accounts for about a third (30%) of the world's maternal deaths. Thirteen percent of all maternal deaths in South Asia are attributed to complications of unsafe abortion and are almost entirely preventable. This article reviews the legal, health system, and sociocultural barriers to safe abortion and suggests strategies to reduce abortion-related morbidity and mortality. Restrictive laws hamper safe abortion in most of the region, but even where laws are more liberal, limited awareness of the law has been a barrier to access. Such health system barriers as an insufficient number of trained providers, inequitable distribution of services, and excessive costs have contributed to death from unsafe abortion. Sociocultural attitudes, including the right of male relatives to make reproductive decisions, the emphasis on male heirs, and the strong social stigma against extramarital pregnancy also put women at risk. Government and other institutions must strive to prevent abortion-related death and disability by making safe abortion services accessible to the fullest extent of the law. Health systems need to provide emergency care for complications and postabortion contraceptive counseling, use appropriate technology, and allow nonphysician providers to deliver care. Safe abortion care programs need to address the needs of the local community, particularly the needs of socially and economically vulnerable subgroups, such as the unmarried and adolescents.

  16. First-trimester medical abortion service in Hong Kong.

    PubMed

    Lo, Sue S T; Ho, P C

    2015-10-01

    Research on medical abortion has been conducted in Hong Kong since the 1990s. It was not until 2011 that the first-trimester medical abortion service was launched. Mifepristone was registered in Hong Kong in April 2014 and all institutions that are listed in the Gazette as a provider for legal abortion can purchase mifepristone from the local provider. This article aimed to share our 3-year experience of this service with the local medical community. Our current protocol is safe and effective, and advocates 200-mg mifepristone and 400-µg sublingual misoprostol 24 to 48 hours later, followed by a second dose of 400-µg sublingual misoprostol 4 hours later if the patient does not respond. The complete abortion rate is 97.0% and ongoing pregnancy rate is 0.4%. Some minor side-effects have been reported and include diarrhoea, fever, abdominal pain, and allergy. There have been no serious adverse events such as heavy bleeding requiring transfusion, anaphylactic reaction, septicaemia, or death.

  17. Do men have rights in abortion? The Greek view.

    PubMed

    Mavroforou, Anna; Koumantakis, Evgenios; Michalodimitrakis, Emmanuel

    2010-03-01

    We have examined from a legal perspective the father's role in the decision to abort a pregnancy in western society. Furthermore, we have taken a closer look into the inadequacies the Greek legal framework on this issue, from a legal and social point of view. Literature in the Greek and English language. One of abortion's many victims is the father of the child. In most European countries and the United States of America, the law does not give any rights to the father on the issue of an abortion. Quite simply, men have no legal rights when it comes to abortion. Legally, an abortion is a private matter between a woman and her doctor, even if she is married. Greece was one of the last countries in Europe to legalize abortion after a long debate in Parliament and the publication of numerous declarations by women's rights organizations. However, despite the liberalization of abortion, which followed the ratification of L 1609/86, the legal framework in which abortions are carried out is not entirely satisfactory. One of the areas that require clarification is the role of father. L 1609/86 does not specify men's rights in abortion. Post-abortion counseling services are dealing with an increasing number of men coming forward, grieving their aborted children. A more careful approach is required and a possible review of the law on abortion may be useful. Counselling for women and their male partners should be offered by state organisations. Clarity of thinking, sympathy and understanding are prerequisites in order for a solution respecting the personality of both the woman and her male partner to be reached.

  18. Abortion patients' perceptions of abortion regulation.

    PubMed

    Cockrill, Kate; Weitz, Tracy A

    2010-01-01

    Most states regulate abortion differently than other health care services. Examples of these regulations include mandating waiting periods and the provision of state-authored information, and prohibiting private and public insurance coverage for abortion. The primary purpose of this paper is to explore abortion patients' perspectives on these regulations. We recruited 20 participants from three abortion providing facilities located in two states in the U.S. South and Midwest. Using a survey and semistructured interview, we collected information about women's knowledge of abortion regulation and policy preferences. During the interviews, women weighed the pros and cons of abortion regulations. We used grounded theory analytical techniques and matrix analysis to organize and interpret the data. We discovered five themes in these women's considerations of regulation: responsibility, empathy, safe and accessible health care, privacy, and equity. Women in the study generally supported policies that they felt protected women or informed decisions. However, most women also opposed laws mandating two-day abortion appointments for women who were traveling long distances. Women tended to favor financial coverage of abortion, arguing that it could help poor women afford abortion or reduce state expenditures. Overall the study participants' opinions on abortion policy reflect key values for advocates and policy makers to consider: responsibility, empathy, safe and accessible health care, privacy, and equity. Future work should examine abortion regulations in light of these shared values. Laws that promote misinformation or prohibit accommodations of unique circumstances are not consistent the positions articulated by the subjects in our study. Copyright 2010 Jacobs Institute of Women

  19. [Tensions between the (il)legal and the (il)legitimate in professional health practices regarding women who seek abortion].

    PubMed

    López Gómez, Alejandra

    2016-01-01

    The implementation of a pre- and post-abortion health care strategy, adopted in 2004 in Uruguay within a restrictive legal context prior to the decriminalization of abortion in 2012, opened a window of opportunity to link women facing unwanted pregnancies and abortion to health services in order to prevent unsafe abortion practices. This article looks into the tensions generated by the change of focus from maternal-child health to health and sexual and reproductive rights, and how those tensions operate. Using semi-structured interviews and focus groups, the practices and perception and assessment frameworks of professionals in their care of women facing unwanted pregnancy and abortion in the National Integrated Health System in Montevideo are analyzed. The results offer insights into some of the barriers and difficulties that can currently be observed in the implementation of the new law.

  20. Induced abortion and contraception in Italy.

    PubMed

    Spinelli, A; Grandolfo, M E

    1991-09-01

    This article discusses the legal and epidemiologic status of abortion in Italy, and its relationship to fertility and contraception. Enacted in May 1978, Italy's abortion law allows the operation to be performed during the 1st 90 days of gestation for a broad range of health, social, and psychological reasons. Women under 18 must receive written permission from a parent, guardian, or judge in order to undergo an abortion. The operation is free of charge. Health workers who object to abortion because of religious or moral reasons are exempt from participating. Regional differences exist concerning the availability of abortion, easy to procure in some places and difficult to obtain in others. After an initial increase following legalization, the abortion rate was 13.5/1000 women aged 15-44 and the abortion ratio was 309/1000 live births -- an intermediate rate and ratio compared to other countries. By the time the Abortion Act of 1978 was adopted, Italy already had one of the lowest fertility levels in Europe. Thus, the legalization of abortion has had no impact on fertility trends. Contrary to initial fears that the legalization of abortion would make abortion a method of family planning, 80% of the women who sought an abortion in 1983-88 were using birth control at the time (withdrawal being the most common method used by this group). In fact, most women who undergo abortions are married, between the ages of 25-34, and with at least one child. Evidence indicates widespread ignorance concerning reproduction. In a 1989 survey, only 65% of women could identify the fertile period of the menstrual cycle. Italy has no sex education in schools or national family planning programs. Compared to most of Europe, Italy still has low levels of reliable contraceptive usage. This points to the need to guarantee the availability of abortion.

  1. Effectiveness of a behavior change communication intervention to improve knowledge and perceptions about abortion in Bihar and Jharkhand, India.

    PubMed

    Banerjee, Sushanta K; Andersen, Kathryn L; Warvadekar, Janardan; Pearson, Erin

    2013-09-01

    Although abortion became legal in India in 1971, many women are unaware of the law. Behavior change communication interventions may be an effective way to promote awareness of the law and change knowledge of and perceptions about abortion, particularly in settings in which abortion is stigmatized. To evaluate the effectiveness of a behavior change communication intervention to improve women's knowledge about India's abortion law and their perceptions about abortion, a quasi-experimental study was conducted in intervention and comparison districts in Bihar and Jharkhand. Household surveys were administered at baseline in 2008 and at follow-up in 2010 to independent, randomly selected cross-sectional samples of rural married women aged 15-49. Logistic regression difference-in-differences models were used to assess program effectiveness. Analysis demonstrated program effectiveness in improving awareness and perceptions about abortion. The changes in the odds of knowing that abortion is legal and where to obtain safe abortion services were larger between baseline and follow-up in the intervention districts than the changes in odds observed in the comparison districts (odds ratios, 16.1 and 1.9, respectively). Similarly, the increase in women's perception of greater social support for abortion within their families and the increase in perceived self-efficacy with respect to family planning and abortion between baseline and follow-up was greater in the intervention districts than in the comparison districts (coefficients, 0.17 and 0.18, respectively). Behavior change communication interventions can be effective in improving knowledge of and perceptions about abortion in settings in which lack of accurate knowledge hinders women's access to safe abortion services. Multiple approaches should be used when attempting to improve knowledge and perceptions about stigmatized health issues such as abortion.

  2. Abortion surveillance--United States, 1991.

    PubMed

    Koonin, L M; Smith, J C; Ramick, M

    1995-05-05

    From 1980 through 1991, the number of legal induced abortions reported to CDC remained stable, varying each year by < or = 5%. This report summarizes and reviews information reported to CDC regarding legal induced abortions obtained in the United States during 1991. For each year since 1969, CDC has compiled abortion data received from 52 reporting areas: 50 states, the District of Columbia, and New York City. In 1991, 1,388,937 abortions were reported--a 2.8% decrease from 1990. The abortion ratio was 339 legal induced abortions per 1,000 live births, and the abortion rate was 24 per 1,000 women 15-44 years of age. Women who were undergoing an abortion were more likely to be young, white, and unmarried; most had had no previous live births and had been obtaining an abortion for the first time. More than half (52%) of all abortions were performed at or before the 8th week of gestation, and 88% were before the 13th week. Younger women (i.e., women < 19 years of age) were more likely to obtain abortions later in pregnancy than were older women. Since 1980, the number and rate of abortions have remained relatively stable, with only small year-to-year fluctuations of < or = 5%. However, since 1987, the abortion-to-live-birth ratio has declined; in 1991, the abortion ratio was the lowest recorded since 1977. An increasing rate of childbearing may partially account for this decline. An accurate assessment of the number and characteristics of women who obtain abortions in the United States is necessary both to monitor efforts to prevent unintended pregnancy and to identify and reduce preventable causes of morbidity and mortality associated with abortions.

  3. Estimating the costs of induced abortion in Uganda: A model-based analysis

    PubMed Central

    2011-01-01

    Background The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. Methods A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. Results The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Conclusion Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical. PMID:22145859

  4. Estimating the costs of induced abortion in Uganda: a model-based analysis.

    PubMed

    Babigumira, Joseph B; Stergachis, Andy; Veenstra, David L; Gardner, Jacqueline S; Ngonzi, Joseph; Mukasa-Kivunike, Peter; Garrison, Louis P

    2011-12-06

    The demand for induced abortions in Uganda is high despite legal and moral proscriptions. Abortion seekers usually go to illegal, hidden clinics where procedures are performed in unhygienic environments by under-trained practitioners. These abortions, which are usually unsafe, lead to a high rate of severe complications and use of substantial, scarce healthcare resources. This study was performed to estimate the costs associated with induced abortions in Uganda. A decision tree was developed to represent the consequences of induced abortion and estimate the costs of an average case. Data were obtained from a primary chart abstraction study, an on-going prospective study, and the published literature. Societal costs, direct medical costs, direct non-medical costs, indirect (productivity) costs, costs to patients, and costs to the government were estimated. Monte Carlo simulation was used to account for uncertainty. The average societal cost per induced abortion (95% credibility range) was $177 ($140-$223). This is equivalent to $64 million in annual national costs. Of this, the average direct medical cost was $65 ($49-86) and the average direct non-medical cost was $19 ($16-$23). The average indirect cost was $92 ($57-$139). Patients incurred $62 ($46-$83) on average while government incurred $14 ($10-$20) on average. Induced abortions are associated with substantial costs in Uganda and patients incur the bulk of the healthcare costs. This reinforces the case made by other researchers--that efforts by the government to reduce unsafe abortions by increasing contraceptive coverage or providing safe, legal abortions are critical.

  5. [Knowledge and opinions concerning legal and ethical issues with abortion among physicians working in emergency wards in Ribeirão Preto, São Paulo, Brazil].

    PubMed

    Loureiro, David Câmara; Vieira, Elisabeth Meloni

    2004-01-01

    This study focused on the knowledge and opinions of physicians regarding legal and ethical aspects of abortion. A self-administered questionnaire was filled out by 57 physicians working in the emergency rooms of two hospitals in Ribeirão Preto, São Paulo State, Brazil in 2001. The questionnaire had 38 questions on general knowledge, legislation, and attitudes towards abortion. Interviewees' mean age was 28.3, most were females, 52.6% were single, 42.1% were married, 54.4% were Catholic, and 21% were Spiritists. Although most of the physicians had a good level of overall knowledge on abortion (70%), one in five was not aware that abortion is the main cause of maternal mortality in Brazil. Most accepted the prevailing legal conditions for performing an abortion in Brazil but would also include fetal malformation incompatible with life, while opposing decriminalization of abortion on other grounds. Limited knowledge is revealed by misconceptions concerning enforcement of the prevailing legislation in practice. The study strongly suggests that many physicians lack knowledge or face difficulties in conforming to the Brazilian legislation on abortion.

  6. Induced abortion as a public health problem in Europe.

    PubMed

    1973-12-01

    The complex and multiple aspects of induced abortion are reflected in the report of a working group on induced abortion as a public health problem which was convened in Helsinki by the WHO Regional Office for Europe in April 1971. Wide variations exist in legislaion on abortion in the countries of western and southern Europe, those of eastern Europe, and those of northern Europe. Except for Romania, the numerical relationship between induced abortion and fertility is not known. The frequency of induced abortion in married women suggests that it is used in some countries for the desired spacing of children. The group noted that the decrease in fertility in Europe has been chiefly achieved by means of coitus interruptus and abortion. Over the period 1957-1959, the reported number of legally induced abortions increased in many European countries. Information from 4 European countries on the number of legally induced abortions showed that the highest rates were found in the age-group 20-34. While in most countries the number of abortions is highest in the age group 20-34, the number of legally induced abortions per 1000 live births increases with the age of the woman, the highest ratios being found in women over 35 years of age. The legal and administrative situation, the ethnic structure, religion, the extent of industrialization, and urbanization, educational resources, and the availability of medical and social services influence the abortion behavior of the community. Conflicts between individuals' needs and society's needs must be resolved. In the view of the group, the most efficient and the safest means of preventing unwanted births is by contraception or by legal abortion carried out by doctors in the hospital. Education for responsible parenthood is essential if contraception is to be fully exploited and the use of legally induced abortion reduced to a minimum.

  7. [Decriminalization of abortion: a common purpose in Latin America].

    PubMed

    1993-12-01

    In the conviction that abortion is a fundamental right of women and that its illegal practice constitutes a serious threat to life, several Latin American women's groups have united to work for decriminalization. The groups have been attempting to increase public awareness of the consequences of illegal abortion. Official silence on the topic appears to deny the existence of a problem. Proposals in the different Latin American countries are adapted to their political and legal circumstances. In Argentina, a campaign has been underway for nearly two years to collect signatures for a petition for a law concerning contraception and abortion. The National Network for Women's Health and other groups have held regional and national workshops on the issue. In Bolivia, radio and television programs have been broadcast in Spanish and indigenous languages on the right to choose, reproductive health, and sex education. Abortion was debated in Brazil during the process of constitutional reform, but it remains illegal. Illegal abortion continues to be a reality and women's groups are lobbying for decriminalization. Abortion is considered a crime in Colombia's penal code. Attempts to legalize abortion have been rejected by the legislature without debate. The practice of abortion under the circumstances has become a lucrative business whose lack of regulation has resulted in a growing number of maternal deaths. Attempts are underway in Costa Rica to legalize abortion in cases of rape or incest. Studies show that illegal abortion is the third most important cause of maternal death. A bill to legalize abortion is under study in Chile's Parliament but has not been approved. Abortion is illegal but common in Ecuador. Efforts are underway in Mexico and Nicaragua to encourage debate on abortion. Peru's Health Commission was recently prevented from classifying abortion for any reason other than grave congenital anomaly as homicide. Abortion has been legal in Puerto Rico since 1974, but

  8. Socio-clinical profile of married women with history of induced abortion: A community-based cross-sectional study in a rural area.

    PubMed

    Pattanaik, Sumitra; Patnaik, Lipilekha; Subhadarshini, Arpita; Sahu, Trilochan

    2017-01-01

    Induced abortion contributes significantly to maternal mortality in developing countries yet women still seek repeat induced abortion in spite of the availability of contraceptive services. (1) To study the sociodemographic profile of abortion seekers. (2) To study the reasons for procuring abortions by married women of reproductive age group. It was a cross-sectional community-based study. All the married women of reproductive age group (15-49 years) with a history of induced abortion were selected as the subjects. The most common reason for seeking an abortion was poverty (39.4%), followed by girl child and husband's insistence, which accounted for 17.2% each. More complications were noted in women undergoing an abortion in places other than government hospitals and also who did it in the second trimester. To reduce maternal deaths from unsafe abortion, several broad activities require strengthening such as decreasing unwanted pregnancies, increasing geographic accessibility and affordability, upgrading facilities that offers medical termination of pregnancy (MTP) services, increasing awareness among the reproductive age about the legal and safe abortion facilities, the consequences of unsafe abortion, ensuring appropriate referral facilities, increasing access to safe abortion services and increasing the quality of abortion care, including postabortion care.

  9. Public funding of abortions and abortion counseling for poor women.

    PubMed

    Edwards, R B

    1997-01-01

    This essay seeks to reveal the weakness in arguments against public funding of abortions and abortion counseling in the US based on economic, ethico-religious, anti-racist, and logical-consistency objections and to show that public funding of abortion is strongly supported by appeals to basic human rights, to freedom of speech, to informed consent, to protection from great harm, to justice, and to equal protection under the law. The first part of the article presents the case against public funding with detailed considerations of the economic argument, the ethico/religious argument, the argument that such funding supports racist genocide or eugenic quality control, and arguments that a logical inconsistency exists between the principles used to justify the legalization of abortions and arguments for public funding. The second part of the article presents the case for public funding by discussing the spending of public funds on morally offensive programs, arguments for public funding of abortion counseling for the poor, and arguments for public funding of abortions for the poor. It is concluded that it is morally unacceptable and rationally unjustifiable to refuse to expend public funds for abortions for low income women, because after all most money for legal abortions for the poor comes from welfare payments made to women. If conservative forces want to insure that no public funds pay for abortions, they must stop all welfare payments to pregnant women.

  10. Hospital response to the legalization of abortion in New York State: an analysis of program innovation.

    PubMed

    Miller, J

    1979-12-01

    The reorientation of hospital services in the state of New York to accommodate women's constitutional right to elective abortion was investigated. Market and resource constraints, the social orientations of the organization, and the values of physicians were examined in the effort to evaluate hospital response between 1971 and 1973. Analysis indicates that program innovation in obstetrical and gynecological services to include elective abortion was inhibited by economic factors that generally determined the feasibility of diverting finite resources to a new service and social orientations and values that determined the compatibility of elective abortions with the dominant values underlying hospital operations. The reform of New York abortion statutes and the subsequent ruling by the Supreme Court reiterating the right of women to terminate pregnancy failed to standardize the delivery of health care so that individual rights to service could be obtained everywhere in the state. The social changes ultimately realized through legislative and judicial action were essentially conditional upon the responsiveness of local health care providers. Legal action that failed to specifically address the administrative role of hospitals in social change qualified local access and could not be completely effective in legitimizing the redefinition of abortion in society.

  11. Abortion law around the world: progress and pushback.

    PubMed

    Finer, Louise; Fine, Johanna B

    2013-04-01

    There is a global trend toward the liberalization of abortion laws driven by women's rights, public health, and human rights advocates. This trend reflects the recognition of women's access to legal abortion services as a matter of women's rights and self-determination and an understanding of the dire public health implications of criminalizing abortion. Nonetheless, legal strategies to introduce barriers that impede access to legal abortion services, such as mandatory waiting periods, biased counseling requirements, and the unregulated practice of conscientious objection, are emerging in response to this trend. These barriers stigmatize and demean women and compromise their health. Public health evidence and human rights guarantees provide a compelling rationale for challenging abortion bans and these restrictions.

  12. Patient privacy and conflicting legal and ethical obligations in El Salvador: reporting of unlawful abortions.

    PubMed

    McNaughton, Heathe Luz; Mitchell, Ellen M H; Hernandez, Emilia G; Padilla, Karen; Blandon, Marta Maria

    2006-11-01

    Postabortion care providers who breach patient confidentiality endanger women's health and violate ethics. A 1998 abortion ban in El Salvador likely spurred an increase in the number of women investigated, because many women were reported to legal authorities by health care providers. Having analyzed safeguards of confidentiality in laws and ethical guidelines, we obtained information from legal records on women prosecuted from 1998 to 2003 and identified factors that may lead to reporting through a survey of obstetrician-gynecologists (n=110). Although ethical and human rights standards oblige providers to respect patients' privacy, 80% of obstetrician-gynecologists mistakenly believed reporting was required. Most respondents (86%) knew that women delay seeking care because of fear of prosecution, yet a majority (56%) participated in notification of legal authorities.

  13. Abortion: a tangle of rights.

    PubMed

    Curtin, L L

    1993-02-01

    Management of abortion personnel within a hospital setting involves a number of rights: the patient's rights to privacy and to the provision of competent, compassionate, and understanding nursing care; the right of nurses to refrain from abortion procedures due to conscience; and the right of hospitals to hire employees who will fulfill their contractual obligations. The US Supreme Court has held that the decision to abort is protected under the right to privacy; no one may interfere with a woman's decision. Public institutions do not have an obligation to fund abortion. If the Court had made abortion a right, then society would be obliged to provide abortion. The discussion of abortion rights focuses on the following topics: the legal duties of health professionals, the legal and moral rights and obligations of nurses, the legal rights and obligations of hospitals, and the rights of abortion patients. A case study is provided of a head nurse and staff in the gynecology ward of a large metropolitan hospital in 1974 who objected to the performance of saline abortion on the ward, to disposing of the fetuses, and to the validity of patients' consent. Their concern was for the health and safety of patients and the rights of patients to informed consent. The hospital did not have a right to force the nurses to comply with the directive on saline abortion procedures, because the hospital did not have the right to violate the conscience of an individual citizen. In another example of a transfer of a nurse to another area of the hospital, the hospital was exercising its prerogative to expect fulfillment of contractual obligations in a way that did not interfere with health care workers' objections to abortion. Roe v. Wade and Doe v. Bolton were the 2 cases that established the existence of institutional conscience. Health care workers have an obligation to inform hospitals in writing if they have objections to participation in abortion procedures. Nurses have an obligation

  14. [Illegal abortion with misoprostol in Guadeloupe].

    PubMed

    Manouana, M; Kadhel, P; Koffi, A; Janky, E

    2013-04-01

    The aim of this study was to describe the typical profile, and to assess the motivations of women who underwent illegal abortion with misoprostol in Guadeloupe (French West Indies). We conducted a 1-year prospective study on women who consulted after failure or complication of an illegal abortion with misoprostol. Fifty-two cases of illegal abortion with misoprostol were recorded. The most common profile was an unemployed woman, who was unmarried, foreign-born, had no medical insurance, and a low level of education; the median age was 28 (range 17 to 40). The justifications given were that the legal procedure was considered to be too slow, the young age of the woman, the ease of the self-medication procedure, a history of illegal abortion by misoprostol in the woman's country of origin, ignorance of the legal process, and financial and/or administrative problems. The problem of illegal abortion is probably underestimated in Guadeloupe and possibly France. This description of the profile of the population concerned and the justifications for choosing illegal abortion by misoprostol provides elements allowing better focus of education concerning abortion, contraception and family planning. Access to legal abortion centers should also be improved. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  15. Induced abortions among adolescent women in rural Maharashtra, India.

    PubMed

    Ganatra, Bela; Hirve, Siddhi

    2002-05-01

    In a study in rural Maharashtra, India, adolescents constituted 13.1% of the 1717 married women who had an induced abortion during an 18-month period in 1996-1998. The 197 adolescents who were subsequently interviewed had a lesser role in the decision-making process on abortion than women older than them. Most abortions were obtained in the private sector. Though spacing was the main reason for adolescents seeking abortion, prior contraceptive use among them was low. Additionally, they were less likely to receive post-abortion contraceptive counselling or to adopt contraception. Sex selection accounted for more than a fifth of abortions among adolescents. Additional qualitative data from 43 never-married and separated adolescents seeking abortion showed that non-consensual sex made many pregnancies unwanted, and cost, limited mobility, lack of family and partner support and the need for privacy to prevent stigma led many to go to traditional providers, even though safer options existed. Family planning programmes need to address the contraceptive needs of newly married adolescent women as well as unmarried adolescents. Informing adolescents of their legal rights, sensitising providers to adopt an empathetic attitude, and exploring innovative ways of increasing access to safe services for unmarried adolescents are all recommended.

  16. Implementation considerations when expanding health worker roles to include safe abortion care: a five-country case study synthesis.

    PubMed

    Glenton, Claire; Sorhaindo, Annik M; Ganatra, Bela; Lewin, Simon

    2017-09-21

    Allowing a broader range of trained health workers to deliver services can be an important way of improving access to safe abortion care. However, the expansion of health worker roles may be challenging to implement. This study aimed to explore factors influencing the implementation of role expansion strategies for non-physician providers to include the delivery of abortion care. We conducted a multi-country case study synthesis in Bangladesh, Ethiopia, Nepal, South Africa and Uruguay, where the roles of non-physician providers have been formally expanded to include the provision of abortion care. We searched for documentation from each country related to non-physician providers, abortion care services and role expansion through general internet searches, Google Scholar and PubMed, and gathered feedback from 12 key informants. We carried out a thematic analysis of the data, drawing on categories from the SURE Framework of factors affecting the implementation of policy options. Several factors appeared to affect the successful implementation of including non-physician providers to provide abortion care services. These included health workers' knowledge about abortion legislation and services; and health workers' willingness to provide abortion care. Health workers' willingness appeared to be influenced by their personal views about abortion, the method of abortion and stage of pregnancy and their perceptions of their professional roles. While managers' and co-workers' attitudes towards the use of non-physician providers varied, the synthesis suggests that female clients focused less on the type of health worker and more on factors such as trust, privacy, cost, and closeness to home. Health systems factors also played a role, including workloads and incentives, training, supervision and support, supplies, referral systems, and monitoring and evaluation. Strategies used, with varying success, to address some of these issues in the study countries included values

  17. The politicization of abortion and the evolution of abortion counseling.

    PubMed

    Joffe, Carole

    2013-01-01

    The field of abortion counseling originated in the abortion rights movement of the 1970s. During its evolution to the present day, it has faced significant challenges, primarily arising from the increasing politicization and stigmatization of abortion since legalization. Abortion counseling has been affected not only by the imposition of antiabortion statutes, but also by the changing needs of patients who have come of age in a very different era than when this occupation was first developed. One major innovation--head and heart counseling--departs in significant ways from previous conventions of the field and illustrates the complex and changing political meanings of abortion and therefore the challenges to abortion providers in the years following Roe v Wade.

  18. Using litigation to defend women prosecuted for abortion in Mexico: challenging state laws and the implications of recent court judgments.

    PubMed

    Paine, Jennifer; Noriega, Regina Tamés; Puga, Alma Luz Beltrán Y

    2014-11-01

    While women in Mexico City can access free, safe and legal abortion during the first trimester, women in other Mexican states face many barriers. To complicate matters, between 2008 and 2009, 16 state constitutions were amended to protect life from conception. While these reforms do not annul existing legal abortion indications, they have created additional obstacles for women. Health providers increasingly report women who seek life-saving care for complications such as haemorrhage to the police, and some cases eventually end up in court. The Grupo de Información en Reproducción Elegida (GIRE) has successfully litigated such cases in state courts, with positive outcomes. However, state courts have mainly focused on procedural issues. The Mexican Supreme Court ruling supporting Mexico City's law has had a positive effect, but a stronger stance is needed. This paper discusses the constitutional framework and jurisprudence regarding abortion in Mexico, and the recent Costa Rica decision of the Inter-American Court of Human Rights. We assert that Mexican states must guarantee women's access to abortion on the legal grounds established in law. We continue to support litigation at the state level to oblige courts to exonerate women prosecuted for illegal abortion. Advocacy should, of course, also address the legislative and executive branches, while working simultaneously to set legal precedents on abortion. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  19. Abortion Law Around the World: Progress and Pushback

    PubMed Central

    2013-01-01

    There is a global trend toward the liberalization of abortion laws driven by women’s rights, public health, and human rights advocates. This trend reflects the recognition of women’s access to legal abortion services as a matter of women’s rights and self-determination and an understanding of the dire public health implications of criminalizing abortion. Nonetheless, legal strategies to introduce barriers that impede access to legal abortion services, such as mandatory waiting periods, biased counseling requirements, and the unregulated practice of conscientious objection, are emerging in response to this trend. These barriers stigmatize and demean women and compromise their health. Public health evidence and human rights guarantees provide a compelling rationale for challenging abortion bans and these restrictions. PMID:23409915

  20. International developments in abortion law from 1988 to 1998.

    PubMed Central

    Cook, R J; Dickens, B M; Bliss, L E

    1999-01-01

    OBJECTIVES: In 2 successive decades since 1967, legal accommodation of abortion has grown in many countries. The objective of this study was to assess whether liberalizing trends have been maintained in the last decade and whether increased protection of women's human rights has influenced legal reform. METHODS: A worldwide review was conducted of legislation and judicial rulings affecting abortion, and legal reforms were measured against governmental commitments made under international human rights treaties and at United Nations conferences. RESULTS: Since 1987, 26 jurisdictions have extended grounds for lawful abortion, and 4 countries have restricted grounds. Additional limits on access to legal abortion services include restrictions on funding of services, mandatory counseling and reflection delay requirements, third-party authorizations, and blockades of abortion clinics. CONCLUSIONS: Progressive liberalization has moved abortion laws from a focus on punishment toward concern with women's health and welfare and with their human rights. However, widespread maternal mortality and morbidity show that reform must be accompanied by accessible abortion services and improved contraceptive care and information. PMID:10191808

  1. Reproductive justice and the pace of change: socioeconomic trends in US infant death rates by legal status of abortion, 1960-1980.

    PubMed

    Krieger, Nancy; Gruskin, Sofia; Singh, Nakul; Kiang, Mathew V; Chen, Jarvis T; Waterman, Pamela D; Gottlieb, Jillian; Beckfield, Jason; Coull, Brent A

    2015-04-01

    US infant death rates for 1960 to 1980 declined most quickly in (1) 1970 to 1973 in states that legalized abortion in 1970, especially for infants in the lowest 3 income quintiles (annual percentage change = -11.6; 95% confidence interval = -18.7, -3.8), and (2) the mid-to-late 1960s, also in low-income quintiles, for both Black and White infants, albeit unrelated to abortion laws. These results imply that research is warranted on whether currently rising restrictions on abortions may be affecting infant mortality.

  2. Patient Privacy and Conflicting Legal and Ethical Obligations in El Salvador: Reporting of Unlawful Abortions

    PubMed Central

    McNaughton, Heathe Luz; Mitchell, Ellen M.H.; Hernandez, Emilia G.; Padilla, Karen; Blandon, Marta Maria

    2006-01-01

    Postabortion care providers who breach patient confidentiality endanger women’s health and violate ethics. A 1998 abortion ban in El Salvador likely spurred an increase in the number of women investigated, because many women were reported to legal authorities by health care providers. Having analyzed safeguards of confidentiality in laws and ethical guidelines, we obtained information from legal records on women prosecuted from 1998 to 2003 and identified factors that may lead to reporting through a survey of obstetrician-gynecologists (n=110). Although ethical and human rights standards oblige providers to respect patients’ privacy, 80% of obstetrician-gynecologists mistakenly believed reporting was required. Most respondents (86%) knew that women delay seeking care because of fear of prosecution, yet a majority (56%) participated in notification of legal authorities. PMID:16571690

  3. Articulating reproductive justice through reparative justice: case studies of abortion in Great Britain and South Africa.

    PubMed

    Macleod, Catriona Ida; Beynon-Jones, Siân; Toerien, Merran

    2017-05-01

    Public health and rights-based approaches to abortion advocacy are well established. Feminists are, however, increasingly using a broader framework of 'reproductive justice', which considers the intersecting conditions that serve to enhance or hinder women's reproductive freedoms, including their capacities to decide about the outcome of their pregnancies. Nonetheless, reproductive justice approaches to abortion are, conceptually, relatively under-developed. We introduce a reparative justice approach as a method of further articulating the concept of reproductive justice. We first explain how this approach can be used to conceptualise safe, accessible and supportive abortion as a key element of reproductive justice in relation to the injustice of unwanted or unsupportable pregnancies. Using Ernesto Verdeja's critical theory of reparative justice and case studies of two countries (South Africa and Great Britain) where abortion is legal, we show how such an approach enables an analysis of reproductive justice within the specificities of particular contexts. We argue that both the rights-based legal framework adopted in South Africa and the medicalised approach of British law have, in practice, limited reparative justice in these contexts. We discuss the implications of reparative justice for abortion advocacy.

  4. Clients’ perceptions of the quality of care in Mexico City’s public-sector legal abortion program

    PubMed Central

    Becker, Davida; Díaz-Olavarrieta, Claudia; Juárez, Clara; García, Sandra G.; Sanhueza, Patricio; Harper, Cynthia C.

    2014-01-01

    Context In 2007 the Mexico City legislature made the groundbreaking decision to legalize first trimester abortion. Limited research has been conducted to understand clients’ perceptions of the abortion services available in public sector facilities. Methods We measured clients’ perceptions of quality of care at three public sector sites in Mexico City in 2009 (n=402). We assessed six domains of quality of care (client-staff interaction, information provision, technical competence, post-abortion contraceptive services, accessibility, and the facility environment), and conducted ordinal logistic regression analysis to identify which domains were important to women for their overall evaluation of care. We measured the association of overall service evaluation with socio-demographic factors and abortion-visit characteristics, in addition to specific quality of care domains. Results Clients reported a high quality of care for abortion services with an overall mean rating of 8.8 out of 10. Multivariable analysis showed that important domains for high evaluation included client perception of doctor as technically skilled (p<0.05), comfort with doctor (p<0.001), perception of confidentiality (p<.01), perception that receptionist was respectful (p<.05) and counseling on self-care at home following the abortion and post-abortion emotions (p<0.05 and p<0.01). Other relevant domains for high evaluation were convenient site hours (p<0.01), waiting time (p<0.001) and clean facility (p<0.05). Nulliparous women rated their care less favorably than parous women (p<0.05). Conclusions Our findings highlight important domains of service quality to women’s overall evaluations of abortion care in Mexico City. Strategies to improve clients’ service experiences should focus on improving counseling, service accessibility and waiting time. PMID:22227626

  5. Stay Legal and Safe in Treating for Bed Bugs

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    Quick fix solutions may sound appealing, but they may not be legal, safe, or effective. To avoid adverse effects such as poisoning, buy EPA-registered pesticides labeled for bed bug control, and follow all label directions and precautions.

  6. Socio-clinical profile of married women with history of induced abortion: A community-based cross-sectional study in a rural area

    PubMed Central

    Pattanaik, Sumitra; Patnaik, Lipilekha; Subhadarshini, Arpita; Sahu, Trilochan

    2017-01-01

    Background: Induced abortion contributes significantly to maternal mortality in developing countries yet women still seek repeat induced abortion in spite of the availability of contraceptive services. Objectives: (1) To study the sociodemographic profile of abortion seekers. (2) To study the reasons for procuring abortions by married women of reproductive age group. Materials and Methods: It was a cross-sectional community-based study. All the married women of reproductive age group (15–49 years) with a history of induced abortion were selected as the subjects. Results: The most common reason for seeking an abortion was poverty (39.4%), followed by girl child and husband's insistence, which accounted for 17.2% each. More complications were noted in women undergoing an abortion in places other than government hospitals and also who did it in the second trimester. Conclusions: To reduce maternal deaths from unsafe abortion, several broad activities require strengthening such as decreasing unwanted pregnancies, increasing geographic accessibility and affordability, upgrading facilities that offers medical termination of pregnancy (MTP) services, increasing awareness among the reproductive age about the legal and safe abortion facilities, the consequences of unsafe abortion, ensuring appropriate referral facilities, increasing access to safe abortion services and increasing the quality of abortion care, including postabortion care. PMID:29026757

  7. Abortion in adolescence: a four-country comparison.

    PubMed

    Welsh, P; McCarthy, M; Cromer, B

    2001-01-01

    The purpose of this study was to conduct a comparison, using qualitative analytic methodology, of perceptions concerning abortion among health care providers and administrators, along with politicians and anti-abortion activists (total n = 75) in Great Britain, Sweden, The Netherlands, and the United States. In none of these countries was there consensus about abortion prior to legalization, and, in all countries, public discussion continues to be present. In general, after legalization of abortion has no longer made it a volatile issue European countries have refocused their energy into providing family planning services, education, and more straightforward access to abortion compared with similar activities in the United States.

  8. Induced Abortion: a Systematic Review and Meta-analysis.

    PubMed

    Dastgiri, Saeed; Yoosefian, Maryam; Garjani, Mehraveh; Kalankesh, Leila R

    2017-03-01

    Induced abortion accounts for 1 in 8 of approximately 600000 maternal deaths that occur annually worldwide. Induced abortion rate can be considered as one of the indicators for assessing availability of the appropriate reproductive health plans for women and identifying needs for appropriate related health policies and programs. Researchers searched Pubmed, Google Scholar, CINAHL, Embase, PsycINFO, Cochrane, Iranian Scientific Information Database (SID), Iranian biomedical journals (Iranmedex), and Iranian Research Institute of Information and Documentation (Irandoc) between January 2000 and June 2013, which reported induced abortion. Search terms from two categories including abortion and termination of pregnancy were compiled. The search terms were "induced abortion", "illegal abortion", "illegal abortion", "unsafe abortion", and "criminal abortion". The search was also conducted with "induced termination of pregnancy", "illegal termination of pregnancy", "illegal termination of pregnancy", "unsafe termination of pregnancy" and "criminal termination of pregnancy". Meta-analysis was carried out by using OpenMeta software. Induced abortion rates were calculated based on the random effect model. Overall induced abortion rate was obtained 58.1 per 1000 women (95%CI: 55.16-61.04). In continental level, rate of induced abortion was 14 per 1000 women (95%CI: 11-16). Nation-wide and local rates were obtained 67.27 per 1000 women (95% CI: 60.02-74.23) and 148.92 (95% CI: 140.06-157.79) respectively. Induced abortion is a major public health problem that occurs worldwide whether under the legal restriction or freedom, and it remains as reproductive health concern globally. To eliminate the need for induced abortion is at the core of any effort for preventing this issue. Option with the highest priority is to prevent unwanted pregnancies through promoting reproductive health plans for women of reproductive age. In case the prevention strategies fail, universal provision of

  9. High Levels of Post-Abortion Complication in a Setting Where Abortion Service Is Not Legalized

    PubMed Central

    Melese, Tadele; Habte, Dereje; Tsima, Billy M.; Mogobe, Keitshokile Dintle; Chabaesele, Kesegofetse; Rankgoane, Goabaone; Keakabetse, Tshiamo R.; Masweu, Mabole; Mokotedi, Mosidi; Motana, Mpho; Moreri-Ntshabele, Badani

    2017-01-01

    Background Maternal mortality due to abortion complications stands among the three leading causes of maternal death in Botswana where there is a restrictive abortion law. This study aimed at assessing the patterns and determinants of post-abortion complications. Methods A retrospective institution based cross-sectional study was conducted at four hospitals from January to August 2014. Data were extracted from patients’ records with regards to their socio-demographic variables, abortion complications and length of hospital stay. Descriptive statistics and bivariate analysis were employed. Result A total of 619 patients’ records were reviewed with a mean (SD) age of 27.12 (5.97) years. The majority of abortions (95.5%) were reported to be spontaneous and 3.9% of the abortions were induced by the patient. Two thirds of the patients were admitted as their first visit to the hospitals and one third were referrals from other health facilities. Two thirds of the patients were admitted as a result of incomplete abortion followed by inevitable abortion (16.8%). Offensive vaginal discharge (17.9%), tender uterus (11.3%), septic shock (3.9%) and pelvic peritonitis (2.4%) were among the physical findings recorded on admission. Clinically detectable anaemia evidenced by pallor was found to be the leading major complication in 193 (31.2%) of the cases followed by hypovolemic and septic shock 65 (10.5%). There were a total of 9 abortion related deaths with a case fatality rate of 1.5%. Self-induced abortion and delayed uterine evacuation of more than six hours were found to have significant association with post-abortion complications (p-values of 0.018 and 0.035 respectively). Conclusion Abortion related complications and deaths are high in our setting where abortion is illegal. Mechanisms need to be devised in the health facilities to evacuate the uterus in good time whenever it is indicated and to be equipped to handle the fatal complications. There is an indication for

  10. Vatican is lone opponent of world conference's compromises on abortion.

    PubMed

    1994-09-07

    Three years in the making, the draft program of action of the 1994 International Conference on Population and Development sets nonbinding policy guidelines to contain the world's population at 7.27 billion in 2015. Although the Vatican was pleased to see Pakistan put forward a compromise formula developed to appease Catholic and Muslim objectors of abortion, the Church was unprepared to accept the compromise immediately and requested further discussion. The Vatican's rejection drew a strong chorus of vocal disapproval from other conference delegates. Even Iran accepted the draft as a "perfect text," while Sweden grudgingly accepted it as a "rock-bottom compromise." With no Catholic countries objecting to the compromise, the Vatican stood alone in its refusal to compromise with the rest of the world's leaders and peoples. Germany, speaking for the European Union, warned that enough concessions had already been made. The rationale for Vatican opposition was unclear since the section explicitly rejects abortion as a means of family planning and urges countries to minimize both the incidence of unsafe abortion and abortion overall by improving family planning. Prevention of unwanted pregnancies must be given highest priority and women should have ready access to compassionate counselling, with abortion never promoted as a means of family planning. Moreover, there is no longer a reference to sexual health education, a plea to governments to review their laws and policies on abortion, and a call to consider women's health rather than relying upon criminal codes and punitive measures. Participants said the Vatican objected to a phrase stating that abortions, where legal, should be safe, while the Church representative argued that any suggestion that abortion is safe contradicts church doctrine on the sanctity of life.

  11. [Induced abortion: a world perspective].

    PubMed

    Henshaw, S K

    1987-01-01

    This article presents current estimates of the number, rate, and proportion of abortions for all countries which make such data available. 76% of the world's population lives in countries where induced abortion is legal at least for health reasons. Abortion is legal in almost all developed countries. Most developing countries have some laws against abortion, but it is permitted at least for health reasons in the countries of 67% of the developing world's population. The other 33%--over 1 billion persons--reside mainly in subSaharan Africa, Latin America, and the most orthodox Muslim countries. By the beginning of the 20th century, abortion had been made illegal in most of the world, with rules in Africa, Asia, and Latin America similar to those in Europe and North America. Abortion legislation began to change first in a few industrialized countries prior to World War II and in Japan in 1948. Socialist European countries made abortion legal in the first trimester in the 1950s, and most of the industrialized world followed suit in the 1960s and 1970s. The worldwide trend toward relaxed abortion restrictions continues today, with governments giving varying reasons for the changes. Nearly 33 million legal abortions are estimated to be performed annually in the world, with 14 million of them in China and 11 million in the USSR. The estimated total rises to 40-60 million when illegal abortions added. On a worldwide basis some 37-55 abortions are estimated to occur for each 1000 women aged 15-44 years. There are probably 24-32 abortions per 100 pregnancies. The USSR has the highest abortion rate among developed countries, 181/1000 women aged 15-44, followed by Rumania with 91/1000, many of them illegal. The large number of abortions in some countries is due to scarcity of modern contraception. Among developing countries, China apparently has the highest rate, 62/1000 women aged 15-44. Cuba's rate is 59/1000. It is very difficult to calculate abortion rates in countries

  12. Future healthcare professionals’ knowledge about the Argentinean abortion law

    PubMed Central

    Oizerovich, Silvia; Stray-Pedersen, Babill

    2016-01-01

    Objectives We assessed healthcare students’ knowledge and opinions on Argentinian abortion law and identified differences between first- and final-year healthcare students. Methods In this cross-sectional study, self-administered anonymous questionnaires were administered to 760 first- and 695 final-year students from different fields of study (medicine, midwifery, nursing, radiology, nutrition, speech therapy, and physiotherapy) of the School of Medicine at the University of Buenos Aires, in 2011-2013. Results Compared to first-year students, a higher percentage of final-year students knew that abortion is legally restricted in Argentina (p < 0.001). A significantly higher percentage of final-year students could correctly identify the circumstances in which abortion is legal: woman´s life risk (87.4% last vs. 79.1% first year), rape of a woman with developmental disability (66.2% first vs. 85.4% last-year; p < 0.001). More final-year students chose severe foetal malformations (37.3% first year vs. 57.3% final year) despite its being illegal. Conclusions Although most final-year students knew that abortion is legally restricted in Argentina, misconceptions regarding circumstances of legal abortion were observed; this may be due to the fact that abortion is inadequately covered in the medical curricula. Medical schools should ensure that sexual and reproductive health topics are an integral part of their curricula. Healthcare providers who are aware of the legality of abortion are more likely to provide the public with sound information and ensure abortions are appropriately performed. PMID:27018552

  13. Does state-level context matter for individuals' knowledge about abortion, legality and health? Challenging the 'red states v. blue states' hypothesis.

    PubMed

    Bessett, Danielle; Gerdts, Caitlin; Littman, Lisa L; Kavanaugh, Megan L; Norris, Alison

    2015-01-01

    Recently, the hypothesis that state-level political context influences individuals' cultural values--the 'red states v. blue states' hypothesis--has been invoked to explain the hyper-polarisation of politics in the USA. To test this hypothesis, we examined individuals' knowledge about abortion in relation to the political context of their current state of residence. Drawing from an internet-survey of 586 reproductive-age individuals in the USA, we assessed two types of abortion knowledge: health-related and legality. We found that state-level conservatism does not modify the existing relationships between individual predictors and each of the two types of abortion knowledge. Hence, our findings do not support the 'red states' versus 'blue states' hypothesis. Additionally, we find that knowledge about abortion's health effects in the USA is low: 7% of our sample thought abortion before 12 weeks gestation was illegal.

  14. Reproductive Justice and the Pace of Change: Socioeconomic Trends in US Infant Death Rates by Legal Status of Abortion, 1960–1980

    PubMed Central

    Gruskin, Sofia; Singh, Nakul; Kiang, Mathew V.; Chen, Jarvis T.; Waterman, Pamela D.; Gottlieb, Jillian; Beckfield, Jason; Coull, Brent A.

    2015-01-01

    US infant death rates for 1960 to 1980 declined most quickly in (1) 1970 to 1973 in states that legalized abortion in 1970, especially for infants in the lowest 3 income quintiles (annual percentage change = −11.6; 95% confidence interval = −18.7, −3.8), and (2) the mid-to-late 1960s, also in low-income quintiles, for both Black and White infants, albeit unrelated to abortion laws. These results imply that research is warranted on whether currently rising restrictions on abortions may be affecting infant mortality. PMID:25713932

  15. Unsafe abortion: a tragic saga of maternal suffering.

    PubMed

    Regmi, M C; Rijal, P; Subedi, S S; Uprety, D; Budathoki, B; Agrawal, A

    2010-01-01

    Unsafe abortion is a significant cause of maternal morbidity and mortality in developing countries despite provision of adequate care and legalization of abortion. The aim of this study was to find out the contribution of unsafe abortion in maternal mortality and its other consequences. A retrospective study was carried out in the Department of Obstetrics and Gynecology in BPKIHS between 2005 April to 2008 September analyzing all the unsafe abortion related admissions. There were 70 unsafe abortion patients. Majority of them (52.8%) were of high grade. Most of them recovered but there were total 8 maternal deaths. Unsafe abortion is still a significant medical and social problem even in post legalization era of this country.

  16. Portugal takes step back on abortion legalization.

    PubMed

    1998-07-01

    According to international press reports, a law that would have allowed Portuguese women abortions through the 10th week of pregnancy and into the 16th week if their physical or mental health was at risk has been rescinded after a referendum to determine the statute's future was voided because of low voter turnout. Passed in February, the law was a liberalization of Portugal's strict anti-abortion laws, which ban all abortions except for narrowly defined medical reasons or in the case of rape (and those are permitted only until the 12th week of pregnancy). Because the issue is such a controversial one, politicians had turned to a national referendum asking Portuguese voters to overturn or ratify the new law. The referendum was the first in the country since the end of its right-wing dictatorship in 1974, and 50% participation was required. Only 31.5% of the country's 8.5 million eligible voters went to the polls on June 28. Of those voting, 50.9% voted against the liberalized new legislation. Sunny weather and World Cup soccer matches were both pointed to as reasons for the low turnout. Officials estimate there are some 20,000 illegal abortions annually in Portugal. Abortion-rights activists in the mostly Roman-Catholic country say hospitals see roughly 10,000 women a year suffering from complications from illegal abortions, and that at least 800 women die each year from the procedure. In the next day's Diario de Noticias, a daily paper in Portugal, the entire front page was filled with a giant question mark. "What now, lawmakers?" the headline read. full text

  17. Abortion.

    PubMed

    1993-05-01

    The Alan Guttmacher Institute's State Reproductive Health Monitor "Legislative Proposals and Actions" provides US legislative information on abortion. The listing contains information on pending bills: the state, the identifying legislative number, the sponsor, the committee, the date the bill was introduced, a description of the bill, and when available the bill's status. The bills cover: 1) clinic licensing, e.g., requiring outpatient health care facilities in which abortions are performed, to have malpractice liability insurance; 2) comprehensive statues, which require parental notification before minor may obtain abortions, mandate abortion counseling to all women 24 hours before the abortion can be performed and prohibit disciplining or discharging a state employee for refusing to provide abortion counseling; 3) fetal personhood and rights, e.g. providing that life is vested in each person at fertilization; 4) fetal research and remains; 5) gender of fetus, which regulate abortions relative to sex selection in pregnancies; 6) harassment regulation; 7) informed consent and waiting periods detailing the risks and alternatives to abortion, and the 24-hour waiting period; 8) insurance coverage, e.g., eliminating language banning the coverage of abortions for state workers, and prohibiting disclosure by a health insurance carrier to the employer of a claimant that the claimant had a surgical abortion; 9) legality of abortion, urging Congress to reject he Freedom of Choice Act; 10) parental consent and notification; 11) postviability requirements; 12) public funding; 13) reporting requirements; 14) reproductive rights, and 15) spousal and paternal consent and notification.

  18. Doing more for less: identifying opportunities to expand public sector access to safe abortion in South Africa through budget impact analysis.

    PubMed

    Lince-Deroche, Naomi; Harries, Jane; Constant, Deborah; Morroni, Chelsea; Pleaner, Melanie; Fetters, Tamara; Grossman, Daniel; Blanchard, Kelly; Sinanovic, Edina

    2018-02-01

    To estimate the costs of public-sector abortion provision in South Africa and to explore the potential for expanding access at reduced cost by changing the mix of technologies used. We conducted a budget impact analysis using public sector abortion statistics and published cost data. We estimated the total costs to the public health service over 10 years, starting in South Africa's financial year 2016/17, given four scenarios: (1) holding service provision constant, (2) expanding public sector provision, (3) changing the abortion technologies used (i.e. the method mix), and (4) expansion plus changing the method mix. The public sector performed an estimated 20% of the expected total number of abortions in 2016/17; 26% and 54% of all abortions were performed illegally or in the private sector respectively. Costs were lowest in scenarios where method mix shifting occurred. Holding the proportion of abortions performed in the public-sector constant, shifting to more cost-effective service provision (more first-trimester services with more medication abortion and using the combined regimen for medical induction in the second trimester) could result in savings of $28.1 million in the public health service over the 10-year period. Expanding public sector provision through elimination of unsafe abortions would require an additional $192.5 million. South Africa can provide more safe abortions for less money in the public sector through shifting the methods provided. More research is needed to understand whether the cost of expanding access could be offset by savings from averting costs of managing unsafe abortions. South Africa can provide more safe abortions for less money in the public sector through shifting to more first-trimester methods, including more medication abortion, and shifting to a combined mifepristone plus misoprostol regimen for second trimester medical induction. Expanding access in addition to method mix changes would require additional funds. Copyright

  19. Second trimester abortion in Viet Nam: changing to recommended methods and improving service delivery.

    PubMed

    Tuyet, Hoang T D; Thuy, Phan; Trang, Huynh N K

    2008-05-01

    In Viet Nam, abortion has been legal up to 22 weeks of pregnancy since the 1960s. There are about one million induced abortions every year. First trimester abortion is provided at central, provincial, district and commune level, while second trimester abortion is provided only at central and provincial level. For second trimester abortion, dilatation and evacuation (D&E) has been introduced at some central and provincial hospitals, and medical abortion protocols have been included in the draft National Standards and Guidelines currently being updated. However, Kovac's, an unsafe method, is still often used at many provincial hospitals. While access to first trimester abortion services is not difficult, there are still many barriers to second trimester abortion, especially for young, unmarried women. In order to prevent unwanted pregnancies, increase access to safe abortion and improve quality of care, the Vietnamese Ministry of Health is working with others to establish national policies and developing effective models for women-friendly comprehensive abortion care, including post-abortion family planning. This paper, based on published information, interviews and observations by the second author of service delivery in 2006-2008, provides an overview of second trimester abortion services in Viet Nam and ongoing plans for improving them.

  20. New German abortion law agreed.

    PubMed

    Karcher, H L

    1995-07-15

    The German Bundestag has passed a compromise abortion law that makes an abortion performed within the first three months of pregnancy an unlawful but unpunishable act if the woman has sought independent counseling first. Article 218 of the German penal code, which was established in 1871 under Otto von Bismarck, had allowed abortions for certain medical or ethical reasons. After the end of the first world war, the Social Democrats tried to legalize all abortions performed in the first three months of pregnancy, but failed. In 1974, abortion on demand during the first 12 weeks was declared legal and unpunishable under the social liberal coalition government of chancellor Willy Brandt; however, the same year, the German Federal Constitution Court in Karlsruhe ruled the bill was incompatible with article 2 of the constitution, which guarantees the right to life and freedom from bodily harm to everyone, including the unborn. The highest German court also ruled that a pregnant woman had to seek a second opinion from an independent doctor before undergoing an abortion. A new, extended article 218, which included a clause giving social indications, was passed by the Bundestag. When Germany was unified, East Germans agreed to be governed by all West German laws, except article 218. The Bundestag was given 2 years to revise the article; however, in 1993, the Federal Constitution Court rejected a version legalizing abortion in the first 3 months of the pregnancy if the woman sought counsel from an independent physician, and suggested the recent compromise passed by the Bundestag, the lower house of the German parliament. The upper house, the Bundesrat, where the Social Democrats are in the majority, still has to pass it. Under the bill passed by the Bundestag, national health insurance will pay for an abortion if the monthly income of the woman seeking the abortion falls under a certain limit.

  1. Abortion law reform in Nepal.

    PubMed

    Upreti, Melissa

    2014-08-01

    Across four decades of political and social action, Nepal changed from a country strongly enforcing oppressive abortion restrictions, causing many poor women's long imprisonment and high rates of abortion-related maternal mortality, into a modern democracy with a liberal abortion law. The medical and public health communities supported women's rights activists in invoking legal principles of equality and non-discrimination as a basis for change. Legislative reform of the criminal ban in 2002 and the adoption of an Interim Constitution recognizing women's reproductive rights as fundamental rights in 2007 inspired the Supreme Court in 2009 to rule that denial of women's access to abortion services because of poverty violated their constitutional rights. The government must now provide services under criteria for access without charge, and services must be decentralized to promote equitable access. A strong legal foundation now exists for progress in social justice to broaden abortion access and reduce abortion stigma. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  2. A decade of international change in abortion law: 1967-1977.

    PubMed Central

    Cook, R J; Dickens, B M

    1978-01-01

    Modern thinking on abortion, reflected in recent legal developments around the world, has turned from concentration upon criminality in favor of female and family well-being. New laws enacted during the last decade are coming to focus upon conditions of health and social welfare of women and their existing families as indications for lawful termination of pregnancy. Regulations governing the delivery of services may be restrictive, however, so as to limit in practice access to means of safe, legal abortion made available in theory. Requirements may be imposed that only medical personnel with unduly high qualifications perform procedures, or that they be undertaken only in institutions meeting standards higher than similar health care requires. Approval procedures may be established involving second medical opinions or committees to monitor observance of the law, which may delay abortions and therefore increase their hazards. Parental and spousal consent requirements may exist in addition with the same effects, or to veto a pregnant female's request. Regulations may be employed more positively, however, to encourage contraceptive practice. A disappointment with legislative reform is that it may fail to improve circumstances if public resources are not applied to achieve the supply of services newly rendered legitimate, and illegal practice may persist. PMID:665881

  3. Myths and misconceptions about abortion among marginalized underserved community.

    PubMed

    Thapa, K; Karki, Y; Bista, K P

    2009-01-01

    Unsafe abortion remains a huge problem in Nepal even after legalization of abortion. Various myths and misconceptions persist which prompt women towards unsafe abortive practices. A qualitative study was conducted among different groups of women using focus group discussions and in depth interviews. Perception and understanding of the participants on abortion, methods and place of abortion were evaluated. A number of misconceptions were prevalent like drinking vegetable and herbal juices, and applying hot pot over the abdomen could abort pregnancy. However, many participants also believed that health care providers should be consulted for abortion. Although majority of the women knew that they should seek medical aid for abortion, they were still possessed with various misconceptions. Merely legalizing abortion services is not enough to reduce the burden of unsafe abortion. Focus has to be given on creating awareness and proper advocacy in this issue.

  4. The role of auxiliary nurse-midwives and community health volunteers in expanding access to medical abortion in rural Nepal.

    PubMed

    Puri, Mahesh; Tamang, Anand; Shrestha, Prabhakar; Joshi, Deepak

    2015-02-01

    Medical abortion was introduced in Nepal in 2009, but rural women's access to medical abortion services remained limited. We conducted a district-level operations research study to assess the effectiveness of training 13 auxiliary nurse-midwives as medical abortion providers, and 120 female community health volunteers as communicators and referral agents for expanding access to medical abortion for rural women. Interviews with service providers and women who received medical abortion were undertaken and service statistics were analysed. Compared to a neighbouring district with no intervention, there was a significant increase in the intervention area in community health volunteers' knowledge of the legal conditions for abortion, the advantages and disadvantages of medical abortion, safe places for an abortion, medical abortion drugs, correct gestational age for home use of medical abortion, and carrying out a urine pregnancy test. In a one-year period in 2011-12, the community health volunteers did pregnancy tests for 584 women and referred 114 women to the auxiliary nurse-midwives for abortion; 307 women in the intervention area received medical abortion services from auxiliary nurse-midwives. There were no complications that required referral to a higher-level facility except for one incomplete abortion. Almost all women who opted for medical abortion were happy with the services provided. The study demonstrated that auxiliary nurse-midwives can independently and confidently provide medical abortion safely and effectively at the sub-health post level, and community health volunteers are effective change agents in informing women about medical abortion. Copyright © 2015 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  5. [Bioethics and abortion. Debate].

    PubMed

    Diniz, D; Gonzalez Velez, A C

    1998-06-01

    Although abortion has been the most debated of all issues analyzed in bioethics, no moral consensus has been achieved. The problem of abortion exemplifies the difficulty of establishing social dialogue in the face of distinct moral positions, and of creating an independent academic discussion based on writings that are passionately argumentative. The greatest difficulty posed by the abortion literature is to identify consistent philosophical and scientific arguments amid the rhetorical manipulation. A few illustrative texts were selected to characterize the contemporary debate. The terms used to describe abortion are full of moral meaning and must be analyzed for their underlying assumptions. Of the four main types of abortion, only 'eugenic abortion', as exemplified by the Nazis, does not consider the wishes of the woman or couple--a fundamental difference for most bioethicists. The terms 'selective abortion' and 'therapeutic abortion' are often confused, and selective abortion is often called eugenic abortion by opponents. The terms used to describe abortion practitioners, abortion opponents, and the 'product' are also of interest in determining the style of the article. The video entitled "The Silent Scream" was a classic example of violent and seductive rhetoric. Its type of discourse, freely mixing scientific arguments and moral beliefs, hinders analysis. Within writings about abortion three extreme positions may be identified: heteronomy (the belief that life is a gift that does not belong to one) versus reproductive autonomy; sanctity of life versus tangibility of life; and abortion as a crime versus abortion as morally neutral. Most individuals show an inconsistent array of beliefs, and few groups or individuals identify with the extreme positions. The principal argument of proponents of legalization is respect for the reproductive autonomy of the woman or couple based on the principle of individual liberty, while heteronomy is the main principle of

  6. Women's demand for late-term abortion--a social or psychiatric issue?

    PubMed

    Nikolić, Gordana; Samardzić, Ljiljana; Krstić, Miroslav

    2014-07-01

    Induced termination of unwanted pregnancy after 12th gestational week (late-term abortion) is legally restricted in Serbia as well as in many other countries. On the other hand, unwanted pregnancy very often brings women into the state of personal crisis. Psychiatric indications for legally approved late-term abortion on women's demand include only severe psychiatric disorders. The aim of this paper was to compare sociodemographic, psychological characteristics and claimed reasons for abortion in the two groups of women with late-term demand for abortion--the group of women satisfying legally prescribed mental health indications, and the group of women not satisfying these indications. The aim of the study was also to determine predictive validity of the abovementioned parameters for late-term abortion as the outcome of unwanted pregnancy. A total of 62 pregnant women with demand for late-term abortion were divided into two groups according to the criteria of satisfying or not satisfying legally proposed psychiatric indications for late-term abortion after psychiatric evaluation. For the assessment of sociodemographic and psychological parameters sociodemographic questionnaire and symptom checklist-90 revised (SCL-90) scale were used, respectively. The outcome of unwanted pregnancy was followed 6 months after the initial assessment. The obtained results showed a statistically significant difference between the groups in educational level, satisfaction with financial situation, elevated anxiety and distress reactions. Unfavorable social circumstances were the main reason for an abortion in both groups and were predictive for an abortion. A 6-month follow-up showed that women had abortion despite legal restrictions. Pregnant women with psychiatric indication for late-term abortion belong to lower socioeconomic and educational level group compared to women without this indication who have more frequently elevated anxiety and distress reactions to unwanted pregnancy

  7. National crisis, supranational opportunity: the Irish construction of abortion as a European service.

    PubMed

    Fletcher, R

    2000-11-01

    In the late 1980s, the anti-abortion movement successfully sought injunctions against pregnancy counselling centres and students' unions in Ireland, preventing them from distributing information on how to obtain an abortion abroad. One of the defensive arguments that the students' unions employed was to claim that the distribution of abortion information was protected as an aspect of the free movement of services under European Community law. This paper addresses the implications of categorising abortion as a supranational economic service for feminist legal strategy. The advantages of categorising abortion as a service to which women have access as consumers are that it legitimates abortion and it provides a new strategy for making abortion claims. The disadvantages are that a woman's legal interest in abortion is based on her capacity to buy the service, fetal life is rendered devoid of value, and the service supplier has as much say about the abortion transaction as the woman consumer. If feminist legal strategy is to successfully use the legal construction of abortion as an economic service, it must work to minimise such negative implications.

  8. [Abortion and crime].

    PubMed

    Citoni, Guido

    2011-01-01

    In this article we address the issue, with a tentative empirical application to the Italian data, of the relationship, very debated mainly in north America, between abortion legalization and reduction of crime rates of youth. The rationale of this relationship is that there is a causal factor at work: the more unwanted pregnancies aborted, the less unwanted children breeding their criminal attitude in an hostile/deprived family environment. Many methodological and empirical criticisms have been raised against the proof of the existence of such a relationship: our attempt to test if this link is valid for Italy cannot endorse its existence. The data we used made necessary some assumptions and the reliability of official estimates of crime rates was debatable (probably downward biased). We conclude that, at least for Italy, the suggested relationship is unproven: other reasons for the need of legal abortion have been and should be put forward.

  9. Why Governments That Fund Elective Abortion Are Obligated to Attempt a Reduction in the Elective Abortion Rate.

    PubMed

    Dumsday, Travis

    2016-03-01

    If elective abortion is publicly funded, then the government is obligated to take active measures designed to reduce its prevalence. I present two arguments for that conclusion. The first argument is directed at those pro-choice thinkers who hold that while some or all elective abortions are morally wrong, they still ought to be legally permitted and publicly subsidized. The second argument is directed at pro-choice thinkers who hold that there is nothing morally wrong with elective abortion and that it should be both legally permitted and publicly subsidized. The second argument employs premises that generalize beyond the abortion debate and that may serve to shed light on broader questions concerning conscience and the requirements of political compromise in a democracy.

  10. [Legal health services of abortion in Uruguay. Strategies of the primary health care public services].

    PubMed

    López-Gómez, Alejandra; Couto, Martín; Píriz, Gabriela; Monza, Ana; Abracinskas, Lilián; Ituarte, María Luisa

    2017-01-01

    To analyze the strategies developed by the health centers to implement the law of legal abortion (LA) in public services of the primary care in Montevideo, Uruguay. A qualitative research was conducted combining techniques of document analysis, self-administered questionnaires to key informants, and in-depth interviews with directors of health centers. A simple summative index of accessibility to abortion services was built. The law approved in Uruguay in 2012 demanded the development of a strategy to promote women's accessibility to LA in the public primary care system. The services failed to fully implement the strategy, due to institutional barriers. Despite the wide availability of LA services in primary care and that they are an integral part of sexual and reproductive health benefits, there is an important barrier to their use in the number of gynecologists that appeal to conscientious objection.

  11. Ugandan opinion-leaders' knowledge and perceptions of unsafe abortion.

    PubMed

    Moore, Ann M; Kibombo, Richard; Cats-Baril, Deva

    2014-10-01

    While laws in Uganda surrounding abortion remain contradictory, a frequent interpretation of the law is that abortion is only allowed to save the woman's life. Nevertheless abortion occurs frequently under unsafe conditions at a rate of 54 abortions per 1000 women of reproductive age annually, taking a large toll on women's health. There are an estimated 148,500 women in Uganda who experience abortion complications annually. Understanding opinion leaders' knowledge and perceptions about unsafe abortion is critical to identifying ways to address this public health issue. We conducted in-depth, semi-structured interviews with 41 policy-makers, cultural leaders, local politicians and leaders within the health care sector in 2009-10 at the national as well as district (Bushenyi, Kamuli and Lira) level to explore their knowledge and perceptions of unsafe abortion and the potential for policy to address this issue. Only half of the sample knew the current law regulating abortion in Uganda. Respondents understood that the result of the current abortion restrictions included long-term health complications, unwanted children and maternal death. Perceived consequences of increasing access to safe abortion included improved health as well as overuse of abortion, marital conflict and less reliance on preventive behaviour. Opinion leaders expressed the most support for legalization of abortion in cases of rape when the perpetrator was unknown. Understanding opinion leaders' perspectives on this politically sensitive topic provides insight into the policy context of abortion laws, drivers behind maintaining the status quo, and ways to improve provision under the law: increase education among providers and opinion leaders. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2013; all rights reserved.

  12. Evaluating the relative effectiveness of high-intensity and low-intensity models of behaviour change communication interventions for abortion care-seeking in Bihar and Jharkhand, India: a cross-sectional study

    PubMed Central

    Banerjee, Sushanta K; Andersen, Kathryn; Pearson, Erin; Warvadekar, Janardan; Khan, Danish U; Batra, Sangeeta

    2017-01-01

    Background This study aimed to compare the effectiveness of a high-intensity model (HIM) and a low-intensity model (LIM) of behaviour change communication interventions in Bihar and Jharkhand states of India designed to improve women's knowledge and usage of safe abortion services, as well as the dose effect of intervention exposure. Methods We conducted two cross-sectional household surveys among married women aged 15–49 years in intervention and comparison districts. Difference-in-difference models were used to assess the efficacy of the intervention, adjusting for sociodemographic characteristics. Results Although both intervention types improved abortion knowledge, the HIM intervention was more effective in improving comprehensive knowledge about abortion. In particular, there were improvements in knowledge on legality of abortion (AOR=2.2; 95% CI 1.6 to 2.9) and nearby sources of safe abortion care (AOR=1.7; 95% CI 1.2 to 1.3). Conclusions Higher level of exposure to abortion-related messages was related to more accurate knowledge about abortion within both intervention groups. Evidence was mixed on changes in abortion care-seeking behaviour. More work is needed to ensure that women seek safe abortion services in lieu of informal services that may be more likely to lead to postabortion complications. PMID:28237953

  13. Family Planning Evaluation. Abortion Surveillance Report--Legal Abortions, United States, Annual Summary, 1970.

    ERIC Educational Resources Information Center

    Center for Disease Control (DHEW/PHS), Atlanta, GA.

    This report summarizes abortion information received by the Center for Disease Control from collaborators in state health departments, hospitals, and other pertinent sources. While it is intended primarily for use by the above sources, it may also interest those responsible for family planning evaluation and hospital abortion planning. Information…

  14. Induced abortion in Italy: levels, trends and characteristics.

    PubMed

    Bettarini, S S; D'Andrea, S S

    1996-01-01

    Subsequent to the legalization of abortion in Italy in 1978, abortion; rates among Italian women first rose and then declined steadily, from a peak of 16.9 abortions per 1,000 women of reproductive age in 1983 to 9.8 per 1,000 in 1993. Abortion rates vary considerably by geographic region, with rates typically highest in the more secular and modernized regions and lowest in regions where traditional values predominate. Data from 1981 and 1991 indicate that age-specific abortion rates decreased during the 1980s for all age-groups, with the largest declines occurring in regions with the highest levels of abortion. Moreover, a shift in the age distribution of abortion rates occurred during the 1980s, with women aged 30-34 registering the highest abortion rate in 1991, whereas in 1981 the highest level of abortion occurred among those aged 25-29. The abortion rate among adolescent women was low at both times (7.6 per 1,000 in 1981 and 4.6 per 1,000 in 1991). These data are based only on reported legal abortions; the number of clandestine abortions remains unknown.

  15. The abortion issue in the 1984 elections.

    PubMed

    Granberg, D

    1987-01-01

    In the 1984 election, Ronald Reagan, the Republican presidential incumbent and an opponent of legal abortion, defeated Walter Mondale, a prochoice Democrat, by a wide margin. Despite Reagan's sweep of 49 states, however, conservatives lost a little ground in the Senate, where four of the seven new senators elected take a prochoice position on abortion. On the other hand, antiabortion forces registered some gains in the House of Representatives. The voting groups were more divided over the abortion issue in 1984 than they had been in 1980: In 1980, Reagan voters and Carter voters did not differ significantly in their attitudes toward abortion, but in 1984, Reagan voters were significantly more likely to be opposed to abortion than were Mondale voters. Nevertheless, only a small minority of voters considered abortion to be a major national issue, and the two voter groups were far more divided on several other issues than they were on abortion. There was no antiabortion consensus among the electorate as a whole, or among Reagan voters in particular. The level of approval for legalized abortion has, in fact, remained quite stable since 1973, and a popular base in favor of banning abortion seems to be lacking.

  16. International developments in abortion laws: 1977-88.

    PubMed

    Cook, R J; Dickens, B M

    1989-08-01

    International developments in abortion laws have been diverse, but the general thrust of legislation and court decisions has been towards decriminalization and liberalization of laws and the reduction of legal barriers to access to therapuetic abortion services presented by spousal and parental authorization requirements. Most legislation has extended abortion eligibility through traditional indications such as danger to maternal health or fetal handicap, but other indications have also been created, such as adolescence, advanced maternal age, family circumstances and Acquired Immunodeficiency Syndrome or Human Immunodeficiency Virus infection. Several jurisdictions established stages of early gestation within which abortion could be undertaken with minimal legal scrutiny. In Canada, the entire prohibition of abortion was held unconstitutional for violating women's integrity and security. Under medical and public health guidance, several countries have amended their constitutions to recognize and protect human life from contraception. Cyprus, Italy, and Taiwan have created an indication for abortion of welfare of the women's family, while France and the Netherlands recognize the women's distress and Hungary cites cases where the women is single or separated for 6 months, where appropriate housing is lacking or where she is 35 years or older and has had 3 deliveries. National health services and insurance schemes vary in their coverage of abortion costs, but generally tend to fund the major park of lawful services. In Britain, France, Israel, the US and Yugoslavia husband's claims to veto abortions have been rejected. Courts have also established that mature adolescents, although legally minors, may give autonomous consent to abortion and are entitled to confidentiality. Few countries' laws define when criminal abortion liability commences or when conception occurs, but the law has moved to restrict abortion in Israel, Honduras, Romania and Finland.

  17. [Abortion].

    PubMed

    Nunes, J P

    1998-01-01

    Abortion is the interruption of a dynamic process in a final and irreversible form. The legalization of abortion is applied to human ontogenesis, that is, the development of the human being. However, the embryo that is growing in the uterus is not a human being because a human being is a complex organism with differentiated systems, its own identity and intrinsic autonomy in its process of development. There are basically four levels of the analysis of the problem of abortion: 1) fundamental emotional arguments; 2) profound ignorance of technical and scientific facts; 3) rational positions obfuscated by the dramatic intensity of everyday situations; and 4) the conjunction of deliberated position where culpability is avoided with solidarity for all subjects of the process with a socially oriented view. The phenomenon of abortion from an epidemiological point of view summons the facts with which it is associated: poverty, illiteracy, shortage or lack of community health resources, absence of centers for adolescents, degradation of the environment, and precariousness of employment.

  18. Abortion Before & After Roe

    PubMed Central

    Joyce, Ted; Tan, Ruoding; Zhang, Yuxiu

    2013-01-01

    We use unique data on abortions performed in New York State from 1971–1975 to demonstrate that women travelled hundreds of miles for a legal abortion before Roe. A100- mile increase in distance for women who live approximately 183 miles from New York was associated with a decline in abortion rates of 12.2 percent whereas the same change for women who lived 830 miles from New York lowered abortion rates by 3.3 percent. The abortion rates of nonwhites were more sensitive to distance than those of whites. We found a positive and robust association between distance to the nearest abortion provider and teen birth rates but less consistent estimates for other ages. Our results suggest that even if some states lost all abortion providers due to legislative policies, the impact on population measures of birth and abortion rates would be small as most women would travel to states with abortion services. PMID:23811233

  19. Towards comprehensive early abortion service delivery in high income countries: insights for improving universal access to abortion in Australia.

    PubMed

    Dawson, Angela; Bateson, Deborah; Estoesta, Jane; Sullivan, Elizabeth

    2016-10-22

    Improving access to safe abortion is an essential strategy in the provision of universal access to reproductive health care. Australians are largely supportive of the provision of abortion and its decriminalization. However, the lack of data and the complex legal and service delivery situation impacts upon access for women seeking an early termination of pregnancy. There are no systematic reviews from a health services perspective to help direct health planners and policy makers to improve access comprehensive medical and early surgical abortion in high income countries. This review therefore aims to identify quality studies of abortion services to provide insight into how access to services can be improved in Australia. We undertook a structured search of six bibliographic databases and hand-searching to ascertain peer reviewed primary research in English between 2005 and 2015. Qualitative and quantitative study designs were deemed suitable for inclusion. A deductive content analysis methodology was employed to analyse selected manuscripts based upon a framework we developed to examine access to early abortion services. This review identified the dimensions of access to surgical and medical abortion at clinic or hospital-outpatient based abortion services, as well as new service delivery approaches utilising a remote telemedicine approach. A range of factors, mostly from studies in the United Kingdom and United States of America were found to facilitate improved access to abortion, in particular, flexible service delivery approaches that provide women with cost effective options and technology based services. Standards, recommendations and targets were also identified that provided services and providers with guidance regarding the quality of abortion care. Key insights for service delivery in Australia include the: establishment of standards, provision of choice of procedure, improved provider education and training and the expansion of telemedicine for medical

  20. Sex-selective abortion in Nepal: a qualitative study of health workers' perspectives.

    PubMed

    Lamichhane, Prabhat; Harken, Tabetha; Puri, Mahesh; Darney, Philip D; Blum, Maya; Harper, Cynthia C; Henderson, Jillian T

    2011-01-01

    Sex-selective abortion is expressly prohibited in Nepal, but limited evidence suggests that it occurs nevertheless. Providers' perspectives on sex-selective abortion were examined as part of a larger study on legal abortion in the public sector in Nepal. In-depth interviews were conducted with health care providers and administrators providing abortion services at four major hospitals (n = 35), two in the Kathmandu Valley and two in outlying rural areas. A grounded theory approach was used to code interview transcripts and to identify themes in the data. Most providers were aware of the ban on sex-selective abortion and, despite overall positive views of abortion legalization, saw sex selection as an increasing problem. Greater availability of abortion and ultrasonography, along with the high value placed on sons, were seen as contributing factors. Providers wanted to perform abortions for legal indications, but described challenges identifying sex-selection cases. Providers also believed that illegal sex-selective procedures contribute to serious abortion complications. Sex-selective abortion complicates the provision of legal abortion services. In addition to the difficulty of determining which patients are seeking abortion for sex selection, health workers are aware of the pressures women face to bear sons and know they may seek unsafe services elsewhere when unable to obtain abortions in public hospitals. Legislative, advocacy, and social efforts aimed at promoting gender equality and women's human rights are needed to reduce the cultural and economic pressures for sex-selective abortion, because providers alone cannot prevent the practice. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  1. Real life is different: a qualitative study of why women delay abortion until the second trimester in Vietnam.

    PubMed

    Gallo, Maria F; Nghia, Nguyen C

    2007-05-01

    Although legal and safe-induced abortion services are available on request in Vietnam, second-trimester abortion still occurs. Given the increased risks and higher costs associated with later-term abortions, we conducted a qualitative study to understand the determinants of delaying abortion until the second trimester. We used purposive sampling to conduct semi-structured face-to-face interviews with 60 women aged 14-47 receiving an abortion at 13-24 weeks of gestation in 5 health facilities in 3 provinces in Vietnam. We also interviewed 6 providers from the study facilities. Three broad categories for factors influencing delays in obtaining abortions emerged: most women failed to recognize their pregnancy during the first trimester; women described structural barriers to accessing services earlier; and some women either needed time to make a decision or only decided to abort after other events had transpired. A richer understanding of the factors that prevent women from obtaining an abortion during the first trimester could be useful for informing interventions that support women in receiving care earlier during their pregnancies.

  2. Abortion as Fatherhood Lost: Problems and Reforms.

    ERIC Educational Resources Information Center

    Shostak, Arthur B.

    1979-01-01

    Reports on emotions of males when a near-fatherhood experience ends in a legal abortion. A sizeable minority of males find their abortion experience more frustrating, trying, and emotionally costly than public and academic neglect of this subject would suggest. Options are suggested to help males deal with abortion's aspects. (Author)

  3. Fetal pain, abortion, viability, and the Constitution.

    PubMed

    Cohen, I Glenn; Sayeed, Sadath

    2011-01-01

    In early 2010, the Nebraska state legislature passed a new abortion restricting law asserting a new, compelling state interest in preventing fetal pain. In this article, we review existing constitutional abortion doctrine and note difficulties presented by persistent legal attention to a socially derived viability construct. We then offer a substantive biological, ethical, and legal critique of the new fetal pain rationale. © 2011 American Society of Law, Medicine & Ethics, Inc.

  4. Induced abortion in sub-Saharan Africa.

    PubMed

    Rogo, K O

    1993-06-01

    Unsafe abortions and their complications are a major cause of maternal mortality. Hospital based studies from most African countries confirm that up to 50% of maternal deaths are due to abortion. This paper reviews problem of induced abortion in sub-Saharan Africa. Issues of prevalence and prevention are addressed while acknowledging the need to review the legal regimes operating in these countries.

  5. Austerity and Abortion in the European Union

    PubMed Central

    Reeves, Aaron; Billari, Francesco; McKee, Martin; Stuckler, David

    2016-01-01

    Economic hardship accompanying large recessions can lead families to terminate unplanned pregnancies. To assess whether abortions have risen during the recession, we collected crude abortion data from 2000 to 2012 from Eurostat for countries that had legal abortions and complete data. Declining trends in abortion ratios between 2000 and 2009 have been reversing. Excess abortions between 2010 and 2012 totaled 10.6 abortions per 1000 pregnancies ending in abortion or birth or 6701 additional abortions (95% CI 1190–9240) with stronger effects in younger ages. Economic shocks may increase recourse to abortion. Further research should explore causal pathways and protective factors. PMID:27009038

  6. Abortion in Chile: the practice under a restrictive regime.

    PubMed

    Casas, Lidia; Vivaldi, Lieta

    2014-11-01

    This article examines, from a human rights perspective, the experience of women, and the practices of health care providers regarding abortion in Chile. Most abortions, as high as 100,000 a year, are obtained surreptitiously and clandestinely, and income and connections play a key role. The illegality of abortion correlates strongly with vulnerability, feelings of guilt and loneliness, fear of prosecution, physical and psychological harm, and social ostracism. Moreover, the absolute legal ban on abortion has a chilling effect on health care providers and endangers women's lives and health. Although misoprostol use has significantly helped to prevent greater harm and enhance women's agency, a ban on sales created a black market. Against this backdrop, feminists have taken action in aid of women. For instance, a feminist collective opened a telephone hotline, Linea Aborto Libre (Free Abortion Line), which has been crucial in informing women of the correct and safe use of misoprostol. Chile is at a crossroads. For the first time in 24 years, abortion law reform seems plausible, at least when the woman's life or health is at risk and in cases of rape and fetal anomalies incompatible with life. The political scenario is unfolding as we write. Congressional approval does not mean automatic enactment of a new law; a constitutional challenge is highly likely and will have to be overcome. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  7. Tackling unsafe abortion in Mauritius.

    PubMed

    Nyong'o, D; Oodit, G

    1996-01-01

    Despite a contraceptive prevalence rate of 75% Mauritius has a high incidence of unsafe abortions because of unprotected intercourse experienced by many young women in a rapidly industrializing environment. The Mauritius Family Planning Association (MFPA) tackled the issue of unsafe abortion in 1993. Abortion is illegal in the country, and the Catholic Church also strongly opposes modern family planning methods, thus the use of withdrawal and/or calendar methods have been increasing. The MFPA organized an advocacy symposium in 1993 on unsafe abortion with the result of revealing the pressure the Church was exerting relative to abortion and contraceptives. The advocacy campaign of the MFPA consists of having abortion legalized on health grounds and improving family planning services, especially for young unmarried women and men. The full support of the media was secured on the abortion issue: articles appeared, meetings were attended by the press, and public relations support was also received from them. The MFPA worked closely with parliamentarians. A motion was tabled in 1994 in the National Assembly which called for legalization of abortion on health grounds, but the Church squelched its debate. In March 1994 MFPA hosted the IPPF African Regional Conference on Unsafe Abortion in Mauritius with the participation of over 100 representatives from 20 countries, and subsequently a second motion was tabled without parliamentary debate. The deliberations were covered by the media and the Ministry of Women's Rights recognized abortion as an urgent issue as outlined in a white paper prepared for the Fourth World Conference on Women held in Beijing in 1995. The campaign changed the policy climate favorably making the public more conscious of unsafe abortion. The Ministry of Health decided to collect more data and the newly elected government seems to be more open about this issue.

  8. Abortion restrictions in the U.S. military: voices from women deployed overseas.

    PubMed

    Grindlay, Kate; Yanow, Susan; Jelinska, Kinga; Gomperts, Rebecca; Grossman, Daniel

    2011-01-01

    U.S. military women and dependents have few options for abortion when facing an unintended pregnancy overseas. Federal law prohibits the use of Department of Defense facilities and funds for abortion except when the woman's life is at risk, and privately funded abortions are permitted at military facilities only if a pregnancy is the result of rape or incest. The purpose of this study was to explore military women's experiences seeking abortion care during overseas deployment. We reviewed routine consultation data and user queries from an online service providing information about medication abortion. Information received between September 2005 and December 2009 from U.S. military women and dependents overseas was included. All women gave consent for anonymous use of their data, which were analyzed qualitatively for themes related to experiences seeking abortion. Data were analyzed for 130 women, including 128 women in the U.S. military and 2 military dependents. Women reported facing numerous challenges accessing abortion overseas, including legal and logistical barriers to care in-country, and real or perceived difficulties accessing abortion elsewhere owing to confidentiality concerns, fear of military reprimand for the pregnancy, and the narrow timeframe for early abortion. With no perceived alternatives, some women considered unsafe methods to terminate the pregnancy themselves. U.S. servicewomen overseas lack access to safe abortion services, which may place their health and careers in jeopardy. These women should have the same rights to abortion care as women living in the United States. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  9. [Development of the legal abortion situation at the gynecologic hospital of Karl-Marx-University, Leipzig from 1.1.1960 to 30.6.1972].

    PubMed

    Schulz, S; Henning, G

    1973-07-13

    Statistics on legal abortions at the Women's Clinic, Karl Marx University, Leipzig, East Germany, are reported. Between 1960-June 30, 1972, there were 3955 abortions and 53,972 births. Of these, 1368 abortions and 1831 births occurred in 1972; a similar large increase in abortions has been reported from other socialist countries. Average age of patients was 30.6 years in 1960, 27.7 years in 1972. In 1960, 83.1% of patients were married, but only 66.4% in 1972. Average hospital stay was 10.3 days in 1960, 3.7 days in 1972. Complications were seen in 32.5% of cases in 1960, and in 8.3% in 1972. Statistics for each year, 1960-1972, are given, and the implications of this information for medical practice and social policy are discussed.

  10. Evaluation of stated motives for legal abortion.

    PubMed

    Törnbom, M; Ingelhammar, E; Lilja, H; Möller, A; Svanberg, B

    1994-03-01

    In a study of 404 women (simple random sample), 20-29 years of age, 201 (group A) applying for abortion and 203 (group B) continuing their pregnancies, the women were given a questionnaire and in addition were interviewed. The aim of the study was to evaluate the spontaneous personal motives of women for abortion at a time when age is not supposed to be a common reason. The results showed that more than half of the women expressed that a bad relationship with the partner in one way or another was a motive for the abortion. Other important motives included characteristics of the women and their partners, mainly immaturity, work/studies and unsuitable life situation for having a child. Less common motives seemed to be economy, dwelling and medical and health factors. It is obvious that women in this study wanted to have a stable relationship to the child's father before they dared or wanted to have a child. Social networks in modern society seem to be too weak. The women do not want to face social and emotional problems as lonely mothers. Political decisions in the society, for example with parental benefit according to your income discourage women from continuing their pregnancies during their studies. It also seems important for the woman to feel mature enough to have a child. The provision and encouragement of methods for safer sex may be a possible way by which to reduce the number of abortions.

  11. Attitudes toward Abortion among Providers of Reproductive Health Care.

    PubMed

    Dodge, Laura E; Haider, Sadia; Hacker, Michele R

    2016-01-01

    Access to abortion continues to decrease in the United States. The aim of this study was to explore attitudes toward abortion among clinicians who provide reproductive health care. Clinician members of several reproductive health professional organizations completed a self-administered survey that assessed their attitudes toward abortion. A total of 278 clinicians who provided clinical reproductive health services within the United States were included. Nearly all strongly agreed that abortion should be available in cases of rape (89.6%), incest (89.2%), life endangerment (93.2%), health endangerment (91.0%), and fetal anomaly (85.9%). Although most strongly disagreed that spousal notification (81.3%) and spousal consent (86.6%) should be required for married women, fewer strongly disagreed that parental notification (57.6%) and parental consent (66.9%) should be required for minors. Respondents were generally supportive of private insurance coverage (70.1% strongly agreed) and Medicaid coverage (65.0% strongly agreed) for abortion services. Support for legal abortion and public funding of abortion were significantly associated with being female (both p ≤ .03) and having no personal religious affiliation (both p ≤ .04). Younger respondents and men were more supportive of third-party involvement and mandatory counseling (all p ≤ .02). Abortion providers were significantly more supportive of abortion access (legality of abortion, public and private funding, no third-party involvement, and no mandated counseling) than nonproviders (all p < .001). Although reproductive health care providers were generally supportive of legal abortion and funding for abortion, lower support among younger respondents may indicate future difficulties in maintaining a clinical workforce that is willing to provide abortion care. Copyright © 2016 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  12. Women's experiences seeking informal sector abortion services in Cape Town, South Africa: a descriptive study.

    PubMed

    Gerdts, Caitlin; Raifman, Sarah; Daskilewicz, Kristen; Momberg, Mariette; Roberts, Sarah; Harries, Jane

    2017-10-02

    In settings where abortion is legally restricted, or permitted but not widely accessible, women face significant barriers to abortion access, sometimes leading them to seek services outside legal facilities. The advent of medication abortion has further increased the prevalence of informal sector abortion. This study investigates the reasons for attempting self-induction, methods used, complications, and sources of information about informal sector abortion, and tests a specific recruitment method which could lead to improved estimates of informal sector abortion prevalence among an at-risk population. We recruited women who have sought informal sector abortion services in Cape Town, South Africa using respondent driven sampling (RDS). An initial seed recruiter was responsible for initiating recruitment using a structured coupon system. Participants completed face-to-face questionnaires, which included information about demographics, informal sector abortion seeking, and safe abortion access needs. We enrolled 42 women, nearly one-third of whom reported they were sex workers. Thirty-four women (81%) reported having had one informal sector abortion within the past 5 years, 14% reported having had two, and 5% reported having had three. These women consumed home remedies, herbal mixtures from traditional healers, or tablets from an unregistered provider. Twelve sought additional care for potential warning signs of complications. Privacy and fear of mistreatment at public sector facilities were among the main reported reasons for attempting informal sector abortion. Most women (67%) cited other community members as their source of information about informal sector abortion; posted signs and fliers in public spaces also served as an important source of information. Women are attempting informal sector abortion because they seek privacy and fear mistreatment and stigma in health facilities. Some were unaware how or where to seek formal sector services, or believed the

  13. A Study of Incomplete Abortion Following Medical Method of Abortion (MMA).

    PubMed

    Pawde, Anuya A; Ambadkar, Arun; Chauhan, Anahita R

    2016-08-01

    Medical method of abortion (MMA) is a safe, efficient, and affordable method of abortion. However, incomplete abortion is a known side effect. To study incomplete abortion due to medication abortion and compare to spontaneous incomplete abortion and to study referral practices and prescriptions in cases of incomplete abortion following MMA. Prospective observational study of 100 women with first trimester incomplete abortion, divided into two groups (spontaneous or following MMA), was administered a questionnaire which included information regarding onset of bleeding, treatment received, use of medications for abortion, its prescription, and administration. Comparison of two groups was done using Fisher exact test (SPSS 21.0 software). Thirty percent of incomplete abortions were seen following MMA; possible reasons being self-administration or prescription by unregistered practitioners, lack of examination, incorrect dosage and drugs, and lack of follow-up. Complications such as collapse, blood requirement, and fever were significantly higher in these patients compared to spontaneous abortion group. The side effects of incomplete abortions following MMA can be avoided by the following standard guidelines. Self medication, over- the-counter use, and prescription by unregistered doctors should be discouraged and reported, and need of follow-up should be emphasized.

  14. Abortion: The Viewpoint of Potential Consumers

    ERIC Educational Resources Information Center

    Hamrick, Michael H.; And Others

    1977-01-01

    A college survey showed strong support by a majority for legalized abortion, governmental support of abortion and family planning services, voluntary sterilization, and sex education and birth control information and/or services in the schools. Important differences of opinion among subgroups were, however, indicated. (Author/MJB)

  15. Luisa's Ghosts: Haunted Legality and Collective Expressions of Pain.

    PubMed

    Krauss, Amy

    2018-04-25

    Feminist health care providers have debated the efficacy of the decriminalization of abortion in Mexico City. Luisa, a counselor in a private clinic, suggested that while the law has expanded the visibility of, and access to safe abortion, it has also called forth "other ghosts." In this article, I take Luisa's critical perspective as a starting point for examining ongoing criminalization and moral stigma as forms of haunting that arise in the wake of the Mexico City abortion policy. Drawing on ethnographic research, I explore how Luisa's ghosts materialize in the embodied- affective relations between patients in new legal clinics. Women who attend public clinics negotiate moral stigma along with religious and familial pressures in the ways they suffer, as well as normalize abortion as a painful experience. Rather than approach pain as purely a sign of victimization, I suggest that its expression constitutes an effervescent collectivity between women in the clinic, making explicit, while at the same time dissipating, an intractable moral-affective knot that might otherwise be ignored.

  16. Induced Abortion: a Systematic Review and Meta-analysis

    PubMed Central

    Dastgiri, Saeed; Yoosefian, Maryam; Garjani, Mehraveh; Kalankesh, Leila R

    2017-01-01

    Background: Induced abortion accounts for 1 in 8 of approximately 600000 maternal deaths that occur annually worldwide. Induced abortion rate can be considered as one of the indicators for assessing availability of the appropriate reproductive health plans for women and identifying needs for appropriate related health policies and programs. Material and Methods: Researchers searched Pubmed, Google Scholar, CINAHL, Embase, PsycINFO, Cochrane, Iranian Scientific Information Database (SID), Iranian biomedical journals (Iranmedex), and Iranian Research Institute of Information and Documentation (Irandoc) between January 2000 and June 2013, which reported induced abortion. Search terms from two categories including abortion and termination of pregnancy were compiled. The search terms were “induced abortion”, “illegal abortion”, “illegal abortion”, “unsafe abortion”, and “criminal abortion”. The search was also conducted with “induced termination of pregnancy”, “illegal termination of pregnancy”, “illegal termination of pregnancy”, “unsafe termination of pregnancy” and “criminal termination of pregnancy”. Meta-analysis was carried out by using OpenMeta software. Induced abortion rates were calculated based on the random effect model. Results: Overall induced abortion rate was obtained 58.1 per 1000 women (95%CI: 55.16-61.04). In continental level, rate of induced abortion was 14 per 1000 women (95%CI: 11-16). Nation-wide and local rates were obtained 67.27 per 1000 women (95% CI: 60.02-74.23) and 148.92 (95% CI: 140.06-157.79) respectively. Discussion and Conclusion: Induced abortion is a major public health problem that occurs worldwide whether under the legal restriction or freedom, and it remains as reproductive health concern globally. To eliminate the need for induced abortion is at the core of any effort for preventing this issue. Option with the highest priority is to prevent unwanted pregnancies through promoting

  17. Evaluation of effect of letrozole prior to misoprostol in comparison with misoprostol alone in success rate of induced abortion.

    PubMed

    Behroozi-Lak, T; Derakhshan-Aydenloo, S; Broomand, F

    2018-03-01

    Abortion, spontaneous or induced, is a common complication of pregnancy and exploration of available and safe regimens for medical abortion in developing countries seems crucial. The present study was aimed to assess the effect of letrozole in combination with misoprostol in women eligible for legal therapeutic abortion with gestational age ≤14weeks. This clinical randomized trial was conducted on 78 women who were candidate of medical abortion and eligible for legal abortion with gestational age ≤14 weeks that were randomly divided into two groups of case and controls. Case group received daily oral dose of 10mg letrozole for three days followed by vaginal misoprostol. In control group the patients received only vaginal misoprostol. The rate of complete abortion, induction-of-abortion time, and side-effects were assessed. Complete abortion was observed in 30 patients (76.9%) in case group and 9 (23.1%) cases were failed. In control group there was 16 (41.03%) complete abortions and 23 (58.97%) cases were failed to abort. Patients with gestational age of between 6 and 10 weeks did not show significant difference in both groups (P=0.134). Regarding pregnancy remnants there were significant differences between two groups (P=0.034). The time form admission to discharge in case groups were significantly shorter than those in control group (P=0.001). The indication for curettage in case group was significantly less than control group (P=0.001). A 3-day course of letrozole (10mg/daily) followed by misoprostol was associated with a higher complete abortion and lower curettage rates and reduction in time from admission to discharge in women with gestational age ≤14 weeks compared to misoprostol alone. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  18. 25 years later, US abortion war still drags on.

    PubMed

    Rovner, J

    1998-01-31

    In the 25 years since the US Supreme Court's landmark Roe vs. Wade decision legalizing abortion, activists on both sides of the issue have drawn further apart as they have vied for the support of the majority of US voters who express ambivalence towards the law. These voters believe that abortion may be murder but that it must be legal. The Roe vs. Wade anniversary has sparked new legislative priorities on both sides. Abortion-rights activists will seek legislation that attempts to decrease the need for abortion by increasing funding for family planning services in the US and abroad, supporting funding for contraceptive research, and requiring health insurers to pay for contraceptives. Abortion opponents will continue to press for "partial birth" abortion bans and will support efforts to make it a federal crime for an adult to transport a minor across state lines to evade state parental notification or consent laws.

  19. Conscientious objection and abortion: rights and duties of public sector physicians.

    PubMed

    Diniz, Debora

    2011-10-01

    The paper analyzes conscientious objection by physicians, through the concrete situation of legal abortion in Brazil. It reviews the two main ethical frameworks about conscientious objection in public health, the incompatibility thesis and the integrity thesis, to analyze the reality of legal abortion services in the referral services of the Brazilian public health care system. From these two perspectives, a third perspective is proposed - the justification thesis, to manage the right to conscientious objection among physicians in referral services. This analysis may contribute to the organization of services for legal abortion and to the education of future physicians working in emergency obstetric care.

  20. Abortion checks at German-Dutch border.

    PubMed

    Von Baross, J

    1991-05-01

    The commentary on West German abortion law, particularly in illegal abortion in the Netherlands, finds the law restrictive and in violation of the dignity and rights of women. The Max-Planck Institute in 1990 published a study that found that a main point of prosecution between 1976 and 1986, as reported by Der Spiegal, was in border crossings from the Netherlands. It is estimated that 10,000 annually have abortions abroad, and 6,000 to 7,000 in the Netherlands. The procedure was for an official to stop a young person and query about drugs; later the woman would admit to an abortion, and be forced into a medical examination. The German Penal Code Section 218 stipulates abortion only for certain reasons testified to by a doctor other than the one performing the abortion. Counseling on available social assistance must be completed 3 days prior to the abortion. Many counseling offices are church related and opposed to abortions. Many doctors refuse legally to certify, and access to abortion is limited. The required hospital stay is 3-4 nights with no day care facilities. Penal Code Section 5 No. 9 allows prosecution for uncounseled illegal abortion. Abortion law reform is anticipated by the end of 1992 in the Bundestag due to the Treaty or the Unification of Germany. The Treaty states that the rights of the unborn child must be protected and that pregnant women relieve their distress in a way compatible with the Constitution, but improved over legal regulations from either West or East Germany, which permits abortion on request within 12 weeks of conception without counseling. It is hoped that the law will be liberalized and Penal Code Section 5 No. 9 will be abolished.

  1. “I Am Ready and Willing to Provide the Service … Though My Religion Frowns on Abortion”—Ghanaian Midwives’ Mixed Attitudes to Abortion Services: A Qualitative Study

    PubMed Central

    Oppong-Darko, Prince; Amponsa-Achiano, Kwame

    2017-01-01

    Background: Unsafe abortion is a major preventable public health problem and contributes to high mortality among women. Ghana has ratified international conventions to prevent unwanted pregnancies and provide safe abortion services, legally authorizing midwives to provide induced abortion services in certain circumstances. Objective: The aim of the study was to understand midwives’ readiness to be involved in legal induced abortions, should the law become less restricted in Ghana. Methods: A qualitative study design, with a topic guide for individual in-depth interviews of selected midwives, was adopted. The interviews were tape-recorded and analyzed using content analysis. Results: Participants emphasized their willingness to reduce maternal mortalities, their experiences of maternal deaths, and their passion for the health of pregnant women. Knowledge of Ghana’s abortion law was generally low. Different views were expressed regarding readiness to engage in abortion services. Some expressed it as being sinful and against their religion to assist in abortion care, whilst others felt it was good to save the lives of women. Conclusion: The midwives made it clear that unsafe abortions are common, stigmatizing and contributing to maternal mortality, issues that must be addressed. They made various suggestions to reduce this preventable tragedy. PMID:29207521

  2. Delivering Medical Abortion at Scale: A Study of the Retail Market for Medical Abortion in Madhya Pradesh, India

    PubMed Central

    Powell-Jackson, Timothy; Acharya, Rajib; Filippi, Veronique; Ronsmans, Carine

    2015-01-01

    Background Medical abortion (mifepristone and misoprostol) has the potential to contribute to reduced maternal mortality but little is known about the provision or quality of advice for medical abortion through the private retail sector. We examined the availability of medical abortion and the practices of pharmacists in India, where abortion has been legal since 1972. Methods We interviewed 591 pharmacists in 60 local markets in city, town and rural areas of Madhya Pradesh. One month later, we returned to 359 pharmacists with undercover patients who presented themselves unannounced as genuine customers seeking a medical abortion. Results Medical abortion was offered to undercover patients by 256 (71.3%) pharmacists and 24 different brands were identified. Two thirds (68.5%) of pharmacists stated that abortion was illegal in India. Only 106 (38.5%) pharmacists asked clients the timing of the last menstrual period and 38 (13.8%) requested to see a doctor’s prescription – a legal requirement in India. Only 59 (21.5%) pharmacists correctly advised patients on the gestational limit for medical abortion, 97 (35.3%) provided correct information on how many and when to take the tablets in a combination pack, and 78 (28.4%) gave accurate advice on where to seek care in case of complications. Advice on post-abortion family planning was almost nonexistent. Conclusions The retail market for medical abortion is extensive, but the quality of advice given to patients is poor. Although the contribution of medical abortion to women’s health in India is poorly understood, there is an urgent need to improve the practices of pharmacists selling medical abortion. PMID:25822656

  3. Evaluating the relative effectiveness of high-intensity and low-intensity models of behaviour change communication interventions for abortion care-seeking in Bihar and Jharkhand, India: a cross-sectional study.

    PubMed

    Banerjee, Sushanta K; Andersen, Kathryn; Pearson, Erin; Warvadekar, Janardan; Khan, Danish U; Batra, Sangeeta

    2017-02-24

    This study aimed to compare the effectiveness of a high-intensity model (HIM) and a low-intensity model (LIM) of behaviour change communication interventions in Bihar and Jharkhand states of India designed to improve women's knowledge and usage of safe abortion services, as well as the dose effect of intervention exposure. We conducted two cross-sectional household surveys among married women aged 15-49 years in intervention and comparison districts. Difference-in-difference models were used to assess the efficacy of the intervention, adjusting for sociodemographic characteristics. Although both intervention types improved abortion knowledge, the HIM intervention was more effective in improving comprehensive knowledge about abortion. In particular, there were improvements in knowledge on legality of abortion (AOR=2.2; 95% CI 1.6 to 2.9) and nearby sources of safe abortion care (AOR=1.7; 95% CI 1.2 to 1.3). Higher level of exposure to abortion-related messages was related to more accurate knowledge about abortion within both intervention groups. Evidence was mixed on changes in abortion care-seeking behaviour. More work is needed to ensure that women seek safe abortion services in lieu of informal services that may be more likely to lead to postabortion complications. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  4. Healthcare students' knowledge and opinions about the Argentinean abortion law.

    PubMed

    Provenzano-Castro, Belén; Oizerovich, Silvia; Stray-Pedersen, Babill

    2016-03-01

    Abortion is legally restricted in Argentina. Although this law is almost 100 years old, most women who meet the criteria for legal abortion are not informed of or offered this possibility within the healthcare system. Healthcare students' knowledge and opinions on abortion may influence their future practice. They may deny a woman with an unwanted pregnancy a practice to which she is legally entitled, resulting in an unsafe abortion. This study assessed knowledge and personal opinions on the abortion law among first year healthcare students in order to design adequate educational strategies. In this descriptive, analytical, cross-sectional study, structured self-administered questionnaires were administered to 781 first year medical, nursing, midwifery, and other healthcare students from the Faculty of Medicine, University of Buenos Aires from 2011 to 2013. Data were recorded anonymously in SPSS 20. Student samples were adjusted for gender and fields of study using the University statistics. Of the students, 48.8% did not know the current regulations. Most of the students thought abortion was legally restricted and failed to recognize the circumstances in which it is allowed. Over 75% of the students were pro-abortion, especially those with sexual experience. Students lack sound knowledge on the abortion law that may affect their personal lives and influence their future professional practice. It is crucial that medical schools include sexual and reproductive health issues in their curricula in order to ensure better quality healthcare services in the future. In Argentina, approximately 400,000 abortions are performed every year, many under unsafe conditions, resulting in one third of the maternal deaths for the past decade. High quality sexual and reproductive healthcare services are a key strategy to improve adolescents' and women's health, thereby lowering maternal mortality. Copyright © 2015 Elsevier B.V. All rights reserved.

  5. Fundamental discrepancies in abortion estimates and abortion-related mortality: A reevaluation of recent studies in Mexico with special reference to the International Classification of Diseases

    PubMed Central

    Koch, Elard; Aracena, Paula; Gatica, Sebastián; Bravo, Miguel; Huerta-Zepeda, Alejandra; Calhoun, Byron C

    2012-01-01

    In countries where induced abortion is legally restricted, as in most of Latin America, evaluation of statistics related to induced abortions and abortion-related mortality is challenging. The present article reexamines recent reports estimating the number of induced abortions and abortion-related mortality in Mexico, with special reference to the International Classification of Diseases (ICD). We found significant overestimations of abortion figures in the Federal District of Mexico (up to 10-fold), where elective abortion has been legal since 2007. Significant overestimation of maternal and abortion-related mortality during the last 20 years in the entire Mexican country (up to 35%) was also found. Such overestimations are most likely due to the use of incomplete in-hospital records as well as subjective opinion surveys regarding induced abortion figures, and due to the consideration of causes of death that are unrelated to induced abortion, including flawed denominators of live births. Contrary to previous publications, we found important progress in maternal health, reflected by the decrease in overall maternal mortality (30.6%) from 1990 to 2010. The use of specific ICD codes revealed that the mortality ratio associated with induced abortion decreased 22.9% between 2002 and 2008 (from 1.48 to 1.14 deaths per 100,000 live births). Currently, approximately 98% of maternal deaths in Mexico are related to causes other than induced abortion, such as hemorrhage, hypertension and eclampsia, indirect causes, and other pathological conditions. Therefore, only marginal or null effects would be expected from changes in the legal status of abortion on overall maternal mortality rates. Rather, maternal health in Mexico would greatly benefit from increasing access to emergency and specialized obstetric care. Finally, more reliable methodologies to assess abortion-related deaths are clearly required. PMID:23271925

  6. Fundamental discrepancies in abortion estimates and abortion-related mortality: A reevaluation of recent studies in Mexico with special reference to the International Classification of Diseases.

    PubMed

    Koch, Elard; Aracena, Paula; Gatica, Sebastián; Bravo, Miguel; Huerta-Zepeda, Alejandra; Calhoun, Byron C

    2012-01-01

    In countries where induced abortion is legally restricted, as in most of Latin America, evaluation of statistics related to induced abortions and abortion-related mortality is challenging. The present article reexamines recent reports estimating the number of induced abortions and abortion-related mortality in Mexico, with special reference to the International Classification of Diseases (ICD). We found significant overestimations of abortion figures in the Federal District of Mexico (up to 10-fold), where elective abortion has been legal since 2007. Significant overestimation of maternal and abortion-related mortality during the last 20 years in the entire Mexican country (up to 35%) was also found. Such overestimations are most likely due to the use of incomplete in-hospital records as well as subjective opinion surveys regarding induced abortion figures, and due to the consideration of causes of death that are unrelated to induced abortion, including flawed denominators of live births. Contrary to previous publications, we found important progress in maternal health, reflected by the decrease in overall maternal mortality (30.6%) from 1990 to 2010. The use of specific ICD codes revealed that the mortality ratio associated with induced abortion decreased 22.9% between 2002 and 2008 (from 1.48 to 1.14 deaths per 100,000 live births). Currently, approximately 98% of maternal deaths in Mexico are related to causes other than induced abortion, such as hemorrhage, hypertension and eclampsia, indirect causes, and other pathological conditions. Therefore, only marginal or null effects would be expected from changes in the legal status of abortion on overall maternal mortality rates. Rather, maternal health in Mexico would greatly benefit from increasing access to emergency and specialized obstetric care. Finally, more reliable methodologies to assess abortion-related deaths are clearly required.

  7. The politics of unsafe abortion in Burkina Faso: The interface of local norms and global public health practice

    PubMed Central

    Storeng, Katerini T.; Ouattara, Fatoumata

    2014-01-01

    In Burkina Faso, abortion is legally restricted and socially stigmatised, but also frequent. Unsafe abortions represent a significant public health challenge, contributing to the country's very high maternal mortality ratio. Inspired by an internationally disseminated public health framing of unsafe abortion, the country's main policy response has been to provide post-abortion care (PAC) to avert deaths from abortion complications. Drawing on ethnographic research, this article describes how Burkina Faso's PAC policy emerged at the interface of political and moral negotiations between public health professionals, national bureaucrats and international agencies and NGOs. Burkinabè decision-makers and doctors, who are often hostile to induced abortion, have been convinced that PAC is ‘life-saving care’ which should be delivered for ethical medical reasons. Moreover, by supporting PAC they not only demonstrate compliance with international standards but also, importantly, do not have to contend with any change in abortion legislation, which they oppose. Rights-based international NGOs, in turn, tactically focus on PAC as a ‘first step’ towards their broader institutional objective to secure safe abortion and abortion rights. Such negotiations between national and international actors result in widespread support for PAC but stifled debate about further legalisation of abortion. PMID:25132157

  8. Nursing and Hospital Abortions in the United States, 1967-1973.

    PubMed

    Haugeberg, Karissa

    2018-03-21

    Before elective abortion was legalized nationally in 1973 with the U.S. Supreme Court decision Roe v. Wade, seventeen states and the District of Columbia liberalized their abortion statutes. While scholars have examined the history of physicians who had performed abortions before and after it was legal and of feminists' work to expand the range of healthcare choices available to women, we know relatively little about nurses' work with abortion. By focusing on the history of nursing in those states that liberalized their abortion laws before Roe, this article reveals how women who sought greater control over their lives by choosing abortion encountered medical professionals who were only just beginning to question the gendered conventions that framed labor roles in American hospitals. Nurses, whose workloads increased exponentially when abortion laws were liberalized, were rarely given sufficient training to care for abortion patients. Many nurses directed their frustrations to the women patients who sought the procedure. This essay considers how the expansion of women's right to abortion prompted nurses to question the gendered conventions that had shaped their work experiences.

  9. [Abortion in unsafe conditions. Concealment, illegality, corruption and negligence].

    PubMed

    Ortiz Ortega, A

    1993-01-01

    "Abortion practiced under conditions of risk" is a phrase used to refer to illegal abortion. The phrase does not highlight the disappearance of risk when legislation changes. Rather, it calls attention to the fact that legal restrictions significantly increase dangers while failing to discourage women determined to terminate pregnancies. The International Planned Parenthood Federation defines abortion under conditions of risk as the use of nonoptimal technology, lack of counseling and services to orient the woman's decision and provide postabortion counseling, and the limitation of freedom to make the decision. The phrase encompasses concealment, illegality, corruption, and negligence. It is designed to impose a reproductive health perspective in response to an unresolved social conflict. Steps have been developed to improve the situation of women undergoing abortion even without a change in its legal status. Such steps include training and purchase of equipment for treatment of incomplete abortions and development of counseling and family planning services. The central difficulty of abortion induced in conditions of risk derives from the laws imposing the need for secrecy. In Mexico, the abortion decision belongs to the government and the society, while individual absorb the consequences of the practice of abortion. Public decision making about abortion is dominated by the concept that the female has an obligation to carry any pregnancy to term. Women who interfere with male descendency and practice a sexuality distinct from reproduction are made to pay a price in health and emotional balance. Resolution of the problem of abortion will require new concepts in terms of legal status, public health issues, and the rights of women. The problem becomes more pressing as abortion becomes more common in a country anxious to advance in the demographic transition. Only a commitment to the reproductive health of women and the full development of their rights as citizens will

  10. Crew Exploration Vehicle Service Module Ascent Abort Coverage

    NASA Technical Reports Server (NTRS)

    Tedesco, Mark B.; Evans, Bryan M.; Merritt, Deborah S.; Falck, Robert D.

    2007-01-01

    The Crew Exploration Vehicle (CEV) is required to maintain continuous abort capability from lift off through destination arrival. This requirement is driven by the desire to provide the capability to safely return the crew to Earth after failure scenarios during the various phases of the mission. This paper addresses abort trajectory design considerations, concept of operations and guidance algorithm prototypes for the portion of the ascent trajectory following nominal jettison of the Launch Abort System (LAS) until safe orbit insertion. Factors such as abort system performance, crew load limits, natural environments, crew recovery, and vehicle element disposal were investigated to determine how to achieve continuous vehicle abort capability.

  11. Two steps back: Poland's new abortion law.

    PubMed

    Nowicka, W

    1993-06-01

    After the fall of Communism in Poland, the Catholic church exerted pressure to increase its influence in public life. One way in which this pressure has manifested itself has been in the passing of a restrictive abortion bill which was signed into law on February 15, 1993. Abortion had been legalized in Poland in 1956 and was used as a means of birth control because of a lack of availability and use of contraceptives. The number of abortions performed was variously reported as 60,000 - 300,000/year. In 1990, the Ministry of Health imposed restrictions on abortions at publicly funded hospitals, and 3 deaths were reported from self-induced abortions. In 1 year (1989-90), the number of induced abortions at 1 hospital dropped from 71 to 19, while the number of self-induced abortions increased from 48 to 85. Further restrictions were introduced in May 1992 as part of the "Ethical Code for Physicians," which allows abortions only in cases where the mother's life or health is in danger or in cases or rape. This code brought abortions to a halt at publicly funded hospitals and doubled or even tripled the cost of private abortions. Women have been refused abortions in tragic and life=threatening situations since the code was adopted. When an outright anti family planning bill was drafted in November 1992, the Polish citizenry collected 1,300,000 signatures to force a referendum. The referendum was not held, but the bill was defeated. The amended bill which passed allows abortions in publicly funded hospitals only when the mother's life or health is in danger and in cases of rape, incest, or incurable deformity of the fetus. The implications of this law remain unclear, since its language is strange and vague. The reproductive rights of Polish women face a further threat because the Catholic church is working to limit the availability of contraceptive methods which they deem to be "early abortives." On the other side of the issue, the Federation for Women and Planned

  12. The Erosion of Rights to Abortion Care in the United States: A Call for a Renewed Anthropological Engagement with the Politics of Abortion.

    PubMed

    Andaya, Elise; Mishtal, Joanna

    2017-03-01

    Women's rights to legal abortion in the United States are now facing their greatest social and legislative challenges since its 1973 legalization. Legislation restricting rights and access to abortion care has been passed at state and federal levels at an unprecedented rate. Given the renewed vigor of anti-abortion movements, we call on anthropologists to engage with this shifting landscape of reproductive politics. This article examines recent legislation that has severely limited abortion access and maps possible directions for future anthropological analysis. We argue that anthropology can provide unique contributions to broader abortion research. The study of abortion politics in the United States today is not only a rich opportunity for applied and policy-oriented ethnographic research. It also provides a sharply focused lens onto broader theoretical concerns in anthropology and new social formations across moral, medical, political, and scientific fields in 21st-century America. © 2016 by the American Anthropological Association.

  13. The abortion issue in the 1980 elections.

    PubMed

    Granberg, D; Burlison, J

    1983-01-01

    The political opponents of legal abortion achieved considerable gains in the 1980 American elections. A president who was committed to a strong antiabortion position was elected, and antiabortion candidates prevailed in six out of seven Senate races that pitted supporters against opponents of legal abortion and in seven out of nine similar confrontations in the House races. However, it is not clear that abortion was an overriding or decisive factor in determining those outcomes. Democrats and Republicans, Carter voters and Reagan voters did not differ significantly in their attitudes toward abortion. The presidential voter groups were divided on several other issues, and along income and racial lines, to a far greater extent than they were on abortion. Voters were not likely to name abortion as one of the more important problems facing the nation. Carter supporters rated abortion as more important than did Reagan supporters. Although the party platforms and the presidential candidates were clearly differentiated in their abortion stands, these differences were not well communicated to the citizenry. When voters attempted to describe the position of each candidate on abortion, they displayed a great deal of uncertainty, error and confusion. In the key Senate races, those who voted for the prochoice candidates held more liberal abortion attitudes than those who voted for the right-to-life candidates. This difference, although statistically significant, was not great, and was smaller than the differences related to several other issues--such as attitudes toward the role of government, women's rights and economic policies.(ABSTRACT TRUNCATED AT 250 WORDS)

  14. Incidence of induced abortion in Malawi, 2015.

    PubMed

    Polis, Chelsea B; Mhango, Chisale; Philbin, Jesse; Chimwaza, Wanangwa; Chipeta, Effie; Msusa, Ausbert

    2017-01-01

    In Malawi, abortion is legal only if performed to save a woman's life; other attempts to procure an abortion are punishable by 7-14 years imprisonment. Most induced abortions in Malawi are performed under unsafe conditions, contributing to Malawi's high maternal mortality ratio. Malawians are currently debating whether to provide additional exceptions under which an abortion may be legally obtained. An estimated 67,300 induced abortions occurred in Malawi in 2009 (equivalent to 23 abortions per 1,000 women aged 15-44), but changes since 2009, including dramatic increases in contraceptive prevalence, may have impacted abortion rates. We conducted a nationally representative survey of health facilities to estimate the number of cases of post-abortion care, as well as a survey of knowledgeable informants to estimate the probability of needing and obtaining post-abortion care following induced abortion. These data were combined with national population and fertility data to determine current estimates of induced abortion and unintended pregnancy in Malawi using the Abortion Incidence Complications Methodology. We estimate that approximately 141,044 (95% CI: 121,161-160,928) induced abortions occurred in Malawi in 2015, translating to a national rate of 38 abortions per 1,000 women aged 15-49 (95% CI: 32 to 43); which varied by geographical zone (range: 28-61). We estimate that 53% of pregnancies in Malawi are unintended, and that 30% of unintended pregnancies end in abortion. Given the challenges of estimating induced abortion, and the assumptions required for calculation, results should be viewed as approximate estimates, rather than exact measures. The estimated abortion rate in 2015 is higher than in 2009 (potentially due to methodological differences), but similar to recent estimates from nearby countries including Tanzania (36), Uganda (39), and regional estimates in Eastern and Southern Africa (34-35). Over half of pregnancies in Malawi are unintended. Our

  15. Incidence of induced abortion in Malawi, 2015

    PubMed Central

    Mhango, Chisale; Philbin, Jesse; Chimwaza, Wanangwa; Chipeta, Effie; Msusa, Ausbert

    2017-01-01

    Background In Malawi, abortion is legal only if performed to save a woman’s life; other attempts to procure an abortion are punishable by 7–14 years imprisonment. Most induced abortions in Malawi are performed under unsafe conditions, contributing to Malawi’s high maternal mortality ratio. Malawians are currently debating whether to provide additional exceptions under which an abortion may be legally obtained. An estimated 67,300 induced abortions occurred in Malawi in 2009 (equivalent to 23 abortions per 1,000 women aged 15–44), but changes since 2009, including dramatic increases in contraceptive prevalence, may have impacted abortion rates. Methods We conducted a nationally representative survey of health facilities to estimate the number of cases of post-abortion care, as well as a survey of knowledgeable informants to estimate the probability of needing and obtaining post-abortion care following induced abortion. These data were combined with national population and fertility data to determine current estimates of induced abortion and unintended pregnancy in Malawi using the Abortion Incidence Complications Methodology. Results We estimate that approximately 141,044 (95% CI: 121,161–160,928) induced abortions occurred in Malawi in 2015, translating to a national rate of 38 abortions per 1,000 women aged 15–49 (95% CI: 32 to 43); which varied by geographical zone (range: 28–61). We estimate that 53% of pregnancies in Malawi are unintended, and that 30% of unintended pregnancies end in abortion. Given the challenges of estimating induced abortion, and the assumptions required for calculation, results should be viewed as approximate estimates, rather than exact measures. Conclusions The estimated abortion rate in 2015 is higher than in 2009 (potentially due to methodological differences), but similar to recent estimates from nearby countries including Tanzania (36), Uganda (39), and regional estimates in Eastern and Southern Africa (34–35). Over

  16. [Towards safe motherhood. World Health Day].

    PubMed

    Plata, M I

    1998-06-01

    The objective of the 'safe motherhood' initiative is to reduce maternal mortality by 50% by the year 2000. A strong policy is needed to permit development of national and international programs. The lifetime risk of death from causes related to complications of pregnancy is estimated at 1/16 in Africa, 1/65 in Asia, 1/130 in Latin America and the Caribbean, 1/1400 in Europe, and 1/3700 in North America. A minimum of 585,000 women die of maternal causes each year, with nearly 90% of the deaths occurring in Asia and Africa. Approximately 50 million women suffer from illnesses related to childbearing. A principal cause of maternal mortality is lack of medical care during labor, delivery, and the postpartum period. Motherhood will become safe if governments, multilateral and bilateral funding agencies, and nongovernmental organizations give it the high priority it requires. Women also die because they lack rights. Their reduced decision-making power and inequitable access to family and social resources prevents them from overcoming barriers to health care. Women die when they begin childbearing at a very young age, yet an estimated 11% of births throughout the world each year are to adolescents. Adolescents have very limited access to family planning, either through legal restrictions or obstacles created by family planning workers. Maternal deaths would be avoided if all births were attended by trained health workers; an estimated 60 million births annually are not. Prevention of unwanted pregnancy and, thus, of the 50 million abortions estimated to take place each year would avoid over 200 maternal deaths each day. Unsafe abortions account for 13% of maternal deaths. The evidence demonstrates that rates of unsafe abortion and abortion mortality are higher where laws are more restrictive.

  17. Participation of nurses in abortions.

    PubMed

    Neustatter, P L

    1980-11-29

    Doctors for a Woman's Choice on Abortion would agree with 1 point in Lord Denning's ruling on the role of nurses in abortions induced by (PGS) prostaglandins (November 15, p. 1091). The nurse should not be doing a doctor's job, as Lord Denning indicated, and we sympathize with any nurse who is doing so (though the 1967 Abortion Act allows any nurse to abstain, on grounds of conscience). However, the ruling that nurses are not legally covered to participate in any way with the "procuring of a miscarriage" (using terminology of the 1861 Offenses against the Persons Act upon which the ruling is based) does not require a radical change in the practice of late abortions (constituting only 7% of the terminations) or any change in the law. PG abortion can be done without a nurse. With the extraamniotic technique, a very cheap pump can be used to give subsequent doses of the PG (a function normally performed by a nurse) through the catheter left inserted through the cervix after the 1st dose has been given by the doctor. Alternatively, the intraamniotic method can be used, where PG is instilled into the amniotic sac via a needle passed through the abdominal wall. This normally requires only 1 dose, given by the doctor. Rarely are subsequent doses needed; however they could be given by the doctor with very little addition to his or her workload. While the fact that PG abortion can be done without nurses is not realized, late abortion will be restricted, a situation which is entirely deplorable. Also deplorable are the comments of an antiabortion nature made by Lord Denning, over and above the legal ruling in his jurisdiction to make. His ruling, furthermore, seems to have been sufficiently confused for the Department of Health to withdraw its circular on abortion and await an interpretation before issuing another.

  18. Abortion care for adolescent and young women.

    PubMed

    Renner, Regina-Maria; de Guzman, Anna; Brahmi, Dalia

    2014-07-01

    Unintended pregnancy among adolescents (10-19years) and young women (20-24years) is a global public health problem. Adolescents face challenges in accessing safe abortion care. To determine, via a systematic data review, whether abortion care for adolescent and young women differs clinically from that for older women. In a comprehensive data review, the Cochrane Central Register of Controlled Trials, MEDLINE, and POPLINE databases were searched from the earliest data entered until November 2012. Randomized controlled trials and observational studies comparing effectiveness, safety, acceptability, and long-term sequelae of abortion care between adolescent/young women and older women were identified. Two reviewers independently extracted data, and the Cochrane guidelines and Newcastle-Ottawa Scale were used for quality assessment. In total, there were 25 studies including 346 000 women undergoing first- and second-trimester medical abortion, vacuum aspiration, or dilation and evacuation. Effectiveness and overall complications were similar among age groups. However, younger women had an increased risk for cervical laceration and a decreased risk of uterine perforation and mortality. Satisfaction and long-term depression were similar between age groups. Except for less uptake of intrauterine devices among adolescents, age did not affect post-abortion contraception. Evidence from various healthcare systems indicates that abortion is safe and efficacious among adolescent and young women. Clinical services should promote access to safe abortion for adolescents. © 2013.

  19. The Dublin Declaration on Maternal Health Care and Anti-Abortion Activism

    PubMed Central

    2017-01-01

    Abstract The Dublin Declaration on Maternal Healthcare—issued by self-declared pro-life activists in Ireland in 2012—states unequivocally that abortion is never medically necessary, even to save the life of a pregnant woman. This article examines the influence of the Dublin Declaration on abortion politics in Latin America, especially El Salvador and Chile, where it has recently been used in pro-life organizing to cast doubt on the notion that legalizing abortion will reduce maternal mortality. Its framers argue that legalizing abortion will not improve maternal mortality rates, but reproductive rights advocates respond that the Dublin Declaration is junk science designed to preserve the world’s most restrictive abortion laws. Analyzing the strategy and impact of the Dublin Declaration brings to light one of the tactics used in anti-abortion organizing. PMID:28630540

  20. Legal Knowledge as a Tool for Social Change

    PubMed Central

    González Vélez, Ana Cristina; Jaramillo, Isabel Cristina

    2017-01-01

    Abstract In May 2006, Colombia’s Constitutional Court liberalized abortion, introducing three circumstances under which the procedure would not be considered a crime: (1) rape or incest; (2) a risk to the woman’s health or life; and (3) fetal malformations incompatible with life. Immediately following the court’s ruling, known as Sentence C-355, members of La Mesa por la Vida y Salud de las Mujeres (hereinafter La Mesa) began to mobilize to ensure the decision’s implementation, bearing in mind the limited impact that the legal framework endorsed by the court has had in other countries in the region. We argue that La Mesa’s strategy is an innovative one in the field of legal mobilization insofar as it presumes that law can be shaped not just by public officials and universities but also by social actors engaged in the creation and diffusion of legal knowledge. In this regard, La Mesa has become a legal expert on abortion by accumulating knowledge about the multiple legal rules affecting the practice of abortion and about the situations in which these rules are to be applied. In addition, by becoming a legal expert, La Mesa has been able to persuade health providers that they will not risk criminal prosecution or being fired if they perform abortions. We call this effect of legal mobilization a “pedagogical effect” insofar as it involves the production of expertise and appropriation of knowledge by health professionals. We conclude by discussing La Mesa’s choice to become a legal expert on abortion as opposed to recruiting academics to do this work or encouraging women to produce and disseminate this knowledge. PMID:28630545

  1. Women on waves: where next for the abortion boat?

    PubMed

    Gomperts, Rebecca

    2002-05-01

    Women on Waves was founded to contribute to the prevention of unwanted pregnancy and unsafe abortions throughout the world by direct action. Because national penal laws, including those governing abortion, generally extend only as far as territorial waters (12 miles), Women on Waves made plans to provide reproductive health services on a ship with a mobile clinic, including abortions, outside the territorial waters of countries where abortion is illegal. We went to Ireland first because it was nearby and there was a dedicated pro-choice community with immediate interest in and commitment to the project. Although we encountered problems that meant we could not do abortions, we were contacted by more than 300 women in five days and provided reproductive health information, contraception, workshops and information on where to obtain legal abortions in Europe. In many parts of the world an anti-abortion backlash is taking place. To safeguard our reproductive rights in the face of anti-abortion activities, it is crucial to recapture a pro-active, pro-choice role. Women on Waves helped to make visible the need for legal abortion services in Ireland, and the extensive class and other differences between women able to access abortions abroad and those who could not. We are currently attempting to resolve our status under Dutch law, but until women everywhere have the right to reproductive freedom, we will continue to make waves.

  2. Setting the research agenda for induced abortion in Africa and Asia.

    PubMed

    Scott, Rachel H; Filippi, Veronique; Moore, Ann M; Acharya, Rajib; Bankole, Akinrinola; Calvert, Clara; Church, Kathryn; Cresswell, Jenny A; Footman, Katharine; Gleason, Joanne; Machiyama, Kazuyo; Marston, Cicely; Mbizvo, Mike; Musheke, Maurice; Owolabi, Onikepe; Palmer, Jennifer; Smith, Christopher; Storeng, Katerini; Yeung, Felicia

    2018-05-10

    Provision of safe abortion is widely recognized as vital to addressing the health and wellbeing of populations. Research on abortion is essential to meet the UN Sustainable Development Goals. Researchers in population health from university, policy, and practitioner contexts working on two multidisciplinary projects on family planning and safe abortion in Africa and Asia were brought together for a workshop to discuss the future research agenda on induced abortion. Research on care-seeking behavior, supply of abortion care services, and the global and national policy context will help improve access to and experiences of safe abortion services. A number of areas have potential in designing intervention strategies, including clinical innovations, quality improvement mechanisms, community involvement, and task sharing. Research on specific groups, including adolescents and young people, men, populations affected by conflict, marginalized groups, and providers could increase understanding of provision, access to and experiences of induced abortion. Methodological and conceptual advances, for example in the measurement of induced abortion incidence, complications, and client satisfaction, conceptualizations of induced abortion access and care, and methods for follow-up of patients who have induced abortions, will improve the accuracy of measurements of induced abortion, and add to understanding of women's experiences of induced abortions and abortion care. © 2018 International Federation of Gynecology and Obstetrics.

  3. Induced abortion in Taiwan.

    PubMed

    Wang, P D; Lin, R S

    1995-04-01

    Induced abortion is widely practised in Taiwan; however, it had been illegal until 1985. It was of interest to investigate induced abortion practices in Taiwan after its legalization in 1985 in order to calculate the prevalence rate and ratio of induced abortion to live births and to pregnancies in Taiwan. A study using questionnaires through personal interviews was conducted on more than seventeen thousand women who attended a family planning service in Taipei metropolitan areas between 1991 and 1992. The reproductive history and sexual behaviour of the subjects were especially focused on during the interviews. Preliminary findings showed that 46% of the women had a history of having had an induced abortion. Among them, 54.8% had had one abortion, 29.7% had had two, and 15.5% had had three or more. The abortion ratio was 379 induced abortions per 1,000 live births and 255 per 1,000 pregnancies. The abortion ratio was highest for women younger than 20 years of age, for aboriginal women and for nulliparous women. When logistic regression was used to control for confounding variables, we found that the number of previous live births is the strongest predictor relating to women seeking induced abortion. In addition, a significant positive association exists between increasing number of induced abortions and cervical dysplasia.

  4. Stigma, abortion, and disclosure--findings from a qualitative study.

    PubMed

    Astbury-Ward, Edna; Parry, Odette; Carnwell, Ros

    2012-12-01

    This study qualitatively explores perceptions of women who have experienced abortion care. It explores women's journey through abortion from confirmation of pregnancy to post-abortion. The study seeks to understand the implications of these perceptions for policy and practice. A qualitative study involving in-depth semi-structured interviews with 17 women, aged between 22 and 57 years, who had undergone legal induced abortion in the UK when they were 16 years or older. Participants were not recruited under the age of 16 because of the ethical and legal complexities of interviewing minors. Additionally, 16 years was deemed to be the most appropriate age as this is the legal age of consent in the UK. Participants were recruited from 12 community contraception and sexual health clinics in two NHS trusts, one in England and one in Wales. Participant recruitment was set at a minimum of 12 and participants were recruited on a "first come first served basis" (i.e., the first 12 who contacted the researcher). The number of participants was raised to seventeen as this was the number deemed to be the most suitable for data saturation in this particular qualitative research. Women in this study understood abortion as highly taboo and a potentially personally stigmatizing event. These perceptions continued to affect disclosure to others, long after the abortion, and affected women's perceptions of the response of others, including society in general, significant others, and health professionals. Women's experiences of abortion may be influenced by perceived negative social attitudes. Health professionals and abortion service providers might combat the perceived isolation of women undergoing abortion by attending not only to clinical/technical aspects of the procedure but also to women's psychological/emotional sensitivities surrounding the event. © 2012 International Society for Sexual Medicine.

  5. Abortion attitudes, 1965-1980: trends and determinants.

    PubMed

    Granberg, D; Granberg, B W

    1980-01-01

    Results of surveys sponsored by the National Opinion Research Center between 1965 and 1980 show that approval of abortion increased from an average of 41% for 6 different reasons in 1965 to 68% in 1973, with levels remaining stable through 1977, decreasing to an average of 64% in 1978, and rebounding to the 1973-77 level in 1980. 7% of respondents disapproved of abortion for all 6 of the stated reasons, which ranged from endangerment of the woman's health through a married woman wanting no more children. More than half of those approving of abortion do not do so for all reasons, with approval ranging from 90% if the woman's health is endangered to 47% if the women is married and wants no more children. Multiple regression analysis of the independent effect of 8 types of factors on abortion attitudes, by themselves and in combination, was conducted. Those favoring and opposing legal abortion do not differ on 11 of 13 values ascribed to child development, but differ on obedience and curiosity, suggesting a more authoritarian attitude toward childrearing and less emphasis on children's self-reliance among abortion opponents. Education has the strongest effect of the various social and demographic variables examined, with the better educated more likely to favor abortion availability, except among Catholics. Approval of abortion decreases with conservatism regarding various aspects of personal morality. The strongest negative relationship occurs with disapproval of premarital sex and preference for large numbers of children. Political party and ideology are only weakly linked to legal abortion approval. Approval of abortion increases with support for women's rights and basic civil liberties.

  6. The costs and cost effectiveness of providing first-trimester, medical and surgical safe abortion services in KwaZulu-Natal Province, South Africa.

    PubMed

    Lince-Deroche, Naomi; Fetters, Tamara; Sinanovic, Edina; Devjee, Jaymala; Moodley, Jack; Blanchard, Kelly

    2017-01-01

    Despite a liberal abortion law, access to safe abortion services in South Africa is challenging for many women. Medication abortion was introduced in 2013, but its reach remains limited. We aimed to estimate the costs and cost effectiveness of providing first-trimester medication abortion and manual vacuum aspiration (MVA) services to inform planning for first-trimester service provision in South Africa and similar settings. We obtained data on service provision and outcomes from an operations research study where medication abortion was introduced alongside existing MVA services in public hospitals in KwaZulu-Natal province. Clinical data were collected through interviews with first-trimester abortion clients and summaries completed by nurses performing the procedures. In parallel, we performed micro-costing at three of the study hospitals. Using a model built in Excel, we estimated the average cost per medical and surgical procedure and determined the cost per complete abortion performed. Results are presented in 2015 US dollars. A total of 1,129 women were eligible for a first trimester abortion at the three study sites. The majority (886, 78.5%) were eligible to choose their abortion procedure; 94.1% (n = 834) chose medication abortion. The total average cost per medication abortion was $63.91 (52.32-75.51). The total average cost per MVA was higher at $69.60 (52.62-86.57); though the cost ranges for the two procedures overlapped. Given average costs, the cost per complete medication abortion was lower than the cost per complete MVA despite three (0.4%) medication abortion women being hospitalized and two (0.3%) having ongoing pregnancies at study exit. Personnel costs were the largest component of the total average cost of both abortion methods. This analysis supports the scale-up of medication abortion alongside existing MVA services in South Africa. Women can be offered a choice of methods, including medication abortion with MVA as a back-up, without

  7. The costs and cost effectiveness of providing first-trimester, medical and surgical safe abortion services in KwaZulu-Natal Province, South Africa

    PubMed Central

    Devjee, Jaymala; Moodley, Jack

    2017-01-01

    Background Despite a liberal abortion law, access to safe abortion services in South Africa is challenging for many women. Medication abortion was introduced in 2013, but its reach remains limited. We aimed to estimate the costs and cost effectiveness of providing first-trimester medication abortion and manual vacuum aspiration (MVA) services to inform planning for first-trimester service provision in South Africa and similar settings. Methods We obtained data on service provision and outcomes from an operations research study where medication abortion was introduced alongside existing MVA services in public hospitals in KwaZulu-Natal province. Clinical data were collected through interviews with first-trimester abortion clients and summaries completed by nurses performing the procedures. In parallel, we performed micro-costing at three of the study hospitals. Using a model built in Excel, we estimated the average cost per medical and surgical procedure and determined the cost per complete abortion performed. Results are presented in 2015 US dollars. Results A total of 1,129 women were eligible for a first trimester abortion at the three study sites. The majority (886, 78.5%) were eligible to choose their abortion procedure; 94.1% (n = 834) chose medication abortion. The total average cost per medication abortion was $63.91 (52.32–75.51). The total average cost per MVA was higher at $69.60 (52.62–86.57); though the cost ranges for the two procedures overlapped. Given average costs, the cost per complete medication abortion was lower than the cost per complete MVA despite three (0.4%) medication abortion women being hospitalized and two (0.3%) having ongoing pregnancies at study exit. Personnel costs were the largest component of the total average cost of both abortion methods. Conclusion This analysis supports the scale-up of medication abortion alongside existing MVA services in South Africa. Women can be offered a choice of methods, including medication

  8. More on Koop's study of abortion.

    PubMed

    1990-01-01

    In the report presented by Surgeon General Everett Koop to former president Ronald Reagan on the medical and physiological impact of abortion in women, after extensive research, it was concluded that the risk of death due to abortion had declined by 5 fold since the legalization of abortion, and pregnancy or childbirth is 25 times more likely to result in death of the mother than an abortion. Also, abortion was seen as having no medical contraindications, given that infertility, miscarriages, low birth weight, and other reproductive problems were equally evident in women who had not received an abortion. In addition, 90% of all abortions occurred in the safer 1st trimester of pregnancy. Evidence of psychological complications following an abortion is thus far lacking, and therefore not a public health concern. However, in spite of the overwhelming evidence in support of the need for abortion services, Dr Koop's bias against abortion remains. Instead, Dr Koop emphasized the need for greater emphasis in prevention of unwanted pregnancies, and encouraged more funding and political support on the development of new, safer, and more effective contraceptives.

  9. Abortion law, policy and services in India: a critical review.

    PubMed

    Hirve, Siddhivinayak S

    2004-11-01

    Despite 30 years of liberal legislation, the majority of women in India still lack access to safe abortion care. This paper critically reviews the history of abortion law and policy in India since the 1960s and research on abortion service delivery. Amendments in 2002 and 2003 to the 1971 Medical Termination of Pregnancy Act, including devolution of regulation of abortion services to the district level, punitive measures to deter provision of unsafe abortions, rationalisation of physical requirements for facilities to provide early abortion, and approval of medical abortion, have all aimed to expand safe services. Proposed amendments to the MTP Act to prevent sex-selective abortions would have been unethical and violated confidentiality, and were not taken forward. Continuing problems include poor regulation of both public and private sector services, a physician-only policy that excludes mid-level providers and low registration of rural compared to urban clinics; all restrict access. Poor awareness of the law, unnecessary spousal consent requirements, contraceptive targets linked to abortion, and informal and high fees also serve as barriers. Training more providers, simplifying registration procedures, de-linking clinic and provider approval, and linking policy with up-to-date technology, research and good clinical practice are some immediate measures needed to improve women's access to safe abortion care.

  10. Abortion in Latin America: changes in practice, growing conflict, and recent policy developments.

    PubMed

    Kulczycki, Andrzej

    2011-09-01

    Latin America is undergoing profound social, economic, political, demographic, and epidemiologic change. Reproductive health indicators have generally improved over the past two decades, but most pregnancies are still unintended and more than 4 million are terminated annually. Clandestine abortions necessitated by restrictive legal and social structures cause more than 1,000 deaths and 500,000 hospitalizations per year, primarily among poor and marginalized women. Abortions are becoming safer and less frequent, however, as a consequence of increased modern contraceptive use, misoprostol adoption, emergency contraception availability, and postabortion care provision, notwithstanding many impediments to these changes. Advocacy and conflict over abortion have grown. The contested policy shifts include Mexico City's 2007 legalization of first-trimester abortion. Drawing on numerous sources of evidence, this article provides a regional analysis of the rapidly changing practice and context of abortion in Latin America, and examines emerging issues, legal and policy developments, and contrasting country situations.

  11. Irish women who seek abortions in England.

    PubMed

    Francome, C

    1992-01-01

    In 1991, 4158 women from Ireland and 1766 from Northern Ireland traveled to England for abortions. This situation has been ignored by Irish authorities. The 1992 case of the 14-year old seeking an abortion in England finally caught legal attention. This study attempts to help define who these abortion seekers are. Questionnaires from 200 Irish abortion seeking women attending private Marie Stopes clinics in London and the British Pregnancy Advisory Services clinic in Liverpool between September 1988 and December 1990 were analyzed. Findings pertain to demographic characteristics, characteristics of first intercourse, family discussion of sexual activity, and contraceptive use. From this limited sample, it appears that Irish women are sexually reserved and without access to modern methods of birth control and abortion. Sex is associated with shame and guilt. 23% had intercourse before the age of 18 years and 42% after the age of 20. 76% were single and 16% were currently married. 95% were Catholic; 33% had been to church the preceding Sunday and 68% within the past month. Basic information about menstruation is also limited and procedures such as dilatation and curettage may be performed selectively. 28% of married women were uninformed about menstruation prior to its onset. Only 24% had been using birth control around the time of pregnancy. The reason for nonuse was frequently the unexpectedness of intercourse. 62% of adults and 66% of women believe in legalizing abortion in Ireland. British groups have tried to break through the abortion information ban by sending telephone numbers of abortion clinics to Irish firms for distribution to employees. On November 25, 1992, in the general election, there was approval of constitutional amendments guaranteeing the right to travel for abortions and to receive information on abortion access. The amendment to allow abortion to save the life of the mother was not accepted.

  12. Introducing early medical abortion in Australia: there is a need to update abortion laws.

    PubMed

    de Costa, Caroline M; Russell, Darren B; de Costa, Naomi R; Carrette, Michael; McNamee, Heather M

    2007-12-01

    Recent changes to Federal Therapeutic Goods Administration legislation have seen the limited introduction of the drug mifepristone to Australia for the purpose of early medical abortion. At the same time it has become evident that both methotrexate and misoprostol, licenced and available for other indications, are being used safely and appropriately for early abortion by Australian medical practitioners. Early medical abortion is widely practiced overseas where its safety and effectiveness are well supported by current evidence. However, abortion law in many states is still contained within the Criminal Codes and does not reflect current evidence-based abortion practice. In other states and territories restrictions on where abortions may be performed pose potential barriers to the introduction of mifepristone for medical abortion. There is an urgent need for abortion law to be clarified and made uniform across the country so that the best possible services can be provided to Australian women.

  13. Socioieconomic outcomes of restricted access to abortion.

    PubMed

    Muller, C

    1971-06-01

    Such questions as the extent to which greater accessibility to abortion services affects poverty and its problems are analyzed, and proposals for identifying the socioeconomic impact of liberalized abortion laws and accessible services are developed. The number of unwanted children born is directly affected by the barriers to legal abortion. In countries that have improved access to legal abortion, the demand for the service has risen among all socioeconomic groups. Long-time family earning potential is severely effected by the defects in the timing and spacing of the birth of children, which often leads to young men and pregnant teen-agers leaving school because of the burdens of pregnancy and child support. Large family size was found in 35% of families in 1965 where the head of the household was a fully employed worker. Children born and living as psychologically rejected or unwanted children risk impaired learning and development which in turn limits future economic achievments. Research into the access of and financing of abortion services should deal with the financial needs of patient groups. The effects of nonhospital service programs, manpower needs, and the surveillance of gaps and coverage of the service needs should be prime research targets.

  14. [Sexual violence in Congo-Kinshasa: necessity of decriminalizing abortion].

    PubMed

    Kalonda, J C Omba

    2012-01-01

    The sexual violence's committed in the Democratic Republic of Congo (DRC) are from their scales and consequences on women, real public health, politico-legal, and socio-economical challenges. More than a million of women have been victims of sexual violence on a period of less than fifteen years. Systematic rapes of women were used as war weapon by different groups involved in the Congolese war. Sexual violence against women has impacted public health by spreading sexually transmissible diseases including HIV/AIDS, causing unwanted pregnancies, leading to the gynaecological complications of rape-related injuries, and inflicting psychological trauma on the victims. Despite high level of unwanted pregnancies observed, the Congolese law is very restrictive and interdict induced abortion. This paper presents three arguments which plead in favour of legalizing abortion in DRC: 1) a restrictive law on abortion forces women to use unsafe abortion and increase incidence of injuries and maternal mortality ; 2) DRC has ratified the universal Declaration of human rights, the African union charter, and has than to promote equality between sexes, in this is included women reproductive rights; 3) an unwanted birth is an additional financial charge for a woman, a factor increasing poverty and psychologically unacceptable in case of rape. From the politico-legal point of view, ending rape impunity and decriminalizing abortion are recommended. Decriminalizing abortion give women choice and save victims and pregnant women from risks related to the pregnancy, a childbirth, or an eventual unsafe abortion. These risks increase the maternal mortality already high in DRC (between 950 and 3000 for 100000 live births).

  15. Trump's Abortion-Promoting Aid Policy.

    PubMed

    Latham, Stephen R

    2017-07-01

    On the fourth day of his presidency, Donald Trump reinstated and greatly expanded the "Mexico City policy," which imposes antiabortion restrictions on U.S. foreign health aid. In general, the policy has prohibited U.S. funding of any family-planning groups that use even non-U.S. funds to perform abortions; prohibited aid recipients from lobbying (again, even with non-U.S. money) for liberalization of abortion laws; prohibited nongovernment organizations from creating educational materials on abortion as a family-planning method; and prohibited health workers from referring patients for legal abortions in any cases other than rape, incest, or to save the life of the mother. The policy's prohibition on giving aid to any organization that performs abortions is aimed at limiting alleged indirect funding of abortions. The argument is that if U.S. money is used to fund nonabortion programs of an abortion-providing NGO, then the NGO can simply shift the money thus saved into its abortion budget. Outside the context of abortion, we do not reason this way. And the policy's remaining three prohibitions are deeply troubling. © 2017 The Hastings Center.

  16. The impact of recent changes in therapeutic abortion laws.

    PubMed

    Kahn, J B; Bourne, J P; Tyler, C W

    1971-12-01

    This report summarizes the current status of abortion legislation as of January 1, 1971. Data are presented from several sources to characterize the population receiving abortion services in terms of age, race, marital status, and indications for pregnancy termination. A special section details the abortion scene in New York City, especially insofar as it pertains to the availability of abortion services to out-of state women. Certain conclusions are drawn. The practice of legal abortion is increasing dramatically. From January to June 1970, there were 34,143 abortions in 9 selected states. It was estimated that no more than 8000 legal abortions per year were done as recently as 1965. It is apparent that the status of a given law regulating the performance of abortions does not necessarily dictate the actual number performed. While it is true that the complexity or liberalism of the worded law may be instrumental in guiding physicians to the greater performance of legal abortions, it is just as clear that the intention of the practicing physician or hospital to comply with the spirit of the law may, in fact, be more critical. A disproportionate number of abortions reported as a given statewide experience are still being done by a limited number of institutions in that state. States like California and Oregon are defined as "liberal performance states". They do more abortions for mental health indications and more abortions on women who are young and unmarried. Based on the abortion data in this report, it is obvious that race-specific abortion ratios do not correspond to race-specific live birth rates. In Jefferson County, Alabama, and in the State of California, black women have obtained hospital abortions at a rate nearly equal to that of white women, but in Georgia and South Carolina, there is a lower abortion ratio among black women than among white women. It has yet to be determined if this variability is the result of a negative patient attitude or a policy

  17. Abortion and informed consent requirements.

    PubMed

    Kapp, M B

    1982-09-01

    Supreme Court decisions have liberalized a woman's right to decide whether to obtain an abortion. Some state and local governments have tried to circumvent these decisions by enacting requirements designed to discourage abortions by, among other things, dictating to physicians an elaborate litany of specific information that must be communicated to a patient as a necessary precondition of her informed consent for an abortion. This article discusses the legal status of such requirements, their implications for the professional autonomy of physicians, and the role of the medical profession in challenging these restrictions, on its own behalf and in concert with its patients.

  18. Abortion incidence between 1990 and 2014: global, regional, and subregional levels and trends

    PubMed Central

    Sedgh, Gilda; Bearak, Jonathan; Singh, Susheela; Bankole, Akinrinola; Popinchalk, Anna; Ganatra, Bela; Rossier, Clémentine; Gerdts, Caitlin; Tunçalp, Özge; Johnson, Brooke Ronald; Johnston, Heidi Bart; Alkema, Leontine

    2017-01-01

    grounds under which abortion is legally allowed. Interpretation Abortion rates have declined significantly since 1990 in the developed world but not in the developing world. Ensuring access to sexual and reproductive health care could help millions of women avoid unintended pregnancies and ensure access to safe abortion. Funding UK Government, Dutch Ministry of Foreign Affairs, Norwegian Agency for Development Cooperation, The David and Lucile Packard Foundation, UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction. PMID:27179755

  19. Accounting for abortion: Accomplishing transnational reproductive governance through post-abortion care in Senegal.

    PubMed

    Suh, Siri

    2018-06-01

    Reproductive governance operates through calculating demographic statistics that offer selective truths about reproductive practices, bodies, and subjectivities. Post-abortion care, a global reproductive health intervention, represents a transnational reproductive regime that establishes motherhood as women's primary legitimate reproductive status. Drawing on ethnographic fieldwork conducted in Senegal between 2010 and 2011, I illustrate how post-abortion care accomplishes reproductive governance in a context where abortion is prohibited altogether and the US is the primary bilateral donor of population aid. Reproductive governance unfolds in hospital gynecological wards and the national health information system through the mobilization and interpretation of post-abortion care data. Although health workers search women's bodies and behavior for signs of illegal abortion, they minimize police intervention in the hospital by classifying most post-abortion care cases as miscarriage. Health authorities deploy this account of post-abortion care to align the intervention with national and global maternal health policies that valorize motherhood. Although post-abortion care offers life-saving care to women with complications of illegal abortion, it institutionalizes abortion stigma by scrutinizing women's bodies and masking induced abortion within and beyond the hospital. Post-abortion care reinforces reproductive inequities by withholding safe, affordable obstetric care from women until after they have resorted to unsafe abortion.

  20. Contribution of the Central American and Caribbean obstetrics and gynecology societies to the prevention of unsafe abortion in the region.

    PubMed

    de Gil, Marina Padilla

    2014-07-01

    Unsafe abortion is a very important public health issue in the Central America and Caribbean region, where the use of modern contraceptive methods remains low and the restrictive legal framework reduces access to safe abortion. The International Federation of Gynecology and Obstetrics (FIGO) Initiative for the Prevention of Unsafe Abortion and its Consequences is contributing toward resolving this problem by strengthening collaboration between medical societies, representatives of each country's Ministry of Health, and local and international agencies. In the 8 countries that decided to join this initiative in 2008, progress has been achieved in improving access to modern contraceptive methods, increasing the use of manual vacuum aspiration and misoprostol, and updating guidelines on postabortion care. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  1. Psychosocial aspects of abortion

    PubMed Central

    Illsley, Raymond; Hall, Marion H.

    1976-01-01

    The literature on psychosocial aspects of abortion is confusing. Individual publications must be interpreted in the context of cultural, religious, and legal constraints obtaining in a particular society at a given time, with due attention to the status and availability of alternatives to abortion that might be chosen by a woman with an “unwanted” pregnancy. A review of the literature shows that, where careful pre- and post-abortion assessments are made, the evidence is that psychological benefit commonly results, and serious adverse emotional sequelae are rare. The outcome of refused abortion seems less satisfactory, with regrets and distress frequently occurring. Research on the administration of abortion services suggests that counselling is often of value, that distress is frequently caused by delays in deciding upon and in carrying out abortions, and by unsympathetic attitudes of service providers. The phenomenon of repeated abortion seeking should be seen in the context of the availability and cost of contraception and sterilization. The place of sterilization with abortion requires careful study. A recommendation is made for observational descriptive research on populations of women with potentially unwanted pregnancies in different cultures, with comparisons of management systems and an evaluation of their impact on service users. PMID:1085671

  2. [The Road towards the Responsible and Safe Legalization of Cannabis Use in Portugal].

    PubMed

    Baptista-Leite, Ricardo; Ploeg, Lisa

    2018-02-28

    Recently, the world has seen examples of the legalization of cannabis for recreational purposes. Due to the diversity of experiences in progress, it is urgent to analyze the impacts of this legalization, from a public health perspective. Therefore, this article aims to review the accumulated knowledge in the states and countries where the use of cannabis is legal and to ponder over the relevance of starting a similar path towards legalization in Portugal, thus supporting political decisions to be properly informed and evidence-based. An extensive literature review was performed using databases and scientific journals, such as PubMed, as well as the search of institutional documentation, including the EMCDDA and SICAD. The gathered information provided insights and enabled assessment of (1) the acute and chronic effects of cannabis use on health, (2) the Portuguese situation related to cannabis and (3) the processes and lessons learned after the legalization of cannabis in other countries or states. Given the above, and according to the data presented, the authors argue for a safe and responsible strategy towards the legalization of cannabis use in Portugal. In accordance, a set of concrete proposals are presented. From a public health perspective, it is assumed that the interest of this proposal is to reduce the problematic use of cannabis, to effectively fight against illicit drug trafficking and drug-related crime, as well as health promotion and prevention of addictions and other adverse health impacts. This article reveals that the effects of legalization might, contrary to general beliefs, generate positive results with respect to these aims, given that there will be greater control on the market, price, quality, and information - to name a few - if implementation occurs with proper consideration and definition. The debate on the responsible and safe legalization of cannabis use in Portugal should be open and promoted, based on a public health

  3. Unsafe abortion after legalisation in Nepal: a cross-sectional study of women presenting to hospitals.

    PubMed

    Rocca, C H; Puri, M; Dulal, B; Bajracharya, L; Harper, C C; Blum, M; Henderson, J T

    2013-08-01

    To investigate abortion practices of Nepali women requiring postabortion care. Cross-sectional study. Four tertiary-care hospitals in urban and rural Nepal. A total of 527 women presenting with complications from induced abortion in 2010. Women completed questionnaires on their awareness of the legal status of abortion and their abortion-seeking experiences. The method of induction and whether the abortion was obtained from an uncertified source was documented. Multivariable logistic regression was used to identify associated factors. Induction method; uncertified abortion source. In all, 234 (44%) women were aware that abortion was legal in Nepal. Medically induced abortion was used by 359 (68%) women and, of these, 343 (89%) took unsafe, ineffective or unknown substances. Compared with women undergoing surgical abortion, women who had medical abortion were more likely to have obtained information from pharmacists (161/359, 45% versus 11/168, 7%, adjusted odds ratio [aOR] 8.1, 95% confidence interval 4.1-16.0) and to have informed no one about the abortion (28/359, 8% versus 3/168, 2%, aOR 5.5, 95% CI 1.1-26.9). Overall, 291 (81%) medical abortions and 50 (30%) surgical abortions were obtained from uncertified sources; these women were less likely to know that abortion was legal (122/341, 36% versus 112/186, 60%, aOR 0.4, 95% CI 0.2-0.7) and more likely to choose a method because it was available nearby (209/341, 61% versus 62/186, 33%, aOR 2.5, 95% CI 1.5-4.3), compared with women accessing certified sources. Among women presenting to hospitals in Nepal with complications following induced abortion of pregnancy, the majority had undergone medically induced abortions using unknown substances acquired from uncertified sources. Women using medications and those accessing uncertified providers were less aware that abortion is now legal in Nepal. These findings highlight the need for continued improvements in the provision and awareness of abortion services in Nepal

  4. Husbands' involvement in abortion in Vietnam.

    PubMed

    Johansson, A; Nga, N T; Huy, T Q; Dat, D D; Holmgren, K

    1998-12-01

    This study analyzes the involvement of men in abortion in Vietnam, where induced abortion is legal and abortion rates are among the highest in the world. Twenty men were interviewed in 1996 about the role they played in their wives' abortions and about their feelings and ethical views concerning the procedure. The results showed that both husbands and wives considered the husband to be the main decisionmaker regarding family size, which included the decision to have an abortion, but that, in fact, some women had undergone an abortion without consulting their husbands in advance. Parents and in-laws were usually not consulted; the couples thought they might object to the decision on moral grounds. Respondents' ethical perspectives on abortion are discussed. When faced with an unwanted pregnancy, the husbands adopted an ethics of care and responsibility toward family and children, although some felt that abortion was immoral. The study highlights the importance of understanding husbands' perspectives on their responsibilities and rights in reproductive decisionmaking and their ethical and other concerns related to abortion.

  5. Patterns of online abortion among teenagers

    NASA Astrophysics Data System (ADS)

    Wahyudi, A.; Jacky, M.; Mudzakkir, M.; Deprita, R.

    2018-01-01

    An on-going debate of whether or not to legalize abortion has not stopped the number of abortion cases decreases. New practices of abortion such as online abortion has been a growing trend among teenagers. This study aims to determine how teenagers use social media such as Facebook, YouTube and Wikipedia for the practice of abortion. This study adopted online research methods (ORMs), a qualitative approach 2.0 by hacking analytical perspective developed. This study establishes online teen abortion as a research subject. This study finds patterns of online abortions among teenagers covering characteristics of teenagers as perpetrators, styles of communication, and their implication toward policy, particularly Electronic Transaction Information (ETI) regulation. Implications for online abortion behavior among teenagers through social media. The potential abortion client especially girls find practical, fast, effective, and efficient solutions that keep their secret. One of prevention patterns that has been done by some people who care about humanity and anti-abortion in the online world is posting a anti-abortion text, video or picture, anti-sex-free (anti -free intercourse before marriage) in an interesting, educative, and friendly ways.

  6. [Proposed method to estimate underreporting of induced abortion in Spain].

    PubMed

    Rodríguez Blas, C; Sendra Gutiérrez, J M; Regidor Poyatos, E; Gutiérrez Fisac, J L; Iñigo Martínez, J

    1994-01-01

    In Spain, from 1987 to 1990 the rate of legal abortion reported to the health authorities has doubled; nevertheless, the observed geographical differences suggest to an underreporting of the number of voluntary pregnancy terminations. Based on information on several sociodemographic, economic and cultural characteristics, contraceptive use, availability of abortion services, fertility indices, and maternal and child health status, five homogenEous groups of autonomous region were identified applying factor and cluster analysis techniques. To estimate the level of underreporting, we assumed that all the regions which shape a cluster ought to have the same abortion rate that the region with the highest rate in each group. We estimate that about 18,463 abortions (33.2%) were not reported during 1990. The proposed method can be used for assessing the notification since it allows to identify geographical areas where very similar rates of legal abortion are expected.

  7. Abortion clinic patients' opinions about obtaining abortions from general women's health care providers.

    PubMed

    Weitz, Tracy Ann; Cockrill, Kate

    2010-12-01

    Most U.S. women obtain abortions at specialty clinics. This qualitative study explores abortion clinic patients' opinions about receiving abortions from general women's health care providers. We conducted 20 h-long, semi-structured interviews with diverse women who had abortions in the U.S. Heartland. Each described her usual health care provider and how she accessed abortion care. We used qualitative analytic methods to organize and interpret the data. Despite having a general provider, most women sought clinic abortions. Some women offered reasons for preferring specialty care and others for preferring abortion from their general provider. Most women assumed their general provider did not "do abortion" and many believed those providers were opposed to abortion. Women who had delivered a baby were concerned with their image in their general provider's eyes. Two women were denied care by their general providers. Women's preferences for abortion care centered on privacy, cost, empathy, ability to control their image, and desire for safe quality care. Two women who sought abortions through their general providers experienced negative repercussions. General providers should proactively make patients aware of their positions on abortion and if supportive indicate that they can provide that care and/or a referral. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  8. Contesting the cruel treatment of abortion-seeking women.

    PubMed

    Fletcher, Ruth

    2014-11-01

    This article draws on legal arguments made by civil society organisations to challenge the legal reasoning that apparently produced the decision in the Ms Y case in Ireland in August 2014. I show how legal standards of reasonableness and practicality ought to be interpreted in ways that are respectful of the patient's wishes and rights. The case concerned a decision by the Health Service Executive, the Irish public health authority, to refuse an abortion to a pregnant asylum seeker and rape survivor on the grounds that a caesarean section and early live delivery were practicable and reasonable alternatives justified by the need to protect fetal life. I argue that the abortion refusal may not have been a reasonable decision, as required by the terms of relevant legislation, for four different reasons. First, the alternative of a caesarean section and early live delivery was not likely to avert the risk of suicide, and in fact did not do so. Second, the consent to the caesarean section alternative may not have been a real consent in the legal sense if it was not voluntary. Third, an abortion refusal and forcible treatment fall below the norms of good medical practice as interpreted through a patient-centred perspective. Fourth, an abortion refusal that entails forms of cruel, inhumane and degrading treatment ought not to be a reasonable action under the legislation. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  9. Acceptability and clinical outcomes of first- and second-trimester surgical abortion by suction aspiration in Colombia.

    PubMed

    DePiñeres, Teresa; Baum, Sarah; Grossman, Daniel

    2014-09-01

    Since partial decriminalization of abortion in Colombia, Oriéntame has provided legal abortion services through 15 weeks gestation in an outpatient primary care setting. We sought to document the safety and acceptability of the second trimester compared to the first-trimester surgical abortion in this setting. This was a prospective cohort study using a consecutive sample of 100 women undergoing surgical first-trimester abortion (11 weeks 6 days gestational age or less) and 200 women undergoing second-trimester abortion (12 weeks 0 days-15 weeks 0 days) over a 5-month period in 2012. After obtaining informed consent, a trained interviewer collected demographic and clinical information from direct observation and the patient's clinical chart. The interviewer asked questions after the procedure regarding satisfaction with the procedure, physical pain and emotional discomfort. Fifteen days later, the interviewer assessed satisfaction with the procedure and any delayed complications. There were no major complications and seven minor complications. Average measured blood loss was 37.87 mL in the first trimester and 109 mL in the second trimester (p<.001). Following the procedure, more second-trimester patients reported being very satisfied (81% vs. 94%, p=.006). Satisfaction was similar between groups at follow-up. There were no differences in reported emotional discomfort after the procedure or at follow-up, with the majority reporting no emotional discomfort. The majority of women (99%) stated that they would recommend the clinic to a friend or family member. Second-trimester surgical abortion in an outpatient primary care setting in Colombia can be provided safely, and satisfaction with these services is high. This is one of the first studies from Latin America, a region with a high proportion of maternal mortality due to unsafe abortion, which documents the safety and acceptability of surgical abortion in an outpatient primary care setting. Findings could support

  10. Protest Motherhood: Pregnancy Decision-Making Behavior and Attitudes Towards Abortion.

    ERIC Educational Resources Information Center

    Chesney-Lind, Meda

    The document describes research on womens' attitudes toward abortion and their decision-making when pregnant leading to either birth or abortion. The objective was "to explore how womens' perceptions of the option of legal abortion have affected their pregnancy decision-making behavior" and to note the impact of their particular choices on their…

  11. Fertility response to abortion reform in Eastern Europe: demographic and economic implications: comment.

    PubMed

    Lindley, J T

    1972-01-01

    Rumania provides the opportunity to determine the effects of change in abortion laws by comparing it to Bulgaria, Czechoslovakia, and Hungary with whom it has a similar background, government, and growth pattern. Rumania had legalized abortion in 1957 but reversed its decision in 1966. 3 years later when compared with the other countries where legalized abortion continued, there was a significant increase in the crude birthrate of Rumania, a notable increase resulting mainly from the change in its abortion law. This same conclusion can also be reached by applying microeconomic theory using the concept that children are, on the margin, the result of a maximizing process. The decision to have an abortion in the countries in question is voluntary. No one is coerced and even when abortion is illegal it can be seen as an increase in price. By doing this the decision of whether to have an abortion can be analyzed as a microeconomic decision. The birth decision is made on the margin where the expected cost of a child is compared with the expected return. Traditional analysis implies that there is no cost involved in not having children, but there are both monetary and nonmonetary costs, the latter being physical and psychological. All forms of birth control involve costs, and the following analysis could be used on any of them. By combining the cost of preventing birth with the concept of traditional theory, there is now a threefold margin of decision rather than a twofold one. The cost of prevention must be included. If the amount that will have to be expended for prevention exceeds the net cost of having the child, the ultimate decision will be to have the child. The demand curve for abortion shows that as abortion is legalized the supply curve will shift out and the price will fall, with the opposite case if abortion is again made illegal. The demand curve might also shift as abortion was legalized or made illegal as the desire for abortion could change. It could be

  12. Estimates of the incidence of induced abortion and consequences of unsafe abortion in Senegal.

    PubMed

    Sedgh, Gilda; Sylla, Amadou Hassane; Philbin, Jesse; Keogh, Sarah; Ndiaye, Salif

    2015-03-01

    Abortion is highly restricted by law in Senegal. Although women seek care for abortion complications, no national estimate of abortion incidence exists. Data on postabortion care and abortion in Senegal were collected in 2013 using surveys of a nationally representative sample of 168 health facilities that provide postabortion care and of 110 professionals knowledgeable about abortion service provision. Indirect estimation techniques were applied to the data to estimate the incidence of induced abortion in the country. Abortion rates and ratios were calculated for the nation and separately for the Dakar region and the rest of the country. The distribution of pregnancies by planning status and by outcome was estimated. In 2012, an estimated 51,500 induced abortions were performed in Senegal, and 16,700 (32%) resulted in complications that were treated at health facilities. The estimated abortion rate was 17 per 1,000 women aged 15-44 and the abortion ratio was 10 per 100 live births. The rate was higher in Dakar (21 per 1,000) than in the rest of the country (16 per 1,000). Poor women were far more likely to experience abortion complications, and less likely to receive treatment for complications, than nonpoor women. About 31% of pregnancies were unintended, and 24% of unintended pregnancies (8% of all pregnancies) ended in abortion. Unsafe abortion exacts a heavy toll on women in Senegal. Reducing the barriers to effective contraceptive use and ensuring access to postabortion care without the risk of legal consequences may reduce the incidence of and complications from unsafe abortion.

  13. Estimates of the Incidence of Induced Abortion And Consequences of Unsafe Abortion in Senegal

    PubMed Central

    Sedgh, Gilda; Sylla, Amadou Hassane; Philbin, Jesse; Keogh, Sarah; Ndiaye, Salif

    2015-01-01

    CONTEXT Abortion is highly restricted by law in Senegal. Although women seek care for abortion complications, no national estimate of abortion incidence exists. METHODS Data on postabortion care and abortion in Senegal were collected in 2013 using surveys of a nationally representative sample of 168 health facilities that provide postabortion care and of 110 professionals knowledgeable about abortion service provision. Indirect estimation techniques were applied to the data to estimate the incidence of induced abortion in the country. Abortion rates and ratios were calculated for the nation and separately for the Dakar region and the rest of the country. The distribution of pregnancies by planning status and by outcome was estimated. RESULTS In 2012, an estimated 51,500 induced abortions were performed in Senegal, and 16,700 (32%) resulted in complications that were treated at health facilities. The estimated abortion rate was 17 per 1,000 women aged 15–44 and the abortion ratio was 10 per 100 live births. The rate was higher in Dakar (21 per 1,000) than in the rest of the country (16 per 1,000). Poor women were far more likely to experience abortion complications, and less likely to receive treatment for complications, than nonpoor women. About 31% of pregnancies were unintended, and 24% of unintended pregnancies (8% of all pregnancies) ended in abortion. CONCLUSIONS Unsafe abortion exacts a heavy toll on women in Senegal. Reducing the barriers to effective contraceptive use and ensuring access to postabortion care without the risk of legal consequences may reduce the incidence of and complications from unsafe abortion. PMID:25856233

  14. Induced abortion amongst undergradute students of University of Port Harcourt.

    PubMed

    Oriji, Vaduneme K; Jeremiah, Israel; Kasso, Terhemen

    2009-01-01

    Induced abortion is the termination of pregnancy through a deliberate intervention intended to end the pregnancy. This practice is widespread in Nigeria despite the restrictive abortion laws in Nigeria. Many women still undergo induced abortion every year and endanger their health and lives as induced abortion can only be procured illegally in Nigeria. We hope to determine the proportion of undergraduate students who had induced abortion in the past and the contributing factors. To determine the proportion of the undergraduate students who support the restrictive abortion laws in Nigeria. A cross sectional questionnaire survey of undergraduate students of the University of Port Harcourt was done through a cluster sampling method along with focus group discussion with some of the respondents. 451 out of 500 administered questionnaires were retrieved and analyzed. The incidence of induced abortion amongst the respondents was 47.2%. About 40% had never used an effective form of contraception in the past and 13% were unaware of contraception. 77.9% of the induced abortion was by dilation and curettage and 1% by manual vacuum aspiration. Up to two third of the respondents were against legalization of abortion. Up to 47% of these undergraduates had performed abortion in the past. Protecting educational career was the single most important reason for this. Although most of these undergraduates are against legalizing abortion, they highly patronize unsafe abortion. Improving contraceptive awareness and usage will reduce unwanted pregnancy and induced abortion. This option appears next to total abstinence in reducing the morbidity and mortality from induced abortion in this country.

  15. Abortion surveillance - United States, 2006.

    PubMed

    Pazol, Karen; Gamble, Sonya B; Parker, Wilda Y; Cook, Douglas A; Zane, Suzanne B; Hamdan, Saeed

    2009-11-27

    Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. 2006. Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, New York City, and the District of Columbia); these data are provided to CDC voluntarily. In 2006, data were received from 49 reporting areas. For the purpose of trend analysis, data were evaluated from the 46 areas that reported data every year during 1996-2006. For 2006, a total of 846,181 abortions were reported to CDC. Among the 46 areas that provided data consistently during 1996-2006, a total of 835,134 abortions (98.7% of the total) were reported; the abortion rate was 16.1 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 236 abortions per 1,000 live births. During the previous decade (1997-2006), reported abortion numbers, rates, and ratios decreased 5.7%, 8.8%, and 14.8%, respectively; most of these declines occurred before 2001. During the previous year (2005-2006), the total number of abortions increased 3.1%, and the abortion rate increased 3.2%; the abortion ratio was stable. In 2006, as during the previous decade (1997-2006), women aged 20-29 years accounted for the majority (56.8%) of abortions and had the highest abortion rates (29.9 abortions per 1,000 women aged 20-24 years and 22.2 abortions per 1,000 women aged 25-29 years); by contrast, abortion ratios were highest at the extremes of reproductive age. Adolescents aged 15-19 years accounted for 16.5% of all abortions in 2006 and had an abortion rate of 14.8 abortions per 1,000 adolescents aged 15-19 years; women aged >or=35 years accounted for a smaller percentage (12.1%) of abortions and had lower abortion rates (7.8 abortions per 1,000 women aged 35-39 years and 2.6 abortions per 1,000 women aged >or=40 years). During 1997-2006, the percentage of abortions and the abortion rate increased among women

  16. Constitutional developments in Latin American abortion law.

    PubMed

    Bergallo, Paola; Ramón Michel, Agustina

    2016-11-01

    For most of the 20th Century, restrictive abortion laws were in place in continental Latin America. In recent years, reforms have caused a liberalizing shift, supported by constitutional decisions of the countries' high courts. The present article offers an overview of the turn toward more liberal rules and the resolution of abortion disputes by reference to national constitutions. For such purpose, the main legal changes of abortion laws in the last decade are first surveyed. Landmark decisions of the high courts of Argentina, Bolivia, Colombia, and Mexico are then analyzed. It is shown that courts have accepted the need to balance interests and competing rights to ground less restrictive laws. In doing so, they have articulated limits to protection of fetal interests, and basic ideas of women's dignity, autonomy, and equality. The process of constitutionalization has only just begun. Constitutional judgments are not the last word, but they are important contributions in reinforcing the legality of abortion. Copyright © 2016 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  17. Emotional distress in Israeli women before and after abortion.

    PubMed

    Teichman, Y; Shenhar, S; Segal, S

    1993-04-01

    Emotional distress in a group of Israeli women who requested legal abortion was compared with that in a group of women on the verge of delivery and in a random group of nonpregnant women on measures of anxiety and depression. Emotional consequences of the abortion were evaluated by before-and-after comparisons of the same measures in a subgroup of the aborting women. Findings indicated significantly greater distress in the aborting women, with lower levels after the abortion. The effects on emotional well-being of personal and contextual factors and their interactions were also examined.

  18. Protocol to the African Charter on the Rights of Women: implications for access to abortion at the regional level.

    PubMed

    Ngwena, Charles G

    2010-08-01

    Article 14(2)(c) of the Protocol to the African Charter on the Rights of Women enjoins States Parties to take appropriate measures "to protect the reproductive rights of women by authorising medical abortion in cases of sexual assault, rape, incest, and where continued pregnancy endangers the mental and physical health of the mother or the life of the mother or the foetus." This paper considers the implications of Article 14 for access to safe, legal abortion. It is submitted that Article 14 has the potential to impact positively on regional abortion law, policy, and practice in 3 main areas. First, it takes forward the global consensus on combating abortion as a major public health danger. Second, it provides African countries with not just an incentive, but also an imperative for reforming abortion laws in a transparent manner. Third, if implemented in the context of a treaty that centers on the equality and non-discrimination of women, Article 14 has the potential to contribute toward transforming access to abortion from a crime and punishment model to a reproductive health model. Copyright 2010 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Fertility effects of abortion and birth control pill access for minors.

    PubMed

    Guldi, Melanie

    2008-11-01

    This article empirically assesses whether age-restricted access to abortion and the birth control pill influence minors' fertility in the United States. There is not a strong consensus in previous literature regarding the relationship between laws restricting minors' access to abortion and minors' birth rates. This is the first study to recognize that state laws in place prior to the 1973 Roe v. Wade decision enabled minors to legally consent to surgical treatment-including abortion-in some states but not in others, and to construct abortion access variables reflecting this. In this article, age-specific policy variables measure either a minor's legal ability to obtain an abortion or to obtain the birth control pill without parental involvement. I find fairly strong evidence that young women's birth rates dropped as a result of abortion access as well as evidence that birth control pill access led to a drop in birth rates among whites.

  20. Post legalisation challenge: minimizing complications of abortion.

    PubMed

    Ojha, N; Sharma, S; Paudel, J

    2004-01-01

    Abortion has been legalized in Nepal since September 2002 by 11th amendment to the Muluki Ain. The present study was conducted in Paropakar Shree Panch Indra Rajya Laxmi Devi Maternity Hospital to assess the magnitude of induced abortion, its causes and the types of complications, in the post legalization phase. Prospective descriptive analyses of the patients who were admitted with history of induced abortion from 16th Dec 2003 to 13th March 2004 was carried out. A total of 305 cases of abortion complications were admitted during the three-month study period, which is 39.7% of the total gynaecological admissions (768). Of these 31 (10.25%) patients had history of induced abortion. Half of the induced abortion cases (52%) were of age group 21-29 yrs and 42% had three or more children. 39% of the cases had history of induced abortion at more than 12 weeks and almost half of the cases (48%) had history of family planning. The most common reason for seeking abortion was too many children (59%) followed by illegitimate pregnancy (16%). Twenty-one patients gave history of abortion being performed by doctors and the most common method used was D and C (75%). 77% of cases presented as incomplete abortion and one case presented with uterine perforation, bowel injury and peritonitis. Twenty patients had evacuation under sedation while five had manual vacuum aspiration (MVA); one patient required laparatomy. In two third of the patients intravenous fluid and antibiotics were used. Four patients required blood transfusion. Abortion complications constitute almost 40% of the total gynaecological admissions. Ten percent of the abortion cases had history of induced abortion. Medical persons, mainly doctors, performed most of the cases of induced abortion and D and C was the most commonly used method. However the patients had faced various types of complications. Untrained provider, resulting in serious life threatening injuries, performed more than a third of the cases of

  1. No. 360-Induced Abortion: Surgical Abortion and Second Trimester Medical Methods.

    PubMed

    Costescu, Dustin; Guilbert, Édith

    2018-06-01

    This guideline reviews evidence relating to the provision of surgical induced abortion (IA) and second trimester medical abortion, including pre- and post-procedural care. Gynaecologists, family physicians, nurses, midwives, residents, and other health care providers who currently or intend to provide and/or teach IAs. Women with an unintended or abnormal first or second trimester pregnancy. PubMed, Medline, and the Cochrane Database were searched using the key words: first-trimester surgical abortion, second-trimester surgical abortion, second-trimester medical abortion, dilation and evacuation, induction abortion, feticide, cervical preparation, cervical dilation, abortion complications. Results were restricted to English or French systematic reviews, randomized controlled trials, clinical trials, and observational studies published from 1979 to July 2017. National and international clinical practice guidelines were consulted for review. Grey literature was not searched. The quality of evidence in this document was rated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) methodology framework. The summary of findings is available upon request. IA is safe and effective. The benefits of IA outweigh the potential harms or costs. No new direct harms or costs identified with these guidelines. Copyright © 2018 Society of Obstetricians and Gynaecologists of Canada. All rights reserved.

  2. Abortion in Turkey: a matter of state, family or individual decision.

    PubMed

    Gürsoy, A

    1996-02-01

    This paper gives a historical, international and cultural outlook on the debate related to the 1982 legalization of abortion in the modern democratic republic of Turkey. A belief that the country is under-populated and subsequent pro-natalist concerns of the turn of the century seem to have strongly influenced the legal prohibition of abortion. The paper first discusses the widespread social practice and the permissive attitudes towards abortion in the late Ottoman Empire and in contemporary Turkey. The contrast between the above social situation and until recently the strict, non-permissive religious and secular attitudes are presented with a discussion of the effects of the westernization and secularization processes in the late Ottoman Empire. Moral concerns and judgements regarding abortion seem to have penetrated Ottoman society as part of the above processes beginning in the nineteenth century. The present day official religious interpretations seem to conform with the more conservative Islamic schools of thought rather than the more liberal Islamic interpretations. Furthermore, the 1982 laws which legalize abortion until the eight week of pregnancy consider family planning to be a family issue and bring the restriction of making married women have their husband's permission before preceding with abortion. As such, the present legal platform opens to question the rationales and population control motives behind the law and the importance of who it is that can make the decision to proceed with abortion. Thus, in the last 70 years a historical and ideological progression can be discerned in the line of assuming first the state and then the family to have decision making legitimacy as regards reproductive choices. Today, the platform of radical discussion has shifted to evaluating the importance of individual women in making this reproductive choice. In this context, in conclusion, the paper discussed the rationale and the logic behind and the implications for

  3. Preventing pelvic infection after abortion.

    PubMed

    Stevenson, M M; Radcliffe, K W

    1995-01-01

    Pelvic infection is the commonest complication of legal abortion. The presence of lower genital tract infections increases the risk of complications, and women requesting abortion are at significant risk of harbouring sexually transmitted diseases (STD). Prophylactic antibiotic treatment can decrease the rate of post-abortal sepsis, but the optimum regime is unclear. In particular, patients with Chlamydia trachomatis infection, and bacterial vaginosis would appear to be at increased risk, and detection and treatment of these conditions can lower this risk. The opportunity to screen and treat for STD presents itself in this setting, allowing patients and their sexual contacts to benefit, with a decrease in the infected pool in the community.

  4. Women's perceptions about abortion in their communities: perspectives from western Kenya.

    PubMed

    Marlow, Heather M; Wamugi, Sylvia; Yegon, Erick; Fetters, Tamara; Wanaswa, Leah; Msipa-Ndebele, Sinikiwe

    2014-05-01

    Unsafe abortion in Kenya is a leading cause of maternal morbidity and mortality. In October 2012, we sought to understand the methods married women aged 24-49 and young, unmarried women aged ≤ 20 used to induce abortion, the providers they utilized and the social, economic and cultural norms that influenced women's access to safe abortion services in Bungoma and Trans Nzoia counties in western Kenya. We conducted five focus groups with young women and five with married women in rural and urban communities in each county. We trained local facilitators to conduct the focus groups in Swahili or English. All focus groups were audiotaped, transcribed, translated, computerized, and coded for analysis. Abortion outside public health facilities was mentioned frequently. Because of the need for secrecy to avoid condemnation, uncertainty about the law, and perceived higher cost of safer abortion methods, women sought unsafe abortions from community midwives, drug sellers and/or untrained providers at lower cost. Many groups believed that abortion was safer at higher gestational ages, but that there was no such thing as a safe abortion method. Our aim was to inform the design of a community-based intervention on safe abortion for women. Barriers to seeking safe services such as high cost, perceived illegality, and fear of insults and abuse at public facilities among both age groups must be addressed. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  5. To abort or not to abort: that is the question.

    PubMed

    Thomison, J B

    1991-02-01

    Abortion is not a medical issue, as the law would like to make it when requesting definitions of when life begins. To medicine, life begins at conception. conception is the 1st step in the miracle of life. It is up to the law and society to determine when life begins legally. Doctors have responsibilities as citizens to do what they can to support laws they believe in. The American Medical Association has remained neutral on the issue. Abortion can be ethical if the mother's life is threatened. But it is unethical and unconstitutional when it is done out of convenience to correct indiscretions.

  6. Abortion: a reader's guide.

    PubMed

    Hisel, L M

    1996-01-01

    This review traces the discussion of abortion in the US through 10 of the best books published on the subject in the past 25 years. The first book considered is Daniel Callahan's "Abortion: Law, Choice and Morality," which was published in 1970. Next is book of essays also published in 1970: "The Morality of Abortion: Legal and Historical Perspectives," which was edited by John T. Noonan, Jr., who became a prominent opponent to the Roe decision. It is noted that Roman Catholics would find the essay by Bernard Haring especially interesting since Haring supported the Church's position on abortion but called for acceptance of contraception. Third on the list is historian James C. Mohr's review of "Abortion in America: The Origins and Evolution of National Policy," which was printed five years after the Roe decision. Selection four is "Enemies of Choice: The Right-to-Life Movement and Its Threat to Abortion" by Andrew Merton. This 1981 publication singled out a concern about sexuality as the overriding motivator for anti-abortion groups. Two years later, Beverly Wildung Harrison published a ground-breaking, feminist, moral analysis of abortion entitled "Our Right to Choose: Toward a New Ethic of Abortion. This was followed by a more empirical and sociopolitical feminist analysis in Kristin Luker's 1984 "Abortion and the Politics of Motherhood." The seventh book is by another feminist, Rosalind Pollack Petchesky, whose work "Abortion and Women's Choice: The State, Sexuality, and Reproductive Freedom" was first published in 1984 and reprinted in 1990. The eighth important book was "Abortion and Catholicism: The American Debate," edited by Thomas A. Shannon and Patricia Beattie Jung. Rounding out the list are the 1992 work "Life Itself: Abortion in the American Mind" by Roger Rosenblatt and Ronald Dworkin's 1993 "Life's Dominion: An Argument About Abortion, Euthanasia, and Individual Freedom."

  7. Health and economic consequences of septic induced abortion.

    PubMed

    Konje, J C; Obisesan, K A; Ladipo, O A

    1992-03-01

    Over a period of 7 years, 230 cases of illegally induced abortions complicated by sepsis were treated at the University College Hospital, Ibadan, Nigeria. The number of terminations complicated by sepsis doubled from 25.4 (between 1981 and 1985) to 51.0 (between 1986 and 1987) cases per year. Peritonitis was the commonest associated complication while maternal mortality was 8.3%. The average cost of treatment was US$223.11, while the average monthly earnings was US$45.00. Legalization of abortion would have resulted in a saving of US$50,022.28. Provision of legal abortion would reduce the incidence of sepsis after termination while reproductive health education and information dissemination and provision of easily accessible family planning services would greatly reduce the number of unwanted pregnancies.

  8. Psychiatric sequelae of induced abortion.

    PubMed

    Gibbons, M

    1984-03-01

    An attempt is made to identify and document the problems of comparative evaluation of the more recent studies of psychiatric morbidity after abortion and to determine the current consensus so that when the results of the joint RCGP/RCOG study of the sequelae of induced abortion become available they can be viewed in a more informed context. The legalization of abortion has provided more opportunities for studies of subsequent morbidity. New laws have contributed to the changing attitudes of society, and the increasing acceptability of the operation has probably influenced the occurrence of psychiatric sequelae. The complexity of measuring psychiatric sequelae is evident from the many terms used to describe symptomatology and behavioral patterns and from the number of assessment techniques involved. Numerous techniques have been used to quantify psychiatric sequelae. Several authors conclude that few psychiatric problems follow an induced abortion, but many studies were deficient in methodology, material, or length of follow-up. A British study in 1975 reported a favorable outcome for a "representative sample" of 50 National Health Service patients: 68% of these patients had an absence of or only mild feelings of guilt, loss, or self reproach and considered abortion as the best solution to their problem. The 32% who had an adverse outcome reported moderate to severe feelings of guilt, regret, loss, and self reproach, and there was evidence of mental illness. In most of these cases the adverse outcome was related to the patient's environment since the abortion. A follow-up study of 126 women, which compared the overall reaction to therapeutic abortion between women with a history of previous mild psychiatric illness and those without reported that a significantly different emotional reaction could not be demonstrated between the 2 groups. In a survey among women seeking an abortion 271 who were referred for a psychiatric opinion regarding terminations of pregnancy

  9. Abortion, breast cancer, and informed consent.

    PubMed

    Kindley, J

    2000-01-01

    The purpose of this article is to show that the current level of scientific evidence linking induced abortion with increased breast cancer risk is sufficient to support an ethical and legal duty to disclose fully the risk to women who are considering induced abortion. The article examines the relationship between this evidence and the elements of a medical malpractice claim alleging failure to obtain informed consent. The first part focuses on the elements of informed consent, which require the plaintiff to establish that the physician had a duty to disclose information, which he failed to disclose, that this failure to disclose was a legal cause of the plaintiff's decision to undergo the procedure, and the procedure was a legal cause of the plaintiff's injury. The second part compares two prevalent standards for determining which risks a physician has a duty to disclose. Part three reviews the scientific evidence of the abortion/breast cancer (ABC) link and explains why it survives both the Frye and the Daubert tests for admissibility of expert testimony. The fourth part assesses the materiality of the risk posed by the ABC link. Parts five and six discuss evidentiary issues and the possibility of punitive damage awards.

  10. Unsafe abortion: a cruel way of birth control.

    PubMed

    Shrivastava, Saurabh RamBihariLal; Shrivastava, Prateek Saurabh; Ramasamy, Jegadeesh

    2014-06-01

    Unsafe abortion refers to a procedure for terminating an unintended pregnancy performed either by persons lacking the necessary skills or in an environment that does not conform to minimal medical standards, or both. The objectives of the study are to assess the factors attributing to practice of unsafe abortion and to suggest feasible and cost-effective measures to counter the same. An extensive search of all materials related to the topic was made using library sources including Pubmed, Medline and World Health Organization. Keywords used in the search include unsafe abortion and unintended pregnancy. Multiple socio-demographic determinants and barriers such as illiterate women, poor socio-economic status, poor awareness about abortion services, associated stigma, and untrained health professionals have been identified resulting in restricted utilization/access of women to safe abortion services. Consequences of unsafe abortion have been alarming, seriously questioning the quality of health care delivery system. Concerted and dedicated efforts of government in collaboration with the private sector, community members and non-governmental organizations are needed to ensure that women have a better access to contraceptives, abortion services, and post-abortion care that are safe, affordable, and free from stigma.

  11. Determinants of first and second trimester induced abortion - results from a cross-sectional study taken place 7 years after abortion law revisions in Ethiopia.

    PubMed

    Bonnen, Kristine Ivalu; Tuijje, Dereje Negussie; Rasch, Vibeke

    2014-12-19

    In 2005 Ethiopia took the important step to protect women's reproductive health by liberalizing the abortion law. As a result women were given access to safe pregnancy termination in first and second trimester. This study aims to describe socio-economic characteristics and contraceptive experience among women seeking abortion in Jimma, Ethiopia and to describe determinants of second trimester abortion. A cross-sectional study conducted October 2011 - April 2012 in Jimma Town, Ethiopia among women having safely induced abortion and women having unsafely induced abortion. In all 808 safe abortion cases and 21 unsafe abortion cases were included in the study. Of the 829 abortions, 729 were first trimester and 100 were second trimester abortions. Bivariate and multivariate logistic regressions were used to determine risk factors associated with second trimester abortion. The associations are presented as odds ratios (OR) with 95% confidential intervals. Age stratified analyses of contraceptive experience among women with first and second trimester abortions are also presented. Socio-economic characteristics associated with increased ORs of second trimester abortion were: age < 19 years, being single, widowed or divorced, attending school, being unemployment, being nullipara or para 3+, and having low education. The contraceptive prevalence rate varied across age groups and was particularly low among young girls and young women experiencing second trimester abortion where only 15% and 19% stated they had ever used contraception. Young age, poor education and the prospect of single parenthood were associated with second trimester abortion. Young girls and young women were using contraception comparatively less often than older women. To ensure women full right to control their fertility in the setting studied, modern contraception should be made available, accessible and affordable for all women, regardless of age.

  12. International developments in abortion laws: 1977-88.

    PubMed Central

    Cook, R J; Dickens, B M

    1988-01-01

    During the period between 1977 and the first quarter of 1988, 35 countries liberalized their abortion laws and four countries limited grounds for the procedure. Most legislation has extended abortion eligibility through traditional indications such as danger to maternal health or fetal handicap, but a number of other indications have been created such as adolescence, advanced maternal age, family circumstances, and AIDS or HIV infection. A number of countries have redesigned their abortion laws as part of a comprehensive package to facilitate access to and delivery of contraception, voluntary sterilization, and abortion services. Abortion litigation has increased and stimulated the liberalization of abortion provisions and the support of women's autonomous choice within the law. In Canada, the entire criminal prohibition of abortion was held unconstitutional for violating women's integrity and security. In contrast, Latin American and other constitutional developments may limit legal abortion to instances of danger to women's lives. PMID:3048126

  13. Media Agendas and Human Rights: The Supreme Court Decision on Abortion.

    ERIC Educational Resources Information Center

    Pollock, John Crothers; And Others

    1978-01-01

    Examines coverage of the abortion issue prior to, during, and after the 1973 Supreme Court decision legalizing elective abortion in daily newspapers in Boston, Chicago, Los Angeles, New York, and Washington, D.C. Considers the effect on news coverage of local religious composition, income levels, race, and abortion rate. (GW)

  14. A strategic assessment of unsafe abortion in Malawi.

    PubMed

    Jackson, Emily; Johnson, Brooke Ronald; Gebreselassie, Hailemichael; Kangaude, Godfrey D; Mhango, Chisale

    2011-05-01

    As part of efforts to achieve Millennium Development Goal 5--to reduce maternal mortality by 75% and achieve universal access to reproductive health by 2015--the Malawi Ministry of Health conducted a strategic assessment of unsafe abortion in Malawi. This paper describes the findings of the assessment, including a human rights-based review of Malawi's laws, policies and international agreements relating to sexual and reproductive health and data from 485 in-depth interviews about sexual and reproductive health, maternal mortality and unsafe abortion, conducted with Malawians from all parts of the country and social strata. Consensus recommendations to address the issue of unsafe abortion were developed by a broad base of local and international stakeholders during a national dissemination meeting. Malawi's restrictive abortion law, inaccessibility of safe abortion services, particularly for poor and young women, and lack of adequate family planning, youth-friendly and post-abortion care services were the most important barriers. The consensus reached was that to make abortion safe in Malawi, there were four areas for urgent action--abortion law reform; sexuality education and family planning; adolescent sexual and reproductive health services; and post-abortion care services. Copyright © 2011 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  15. Should Parental Involvement Be Required for Minors' Abortions?

    ERIC Educational Resources Information Center

    Rodman, Hyman

    1991-01-01

    Discusses the U.S. Supreme Court's recent indication of willingness to accept state restrictions on a woman's right to abortion. Presents several key reasons why parental involvement should not be legally required for minors' abortions, and suggests that family practitioners are in an excellent position to inform the public and policymakers about…

  16. Association between educational level and access to safe abortion in a Brazilian population.

    PubMed

    Dias, Tábata Z; Passini, Renato; Duarte, Graciana A; Sousa, Maria H; Faúndes, Aníbal

    2015-03-01

    To evaluate sociodemographic factors associated with induced abortion. As part of a cross-sectional, descriptive study, 15 800 civil servants from Campinas, Brazil, were invited to complete a self-administered questionnaire about absolutely unwanted pregnancies in January 2010. Bivariate analysis and multivariate Poisson regression analysis were used to explore the associations between induced abortion and sociodemographic characteristics. Overall, 1660 questionnaires were returned. Unwanted pregnancy was reported by 296 (17.8%) respondents, of whom 165 (55.7%) resorted to abortion. Multiple regression analysis showed that college education was the only variable associated with an increased chance of abortion. Among 157 participants who answered questions about the abortion procedure, 97 (61.8%) reported that it had been performed by a physician. Following abortion, 35 (22.9%) of 153 reported that medical care was required and 26 (16.6%) of 157 reported hospitalization, principally those with a lower level of education and those whose abortion had been performed by a nonphysician. Compared with women with a college education, those with a lower education level were less likely to terminate an absolutely unwanted pregnancy and to have an abortion performed by a physician, and they were more likely to have complications. These findings confirm the social inequalities associated with abortion in Brazil. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  17. [The gynecologist and the problem of therapeutic abortion].

    PubMed

    Pundel, J P

    1972-01-01

    Most of this essay on the abortion problem in French-speaking western Europe concerns the Sermon of Hippocrates forbidding abortion; the discussion ends with an ethical discussion on abortion codes in a pluralist society. 1st, scholars question whether Hippocrates himself actually wrote the text of the Sermon, or whether his Pythagorean followers did. 2nd, probably abortion in Hippocrates' time was relegated to midwives and lithotomists. The meaning of the quotation "I do not give any abortive remedy" is obscure since in other contexts Hippocrates distinguished between abortive and contraceptive drugs and also abortive instruments. Finally, Hipoocrates specifically recommended abortion, e.g., to avoid pregnancy for prostitutes. Persons in authority, then, should not invoke Hippocrates or any other moral code to deprive a woman of medical abortion, especially in cases of rape, age, and failure of contraception. Divorce, for example, has been legalized in most countries, without forcing anyone to take advantage of it.

  18. Crew Exploration Vehicle Ascent Abort Overview

    NASA Technical Reports Server (NTRS)

    Davidson, John B., Jr.; Madsen, Jennifer M.; Proud, Ryan W.; Merritt, Deborah S.; Sparks, Dean W., Jr.; Kenyon, Paul R.; Burt, Richard; McFarland, Mike

    2007-01-01

    One of the primary design drivers for NASA's Crew Exploration Vehicle (CEV) is to ensure crew safety. Aborts during the critical ascent flight phase require the design and operation of CEV systems to escape from the Crew Launch Vehicle and return the crew safely to the Earth. To accomplish this requirement of continuous abort coverage, CEV ascent abort modes are being designed and analyzed to accommodate the velocity, altitude, atmospheric, and vehicle configuration changes that occur during ascent. The analysis involves an evaluation of the feasibility and survivability of each abort mode and an assessment of the abort mode coverage. These studies and design trades are being conducted so that more informed decisions can be made regarding the vehicle abort requirements, design, and operation. This paper presents an overview of the CEV, driving requirements for abort scenarios, and an overview of current ascent abort modes. Example analysis results are then discussed. Finally, future areas for abort analysis are addressed.

  19. The effect of induced abortion on the incidence of Down's syndrome in Hawaii.

    PubMed

    Smith, R G; Gardner, R W; Steinhoff, P; Chung, C S; Palmore, J A

    1980-01-01

    There was a decrease in the recorded number of cases and in the incidence rate of Down's syndrome in Hawaii between 1963-1969 and 1971-1977. Independent of all other factors, induced abortion accounted for 43 percent of the decline in the number of cases, based on the assumption that a substantial number of clandestine abortions were being performed in Hawaii before the 1970 legalization of abortion. However, if we assume that very few illegal abortions were performed prior to 1970, there would have been an actual 3.5 percent increase in the number of cases of Down's syndrome in the absence of legal abortion. Declining pregnancy rates and decreasing age-specific incidence rates of Down's syndrome also contributed to the drop in the number of cases between 1963-1969 and 1971-1977.

  20. Abortion surveillance - United States, 2007.

    PubMed

    Pazol, Karen; Zane, Suzanne; Parker, Wilda Y; Hall, Laura R; Gamble, Sonya B; Hamdan, Saeed; Berg, Cynthia; Cook, Douglas A

    2011-02-25

    Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. 2007. Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). This information is provided voluntarily. For 2007, data were received from 49 reporting areas. For the purpose of trend analysis, data were evaluated from the 45 areas that reported data every year during the preceding decade (1998-2007). Abortion rates (number of abortions per 1,000 women) and ratios (number of abortions per 1,000 live births) were calculated using census and natality data, respectively. A total of 827,609 abortions were reported to CDC for 2007. Among the 45 reporting areas that provided data every year during 1998-2007, a total of 810,582 abortions (97.9% of the total) were reported for 2007; the abortion rate was 16.0 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 231 abortions per 1,000 live births. Compared with 2006, the total number and rate of reported abortions decreased 2%, and the abortion ratio decreased 3%. Reported abortion numbers, rates, and ratios were 6%, 7%, and 14% lower, respectively, in 2007 than in 1998. Women aged 20-29 years accounted for 56.9% of all abortions in 2007 and for the majority of abortions during the entire period of analysis (1998-2007). In 2007, women aged 20-29 years also had the highest abortion rates (29.4 abortions per 1,000 women aged 20-24 years and 21.4 abortions per 1,000 women aged 25-29 years). Adolescents aged 15-19 years accounted for 16.5% of all abortions in 2007 and had an abortion rate of 14.5 abortions per 1,000 adolescents aged 15-19 years; women aged ≥35 years accounted for a smaller percentage (12.0%) of abortions and had lower abortion rates (7.7 abortions per 1,000 women aged 35-39 years and 2.6 abortions per 1,000 women aged ≥40 years

  1. Attitudes to abortion in the era of reform: evidence from the Abortion Law Reform Association correspondence.

    PubMed

    Jones, Emma L

    2011-01-01

    This article examines letters sent by members of the general public to the Abortion Law Reform Association (ALRA) in the decade immediately before the 1967 Abortion Act. It shows how a voluntary organisation, in their aim of supporting a specific cause of unclear legality, called forth correspondence from those in need. In detailing the personal predicaments of those facing an unwanted pregnancy, this body of correspondence was readily deployed by ALRA in their efforts to mobilise support for abortion law reform, thus exercising a political function. A close examination of the content of the letters and the epistolary strategies adopted by their writers reveals that as much as they were a lobbying tool for changes in abortion law, these letters were discursively shaped by debates surrounding that very reform.

  2. Abortion Stigma Among Low-Income Women Obtaining Abortions in Western Pennsylvania: A Qualitative Assessment.

    PubMed

    Gelman, Amanda; Rosenfeld, Elian A; Nikolajski, Cara; Freedman, Lori R; Steinberg, Julia R; Borrero, Sonya

    2017-03-01

    Abortion stigma may cause psychological distress in women who are considering having an abortion or have had one. This phenomenon has been relatively underexplored in low-income women, who may already be at an increased risk for poor abortion-related outcomes because of difficulties accessing timely and safe abortion services. A qualitative study conducted between 2010 and 2013 used semistructured interviews to explore pregnancy intentions among low-income women recruited from six reproductive health clinics in Western Pennsylvania. Transcripts from interviews with 19 participants who were planning to terminate a pregnancy or had had an abortion in the last two weeks were examined through content analysis to identify the range of attitudes they encountered that could contribute to or reflect abortion stigma, the sources of these attitudes and women's responses to them. Women commonly reported that partners, family members and they themselves held antiabortion attitudes. Such attitudes communicated that abortion is morally reprehensible, a rejection of motherhood, rare and thus potentially deviant, detrimental to future fertility and an irresponsible choice. Women reacted to external and internal negative attitudes by distinguishing themselves from other women who obtain abortions, experiencing negative emotions, and concealing or delaying their abortions. Women's reactions to antiabortion attitudes may perpetuate abortion stigma. Further research is needed to inform interventions to address abortion stigma and improve women's abortion experiences. Copyright © 2016 by the Guttmacher Institute.

  3. Abortion Stigma Among Low-Income Women Obtaining Abortions in Western Pennsylvania: A Qualitative Assessment

    PubMed Central

    Gelman, Amanda; Rosenfeld, Elian A.; Nikolajski, Cara; Freedman, Lori R.; Steinberg, Julia R.; Borrero, Sonya

    2017-01-01

    CONTEXT Abortion stigma may cause psychological distress in women who are considering having an abortion or have had one. This phenomenon has been relatively underexplored in low-income women, who may already be at an increased risk for poor abortion-related outcomes because of difficulties accessing timely and safe abortion services. METHODS A qualitative study conducted between 2010 and 2013 used semistructured interviews to explore pregnancy intentions among low-income women recruited from six reproductive health clinics in Western Pennsylvania. Transcripts from interviews with 19 participants who were planning to terminate a pregnancy or had had an abortion in the last two weeks were examined through content analysis to identify the range of attitudes they encountered that could contribute to or reflect abortion stigma, the sources of these attitudes and women’s responses to them. RESULTS Women commonly reported that partners, family members and they themselves held antiabortion attitudes. Such attitudes communicated that abortion is morally reprehensible, a rejection of motherhood, rare and thus potentially deviant, detrimental to future fertility and an irresponsible choice. Women reacted to external and internal negative attitudes by distinguishing themselves from other women who obtain abortions, experiencing negative emotions, and concealing or delaying their abortions. CONCLUSIONS Women’s reactions to antiabortion attitudes may perpetuate abortion stigma. Further research is needed to inform interventions to address abortion stigma and improve women’s abortion experiences. PMID:27984674

  4. Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country.

    PubMed

    Bernabé-Ortiz, Antonio; White, Peter J; Carcamo, Cesar P; Hughes, James P; Gonzales, Marco A; Garcia, Patricia J; Garnett, Geoff P; Holmes, King K

    2009-02-03

    Clandestine induced abortions are a public health problem in many developing countries where access to abortion services is legally restricted. We estimated the prevalence and incidence of, and risk factors for, clandestine induced abortions in a Latin American country. We conducted a large population-based survey of women aged 18-29 years in 20 cities in Peru. We asked questions about their history of spontaneous and induced abortions, using techniques to encourage disclosure. Of 8242 eligible women, 7992 (97.0%) agreed to participate. The prevalence of reported induced abortions was 11.6% (95% confidence interval [CI] 10.9%-12.4%) among the 7962 women who participated in the survey. It was 13.6% (95% CI 12.8%-14.5%) among the 6559 women who reported having been sexually active. The annual incidence of induced abortion was 3.1% (95% CI 2.9%-3.3%) among the women who had ever been sexually active. In the multivariable analysis, risk factors for induced abortion were higher age at the time of the survey (odds ratio [OR] 1.11, 95% CI 1.07-1.15), lower age at first sexual intercourse (OR 0.87, 95% CI 0.84-0.91), geographic region (highlands: OR 1.56, 95% CI 1.23-1.97; jungle: OR 1.81, 95% CI 1.41-2.31 [v. coastal region]), having children (OR 0.82, 95% CI 0.68-0.98), having more than 1 sexual partner in lifetime (2 partners: OR 1.61, 95% CI 1.23-2.09; > or = 3 partners: OR 2.79, 95% CI 2.12-3.67), and having 1 or more sexual partners in the year before the survey (1 partner: OR 1.36, 95% CI 1.01-1.72; > or = 2 partners: OR 1.54, 95% CI 1.14-2.02). Overall, 49.0% (95% CI 47.6%-50.3%) of the women who reported being currently sexually active were not using contraception. The incidence of clandestine, potentially unsafe induced abortion in Peru is as high as or higher than the rates in many countries where induced abortion is legal and safe. The provision of contraception and safer-sex education to those who require it needs to be greatly improved and could potentially

  5. Fertility Effects of Abortion and Birth Control Pill Access for Minors

    PubMed Central

    GULDI, MELANIE

    2008-01-01

    This article empirically assesses whether age-restricted access to abortion and the birth control pill influence minors’ fertility in the United States. There is not a strong consensus in previous literature regarding the relationship between laws restricting minors’ access to abortion and minors’ birthrates. This is the first study to recognize that state laws in place prior to the 1973 Roe v. Wade decision enabled minors to legally consent to surgical treatment—including abortion—in some states but not in others, and to construct abortion access variables reflecting this. In this article, age-specific policy variables measure either a minor’s legal ability to obtain an abortion or to obtain the birth control pill without parental involvement. I find fairly strong evidence that young women’s birthrates dropped as a result of abortion access as well as evidence that birth control pill access led to a drop in birthrates among whites. PMID:19110899

  6. [History of induced abortion in Denmark from 1200 to 1979].

    PubMed

    Manniche, E

    1982-10-01

    History of induced abortion in Denmark from 1200 to 1979 is reviewed. The 1st Danish law of 1200 did not touch upon the question of induced abortion. From the beginning of the 13th century to Religious Reformation in 1536, Roman Catholic law influenced every aspect of Danish life including induced abortion. In 1683 in King Christian V's constitution called Dansk Lov induced abortion was discussed. Immoral women who aborted fetuses or killed newborn babies were decapitated. In Copenhagen in the years 1624-1632 and 1638-1663 17 women were executed because of induced abortion or murder of newborn babies. Although Dansk Lov was effective till 1866, Danish kings came to treat female criminals less severely since about 1780-1800. For example, between 1855 and 1866 42 women convicted of murder of newborn babies or abortion were given pardon (12 years of imprisonment instead of life sentence). In 1866, abortion and murder of babies were treated separately in the Danish criminal law. Induced abortion meant up to 8 years of imprisonment and labor. In 1930 life sentence was abolished; induced abortion called for only up to 2 years of imprisonment, while those who assisted for money were punished more severely (up to 8 years in prison). In 1937 the Danes legalized induced abortion for medical, ethical, (e.g. rape case) and eugenic reasons. By 1973 legalized abortion was available, free of charge, to every Danish female resident within 12 weeks of pregnancy. In 1980 abortion rate was about 41% of total births. It is estimated 2/3 of Danish women experience abortion. Lastly, illegitimate births and miscarriages are on the rise due to changes in women's social status and role.

  7. Women's awareness of liberalization of abortion law and knowledge of place for obtaining services in Nepal.

    PubMed

    Thapa, Shyam; Sharma, Sharad K

    2015-03-01

    In Nepal, following the liberalization of the abortion law, expansion and scaling up of services proceeded in parallel with efforts to create awareness of the legalization status of abortion and provide women with information about where services are available. This article assesses the effectiveness of these programmatic interventions in the early years of the country's abortion program. Data from a 2006 national survey are analyzed with 2 outcome measures-awareness of the legal status of abortion and knowledge of places to obtain abortion services among women ages 15 to 44 years. The variations in the outcomes are analyzed by ecological-development subregion, residence, education, household wealth quintile, age, and number of living children. Bivariate and multivariate logistic regression techniques are used. Overall 32.3% (95% confidence interval = 31.4% to 33.2%) of the respondents were aware of the legal status of abortion and 56.5% (95% confidence interval = 55.5% to 57.4%) knew of a place where they could obtain an abortion. Both outcome measures showed considerable variations by the covariates. Women with secondary or higher level of education had the highest odds ratio of being aware of the law and having knowledge of a source for abortion services. Ecological-development subregions showed the second highest levels of odds ratios. Significant disparities among the population subgroups existed in the diffusion of awareness of the legal status of abortion and having knowledge of a place for abortion services in Nepal. The results point to which population subgroups to focus on and also serve as a baseline for assessing future progress in the diffusion process. © 2012 APJPH.

  8. Medical abortion reversal: science and politics meet.

    PubMed

    Bhatti, Khadijah Z; Nguyen, Antoinette T; Stuart, Gretchen S

    2018-03-01

    Medical abortion is a safe, effective, and acceptable option for patients seeking an early nonsurgical abortion. In 2014, medical abortion accounted for nearly one third (31%) of all abortions performed in the United States. State-level attempts to restrict reproductive and sexual health have recently included bills that require physicians to inform women that a medical abortion is reversible. In this commentary, we will review the history, current evidence-based regimen, and regulation of medical abortion. We will then examine current proposed and existing abortion reversal legislation. The objective of this commentary is to ensure physicians are armed with rigorous evidence to inform patients, communities, and policy makers about the safety of medical abortion. Furthermore, given the current paucity of evidence for medical abortion reversal, physicians and policy makers can dispel bad science and misinformation and advocate against medical abortion reversal legislation. Copyright © 2017 Elsevier Inc. All rights reserved.

  9. Making it safe, making it legal, and creating peace of mind.

    PubMed

    Strom, D J

    2001-11-01

    The job of a medical or academic radiation safety officer has three parts: keeping it safe, keeping it legal, and helping people feel that they are safe. Absence of peace-of-mind about radiation protection matters can create very real health effects, even when there is little or no radiation exposure involved. Frightened people may make decisions such as changing jobs (and losing health insurance), terminating a pregnancy, or moving, all of which impact health. Furthermore, frightened people who choose to stick with it may suffer from anxiety, stress, insomnia, and weight loss or even weight gain. Genuinely listening to the concerns of those who benefit from radiation safety services can help to provide peace-of-mind and minimize decisions that are risky to health.

  10. Women's right to health and Ireland's abortion laws.

    PubMed

    Taylor, Maeve

    2015-07-01

    The provision of the Irish Constitution that guarantees "the unborn" a right to life equal to that of a pregnant woman has consequences for access to abortion and the care of women in pregnancy generally. Long-awaited legislation to give effect to the narrow constitutional right to abortion was enacted into law in 2013. In 2014, a guidance document for health professionals' implementation of the legislation was published. However, the legislation and guidance document fall far short of international human rights bodies' recommendations: they fail to deliver effective procedural rights to all of the women eligible for lawful abortion within the state and create new legal barriers to women's reproductive rights. At the same time, cases continue to highlight that the Irish Constitution imposes an unethical and rights-violating legal regime in non-abortion-related contexts. Recent developments suggest that both the failure to put guidelines in place and the development of guidelines that are not centered on women or based on rights further reduce women's access to rights and set unacceptable limitations on women's reproductive autonomy. Nevertheless, public and parliamentary scrutiny of cases involving Ireland's abortion laws is increasingly focusing on the need for reform. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  11. Abortion and mental health: Evaluating the evidence.

    PubMed

    Major, Brenda; Appelbaum, Mark; Beckman, Linda; Dutton, Mary Ann; Russo, Nancy Felipe; West, Carolyn

    2009-12-01

    The authors evaluated empirical research addressing the relationship between induced abortion and women's mental health. Two issues were addressed: (a) the relative risks associated with abortion compared with the risks associated with its alternatives and (b) sources of variability in women's responses following abortion. This article reflects and updates the report of the American Psychological Association Task Force on Mental Health and Abortion (2008). Major methodological problems pervaded most of the research reviewed. The most rigorous studies indicated that within the United States, the relative risk of mental health problems among adult women who have a single, legal, first-trimester abortion of an unwanted pregnancy is no greater than the risk among women who deliver an unwanted pregnancy. Evidence did not support the claim that observed associations between abortion and mental health problems are caused by abortion per se as opposed to other preexisting and co-occurring risk factors. Most adult women who terminate a pregnancy do not experience mental health problems. Some women do, however. It is important that women's varied experiences of abortion be recognized, validated, and understood. 2009 APA.

  12. The Dublin Declaration on Maternal Health Care and Anti-Abortion Activism: Examples from Latin America.

    PubMed

    Morgan, Lynn M

    2017-06-01

    The Dublin Declaration on Maternal Healthcare-issued by self-declared pro-life activists in Ireland in 2012-states unequivocally that abortion is never medically necessary, even to save the life of a pregnant woman. This article examines the influence of the Dublin Declaration on abortion politics in Latin America, especially El Salvador and Chile, where it has recently been used in pro-life organizing to cast doubt on the notion that legalizing abortion will reduce maternal mortality. Its framers argue that legalizing abortion will not improve maternal mortality rates, but reproductive rights advocates respond that the Dublin Declaration is junk science designed to preserve the world's most restrictive abortion laws. Analyzing the strategy and impact of the Dublin Declaration brings to light one of the tactics used in anti-abortion organizing.

  13. Induced abortion in villages of Ballabgarh HDSS: rates, trends, causes and determinants.

    PubMed

    Kant, Shashi; Srivastava, Rahul; Rai, Sanjay Kumar; Misra, Puneet; Charlette, Lena; Pandav, Chandrakant S

    2015-05-29

    Induced abortion has been legal in India on a broad range of medical and social grounds since 1980s. Often, induced abortion is resorted to as a means for contraception, and has a potential to be misused for sex selective feticide. We assessed the rates, trends, causes and determinants of induced abortions from 2008-12 in a rural community of northern India. Present study is a secondary data analysis of pregnancy outcomes at Ballabgarh Health and Demographic Surveillance System from 2008-12. The data was retrieved from the Health and Management Information System maintained at Ballabgarh. Cause of abortion was self-reported by the women who underwent abortion. Of the 11,102 pregnancies, 1,226 (11%) culminated as abortions of which 425 (3.8%) were induced abortions. Spontaneous abortion rate (7.2%) was twice that of induced abortion rate (3.8%). Both abortion rates had an increasing trend during the course of the study period. Self-reported reasons for opting for induced abortions were bleeding per vaginum (23%), unwanted pregnancy (16%), and unviable fetus diagnosed by ultrasonography (11%). Eight percent of the induced abortions were due to the female sex of the fetus. About 11% of the abortions were performed beyond 20 weeks of gestation which was the upper legal permissible gestational age for performing induced abortions in India. About 10% of the abortions were performed by unqualified practitioners. Caste, wealth index, birth order and size of the village population were the factors that were significantly associated with induced abortion. Though the abortion rate was low, the proportionate contribution of induced abortion was more than what could be expected. Unsafe and sex selective abortion, though illegal, was prevalent. Upper caste and higher socio-economic status families were more likely to opt for induced abortion.

  14. Abortion: the antithesis of womanhood?

    PubMed

    Timpson, J

    1996-04-01

    The debate regarding the practice and role of abortion has been an enduring and problematic area of discourse within the nursing literature, with a tendency towards a polarized and inevitably simplistic analysis of what, for many practitioners, women and families, remains a highly complex and morally fraught concept. This paper attempts to explore the concept of abortion from within a feminist epistemology, to present a review of the literature as regards women's reproductive health and responsibilities, and thereby to contribute to the process of better understanding the role of abortion within contemporary health care practice. In order to facilitate the study it has been necessary to explore the wide spectrum of historical, philosophical, legal, moral and political imperatives pertaining to the meaning of abortion as represented within contemporary society, not only in relation to women and their reproductive health, but to feminism, women's well-being and self-determinism per se.

  15. Brazilians have different views on when abortion should be legal, but most do not agree with imprisoning women for abortion.

    PubMed

    Faúndes, Aníbal; Duarte, Graciana Alves; de Sousa, Maria Helena; Soares Camargo, Rodrigo Paupério; Pacagnella, Rodolfo Carvalho

    2013-11-01

    Unsafe abortions remain a major public health problem in countries with very restrictive abortion laws. In Brazil, parliamentarians - who have the power to change the law - are influenced by "public opinion", often obtained through surveys and opinion polls. This paper presents the findings from two studies. One was carried out in February-December 2010 among 1,660 public servants and the other in February-July 2011 with 874 medical students from three medical schools, both in São Paulo State, Brazil. Both groups of respondents were asked two sets of questions to obtain their opinion about abortion: 1) under which circumstances abortion should be permitted by law, and 2) whether or not women in general and women they knew who had had an abortion should be punished with prison, as Brazilian law mandates. The differences in their answers were enormous: the majority of respondents were against putting women who have had abortions in prison. Almost 60% of civil servants and 25% of medical students knew at least one woman who had had an illegal abortion; 85% of medical students and 83% of civil servants thought this person(s) should not be jailed. Brazilian parliamentarians who are currently reviewing a reform in the Penal Code need to have this information urgently. Copyright © 2013 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  16. The need for family planning and safe abortion services among women sex workers seeking STI care in Cambodia.

    PubMed

    Delvaux, Thérèse; Crabbé, François; Seng, Sopheap; Laga, Marie

    2003-05-01

    In Cambodia, clinics established for the prevention and management of sexually transmitted infections (STIs) in women sex workers do not address other reproductive health services. The aim of this study was to assess the need for more comprehensive sexual and reproductive health services for women sex workers in Cambodia. In January 2000, relevant documents were reviewed, interviews with key informants carried out and group interviews with women sex workers conducted. Medical records from women sex workers were also reviewed and some data collected prospectively in one government STI clinic. Interviews with the women and data from the government clinic indicated that excluding condoms, a very low proportion of women sex workers were currently using a modern contraceptive method--5% of 38 women and 1.6% of 632 women, respectively. Induced abortion was widely used but was perceived to be risky and costly. Data from a mobile team intervention and the government clinic respectively showed that 25.5% (n = 1744) and 21.9% (n = 588) of women sex workers reported at least one previous induced abortion. These findings reveal the need for accessible contraception and safe abortion services among sex workers in Cambodia, and raise the issue of the reproductive rights and reproductive health needs of women sex workers in general.

  17. [Knowledge and attitudes of medical students on decriminalized induced abortion].

    PubMed

    Quintero-Roa, Eliana M; Ochoa-Vera, Miguel E

    2015-12-01

    Objective To explore if the academic exposure to legal abortion affects the knowledge and attitudes of medical students. Method To asses this relationship, both qualitative and quantitative approaches were performed. We analyzed a medical student cohort enrolled in gynecology and obstetrics at two accredited universities in Bucaramanga, Colombia during the second half of 2011. Students were invited to participate in two anonymous surveys. One survey was conducted in the first three weeks of the semester, and the second was done in the last three weeks. A quantitative approach was taken by a group interview of two random groups of participants. One group was composed of medical students of gynecology and obstetrics (fourth year of medicine), and the other group was composed of medical students in their last year (internal medical students). Results The items pregnancy with risk to the mother´s life, or affected by a non-viable fetal malformation, or result of rape were recognized and accepted. 46% of the participants changed their attitude about legal abortion at the end of the semester. Three out of every four participants changed their attitude to accept the decriminalized conditions, while one out of every four people had the opposite change of opinion. Medical student´s don´t believe that general practitioners are trained to advice patients in these cases. Conclusions Educating and training general practitioners in issues related to legal abortion may decrease the risk of inadequate medical assessment in cases of legal abortion.

  18. Medically indigent women seeking abortion prior to legalization: New York City, 1969-1970.

    PubMed

    Belsky, J E

    1992-01-01

    If the efforts now underway to limit access to abortion services in the United States are successful, their greatest impact will be on women who lack the funds to obtain abortions elsewhere. There is little published information, however, about the experience of medically indigent women who sought abortions under the old, restrictive state laws. This article details the psychiatric evaluation of 199 women requesting a therapeutic abortion at a large municipal hospital in New York City under a restrictive abortion law. Thirty-nine percent had tried to abort the pregnancy. Fifty-seven percent had concrete evidence of serious psychiatric disorder. Forty-eight percent had been traumatized by severe family disruption, gross emotional deprivation or abuse during childhood. Seventy-nine percent lacked emotional support from the man responsible for the pregnancy, and the majority were experiencing overwhelming stress from the interplay of multiple problems exacerbated by their unwanted pregnancy.

  19. Abortion (Amendment) Bill.

    PubMed

    Ashton, J

    1980-02-09

    Mr. Corrie's argument for the Abortion (Amendment) Bill is based on a misunderstanding of the problem. All evidence supports the conclusion that is is impossible to prevent abortion by legislation. It was a recognition of this fact which persuaded many people of the necessity for a liberal Act in 1967. Since that time nothing has changed to alter the supposition that a large proportion of women denied legal abortion will seek an illegal abortion. The major medical establishment bodies recognize and accept this and are opposed to the Corrie Bill. Those who work in this area know that what is needed is a much greater effort in providing sex education and access to contraceptive advice and methods for those with special problems. 1 of the ironies of the proposed legislation is that abortion rates have until very recently been declining, following the major expansion of family planning provision in 1974. The attempt to lower the accepted limit for abortion to 20 weeks would only add to the anguish and problems of women and doctors in the very small proportion of cases involved, and it is difficult to see why the Lane Committee recommendation of 24 weeks cannot be accepted as a compromise. Of the 3 principle changes introduced in the Bill, it is the 1 which aims to separate counseling from operating which has the most important consequences. This measure is aimed at the 2 primary abortion charities which were established to meet the deficiencies of provision by the National Health Service. Between them they account for 30-40% of the abortions performed. There is no evidence for the suggestion that people working for these charities have a financial interest in drumming up work.

  20. Mandatory waiting periods and biased abortion counseling in Central and Eastern Europe.

    PubMed

    Hoctor, Leah; Lamačková, Adriana

    2017-11-01

    Several Central and Eastern European countries have recently enacted retrogressive laws and policies introducing new preconditions that women must fulfill before they can obtain legal abortion services. Mandatory waiting periods and biased counseling and information requirements are particularly common examples of these new prerequisites. The present article considers these requirements in light of international human rights standards and public health guidelines, and outlines the manner in which, by imposing regressive barriers on women's access to legal abortion services, these new laws and policies undermine women's health and well-being, fail to respect women's human rights, and reinforce harmful gender stereotypes and abortion stigma. © 2017 International Federation of Gynecology and Obstetrics.

  1. Medical abortion: understanding perspectives of rural and marginalized women from rural South India.

    PubMed

    Sri, B Subha; Ravindran, T K Sundari

    2012-09-01

    To understand how rural and other groups of marginalized women define safe abortion; their perspectives and concerns regarding medical abortion (MA); and what factors affect their access to safe abortion. Focus group discussions were held with various groups of rural and marginalized women in Tamil Nadu to understand their perspectives and concerns on abortion, especially MA. Nearly a decade after mifepristone was approved for abortion in India, most study participants had never heard of MA. When they learned of the method, most preferred it over other methods of abortion. The women also had questions and concerns about the method and recommendations on how services should be provided. Their definition of a "safe abortion" included criteria beyond medical safety. They placed a high priority on "social safety," including confidentiality and privacy. In their view, factors affecting access to safe abortion and choice of provider included cost, assurance of secrecy, promptness of service provision, and absence of provider gatekeeping and provider-imposed conditions for receiving services. Women's preference for MA shows the potential of this technology to address the problem of unsafe abortion in India. Women need better access to information and services to realize this potential, however. Women's preferences regarding information dissemination and service provision need to be taken into account if policies and programs are to be truly responsive to the needs of marginalized women. Copyright © 2012. Published by Elsevier Ireland Ltd.

  2. [Induced abortion: a vulnerable public health problem].

    PubMed

    Requena, M

    1991-03-01

    Induced abortion is an urgent public health problem that can be controlled if it is approached in its true complexity and with a social and humanist perspective. Induced abortion has been discussed in Chile since the last century, but not always openly. Abortion is not just an individual and collective medical problem, it is also an ethical, religious, legal, demographic, political, and psychological problem. Above all it is a problem of human rights. In the past 60 years, more than 50 countries representing 76% of the world population have liberalized their abortion legislation. Around 980 million women have some degrees of access of legal abortion. The magnitude of illegal abortion is difficult to determine because of the desire of women to hide their experiences. Estimates of the incidence of abortion in Chile made some 25 years ago are no longer valid because of the numerous social changes in the intervening years. The number of abortions in Chile in 1987 was estimated using an indirect residual method at 195,441, of which 90%, or 175,897, were induced. By this estimate, 38.8% of pregnancies in Chile end in abortion. Data on hospitalizations for complications of induced abortion show an increase from 13.9/1000 fertile aged women in 1940 to 29.1 in 1965. By 1987, with increased contraceptive usage, the rate declined to 10.5 abortions per 1000 fertile aged women. The cost of hospitalization for abortion complications in 1987, despite the decline, was still estimated at US $4.3 million, a large sum in an era of declining health resources. The problem of induced abortion can be analyzed by placing it in the context of elements affecting the desire to control fertility. 4 complexes of variables are involved: those affecting the supply of contraceptive, the demand for contraceptives, the various costs of fertility control measure, and alternatives to fertility control for satisfying various needs. The analysis is further complicated when efforts are made to

  3. Orion Crew Exploration Vehicle Launch Abort System Guidance and Control Analysis Overview

    NASA Technical Reports Server (NTRS)

    Davidson, John B.; Kim, Sungwan; Raney, David L.; Aubuchon, Vanessa V.; Sparks, Dean W.; Busan, Ronald C.; Proud, Ryan W.; Merritt, Deborah S.

    2008-01-01

    Aborts during the critical ascent flight phase require the design and operation of Orion Crew Exploration Vehicle (CEV) systems to escape from the Crew Launch Vehicle (CLV) and return the crew safely to the Earth. To accomplish this requirement of continuous abort coverage, CEV ascent abort modes are being designed and analyzed to accommodate the velocity, altitude, atmospheric, and vehicle configuration changes that occur during ascent. Aborts from the launch pad to early in the flight of the CLV second stage are performed using the Launch Abort System (LAS). During this type of abort, the LAS Abort Motor is used to pull the Crew Module (CM) safely away from the CLV and Service Module (SM). LAS abort guidance and control studies and design trades are being conducted so that more informed decisions can be made regarding the vehicle abort requirements, design, and operation. This paper presents an overview of the Orion CEV, an overview of the LAS ascent abort mode, and a summary of key LAS abort analysis methods and results.

  4. Female autonomy and reported abortion-seeking in Ghana, West Africa.

    PubMed

    Rominski, Sarah D; Gupta, Mira; Aborigo, Raymond; Adongo, Phillip; Engman, Cyril; Hodgson, Abraham; Moyer, Cheryl

    2014-09-01

    To investigate factors associated with self-reported pregnancy termination in Ghana and thereby appreciate the correlates of abortion-seeking in order to understand safe abortion care provision. In a retrospective study, data from the Ghana 2008 Demographic and Health Survey were used to investigate factors associated with self-reported pregnancy termination. Variables on an individual and household level were examined by both bivariate analyses and multivariate logistic regression. A five-point autonomy scale was created to explore the role of female autonomy in reported abortion-seeking behavior. Among 4916 women included in the survey, 791 (16.1%) reported having an abortion. Factors associated with abortion-seeking included being older, having attended school, and living in an urban versus a rural area. When entered into a logistic regression model with demographic control variables, every step up the autonomy scale (i.e. increasing autonomy) was associated with a 14.0% increased likelihood of reporting the termination of a pregnancy (P < 0.05). Although health system barriers might play a role in preventing women from seeking safe abortion services, autonomy on an individual level is also important and needs to be addressed if women are to be empowered to seek safe abortion services. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Adolescents and Abortion: Choice in Crisis.

    ERIC Educational Resources Information Center

    Stone, Rebecca

    This publication seeks to explain the many facets of adolescent abortion: teenagers' need for access to safe abortion; the need for confidentiality in order to ensure safety; the real intent and effect of parental involvement laws; and the roles of parents and the state in safeguarding the health of pregnant teenagers. The first section looks at…

  6. Abortion in democratic Spain: the parliamentary political agenda 1979-2004.

    PubMed

    Cambronero-Saiz, Belén; Ruiz Cantero, María Teresa; Vives-Cases, Carmen; Carrasco Portiño, Mercedes

    2007-05-01

    Since Spain's transition to democracy, abortion has been a public policy issue both inside and outside parliament. This paper describes the history of abortion law reform in Spain from 1979 to 2004 and analyses the discourse on abortion of members of the Spanish parliament by sex and political allegiance. The analysis is based on a retrospective study of the frequency of legislative initiatives and the prevalence of different arguments and positions in debates on abortion found through a systematic search of the parliamentary database. Little time was given to abortion in the parliamentary agenda compared to other women's issues such as violence against women. There were 229 bills and other parliamentary initiatives in that period, 60% initiated and led by pro-choice women. 143 female and 72 male parliamentarians took part in the debates. The inclusion of socio-economic grounds for legal abortion (64%), and making abortion on request legal in the first 12 weeks of pregnancy (60%) were the most frequent forms of law reform proposed, based most often on pro-women's rights arguments. Male and female members of anti-choice parties and most male members of other parties argued for fetal rights. Pro-choice parties tabled more bills than anti-choice parties but till now all reforms proposed since 1985 have been voted down.

  7. Acceptance of family planning methods by induced abortion seekers: An observational study over five years.

    PubMed

    Kathpalia, S K

    2016-01-01

    Prior to legalization of abortion, induced abortions were performed in an illegal manner and that resulted in many complications hence abortion was legalized in India in 1971 and the number of induced abortions has been gradually increasing since then. One way of preventing abortions is to provide family planning services to these abortion seekers so that same is not repeated. The study was performed to find out the acceptance of contraception after abortion. A prospective study was performed over a period of five years from 2010 to 2014. The study group included all the cases reporting for abortion. A proforma was filled in detail to find out the type of contraception being used before pregnancy and acceptance of contraception after abortion. The existing facilities were also evaluated. 1228 abortions were performed over a period of five years. 94.5% of abortions were during the first trimester. 39.9% had not used any contraceptive before, contraceptives used were natural and barrier which had high failure. The main indication for seeking abortion was failure of contraception and completion of family. 39.6% of patients accepted sterilization as a method of contraception. The existing post abortion family planning services are inadequate. Post abortion period is one which is important to prevent subsequent abortions and family planning services after abortion need to be strengthened.

  8. Acceptance of family planning methods by induced abortion seekers: An observational study over five years

    PubMed Central

    Kathpalia, S.K.

    2016-01-01

    Background Prior to legalization of abortion, induced abortions were performed in an illegal manner and that resulted in many complications hence abortion was legalized in India in 1971 and the number of induced abortions has been gradually increasing since then. One way of preventing abortions is to provide family planning services to these abortion seekers so that same is not repeated. The study was performed to find out the acceptance of contraception after abortion. Methods A prospective study was performed over a period of five years from 2010 to 2014. The study group included all the cases reporting for abortion. A proforma was filled in detail to find out the type of contraception being used before pregnancy and acceptance of contraception after abortion. The existing facilities were also evaluated. Results 1228 abortions were performed over a period of five years. 94.5% of abortions were during the first trimester. 39.9% had not used any contraceptive before, contraceptives used were natural and barrier which had high failure. The main indication for seeking abortion was failure of contraception and completion of family. 39.6% of patients accepted sterilization as a method of contraception. The existing post abortion family planning services are inadequate. Conclusion Post abortion period is one which is important to prevent subsequent abortions and family planning services after abortion need to be strengthened. PMID:26900216

  9. Making It Safe, Making It Legal, and Creating Peace of Mind

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Strom, Daniel J.

    2001-11-01

    The job of a medical or academic radiation safety officer has three parts: keeping it safe, keeping it legal, and helping people feel that they are safe. Absence of peace-of-mind about radiation protection matters can create very real health effects, even when there is little or no radiation exposure involved. Frightened people may make decisions such as changing jobs (and losing health insurance), terminating a pregnancy, or moving, all of which impact health. Furthermore, frightened people who choose to stick with it may suffer from anxiety, stress, insomnia, and weight loss or even weight gain. Genuinely listening to the concernsmore » of those who benefit from radiation safety services can help to provide peace-of-mind and minimize decisions that are risky to health.« less

  10. Understanding abortion via different scholarly methodologies: book review essay.

    PubMed

    Erde, Edmund L

    1986-01-01

    Erde review three works that in his opinion have made important contributions to the abortion debate: Abortion Policy: An Evaluation of the Consequences For Maternal and Infant Health, by Jerome S. Legge, Jr. (Albany: State University of New York Press; 1985); Abortion and the Politics of Motherhood, by Kristen Luker (Berkeley: University of California Press; 1984); and Abortion: Moral and Legal Perspective, edited by J.L. Garfield and P. Hennessey (Amherst: University of Massachusetts Press; 1984). A later issue of the Journal of Medical Humanities and Bioethics will carry Erde's review of two additional scholarly books on abortion: Abortion: Understanding the Differences, edited by Sidney Callahan and Daniel Callahan (New York: Plenum Press; 1984), and Abortion and the Status of the Fetus, edited by William B. Bondeson, H.T. Engelhardt, Jr., S.F. Spicker, and D.H. Winship (Boston: D. Reidel; 1983).

  11. Abort Options for Potential Mars Missions

    NASA Technical Reports Server (NTRS)

    Tartabini, P. V.; Striepe, S. A.; Powell, R. W.

    1994-01-01

    Mars trajectory design options were examined that would accommodate a premature termination of a nominal manned opposition class mission for opportunities between 2010 and 2025. A successful abort must provide a safe return to Earth in the shortest possible time consistent with mission constraints. In this study, aborts that provided a minimum increase in the initial vehicle mass in low Earth orbit (IMLEO) were identified by locating direct transfer nominal missions and nominal missions including an outbound or inbound Venus swing-by that minimized IMLEO. The ease with which these missions could be aborted while meeting propulsion and time constraints was investigated by examining free return (unpowered) and powered aborts. Further reductions in trip time were made to some aborts by the addition or removal of an inbound Venus swing-by. The results show that, although few free return aborts met the specified constraints, 85% of each nominal mission could be aborted as a powered abort without an increase in propellant. Also, in many cases, the addition or removal of a Venus swing-by increased the number of abort opportunities or decreased the total trip time during an abort.

  12. Why resort to illegal abortion in Zambia? Findings of a community-based study in Western Province.

    PubMed

    Koster-Oyekan, W

    1998-05-01

    This article presents part of the findings of a community-based study on the causes and effects of unplanned pregnancies in four districts of Western Province, Zambia. The study broke the silence around abortion in Western Province and revealed that induced abortion poses a public health problem. Using innovative methodology of recording and analyzing histories of deaths from induced abortion, the abortion mortality ratio was calculated for the study districts. Findings reveal all extremely high induced abortion mortality ratio of 120 induced abortion-related deaths per 100,000 live births. More than half the deaths were of schoolgirls. Although abortion in Zambia is legal on medical and social grounds, most women in Western Province resort to illegal abortions because legal abortion services are inaccessible and unacceptable. The main reasons women resort to abortion is for fear of being expelled from school, their unwillingness to reveal a secret relationship, to protect the health of their previous baby and common knowledge that postpartum sexual taboos have been transgressed. An inventory was made of abortion methods, taboos and abortion-providers. The article describes how health staff were involved throughout the study, and shows how recommendations were made by involving all parties concerned.

  13. A statement on abortion by 100 professors of obstetrics: 40 years later.

    PubMed

    2013-10-01

    In this Journal in 1972, 100 leaders in obstetrics and gynecology published a compelling statement that recognized the legalization of abortion in several states and anticipated the 1973 Supreme Court decision in Roe v Wade. They projected the numbers of legal abortions that likely would be required by women in the United States and described the role of the teaching hospital in meeting that responsibility. They wrote to express their concern for women's health in a new legal and medical era of reproductive control and to define the responsibilities of academic obstetrician-gynecologists. Forty years later, 100 professors examine the statement of their predecessors in light of medical advances and legal changes and suggest a further course of action for obstetrician gynecologists. © 2013.

  14. Enablers of and barriers to abortion training.

    PubMed

    Guiahi, Maryam; Lim, Sahnah; Westover, Corey; Gold, Marji; Westhoff, Carolyn L

    2013-06-01

    Since the legalization of abortion services in the United States, provision of abortions has remained a controversial issue of high political interest. Routine abortion training is not offered at all obstetrics and gynecology (Ob-Gyn) training programs, despite a specific training requirement by the Accreditation Council for Graduate Medical Education. Previous studies that described Ob-Gyn programs with routine abortion training either examined associations by using national surveys of program directors or described the experience of a single program. We set out to identify enablers of and barriers to Ob-Gyn abortion training in the context of a New York City political initiative, in order to better understand how to improve abortion training at other sites. We conducted in-depth qualitative interviews with 22 stakeholders from 7 New York City public hospitals and focus group interviews with 62 current residents at 6 sites. Enablers of abortion training included program location, high-capacity services, faculty commitment to abortion training, external programmatic support, and resident interest. Barriers to abortion training included lack of leadership continuity, leadership conflict, lack of second-trimester abortion services, difficulty obtaining mifepristone, optional rather than routine training, and antiabortion values of hospital personnel. Supportive leadership, faculty commitment, and external programmatic support appear to be key elements for establishing routine abortion training at Ob-Gyn residency training programs.

  15. An overview of medical abortion for clinical practice.

    PubMed

    Bryant, Amy G; Regan, Elizabeth; Stuart, Gretchen

    2014-01-01

    Medical abortion is a safe, convenient, and effective method for terminating an early unintended pregnancy. Medical abortion can be performed up to 63 days from the last menstrual period and may even be used up to 70 days for women who prefer medical abortion over surgical abortion. Counseling on the adverse effects and expectations for medical abortion is critical to success. Medical abortion can be performed in a clinic without special equipment, and it is perceived as more "natural" than a surgical abortion by many women. Follow-up for medical abortion can be simplified to include only serum human chorionic gonadotropin measurements when necessary, although obtaining an ultrasound remains the criterion standard. Pain associated with medical abortion is best treated with nonsteroidal anti-inflammatory medications, possibly in combination with opioid analgesics. Medical abortion can contribute to continuity of care for women who wish to remain with their primary care providers for management of their abortion.

  16. Is therapeutic abortion preventable?

    PubMed

    Droegemueller, W; Taylor, E S

    1970-05-01

    Colorado was the first state in the U.S. to legalize therapeutic abortion in April 1967 on grounds of fetal indications, rape, incest, medical and psychiatric illness. The authors review 41 cases performed at the University of Colorado Medical Center during 1967-68, and 73 cases during 1968-69. The major indication for abortion was psychiatric illness (44% in 1967-68 and 49% in 1968-69); followed by rape (34% in 1967-68, 26% in 1968-69); fetal indications (12% in 1967-68, 22% in 1968-69); and medical problems (10% in 1967-68, 3% 1968-69). The authors categorized and analyzed and fetal and medical indications by their preventability. It was concluded that most could have been prevented by proper contraceptive advice and practice. Of 21 abortions for fetal indications, 71% were clearly preventable, and 5 out of 6 abortions performed for medical reasons were for patients with chronic illnesses. Patients such as these with chronic medical illness, and others with significant genetic risks, should be encouraged to use oral contraceptives or to undergo sterilizations, for the failure rate for mechanical contraceptives is found to be unacceptably high. Considering the psychological impact of abortion on the patient and the morbidity and expense involved, it is a poor substitute for the birth control.

  17. Abortion Surveillance - United States, 2013.

    PubMed

    Jatlaoui, Tara C; Ewing, Alexander; Mandel, Michele G; Simmons, Katharine B; Suchdev, Danielle B; Jamieson, Denise J; Pazol, Karen

    2016-11-25

    Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. 2013. Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). The reporting areas provide this information voluntarily. For 2013, data were received from 49 reporting areas. For trend analysis, abortion data were evaluated from 47 areas that reported data every year during 2004-2013. Census and natality data, respectively, were used to calculate abortion rates (number of abortions per 1,000 women) and ratios (number of abortions per 1,000 live births). A total of 664,435 abortions were reported to CDC for 2013. Of these abortions, 98.2% were from the 47 reporting areas that provided data every year during 2004-2013. Among these 47 reporting areas, the abortion rate for 2013 was 12.5 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 200 abortions per 1,000 live births. From 2012 to 2013, the total number, rate, and ratio of reported abortions decreased 5%. From 2004 to 2013, the total number, rate, and ratio of reported abortions decreased 20%, 21%, and 17%, respectively. In 2013, all three measures reached their lowest level for the entire period of analysis (2004-2013). In 2013 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates; women in their 30s and older accounted for a much smaller percentage of abortions and had lower abortion rates. In 2013, women aged 20-24 and 25-29 years accounted for 32.7% and 25.9% of all abortions, respectively, and had abortion rates of 21.8 and 18.2 abortions per 1,000 women aged 20-24 and 25-29 years, respectively. In contrast, women aged 30-34, 35-39, and ≥40 years accounted for 16.8%, 9.2%, and 3.6% of all abortions, respectively, and had abortion rates of 11.8, 7.0, and 2

  18. Abortion Surveillance - United States, 2012.

    PubMed

    Pazol, Karen; Creanga, Andreea A; Jamieson, Denise J

    2015-11-27

    Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. 2012. Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). The reporting areas provide this information voluntarily. For 2012, data were received from 49 reporting areas. For trend analysis, abortion data were evaluated from 47 areas that reported data every year during 2003-2012. Census and natality data, respectively, were used to calculate abortion rates (number of abortions per 1,000 women) and ratios (number of abortions per 1,000 live births). A total of 699,202 abortions were reported to CDC for 2012. Of these abortions, 98.4% were from the 47 reporting areas that provided data every year during 2003-2012. Among these same 47 reporting areas, the abortion rate for 2012 was 13.2 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 210 abortions per 1,000 live births. From 2011 to 2012, the total number and ratio of reported abortions decreased 4% and the abortion rate decreased 5%. From 2003 to 2012, the total number, rate, and ratio of reported abortions decreased 17%, 18%, and 14%, respectively, and reached their lowest level in 2012 for the entire period of analysis (2003-2012). In 2012 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates; women in their 30s and older accounted for a much smaller percentage of abortions and had lower abortion rates. In 2012, women aged 20-24 and 25-29 years accounted for 32.8% and 25.4% of all abortions, respectively, and had abortion rates of 23.3 and 18.9 abortions per 1,000 women aged 20-24 and 25-29 years, respectively. In contrast, women aged 30-34, 35-39, and ≥40 years accounted for 16.4%, 9.1%, and 3.7% of all abortions, respectively, and had abortion rates of

  19. Abortion surveillance--United States, 2008.

    PubMed

    Pazol, Karen; Zane, Suzanne B; Parker, Wilda Y; Hall, Laura R; Berg, Cynthia; Cook, Douglas A

    2011-11-25

    Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. 1999-2008. Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). This information is provided voluntarily. For 2008, data were received from 49 reporting areas. For the purpose of trend analysis, data were evaluated from the 45 areas that reported data every year during 1999-2008. Abortion rates (number of abortions per 1,000 women) and ratios (number of abortions per 1,000 live births) were calculated using census and natality data, respectively. A total of 825,564 abortions were reported to CDC for 2008. Of these, 808,528 abortions (97.9% of the total) were from the 45 reporting areas that provided data every year during 1999-2008. Among these same 45 reporting areas, the abortion rate for 2008 was 16.0 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 234 abortions per 1,000 live births. Compared with 2007, the total number and rate of reported abortions for these 45 reporting areas essentially were unchanged, although the abortion ratio was 1% higher. Reported abortion numbers, rates, and ratios remained 3%, 4%, and 10% lower, respectively, in 2008 than they had been in 1999. Women aged 20-29 years accounted for 57.1% of all abortions reported in 2008 and for the majority of abortions during the entire period of analysis (1999-2008). In 2008, women aged 20-29 years also had the highest abortion rates (29.6 abortions per 1,000 women aged 20-24 years and 21.6 abortions per 1,000 women aged 25-29 years). Adolescents aged 15-19 years accounted for 16.2% of all abortions in 2008 and had an abortion rate of 14.3 abortions per 1,000 adolescents aged 15-19 years; women aged ≥35 years accounted for a smaller percentage (11.9%) of abortions and had lower abortion rates (7.8 abortions per 1

  20. Abortion surveillance - United States, 2011.

    PubMed

    Pazol, Karen; Creanga, Andreea A; Burley, Kim D; Jamieson, Denise J

    2014-11-28

    Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. 2011. Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). The reporting areas provide this information voluntarily. For 2011, data were received from 49 reporting areas. For trend analysis, abortion data were evaluated from 46 areas that reported data every year during 2002-2011. Census and natality data, respectively, were used to calculate abortion rates (number of abortions per 1,000 women) and ratios (number of abortions per 1,000 live births). A total of 730,322 abortions were reported to CDC for 2011. Of these abortions, 98.3% were from the 46 reporting areas that provided data every year during 2002-2011. Among these same 46 reporting areas, the abortion rate for 2011 was 13.9 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 219 abortions per 1,000 live births. From 2010 to 2011, the total number and rate of reported abortions decreased 5% and the abortion ratio decreased 4%, and from 2002 to 2011, the total number, rate, and ratio of reported abortions decreased 13%, 14%, and 12%, respectively. In 2011, all three measures reached their lowest level for the entire period of analysis (2002-2011). In 2011 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates, and women in their 30s and older accounted for a much smaller percentage of abortions and had lower abortion rates. In 2011, women aged 20-24 and 25-29 years accounted for 32.9% and 24.9% of all abortions, respectively, and had abortion rates of 24.9 and 19.4 abortions per 1,000 women aged 20-24 and 25-29 years, respectively. In contrast, women aged 30-34, 35-39, and ≥40 years accounted for 15.8%, 8.9%, and 3.6% of all abortions, respectively

  1. "They're legal so they're safe, right?" What did the legal status of BZP-party pills mean to young people in New Zealand?

    PubMed

    Sheridan, Janie; Butler, Rachael

    2010-01-01

    The legislation on psychoactive substances has a role to play with regard to shaping social values and influencing the normalisation of drug use. In New Zealand from 2005 to 2008, benzylpiperazine-containing 'legal' party pills (BZP-party pills) were legally available for purchase, subject to controls around a minimum purchase age of 18 years, and prohibitions on free of charge distribution and advertising in certain media. This paper explores what their legal status communicated to young users. Interviews and group discussions with young people (n=58) who had used BZP-party pills in the preceding 6 months. Data were collected between June and December 2006 via a series of interviews with individuals, 'friendship' pairs, and groups comprised of participants known to each other. Young people saw BZP-party pills as 'safe' and of good quality as they were legal/government sanctioned, but also thus of inferior strength, suggesting they could take more of them. However, after using them they often reviewed their view of their safety and quality due to varied experiences. Being legal for some people meant they could use the substances without breaking the law, or having to go to 'dealers'. Their legal status also meant they were easily accessible and were seen to be 'socially acceptable', with some young people indicating they would be happy to discuss their use with their parents. However, social acceptability was, for some, a reason not to use them. These data provide a unique insight into the tension between positive and negative harm reduction messages relating to the legal nature of psychoactive drugs and as such begin to fill an information void in this area. The legal status of these 'party pills' conveys mixed messages to young people and whilst being seen as potentially safe and of good quality, this often leads to higher than 'recommended' doses being used. Nevertheless, not breaking the law or having to access BZP-party pills from 'dealers', and being able to

  2. Abortion in Croatia and Slovenia.

    PubMed

    1992-01-01

    In Slovenia abortion will continue to be available during the first 10 weeks of pregnancy as it has been since 1978. The Slovenian Constitutional Court passed this decision in December, 1991 calling the right to abortion a basic human right. T he ruling was a setback both for the government's conservative parties and the Catholic church. In Croatia, where the Catholic church is campaigning against abortion, the situation is quite different. Zagreb is full of stickers and posters with anti-abortion messages branding abortion murder and spreading inaccurate information in announcements. In 1990, there were 56,000 abortions. For every child that was born, one was aborted. The largest Croatian newspaper publicizes the Catholic view. They want pro-choice women of the volunteer group Tresnjevka to stop their struggle. The church and conservative women's groups press for inclusion of abortion in the Constitution. They are very powerful, and the fear is that might soon succeed in restricting or outlawing abortion. Tresnjevka is making efforts to organize a coordination and information center for women in Zagreb where there are 350,000 women and children refugees. Informative brochures are printed on natural healing methods in gynecology, as drugs are very scarce, and addresses for gynecological emergency care are also provided. Abortion has been legally available on demand during the 1st 10 weeks of pregnancy since 1978. Fore year Tresnjevka has worked for women, trying to raise funds from personal donations and from the government for their activities. Funds from foreign countries have never been received. At present many of the group's activities are on hold because of lack of funds, nevertheless the determination to continue fighting is alive.

  3. Perception on the abortion laws in Sri Lanka: A community based study in the city of Colombo

    PubMed

    Suranga, M S; Silva, K T; Senanayake, L

    2016-12-30

    Abortion is legally permitted in Sri Lanka, only if it is performed to save the mother’s life. However, it is estimated that a large number of induced abortions take place in Sri Lanka. Knowledge and attitudes towards induced abortion in the society are key issues influencing the policy response towards changes in the law. This study aimed to assess the knowledge and attitudes of adults towards induced abortion in Sri Lanka. Six Grama Niladhari Divisions (GNDs) and five to eight housing clusters from each GND were selected from Thimbirigasyaya Divisional Secretariat Division using multi stage stratified random sampling. Fifty households were systematically selected from each GND. An interview was scheduled among 743 residents aged between 19 to 49 years of age after receiving written informed consent. Only 11% of the respondents knew the situations in which abortion was legal in Sri Lanka. Approximately one tenth of the respondents (11%) did not agree with the current law which allows an induced abortion only to save the life of the mother. However, a majority agreed to legalization of abortion for rape (65%), incest (55%) and pregnancies with lethal fetal abnormalities (53%). Less than one tenth of respondents agreed with legalisation of induced abortion for other reasons such as con-traceptive failure (6%), poor economic conditions (7%) and, on request (4%). Although the society rejects abortion on request majority are in favour of allowing abortions for rape, incest and fetuses with lethal abnormalities.

  4. Abortion-Related Mortality in the United States 1998–2010

    PubMed Central

    Zane, Suzanne; Creanga, Andreea A.; Berg, Cynthia J.; Pazol, Karen; Suchdev, Danielle B.; Jamieson, Denise J.; Callaghan, William M.

    2015-01-01

    OBJECTIVE To examine characteristics and causes of legal induced abortion–related deaths in the United States between 1998 and 2010. METHODS Abortion-related deaths were identified through the national Pregnancy Mortality Surveillance System with enhanced case-finding. We calculated the abortion mortality rate by race, maternal age, and gestational age and the distribution of causes of death by gestational age and procedure. RESULTS During the period from 1998–2010, of approximately 16.1 million abortion procedures, 108 women died, for a mortality rate of 0.7 deaths per 100,000 procedures overall, 0.4 deaths for non-Hispanic white women, 0.5 deaths for Hispanic women, and 1.1 deaths for black women. The mortality rate increased with gestational age, from 0.3 to 6.7 deaths for procedures performed at 8 weeks or less and at 18 weeks or greater, respectively. A majority of abortion-related deaths at 13 weeks of gestation or less were associated with anesthesia complications and infection, whereas a majority of abortion-related deaths at more than 13 weeks of gestation were associated with infection and hemorrhage. In 20 of the 108 cases, the abortion was performed as a result of a severe medical condition where continuation of the pregnancy threatened the woman’s life. CONCLUSION Deaths associated with legal induced abortion continue to be rare events—less than 1 per 100,000 procedures. Primary prevention of unintended pregnancy, including those in women with serious pre-existing medical conditions, and increased access to abortion services at early gestational ages may help to further decrease abortion-related mortality in the United States. PMID:26241413

  5. Conducting collaborative abortion research in international settings.

    PubMed

    Gipson, Jessica D; Becker, Davida; Mishtal, Joanna Z; Norris, Alison H

    2011-01-01

    Nearly 20% of the 208 million pregnancies that occur annually are aborted. More than half of these (21.6 million) are unsafe, resulting in 47,000 abortion-related deaths each year. Accurate reports on the prevalence of abortion, the conditions under which it occurs, and the experiences women have in obtaining abortions are essential to addressing unsafe abortion globally. It is difficult, however, to obtain accurate and reliable reports of attitudes and practices given that abortion is often controversial and stigmatized, even in settings where it is legal. To improve the understanding and measurement of abortion, specific considerations are needed throughout all stages of the planning, design, and implementation of research on abortion: Establishment of strong local partnerships, knowledge of local culture, integration of innovative methodologies, and approaches that may facilitate better reporting. This paper draws on the authors' collaborative research experiences conducting abortion-related studies using clinic- and community-based samples in five diverse settings (Poland, Zanzibar, Mexico City, the Philippines, and Bangladesh). The purpose of this paper is to share insights and lessons learned with new and established researchers to inform the development and implementation of abortion-related research. The paper discusses the unique challenges of conducting abortion-related research and key considerations for the design and implementation of abortion research, both to maximize data quality and to frame inferences from this research appropriately. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  6. The search for meaning: RU 486 and the law of abortion.

    PubMed Central

    Banwell, S S; Paxman, J M

    1992-01-01

    The advent of RU 486 (mifepristone), a steroid analogue capable of inducing menses within 8 to 10 weeks of a missed menstrual period, has provoked a firestorm of concern and controversy. When used in conjunction with prostaglandin (RU 486/PG), it is at least 95% effective. Used in France principally to terminate confirmed pregnancies very early in the process of gestation, RU 486 raises many interesting legal questions. This article focuses on whether and how RU 486/PG can be accommodated within the framework of the world's current abortion laws. Four avenues are explored and conclusions drawn. First, it is clear that RU 486/PG can be used readily, if approved, within the regimens established by liberal abortion laws, as has been the experience in France, the United Kingdom, and even China. Second, although unlikely, the introduction of this new technology may inspire a reexamination of restrictive abortion statutes themselves. Third, some of the presently restrictive laws may be interpreted to permit RU 486/PG use as a legal procedure, for a very narrow range of reasons. Finally, in some settings the early use of RU 486/PG (before pregnancy can be confirmed) may fall outside the reach of abortion legislation and hence be acceptable from a legal point of view. PMID:1415870

  7. Abortion Surveillance - United States, 2014.

    PubMed

    Jatlaoui, Tara C; Shah, Jill; Mandel, Michele G; Krashin, Jamie W; Suchdev, Danielle B; Jamieson, Denise J; Pazol, Karen

    2017-11-24

    Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. 2014. Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). The reporting areas provide this information voluntarily. For 2014, data were received from 49 reporting areas. For trend analysis, abortion data were evaluated from 48 areas that reported data every year during 2005-2014. Census and natality data, respectively, were used to calculate abortion rates (number of abortions per 1,000 women aged 15-44 years) and ratios (number of abortions per 1,000 live births). A total of 652,639 abortions were reported to CDC for 2014. Of these abortions, 98.4% were from the 48 reporting areas that provided data every year during 2005-2014. Among these 48 reporting areas, the abortion rate for 2014 was 12.1 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 186 abortions per 1,000 live births. From 2013 to 2014, the total number and rate of reported abortions decreased 2%, and the ratio decreased 7%. From 2005 to 2014, the total number, rate, and ratio of reported abortions decreased 21%, 22%, and 21%, respectively. In 2014, all three measures reached their lowest level for the entire period of analysis (2005-2014). In 2014 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates; women in their 30s and older accounted for a much smaller percentage of abortions and had lower abortion rates. In 2014, women aged 20-24 and 25-29 years accounted for 32.2% and 26.7% of all reported abortions, respectively, and had abortion rates of 21.3 and 18.4 abortions per 1,000 women aged 20-24 and 25-29 years, respectively. In contrast, women aged 30-34, 35-39, and ≥40 years accounted for 17.1%, 9.7%, and 3.6% of all reported abortions

  8. [Abortion and fetal non-viability: the Brazilian debate].

    PubMed

    Diniz, Debora

    2005-01-01

    The Case Against Non-Compliance with the Fundamental Principle concerning Anencephaly, under review by the Brazilian Supreme Court, is a milestone in the debate on abortion in Latin America. Since the currently prevailing version of the Brazilian Penal Code was enacted in 1940, there has been fierce resistance to any change in the country's abortion policy. This article discusses the arguments and political strategies used in the anencephaly suit brought before the Supreme Court, particularly the ethical and legal position that interruption of pregnancy in cases of anencephaly does not constitute abortion, but should be considered a therapeutic anticipation of delivery.

  9. [On research concerning abortion in Latin America and studies on women].

    PubMed

    Barroso, C

    1989-01-01

    "Research on abortion is important for the Latin American women's movements. Rates of illegal abortion seem quite high. Cuba is the only country where abortion is legal. Policies on abortion are closely related to attitudes towards sexuality and women. Contraception has, in addition to health and economic costs, social and psychological costs, therefore unwanted pregnancies are the normal results of behavior that follows a certain rationality. Consequences of abortion depend on a woman's integration in her social network. The Latin American scene has two main differences from industrialized countries: mass poverty and the influence of the Catholic Church. Conditions of poverty affect less the motivation for abortion and more the conditions of its use." (SUMMARY IN ENG) excerpt

  10. Intended and unintended consequences of abortion law reform: perspectives of abortion experts in Victoria, Australia.

    PubMed

    Keogh, L A; Newton, D; Bayly, C; McNamee, K; Hardiman, A; Webster, A; Bismark, M

    2017-01-01

    In Victoria, Australia, abortion was decriminalised in October 2008, bringing the law in line with clinical practice and community attitudes. We describe how experts in abortion service provision perceived the intent and subsequent impact of the 2008 Victorian abortion law reform. Experts in abortion provision in Victoria were recruited for a qualitative semi-structured interview about the 2008 law reform and its perceived impact, until saturation was reached. Nineteen experts from a range of health care settings and geographic locations were interviewed in 2014/2015. Thematic analysis was conducted to summarise participants' views. Abortion law reform, while a positive event, was perceived to have changed little about the provision of abortion. The views of participants can be categorised into: (1) goals that law reform was intended to address and that have been achieved; (2) intent or hopes of law reform that have not been achieved; (3) unintended consequences; (4) coincidences; and (5) unfinished business. All agreed that law reform had repositioned abortion as a health rather than legal issue, had shifted the power in decision making from doctors to women, and had increased clarity and safety for doctors. However, all described outstanding concerns; limited public provision of surgical abortion; reduced access to abortion after 20 weeks; ongoing stigma; lack of a state-wide strategy for equitable abortion provision; and an unsustainable workforce. Law reform, while positive, has failed to address a number of significant issues in abortion service provision, and may have even resulted in a 'lull' in action. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  11. Increasing access to legal termination of pregnancy and postabortion contraception at the University Teaching Hospital, Lusaka, Zambia.

    PubMed

    Macha, Swebby; Muyuni, Mutinta; Nkonde, Scholastica; Faúndes, Anibal

    2014-07-01

    The Zambian Association of Gynecology and Obstetrics is one of the International Federation of Gynecology and Obstetrics (FIGO) member societies participating in the FIGO Initiative for the Prevention of Unsafe Abortion and its Consequences from the East, Central, and Southern Africa region. The activities included in this country's plan of action were to provide access to safe abortion within the full extent of the law to women receiving care at the University Teaching Hospital in Lusaka, and to increase the proportion of women leaving the hospital with a contraceptive method. Zambian law regarding abortion is liberal, but in general it was not applied until very recently. The proportion of legal terminations of pregnancy among patients receiving abortion care at the hospital increased from 3.2% in 2009 to 7.7% in 2011, while the percentage of women leaving the hospital with a contraceptive method increased from 25.3% to 69.4% over the same period. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  12. A dualist analysis of abortion: personhood and the concept of self qua experiential subject.

    PubMed

    Himma, K E

    2005-01-01

    There is no issue more central to the abortion debate than the controversial issue of whether the fetus is a moral person. Abortion-rights opponents almost universally claim that abortion is murder and should be legally prohibited because the fetus is a moral person at the moment of conception. Abortion-rights proponents almost universally deny the crucial assumption that the fetus is a person; on their view, whatever moral disvalue abortion involves does not rise to the level of murder and hence does not rise to the level of something that should be legally prohibited. In this essay, I argue that, under dualist assumptions about the nature of mind, the fetus is not a person until brain activity has begun.(i) First, I argue it is a necessary condition for a thing to be a moral person that it is (or has) a self. Second, I argue it is a necessary condition for a fetus to be (or have) a self, under dualist assumptions, that there has been some electrical activity in the brain. I conclude that a dualist can take the position that abortion ought to be legally permitted at least until the beginning of brain activity in the fetus.iI make no attempt to determine what conditions are sufficient for moral personhood; for this reason, the relevant claim about personhood is purely negative.

  13. Abortion surveillance--United States, 2009.

    PubMed

    Pazol, Karen; Creanga, Andreea A; Zane, Suzanne B; Burley, Kim D; Jamieson, Denise J

    2012-11-23

    Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. 2009. Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). The reporting areas provide this information voluntarily. For 2009, data were received from 48 reporting areas. For the purpose of trend analysis, abortion data were evaluated from the 45 areas that reported data every year during 2000-2009. Census and natality data, respectively, were used to calculated abortion rates (number of abortions per 1,000 women) and ratios (number of abortions per 1,000 live births). A total of 784,507 abortions were reported to CDC for 2009. Of these abortions, 772,630 (98.5%) were from the 45 reporting areas that provided data every year during 2000-2009. Among these same 45 reporting areas, the abortion rate for 2009 was 15.1 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 227 abortions per 1,000 live births. Compared with 2008, the total number and rate of reported abortions for 2009 decreased 5%, representing the largest single year decrease for the entire period of analysis. The abortion ratio decreased 2%. From 2000 to 2009, the total number, rate, and ratio of reported abortions decreased 6%, 7%, and 8%, respectively, to the lowest levels for 2000-2009. In 2009 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates, whereas women aged ≥30 years accounted for a much smaller percentage of abortions and had lower abortion rates. In 2009, women aged 20-24 and 25-29 years accounted for 32.7% and 24.4% of all abortions, respectively, and had an abortion rate of 27.4 abortions per 1,000 women aged 20-24 years and 20.4 abortions per 1,000 women aged 25-29 years. In contrast, women aged 30-34, 35-39, and ≥40 years

  14. INDUCED ABORTION FROM AN ISLAMIC PERSPECTIVE: IS IT CRIMINAL OR JUST ELECTIVE?

    PubMed Central

    Albar, Mohammed A.

    2001-01-01

    Background: Induced Abortion for social reasons is spreading all over the world. It is estimated that globally 50 million unborn babies are killed annually, resulting in the deaths of 200,000 pregnant women and the suffering of millions. The complications of illegal abortion are very serious. Abortion is still used in many countries as a means of family planning. The medical reasons for abortion are limited and con-sti-tute a small proportion of all abortion cases. This paper discusses the different views on abortion, its history, its evolution over time, and the present legal circumstances. The emphasis is on the situation in Islamic countries and the effect of Islamic Fatwas on abortion. PMID:23008648

  15. Population Policy: Abortion and Modern Contraception Are Substitutes.

    PubMed

    Miller, Grant; Valente, Christine

    2016-08-01

    A longstanding debate exists in population policy about the relationship between modern contraception and abortion. Although theory predicts that they should be substitutes, the empirical evidence is difficult to interpret. What is required is a large-scale intervention that alters the supply (or full price) of one or the other and, importantly, that does so in isolation (reproductive health programs often bundle primary health care and family planning-and in some instances, abortion services). In this article, we study Nepal's 2004 legalization of abortion provision and subsequent expansion of abortion services, an unusual and rapidly implemented policy meeting these requirements. Using four waves of rich individual-level data representative of fertile-age Nepalese women, we find robust evidence of substitution between modern contraception and abortion. This finding has important implications for public policy and foreign aid, suggesting that an effective strategy for reducing expensive and potentially unsafe abortions may be to expand the supply of modern contraceptives.

  16. A statement on abortion by 100 professors of obstetrics: 40 years later.

    PubMed

    2013-09-01

    In this Journal in 1972, 100 leaders in obstetrics and gynecology published a compelling statement that recognized the legalization of abortion in several states and anticipated the 1973 Supreme Court decision in Roe v Wade. They projected the numbers of legal abortions that likely would be required by women in the United States and described the role of the teaching hospital in meeting that responsibility. They wrote to express their concern for women's health in a new legal and medical era of reproductive control and to define the responsibilities of academic obstetrician-gynecologists. Forty years later, 100 professors examine the statement of their predecessors in light of medical advances and legal changes and suggest a further course of action for obstetrician gynecologists. Copyright © 2013 Mosby, Inc. All rights reserved.

  17. Mid-trimester induced abortion: a review.

    PubMed

    Lalitkumar, S; Bygdeman, M; Gemzell-Danielsson, K

    2007-01-01

    Mid-trimester abortion constitutes 10-15% of all induced abortion. The aim of this article is to provide a review of the current literature of mid-trimester methods of abortion with respect to efficacy, side effects and acceptability. There have been continuing efforts to improve the abortion technology in terms of effectiveness, technical ease of performance, acceptability and reduction of side effects and complications. During the last decade, medical methods for mid-trimester induced abortion have shown a considerable development and have become safe and more accessible. The combination of mifepristone and misoprostol is now an established and highly effective method for termination of pregnancy (TOP). Advantages and disadvantages of medical versus surgical methods are discussed. Randomized studies are lacking, and more studies on pain treatment and the safety of any method used in patients with a previous uterine scar are debated, and data are scarce. Pain management in abortion requires special attention. This review highlights the need for randomized studies to set guidelines for mid-trimester abortion methods in terms of safety and acceptability as well as for better analgesic regimens.

  18. State obligations to implement African abortion laws: employing human rights in a changing legal landscape.

    PubMed

    Ngwena, Charles G

    2012-11-01

    Women in the African region are overburdened with unsafe abortion. Abortion regimes that fail to translate any given abortion rights into tangible access are partly to blame. Historically, African abortion laws have been highly restrictive. However, the post-independence era has witnessed a change toward liberalizing abortion law, even if incremental for many jurisdictions. Furthermore, Article 14 of the Protocol to the African Charter on Human and Peoples' Rights on the Rights of Women in Africa has significantly augmented the regional trend toward liberalization by recognizing abortion as a human right in given circumstances. However, states are failing to implement abortion laws. The jurisprudence that is emerging from the European Court of Human Rights and United Nations treaty bodies is a tool that can be used to render African governments accountable for failure to implement domestic abortion laws. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  19. The ethics of abortions for fetuses with congenital abnormalities.

    PubMed

    Jotkowitz, Alan; Zivotofsky, Ari Z

    2010-10-01

    Abortion remains a highly contentious moral issue, with the debate usually framed as a battle between the fetus's right to life and the woman's right to choose. Often overlooked in this debate is the impact of the concurrent legalization of abortion and the development of new prenatal screening tests on the birth prevalence of many inherited diseases. Most proponents of abortion support abortion for fetuses with severe congenital diseases, but there has unfortunately been, in our opinion, too little debate over the moral appropriateness of abortion for much less severe congenital conditions such as Down's syndrome, deafness, and dwarfism. Due to scientific advances, we are looking at a future in which prenatal diagnosis will be safer and more accurate, raising the specter, and the concomitant ethical concerns, of wholesale abortions. Herein, we present a reframing of the abortion debate that better encompasses these conditions and offers a more nuanced position. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  20. [Medical abortion provided by telemedicine to women in Latin America: complications and their treatment].

    PubMed

    Larrea, Sara; Palència, Laia; Perez, Glòria

    2015-01-01

    To analyze reported complications and their treatment after a medical abortion with mifepristone and misoprostol provided by a telemedicine service to women living in Latin America. Observational study based on the registry of consultations in a telemedicine service. A total of 872 women who used the service in 2010 and 2011 participated in the study. The dependent variables were overall complications, hemorrhage, incomplete abortion, overall treatments, surgical evacuation, and antibiotics. Independent variables were age, area of residence, socioeconomic deprivation, previous children, pregnancies and abortions, and week of pregnancy. We fitted Poisson regression models with robust variance to estimate incidence ratios and 95% confidence intervals (95%CI). Complications were reported by 14.6% of the participants: 6.2% reported hemorrhage and 6.8% incomplete abortion. Nearly one-fifth (19.0%) received postabortion treatment: 10.9% had a surgical evacuation and 9.3% took antibiotics. Socioeconomic deprivation increased the risk of complications by 64% (95%CI: 15%-132%), and, among these, the risk of incomplete abortion by 82% (95%CI: 8%-206%) and the risk of surgical intervention by 62% (95%CI: 7%-144%). Previous pregnancies increased the risk of complications and, specifically, the risk of hemorrhage by 2.29 times (95%CI: 1.33-3.95%). Women with a pregnancy of 12 or more weeks had a 2.45 times higher risk of receiving medical treatment and a 2.94 times higher risk of taking antibiotics compared with women with pregnancies of 7 or less weeks. Medical abortion provided by telemedicine seems to be a safe and effective alternative in contexts where it is legally restricted. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

  1. Cost-effectiveness analysis of unsafe abortion and alternative first-trimester pregnancy termination strategies in Nigeria and Ghana.

    PubMed

    Hu, Delphine; Grossman, Daniel; Levin, Carol; Blanchard, Kelly; Adanu, Richard; Goldie, Sue J

    2010-06-01

    To explore the policy implications of increasing access to safe abortion in Nigeria and Ghana, we developed a computer-based decision analytic model which simulates induced abortion and its potential complications in a cohort of women, and comparatively assessed the cost-effectiveness of unsafe abortion and three first-trimester abortion modalities: hospital-based dilatation and curettage, hospital- and clinic-based manual vacuum aspiration (MVA), and medical abortion using misoprostol (MA). Assuming all modalities are equally available, clinic-based MVA is the most cost-effective option in Nigeria. If clinic-based MVA is not available, MA is the next best strategy. Conversely, in Ghana, MA is the most cost-effective strategy, followed by clinic-based MVA if MA is not available. From a real world policy perspective, increasing access to safe abortion in favor over unsafe abortion is the single most important factor in saving lives and societal costs, and is more influential than the actual choice of safe abortion modality.

  2. Abortion in Islamic Ethics, and How it is Perceived in Turkey: A Secular, Muslim Country.

    PubMed

    Ekmekci, Perihan Elif

    2017-06-01

    Abortion is among the most widely discussed concepts of medical ethics. Since the well-known ethical theories have emerged from Western world, the position of Islamic ethics regarding main issues of medical ethics has been overlooked. Muslims constitute a considerable amount of world population. Turkish Republic is the only Muslim country ruled with secular democracy and one of the three Muslim countries where abortion is legalized. The first aim of this paper is to present discussions on abortion in Islamic ethics in the context of major ethical concepts; the legal status of the fetus, respect for life and the right not to be born. The second aim is to put forth Turkey's present legislation about abortion in the context of Islamic ethical and religious aspects.

  3. Change Over Time in Attitudes About Abortion Laws Relative to Recent Restrictions in Texas

    PubMed Central

    Smith, Chelsea

    2016-01-01

    Objective Over the past five years, Texas has become a hotbed of debate on abortion rights and restrictions. Legislation in 2011 and 2013 made it more difficult for women to obtain abortions and for clinics to provide the procedure, laws which have resulted in practical obstacles and the closure of clinics. Less is known about whether that political activity has extended to public opinion on abortion in Texas, especially in the national context of increasing partisanship. Study Design Data from the cross-sectional Houston Area Survey (HAS; n = 4,856) were used to compare attitudes about abortion at three time points: in 2010 before the major waves of legislation, in 2012 after the 2011 legislation, and in 2014 after the 2013 legislation. Logistic regressions estimated support for legal abortion over time, after adjusting for personal characteristics, views on other social issues, religiosity, political party identification, and political ideology. Results At all three time points studied, slightly more than half of Houstonians supported legal abortion for any reason a woman wanted to obtain one. Compared to 2010, support was significantly higher in 2012 and 2014, whereas the decline in support between 2012 and 2014 was not statistically significant after adjusting for religiosity and politics. Conclusions This study identified increased public support for legal abortion following the Texas state legislature’s restrictive laws in 2011 and 2013. Implications As the Texas legislature increasingly restricts access to abortion, residents of the state’s largest and most diverse city do not hold attitudes in line with those restrictions. Clinicians may thus have more public support for their services than the divided political climate would suggest. PMID:27318007

  4. Preventing unsafe abortion and limiting its consequences: what can be done?

    PubMed

    Misago, C

    1994-12-01

    The continued illegality of induced abortion in Latin America has led to substantial, preventable maternal mortality and morbidity. The first strategy for preventing unsafe clandestine abortion is to reduce the incidence of unwanted pregnancy through measures such as improved access to effective contraception, post-abortion family planning counseling, health education campaigns aimed at promoting condom use among young people, involvement of men in family planning decision making, biomedical research on safer and more effective male and female contraceptive methods, and empowering women to demand the use of condoms or avoid unwanted intercourse. The second strategy is to reduce abortion-related mortality and morbidity through more effective clinical management of incomplete illegal abortions, introduction of menstrual regulation services, formation of women's solidarity groups aimed at discouraging the practice of self-induced abortion, and, ultimately, abortion legalization.

  5. Pregnancy and the 40-Year Prison Sentence: How "Abortion Is Murder" Became Institutionalized in the Salvadoran Judicial System.

    PubMed

    Viterna, Jocelyn; Bautista, Jose Santos Guardado

    2017-06-01

    Using the case of El Salvador, this article demonstrates how the anti-abortion catchphrase "abortion is murder" can become embedded in the legal practice of state judicial systems. In the 1990s, a powerful anti-abortion movement in El Salvador resulted in a new legal context that outlawed abortion in all circumstances, discouraged mobilization for abortion rights, and encouraged the prosecution of reproduction-related "crimes." Within this context, Salvadoran women initially charged with the crime of abortion were convicted of "aggravated homicide" and sentenced to up to 40 years in prison. Court documents suggest that many of these women had not undergone abortions, but had suffered naturally occurring stillbirths late in their pregnancies. Through analysis of newspaper articles and court cases, this article documents how El Salvador came to prosecute obstetrical emergencies as "murder," and concludes that activism on behalf of abortion rights is central to protecting poor pregnant women from prosecution for reproduction-related "crimes."

  6. Politics and abortion in Bulgaria.

    PubMed

    Sirakova, K

    1992-01-01

    Political change in Bulgaria has meant the beginning of the recognition of the reproduction rights of women. Abortion, for example, was legalized in 1990. Women in Bulgaria, however, still lack the information they need on basic hygiene and sex. It is impossible to promulgate a progressive strategy in Bulgaria if one ignores the isolation of the Turkish and Gypsy ethnic communities. In addition, an economic crisis exists, and no real measures have been undertaken to mitigate the situation. The new democratic institutions have settled comfortably into the structures of the former communist rule, even to the point of adopting the same extensive demagogic terminology which perpetrates the old gap between words and deeds. For example, although a new birth control strategy and plan for sex education was announced 2 years ago, nothing definite has been done. One development, however, has been the legalization of abortion, which was accompanied by an immediate drop in the abortion rate (still 1.5 abortions/birth). Because of a lack of sex education, 900 children are born to girls under age 15 each year. Bulgaria is just starting to embrace modern values and must update its attitudes towards women. Bulgaria's formal institutions seem to be unable to face this issue, and many societies and foundations have emerged to work for women's rights, to protect out-of-wedlock children, and to fight disease (including AIDS) and drug addiction. However, these organizations are not producing real results and are simply providing shelter to representatives of the old nomenclature. Real efforts to overcome these problems will continue despite the current discouraging state of affairs.

  7. Antiprogestin drugs: ethical, legal and medical issues.

    PubMed

    Cook, R J; Grimes, D A

    1992-01-01

    RU 486 allows women the choice of a medical rather than a surgical abortion, and, for most women, the choice is one of procedure, not of whether to have an abortion. Issues surrounding RU 486 were explored in an American Society of Law and Medicine conference in December 1991 entitled "Antiprogestin Drugs: Ethical, Legal and Medical Issues." An introduction to 14 conference papers provides an overview of the proceedings. Baulieu, the father of RU 486, described updated developments in its use and the medically supervised method of abortion. Bygdeman and Swahn presented their work in Sweden on combining RU 486 with a prostaglandin to make abortion more effective. They suggested that the drug may be an attractive postovulation contraceptive. Greenslad et al. discussed service delivery aspects of the use of RU 486. Holt considered the implications of use of the drug in low-resource settings. A survey of obstetricians and gynecologists, presented by Heilig, indicates that 22% more physicians would perform a medical abortion. Patient perspectives were addressed by David, who stated that measuring acceptability of an abortion technique is difficult; women have historically used whatever method is available. A collaborative research project in India and Cuba on why women chose certain methods was reported by Winikoff et al. (90% of women would choose medical abortion if faced with the choice again). Berer analyzed French data on women's perspectives on medical vs. surgical abortion. The question of adolescent use of the drug was considered by Senderowitz, who lamented the lack of data on the subject and described what is known about adolescent pregnancy. Macklin proposed a framework for ethical analysis and used facts to address ethical questions. Weinstein provided another ethical framework, to analyze whether pharmacists have a right to refuse to provide abortifacient drugs. Buc approached the subject from a legal point of view and concluded that, whereas legal problems

  8. In Mexico, abortion rights strictly for the books.

    PubMed

    Farmer, A

    2000-06-01

    This paper characterizes the Mexican abortion laws using the case of a girl aged 14 years, Paulina Ramirez Jacinta, who was raped, became pregnant, and chose to terminate the unwanted pregnancy, yet was denied an abortion. This case clearly showed that Mexican abortion law, despite its legality, is highly restrictive in nature and, in a way, violated the human rights of Paulina. Even though it permits first-trimester abortion procedures for rape victims or women whose lives are endangered by the pregnancy, many pregnant women still resort to illegal abortion. To further aggravate the restrictive nature of the law, Baja California state Rep. Martin Dominguez Rocha made a proposal to eliminate the rape exception in the state's penal code. The case of Paulina will be handled by the lawyers at the Center for Reproductive Law and Policy in order to arrive at a settlement favorable to Paulina.

  9. Can policy analysis theories predict and inform policy change? Reflections on the battle for legal abortion in Indonesia

    PubMed Central

    Surjadjaja, Claudia; Mayhew, Susannah H

    2011-01-01

    The relevance and importance of research for understanding policy processes and influencing policies has been much debated, but studies on the effectiveness of policy theories for predicting and informing opportunities for policy change (i.e. prospective policy analysis) are rare. The case study presented in this paper is drawn from a policy analysis of a contemporary process of policy debate on legalization of abortion in Indonesia, which was in flux at the time of the research and provided a unique opportunity for prospective analysis. Applying a combination of policy analysis theories, this case study provides an analysis of processes, power and relationships between actors involved in the amendment of the Health Law in Indonesia. It uses a series of practical stakeholder mapping tools to identify power relations between key actors and what strategic approaches should be employed to manage these to enhance the possibility of policy change. The findings show how the moves to legalize abortion have been supported or constrained according to the balance of political and religious powers operating in a macro-political context defined increasingly by a polarized Islamic-authoritarian—Western-liberal agenda. The issue of reproductive health constituted a battlefield where these two ideologies met and the debate on the current health law amendment became a contest, which still continues, for the larger future of Indonesia. The findings confirm the utility of policy analysis theories and stakeholder mapping tools for predicting the likelihood of policy change and informing the strategic approaches for achieving such change. They also highlight opportunities and dilemmas in prospective policy analysis and raise questions about whether research on policy processes and actors can or should be used to inform, or even influence, policies in ‘real-time’. PMID:21183461

  10. Can policy analysis theories predict and inform policy change? Reflections on the battle for legal abortion in Indonesia.

    PubMed

    Surjadjaja, Claudia; Mayhew, Susannah H

    2011-09-01

    The relevance and importance of research for understanding policy processes and influencing policies has been much debated, but studies on the effectiveness of policy theories for predicting and informing opportunities for policy change (i.e. prospective policy analysis) are rare. The case study presented in this paper is drawn from a policy analysis of a contemporary process of policy debate on legalization of abortion in Indonesia, which was in flux at the time of the research and provided a unique opportunity for prospective analysis. Applying a combination of policy analysis theories, this case study provides an analysis of processes, power and relationships between actors involved in the amendment of the Health Law in Indonesia. It uses a series of practical stakeholder mapping tools to identify power relations between key actors and what strategic approaches should be employed to manage these to enhance the possibility of policy change. The findings show how the moves to legalize abortion have been supported or constrained according to the balance of political and religious powers operating in a macro-political context defined increasingly by a polarized Islamic-authoritarian-Western-liberal agenda. The issue of reproductive health constituted a battlefield where these two ideologies met and the debate on the current health law amendment became a contest, which still continues, for the larger future of Indonesia. The findings confirm the utility of policy analysis theories and stakeholder mapping tools for predicting the likelihood of policy change and informing the strategic approaches for achieving such change. They also highlight opportunities and dilemmas in prospective policy analysis and raise questions about whether research on policy processes and actors can or should be used to inform, or even influence, policies in 'real-time'.

  11. The measurement of public opinion on abortion: the effects of survey design.

    PubMed

    Bumpass, L L

    1997-01-01

    A factorial experiment examined the effects of the wording and sequence of survey questions on the measurement of attitudes toward abortion. When a first-trimester pregnancy is specified, 55% of respondents agree that a woman should be able to obtain a legal abortion for any reason, compared with 44% when no pregnancy duration is stated. Specifying first-trimester pregnancies has little effect on the proportion of respondents who agree that abortion should be available for maternal health, fetal defects or rape, but it significantly increases the proportion who agree that a woman should be able to obtain an abortion if she is single, has financial constraints or wants no more children. When gestational lengths from one to six months are presented to respondents in ascending order, agreement that a woman should be able to obtain an abortion for any reason is lower for any given length of gestation than when pregnancy durations are presented in descending order. Forty-eight percent of respondents agree that abortion should be legal for any reason when that question is posed after a series of specific reasons; however, 60% do so when it is the first question in the sequence. The difference in agreement with abortion for any reason between Catholics and non-Baptist Protestants, and between Republicans and Democrats, is much smaller when the question is asked first than when it is presented last.

  12. An exploratory pilot study of nurse-midwives' attitudes toward active euthanasia and abortion.

    PubMed

    Musgrave, C F; Soudry, I

    2000-12-01

    Over the past three decades, active euthanasia and abortion have received increasing international attention. Since both these practices are relevant to the role of the nurse-midwife, it is important to know what influences their attitudes towards them. Therefore, the purpose of this study was: 1, to survey the attitudes of nurse-midwives' to active euthanasia and its legalization; 2, to determine the relationship between nurse-midwives' attitudes toward active euthanasia and its legalization, and attitudes toward abortion, self-reported religiosity and religious affiliation. The study setting was an international midwifery conference and the sample consisted of 139 nurse-midwives attending the conference. The majority of nurse-midwives displayed a positive attitude toward active euthanasia and its legalization. In addition, there was a positive relationship between their attitude to abortion and active euthanasia. Self-reported religiosity and religious affiliation were significantly related to attitudes toward active euthanasia and its legalization. An interesting positive relationship between country of practice and attitudes to euthanasia was also found. Nurse-midwives practicing in countries with more liberal euthanasia and assisted suicide legislation were more supportive of active euthanasia. With the increasing acceptance of active euthanasia's legalization, the results of this study pose some ethical questions that nurse-midwives internationally will have to consider.

  13. [Is a sociology of abortion possible?].

    PubMed

    Isambert, F A

    1982-01-01

    Abortion is a thorny problem whose study is problematic because it is a source of social and juridical discord, of moral incertitude, of medical and psychiatric confusion, and of personal anguish. The question arises of whether a single perspective can be found which allows comprehension of the entire phenomenon. This work uses published sources to examine the abortion debate, beginning with the varying views of abortion expressed in the struggles to liberalize abortion legislation in France, Europe, and the US. 4 particular views of abortion were identified in the Paris press; the traditional religious view, which condemns abortion because the fetus is regarded as fully human from conception; the view of abortion as a means of fertility regulation; the view of abortion as a cause of public health problems that could be alleviated through legalization and medical control; and the view that abortion allows women to control their own bodies. The law is obliged to reconcile these diverse positions. Abortion legislation in different countries ranges along a continuum from severe to lenient, but regional variations are also evident. Abortion trials in the US and France shortly before liberalization of the laws of either country showed striking similarities but also notable differences due largely to dissimilarities in the social structures of the 2 countries. The relations between the individual and the state, morality, and the law, as reflected in the abortion debate, rested on inverse bases in the 2 countries. The typically American doctrine of privacy occupied a prominent place in the American legislation, while the French was more concerned with the humanitarian goal of reducing health damage from illegal abortions. Tension and ambiguity nevertheless unavoidably characterize the abortion regulations in the 2 countries. Abortion as an institution is a controlled and practical compromise between 2 poles, those giving primacy to individual interests, as in the US, and

  14. Abortion-related maternal mortality in the Russian Federation.

    PubMed

    Zhirova, Irina Alekseevna; Frolova, Olga Grigorievna; Astakhova, Tatiana Mikhailovna; Ketting, Evert

    2004-09-01

    This study examines characteristics and determinants of maternal mortality associated with induced and spontaneous abortion in the Russian Federation. In addition to national statistical data, the study uses the original medical files of 113 women, representing 74 percent of all women known to have died after undergoing an abortion in 1999. The number of abortions and abortion-related maternal deaths fell fairly steadily during the 1991-2000 decade to levels of 56 percent and 52 percent of the 1991 base, respectively. Regional and urban-rural variation is limited. Nine percent of abortion-related maternal mortality is due to spontaneous abortion; 24 percent is related to induced abortions performed inside and 67 percent to those performed outside a medical institution. In the latter group, older women, usually with a history of several pregnancies, are overrepresented. The high rate of abortion-related maternal mortality is due largely to the number of abortions performed at 13-21 weeks' and 22-27 weeks' gestation both inside and outside medical institutions. Improving access to safe second-trimester abortion, preventing delays during the abortion procedure, and adequate treatment of complications are key strategies for reducing abortion-related maternal mortality.

  15. TEN RILLINGTON PLACE AND THE CHANGING POLITICS OF ABORTION IN MODERN BRITAIN.

    PubMed

    Jones, Emma L; Pemberton, Neil

    2014-12-01

    This article addresses the social, cultural, and political history of backstreet abortion in post-war Britain, focusing on the murders of Beryl Evans and her daughter Geraldine, at Ten Rillington Place in 1949. It shows how the commonplace connection of John Christie to abortion and Beryl Evan's death was not a given in the wider public, legal, political, and forensic imagination of the time, reflecting the multi-layered and shifting meanings of abortion from the date of the original trials in the late 1940s and 1950s, through the subsequent judicial and literary reinvestigations of the case in the 1960s, to its cinematic interpretation in the 1970s. Exploring the language of abortion used in these different contexts, the article reveals changes in the gendering of abortionists, the increasing power and presence of abortion activists and other social reformers, the changing representation of working-class women and men, and the increasing critique of the practice of backstreet abortion. The case is also made for a kind of societal blind spot on abortion at the time of both the Evans and Christie trials; in particular, a reluctance to come to terms with the concept of the male abortionist, which distorted the criminal investigations and the trials themselves. Only when public acceptance for legalizing abortion grew in the more liberal climate of the 1960s and beyond did a revisionist understanding of the murder of Beryl Evans, in which abortion came to be positioned as a central element, gain a sustained hearing.

  16. The Incidence of Abortion in Nigeria

    PubMed Central

    Bankole, Akinrinola; Adewole, Isaac F.; Hussain, Rubina; Awolude, Olutosin; Singh, Susheela; Akinyemi, Joshua O.

    2016-01-01

    CONTEXT Because of Nigeria’s low contraceptive prevalence, a substantial number of women have unintended pregnancies, many of which are resolved through clandestine abortion, despite the country’s restrictive abortion law. Up-to-date estimates of abortion incidence are needed. METHODS A widely used indirect methodology was used to estimate the incidence of abortion and unintended pregnancy in Nigeria in 2012. Data on provision of abortion and postabortion care were collected from a nationally representative sample of 772 health facilities, and estimates of the likelihood that women who have unsafe abortions experience complications and obtain treatment were collected from 194 health care professionals with a broad understanding of the abortion context in Nigeria. RESULTS An estimated 1.25 million induced abortions occurred in Nigeria in 2012, equivalent to a rate of 33 abortions per 1,000 women aged 15–49. The estimated unintended pregnancy rate was 59 per 1,000 women aged 15–49. Fifty-six percent of unintended pregnancies were resolved by abortion. About 212,000 women were treated for complications of unsafe abortion, representing a treatment rate of 5.6 per 1,000 women of reproductive age, and an additional 285,000 experienced serious health consequences but did not receive the treatment they needed. CONCLUSION Levels of unintended pregnancy and unsafe abortion continue to be high in Nigeria. Improvements in access to contraceptive services and in the provision of safe abortion and postabortion care services (as permitted by law) may help reduce maternal morbidity and mortality. PMID:26871725

  17. Abortion and sex determination: conflicting messages in information materials in a District of Rajasthan, India.

    PubMed

    Nidadavolu, Vijaya; Bracken, Hillary

    2006-05-01

    Public information campaigns are an integral component of reproductive health programmes, including on abortion. In India, where sex selective abortion is increasing, public information is being disseminated on the illegality of sex determination. This paper presents findings from a study undertaken in 2003 in one district in Rajasthan to analyse the content of information materials on abortion and sex determination and people's perceptions of them. Most of the informational material about abortion was produced by one abortion service provider, but none by the public or private sector. The public sector had produced materials on the illegality of sex determination, some of which failed to distinguish between sex selection and other reasons for abortion. In the absence of knowledge of the legal status of abortion, the negative messages and strong language of these materials may have contributed to the perception that abortion is illegal in India. Future materials should address abortion and sex determination, including the legal status of abortion, availability of providers and social norms that shape decision-making. Married and unmarried women should be addressed and the participation of family members acknowledged, while supporting independent decisions by women. Sex determination should also be addressed, and the conditions under which a woman can and cannot seek an abortion clarified, using media and materials accessible to low-literate audiences. Based on what we learned in this research, a pictorial booklet and educator's manual were produced, covering both abortion and sex determination, and are being distributed in India.

  18. Supreme Court Rulings on Abortion: Roe v. Wade and Selected Progeny

    ERIC Educational Resources Information Center

    Uerling, Donald F.

    2006-01-01

    Abortion is one of the most controversial and contentious issues of our time. Few topics generate as much public debate or leave as little room for political compromise. This article presents a discussion of selected United States Supreme Court decisions on abortion and the legal reasoning supporting those decisions. It should be noted initially…

  19. Risk of breast cancer among young women: relationship to induced abortion.

    PubMed

    Daling, J R; Malone, K E; Voigt, L F; White, E; Weiss, N S

    1994-11-02

    Certain events of reproductive life, especially completed pregnancies, have been found to influence a woman's risk of breast cancer. Prior studies of the relationship between breast cancer and a history of incomplete pregnancies have provided inconsistent results. Most of these studies included women beyond the early part of their reproductive years at the time induced abortion became legal in the United States. We conducted a case-control study of breast cancer in young women born recently enough so that some or most of their reproductive years were after the legalization of induced abortion to determine if certain aspects of a woman's experience with abortion might be associated with risk of breast cancer. Female residents of three counties in western Washington State, who were diagnosed with breast cancer (n = 845) from January 1983 through April 1990, and who were born after 1944, were interviewed in detail about their reproductive histories, including the occurrence of induced abortion. Case patients were obtained through our population-based tumor registry (part of the Surveillance, Epidemiology, and End Results Program of the National Cancer Institute). Similar information was obtained from 961 control women identified through random digit dialing within these same counties. Logistic regression analysis was used to estimate odds ratios and confidence intervals (CIs). Among women who had been pregnant at least once, the risk of breast cancer in those who had experienced an induced abortion was 50% higher than among other women (95% CI = 1.2-1.9). While this increased risk did not vary by the number of induced abortions or by the history of a completed pregnancy, it did vary according to the age at which the abortion occurred and the duration of that pregnancy. Highest risks were observed when the abortion was done at ages younger than 18 years--particularly if it took place after 8 weeks' gestation--or at 30 years of age or older. No increased risk of breast

  20. Abortion surveillance - United States, 2010.

    PubMed

    Pazol, Karen; Creanga, Andreea A; Burley, Kim D; Hayes, Brenda; Jamieson, Denise J

    2013-11-29

    Since 1969, CDC has conducted abortion surveillance to document the number and characteristics of women obtaining legal induced abortions in the United States. 2010. Each year, CDC requests abortion data from the central health agencies of 52 reporting areas (the 50 states, the District of Columbia, and New York City). The reporting areas provide this information voluntarily. For 2010, data were received from 49 reporting areas. For the purpose of trend analysis, abortion data were evaluated from the 46 areas that reported data every year during 2001-2010. Census and natality data, respectively, were used to calculate abortion rates (number of abortions per 1,000 women) and ratios (number of abortions per 1,000 live births). A total of 765,651 abortions were reported to CDC for 2010. Of these abortions, 753,065 (98.4%) were from the 46 reporting areas that provided data every year during 2001-2010. Among these same 46 reporting areas, the abortion rate for 2010 was 14.6 abortions per 1,000 women aged 15-44 years, and the abortion ratio was 228 abortions per 1,000 live births. Compared with 2009, the total number and rate of reported abortions for 2010 decreased 3% and reached the lowest levels for the entire period of analysis (2001-2010); the abortion ratio was stable, changing only 0.4%. From 2001 to 2010, the total number, rate, and ratio of reported abortions decreased 9%, 10%, and 8%, respectively. Given the 3% decrease from 2009 to 2010 in the total number and rate of reported abortions, in combination with the 5% decrease that had occurred in the previous year from 2008 to 2009, the overall decrease for both measures was greater during 2006-2010 than during 2001-2005, despite the annual variations that resulted in no net decrease during 2006-2008. In 2010 and throughout the period of analysis, women in their 20s accounted for the majority of abortions and had the highest abortion rates, whereas women in their 30s and older accounted for a much smaller

  1. "Abortion will deprive you of happiness!": Soviet reproductive politics in the post-Stalin era.

    PubMed

    Randall, Amy E

    2011-01-01

    This article examines Soviet reproductive politics after the Communist regime legalized abortion in 1955. The regime's new abortion policy did not result in an end to the condemnation of abortion in official discourse. The government instead launched an extensive campaign against abortion. Why did authorities bother legalizing the procedure if they still disapproved of it so strongly? Using archival sources, public health materials, and medical as well as popular journals to investigate the antiabortion campaign, this article argues that the Soviet government sought to regulate gender and sexuality through medical intervention and health "education" rather than prohibition and force in the post-Stalin era. It also explores how the antiabortion public health campaign produced "knowledge" not only about the procedure and its effects, but also about gender and sexuality, subjecting both women and men to new pressures and regulatory norms.

  2. TRAP laws and the invisible labor of US abortion providers

    PubMed Central

    Mercier, Rebecca J; Buchbinder, Mara; Bryant, Amy

    2016-01-01

    Targeted Regulations of Abortion Providers (TRAP laws) are proliferating in the United States and have increased barriers to abortion access. In order to comply with these laws, abortion providers make significant changes to facilities and clinical practices. In this article, we draw attention to an often unacknowledged area of public health threat: how providers adapt to increasing regulation, and the resultant strains on the abortion provider workforce. Current US legal standards for abortion regulations have led to an increase in laws that target abortion providers. We describe recent research with abortion providers in North Carolina to illustrate how providers adapt to new regulations, and how compliance with regulation leads to increased workload and increased financial and emotional burdens on providers. We use the concept of invisible labor to highlight the critical work undertaken by abortion providers not only to comply with regulations, but also to minimize the burden that new laws impose on patients. This labor provides a crucial bridge in the preservation of abortion access. The impact of TRAP laws on abortion providers should be included in the consideration of the public health impact of abortion laws. PMID:27570376

  3. Abortion in Islamic Ethics, and How it is Perceived in Turkey: A Secular, Muslim Country

    PubMed Central

    Ekmekci, Perihan Elif

    2016-01-01

    Abortion is among the most widely discussed concepts of medical ethics. Since the well-known ethical theories have emerged from Western world, the position of Islamic ethics regarding main issues of medical ethics has been overlooked. Muslims constitute a considerable amount of world population. Turkish Republic is the only Muslim country ruled with secular democracy and one of the three Muslim countries where abortion is legalized. The first aim of this paper is to present discussions on abortion in Islamic ethics in the context of major ethical concepts; the legal status of the fetus, respect for life and the right not to be born. The second aim is to put forth Turkey’s present legislation about abortion in the context of Islamic ethical and religious aspects. PMID:27364347

  4. Unsafe abortion - the current global scenario.

    PubMed

    Faúndes, Anibal

    2010-08-01

    Unsafe abortion is prevalent in many developing countries, mostly in sub-Saharan Africa, Latin America and South and Southeast Asia, where abortion laws are more restrictive, the unmet need for contraception high and the status of women in society low. The main interventions for reducing the prevalence of unsafe abortion are known: better and more widely available family planning services, comprehensive sex education, improved access to safe abortion and high-quality post-abortion care, including contraceptive counselling and on-site services. Although these proposals have been included in statements and recommendations drawn up at several international conferences and adopted by the vast majority of nations, they have either been inadequately implemented or not implemented at all in the countries in which the need is greatest. A well-coordinated effort by both national and international organisations and agencies is required to put these recommendations into practice; however, the most important factor determining the success of such efforts is the commitment of governments towards preventing unsafe abortion and reducing its prevalence and consequences. 2010 Elsevier Ltd. All rights reserved.

  5. Cervical dilation before first-trimester surgical abortion (<14 weeks' gestation).

    PubMed

    Allen, Rebecca H; Goldberg, Alisa B

    2016-04-01

    First-trimester surgical abortion is a common, safe procedure with a major complication rate of less than 1%. Cervical dilation before suction abortion is usually accomplished using tapered mechanical dilators. Risk factors for major complications in the first trimester include increasing gestational age and provider inexperience. Cervical priming before first-trimester surgical abortion has been studied using osmotic dilators and pharmacologic agents, most commonly misoprostol. Extensive data demonstrate that a variety of agents are safe and effective at causing preoperative cervical softening and dilation; however, given the small absolute risk of complications, the benefit of routine use of misoprostol or osmotic dilators in first-trimester surgical abortion is unclear. Although cervical priming results in reduced abortion time and improved provider ease, it requires a delay of at least 1 to 3 h and may confer side effects. The Society of Family Planning does not recommend routine cervical priming for first-trimester suction abortion but recommends limiting consideration of cervical priming for women at increased risk of complications from cervical dilation, including those late in the first trimester, adolescents and women in whom cervical dilation is expected to be challenging. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Males, Fathers and Husbands: Changing Roles and Reciprocal Legal Rights

    ERIC Educational Resources Information Center

    Aberg, Miriam; And Others

    1977-01-01

    Discrimination toward men can be found in the legal definition of marriage, legal age requirements at marriage, support, child custody, unmarried fathers' rights, abortion, and cohabitation. With the increasing equality between the sexes, men will gain in their legal options of roles. (Author)

  7. Comment: unethical ethics investment boycotts and abortion.

    PubMed

    Furedi, A

    1998-01-01

    Ethical investment funds have traditionally boycotted the arms industry, companies known to pollute the environment, and those involved in animal research. However, recent newspaper reports suggest that some investment funds plan to also boycott hospitals and pharmaceutical companies involved in abortion-related activities. Ethical Financial, anti-abortion independent financial advisors, are encouraging a boycott of investment in private hospitals and manufacturers of equipment involved in abortions, and pharmaceutical firms which produce postcoital contraception or conduct embryo research. Ethical Financial claims that Family Assurance has agreed to invest along anti-abortion lines, Aberdeen Investment is already boycotting companies linked to abortion, and Hendersons ethical fund plans to follow suit. There is speculation that Standard Life, the largest mutual insurer in Europe, will also refuse to invest in abortion-related concerns when it launches its ethical fund in the spring. Managers of ethical funds should, however, understand that, contrary to the claims of the anti-choice lobby, there is extensive public support for legal abortion, emergency contraception, and embryo research. Individuals and institutions which contribute to the development of reproductive health care services are working to alleviate the distress of unwanted pregnancy and infertility, laudable humanitarian goals which should be encouraged. Those who try to restrict the development of abortion methods and services simply show contempt for women, treating them as people devoid of conscience who are incapable of making moral choices.

  8. Reductions in abortion-related mortality following policy reform: evidence from Romania, South Africa and Bangladesh

    PubMed Central

    2011-01-01

    Unsafe abortion is a significant contributor to worldwide maternal mortality; however, abortion law and policy liberalization could lead to drops in unsafe abortion and related deaths. This review provides an analysis of changes in abortion mortality in three countries where significant policy reform and related service delivery occurred. Drawing on peer-reviewed literature, population data and grey literature on programs and policies, this paper demonstrates the policy and program changes that led to declines in abortion-related mortality in Romania, South Africa and Bangladesh. In all three countries, abortion policy liberalization was followed by implementation of safe abortion services and other reproductive health interventions. South Africa and Bangladesh trained mid-level providers to offer safe abortion and menstrual regulation services, respectively, Romania improved contraceptive policies and services, and Bangladesh made advances in emergency obstetric care and family planning. The findings point to the importance of multi-faceted and complementary reproductive health reforms in successful implementation of abortion policy reform. PMID:22192901

  9. [Opinion of medical and law students of Federal University of Rio Grande do Norte about abortion in Brazil].

    PubMed

    Medeiros, Robinson Dias de; Azevedo, George Dantas de; Oliveira, Emilly Auxiliadora Almeida de; Araújo, Fábio Aires; Cavalcanti, Francisco Jakson Benigno; Araújo, Gabriela Lucena de; Castro, Igor Rebouças

    2012-01-01

    To analyze and compare the knowledge and opinions of Law and Medical students regarding the issue of abortion in Brazil. This was a cross-sectional study involving 125 graduate students from the class of 2010. Of these, 52 were medical students (MED group) and 73 law students (LAW group). A questionnaire was applied based on published research about the topic. Dependent variables were: monitoring the abortion debate, knowledge concerning situations where abortion is permitted under Brazilian law, opinion about situations that agree with extending legal permission to terminate pregnancy and prior knowledge of someone who has undergone induced abortion. Independent variables were: sex, age, household income and graduation course. χ² and Fisher's exact tests, with the level of significance set at 5%. Most interviewees reported monitoring the debate on abortion in Brazil (67.3% of the MED group and 70.2% of the LAW group, p>0.05). When assessing knowledge on the subject, medical students had a significantly higher percentage of correct answers than law students (100.0 and 87.5%, respectively; p=0.005) regarding the legality of abortion for pregnancies resulting from rape. Elevated percentages of correct responses were also recorded for both groups in relation to pregnancies that threaten the life of the mother (94.2 and 87.5% for MED and LAW groups, respectively), but without statistical significance. A significant percentage of respondents declared they were in favor of extending legal abortion to other situations, primarily in cases of anencephaly (68%), pregnancy severely harming the mother's physical health (42.1%) or that of the fetus in cases of severe congenital malformation (33.7%). Results showed a satisfactory knowledge on the part of law and medical school graduate students regarding the legality of abortion in Brazil, combined with a favorable trend towards extending legal permission to other situations not covered by the law. It is important to

  10. Prolonged grieving after abortion: a descriptive study.

    PubMed

    Brown, D; Elkins, T E; Larson, D B

    1993-01-01

    Although flawed by methodological problems, the research literature tends to provide support for the assumption that induced abortion in the 1st trimester is not accompanied by enduring negative psychological sequelae. In cases where such sequelae are reported, the morbidity is attributed to a pre-existing psychiatric condition or circumstances precipitating the choice of abortion. However, detailed descriptive letters from 45 women prepared in response to a request by a pastor of an upper-middle-class Protestant congregation in Florida indicate that prolonged grieving after abortion may be more widespread phenomenon than previously believed. Letter writers ranged in age from 25-60 years; 75% were unmarried at the time of the procedure and 29% aborted before the legalization of abortion in the US. The most frequently cited long-term sequela, especially among those who felt coerced to abort, was a continued feeling of guilt. Fantasies about the aborted fetus was the next most frequently mentioned experience. Half of the letter writers referred to their abortions, as "murder" and 44% voiced regret about their decision to abort. Other long-term effects included depression (44%), feelings of loss (31%), shame (27%), and phobic responses to infants (13%). For 42% of these women, the adverse psychological effects of abortion endured over 10 years. Since letter-writers came from a self-selected population group with a known bias against abortion and only negative experiences were solicited, these experiences must be regarded as subjectives and anecdotal. However, they draw attention to the need for methodologically sound studies of a possible prolonged grief syndrome among a small percentage of women who have abortions, especially when coercion is involved.

  11. [Epidemiology of induced abortion in Côte d'Ivoire].

    PubMed

    Vroh, Joseph Benie Bi; Tiembre, Issaka; Attoh-Toure, Harvey; Kouadio, Daniel Ekra; Kouakou, Lucien; Coulibaly, Lazare; Kouakou, Hyacinthe Andoh; Tagliante-Saracino, Janine

    2012-06-08

    The objective of this study was to examine induced abortion in Côte d'Ivoire. A nationwide cross-sectional descriptive study of induced abortion was carried out in 2007 among 3,057 women aged 15-49 years. The study showed that induced abortion is a widespread practice in Côte d'Ivoire, with a prevalence estimated at 42.5%. The women who had undergone an abortion were generally under 25, unmarried, and illiterate, and had used contraception. More than half (52.1%) of all induced abortions were performed at home by traditional abortionists or were self-induced with plants or decoctions. The main reasons for induced abortion were concern about the reaction of parents (27.7%), age (22.2%), a lack of financial resources (21.3%) and the desire of women to continue their education. More than half of the participants (55.8%) stated that they had suffered complications, which were more common after a home abortion than after a hospital abortion. Political and legal measures or reforms aimed at changing abortion laws in Côte d'Ivoire and better access to family planning are required in order to prevent or treat the social issue of induced abortion.

  12. Ascent abort capability for the HL-20

    NASA Technical Reports Server (NTRS)

    Naftel, J. C.; Talay, T. A.

    1993-01-01

    The HL-20 has been designed with the capability for rescue of the crew during all phases of powered ascent from on the launch pad until orbital injection. A launch-escape system, consisting of solid rocket motors located on the adapter between the HL-20 and the launch vehicle, provides the thrust that propels the HL-20 to a safe distance from a malfunctioning launch vehicle. After these launch-escape motors have burned out, the adapter is jettisoned and the HL-20 executes one of four abort modes. In three abort modes - return-to-launch-site, transatlantic-abort-landing, and abort-to-orbit - not only is the crew rescued, but the HL-20 is recovered intact. In the ocean-landing-by-parachute abort mode, which occurs in between the return-to-launch-site and the transatlantic-abort-landing modes, the crew is rescued, but the HL-20 would likely sustain damage from the ocean landing. This paper describes the launch-escape system and the four abort modes for an ascent on a Titan III launch vehicle.

  13. Conscientious objection, barriers, and abortion in the case of rape: a study among physicians in Brazil.

    PubMed

    Diniz, Debora; Madeiro, Alberto; Rosas, Cristião

    2014-05-01

    In Brazil, to have a legal abortion in the case of rape, the woman's statement that rape has occurred is considered sufficient to guarantee the right to abortion. The aim of this study was to understand the practice and opinions about providing abortion in the case of rape among obstetricians-gynecologists (OBGYNs) in Brazil. A mixed-method study was conducted from April to July 2012 with 1,690 OBGYNs who responded to a structured, electronic, self-completed questionnaire. In the quantitative phase, 81.6% of the physicians required police reports or judicial authorization to guarantee the care requested. In-depth telephone interviews with 50 of these physicians showed that they frequently tested women's rape claim by making them repeat their story to several health professionals; 43.5% of these claimed conscientious objection when they were uncertain whether the woman was telling the truth. The moral environment of illegal abortion alters the purpose of listening to a patient - from providing care to passing judgement on her. The data suggest that women's access to legal abortion is being blocked by these barriers in spite of the law. We recommend that FEBRASGO and the Ministry of Health work together to clarify to physicians that a woman's statement that rape occurred should allow her to access a legal abortion. Copyright © 2014 Reproductive Health Matters. Published by Elsevier Ltd. All rights reserved.

  14. RB-ARD: A proof of concept rule-based abort

    NASA Technical Reports Server (NTRS)

    Smith, Richard; Marinuzzi, John

    1987-01-01

    The Abort Region Determinator (ARD) is a console program in the space shuttle mission control center. During shuttle ascent, the Flight Dynamics Officer (FDO) uses the ARD to determine the possible abort modes and make abort calls for the crew. The goal of the Rule-based Abort region Determinator (RB/ARD) project was to test the concept of providing an onboard ARD for the shuttle or an automated ARD for the mission control center (MCC). A proof of concept rule-based system was developed on a LMI Lambda computer using PICON, a knowdedge-based system shell. Knowdedge derived from documented flight rules and ARD operation procedures was coded in PICON rules. These rules, in conjunction with modules of conventional code, enable the RB-ARD to carry out key parts of the ARD task. Current capabilities of the RB-ARD include: continuous updating of the available abort mode, recognition of a limited number of main engine faults and recommendation of safing actions. Safing actions recommended by the RB-ARD concern the Space Shuttle Main Engine (SSME) limit shutdown system and powerdown of the SSME Ac buses.

  15. Who makes the abortion decision?: law, practice, and the limits of the liberal solution.

    PubMed

    Lamanna, M A

    1991-01-01

    Since abortion is an important aspect of women's control over reproduction, barriers to abortion threaten women's efforts to attain equality. The ensuing discussion rests upon 2 assumptions: 1) That women want and need control over their reproductive capacity, and 2) that women want personal access to abortion and desire the availability of abortion to women generally. Under Roe v. Wade, abortions can only be performed if physicians choose to do them; this has left 4/5ths of US counties without an abortion provider. Roe neither compelled the availability of abortion services to all interested women, nor did it establish a "women's entitlement to an abortion based on her decision... "While the liberal solution in the Law may provide formal new rights, these rights are often ineffective because they fail to address attitudes firmly rooted in the social structure. Feminists' radical, self-help approach of becoming their own abortion providers offers a limited solution because of 1) geography and regional culture: the "paucity of abortion providers is likely to be replicated for feminist health collectives"; 2) the legal risk in underground institutions; and 3) the woman's choice, i.e., will the tradition-minded women use an alternative medical facility? Finally, "the woman's own decision-making process may be the ultimate barrier to abortion." The high visibility and intense emotions brought to contemporary abortion discussions in the post-Roe era may be far more chilling to individual decision than the relative silence of the 1950s. Psychological, as well as physical, availability of abortion must be kept in mind. For the future, social scientists can provide awareness of the social context in which the legal definition of abortion rights confronts the lives of women.

  16. [Factors associated with the seeking of legal induced abortion services in Mexico City in 2010].

    PubMed

    Figueroa-Lara, Alejandro; Aracena-Genao, Belkis; Reyes-Morales, Hortensia; Lamadrid-Figueroa, Héctor

    2012-01-01

    To identify factors associated with the seeking of the legal-interruption-pregnancy (LIP) services in Mexico City. We used a case-control design. Users who utilized the LIP were defined as cases, while users of the antenatal care service with gestational age 13 or more weeks and who reported having an unwanted pregnancy were defined as controls. Logistic regressions were fitted to estimate odds ratios. Higher level of education (OR=1.47, 95% CI:1.04-2.07), women's occupation (being student OR=7.31, 95% CI:1.58-33.95; worker OR=13.43, 95% CI:2.04-88.54), and number of previous abortions (OR=11.41, 95% CI:1.65-79.07) were identified as factors associated with the lookup of LIP. In Mexico City context, empowered women with a higher level of education, or having a work activity are the users of LIP services. Strategies for improving access of women with low empowerment conditions are needed.

  17. Women’s and Healthcare Workers’ Beliefs and Experiences Surrounding Abortion: The Case of Haiti

    PubMed Central

    Albuja, Laura Dean; Cianelli, Rosina; Anglade, Debbie; Owusu, Brenda; Joseph, Laly; Sailsman, Sonique; Ferrer, Lilian

    2017-01-01

    Purpose Women in developing countries usually encounter serious inequities in terms of women’s health. To date, there is limited understanding of abortion from the perspective of Haitian women. As a limited-resource country, Haiti faces complex social issues and healthcare challenges. With abortion being illegal, many adult and teenage women seek clandestine abortions. The aim of this study was to explore and gain a greater understanding of women’s and healthcare workers’ beliefs and experiences about abortion in Haiti. Methods Descriptive qualitative design was used to elicit information for the study. Eight focus groups were conducted with Haitian women and healthcare workers in five communities in the south of Haiti: Les Cayes, Aquin, St. Louis du Sud, Cavaillon, Maniche, and Ile a Vache. Participants were purposively selected and consented to participate and to be tape recorded. Content analysis followed using the verbatim transcripts, with triangulation of four researchers; saturation was reached with this number of focus groups. Findings The transcripts revealed six main themes regarding beliefs and experiences about abortion in Haiti: cultural aspects, consumers, perils of care, and legal concerns. Both women and healthcare workers discussed the repercussions of illegal abortion and the role of the government and hospitals. Participants identified similar perils and complications of unsafe abortions, such as postpartum hemorrhage and infection. Conclusions Results showed an urgent need to create a public health response that addresses different dimensions of abortion by engaging women and healthcare providers in rapid and concrete actions that promote access and safe care of women. It is imperative to conduct more research related to abortion in order to examine other associated factors to better understand the links between abortion and sexual health disparities among Haitian women. These results highlight the need for a rapid response to the need of

  18. Self-assessment of eligibility for early medical abortion using m-Health to calculate gestational age in Cape Town, South Africa: a feasibility pilot study.

    PubMed

    Momberg, Mariette; Harries, Jane; Constant, Deborah

    2016-04-16

    Although abortion is legally available in South Africa, barriers to access exist. Early medical abortion is available to women with a gestational age up to 63 days and timely access is essential. This study aimed to determine women's acceptability and ability to self-assess eligibility for early medical abortion using an online gestational age calculator. Women's acceptability, views and preferences of using mobile technology for gestational age (GA) determination were explored. No previous studies to ascertain the accuracy of online self-administered calculators in a non-clinical setting have been conducted. A convenience sample of abortion seekers were recruited from two health care clinics in Cape Town, South Africa in 2014. Seventy-eight women were enrolled and tasked with completing an online self-assessment by entering the first day of their last menstrual period (LMP) onto a website which calculated their GA. A short survey explored the feasibility and acceptability of employing m-Health technology in abortion services. Self-calculated GA was compared with ultrasound gestational age obtained from clinical records. Participant mean age was 28 (SD 6.8), 41% (32/78) had completed high school and 73% (57/78) reported owning a smart/feature phone. Internet searches for abortion information prior to clinic visit were undertaken by 19/78 (24%) women. Most participants found the online GA calculator easy to use (91%; 71/78); thought the calculation was accurate (86%; 67/78) and that it would be helpful when considering an abortion (94%; 73/78). Eighty-three percent (65/78) reported regular periods and recalled their LMP (71%; 55/78). On average women overestimated GA by 0.5 days (SD 14.5) and first sought an abortion 10 days (SD 14.3) after pregnancy confirmation. Timely access to information is an essential component of effective abortion services. Advances in the availability of mobile technology represent an opportunity to provide accurate and safe abortion

  19. A follow-up of 72 cases referred for abortion.

    PubMed

    Gillis, A

    1975-01-01

    Whilst the medical indications for therapeutic abortion and the legal limitations set vary enormously from one country to another there is in general an undoubted trend towards giving the pregnant woman herself a greater say in the decision. During the first year of the operation of the Abortion Act, 1967, in England some 72 pregnant women were referred to the author and his colleagues for a recommendation on abortion. A psychiatric examination and follow-up over a period of one year was made both in those cases where abortion was performed as well as in those cases who were refused therapeutic abortion. In this communication a comparison is made between the reactions and outcome in the two groups. A provisional conclusion is reached that no significant psychiatric disturbance could be attributed to the performance of the operation or on the other hand to refusal of the woman's request.

  20. Knowledge and Attitudes of a Number of Iranian Policy-makers towards Abortion

    PubMed Central

    Shamshiri-Milani, Hourieh; Pourreza, Abolghasem; Akbari, Feizollah

    2010-01-01

    Introduction Unsafe and illegal abortions are the third leading cause of maternal death. It affects physical, emotional and social health of women and their families. Abortion is a multi-dimensional phenomenon with several social, legal, and religious implications. The views of policy-makers affect the approach to abortion in every society. Understanding the attitudes and knowledge of high-ranking decision makers towards abortion was the purpose of this study. Materials and Methods A qualitative research was implemented by carrying out individual interviews with 29 out of a selection of 80 presidents of medical sciences universities, senior executive managers in the legal system, forensic medicine and decision-makers in the health system and a number of top Muslim clerics, using a semi-structured questionnaire for data gathering. Content analysis revealed the results. Results There were considerable unwillingness and reluctance among the interviewees to participate in the study. The majority of participants fairly knew about the prevalence of illegal abortions and their complications. There was strong agreement on abortion when health of the mother or the fetus was at risk. Abortion for reproductive health reasons was supported by a minority of the respondents. The majority of them disagreed with abortion when pregnancy was the result of a rape, temporary marriage or out of wedlock affairs. Making decision for abortion by the pregnant mother, as a matter of her right, did not gain too much approval. Conclusion It seemed that physical health of the mother or the fetus was of more importance to the respondents than their mental or social health. The mother's hardship was not any indication for induced abortion in the viewpoints of the interviewed policy-makers. Strengthening family planning programs, making appropriate laws in lines with religious orders and advocacy programs targeting decision makers are determined as strategies for improving women's health rights

  1. Knowledge and Attitudes of a Number of Iranian Policy-makers towards Abortion.

    PubMed

    Hourieh, Shamshiri-Milani; Abolghasem, Pourreza; Feizollah, Akbari

    2010-10-01

    Unsafe and illegal abortions are the third leading cause of maternal death. It affects physical, emotional and social health of women and their families. Abortion is a multi-dimensional phenomenon with several social, legal, and religious implications. The views of policy-makers affect the approach to abortion in every society. Understanding the attitudes and knowledge of high-ranking decision makers towards abortion was the purpose of this study. A qualitative research was implemented by carrying out individual interviews with 29 out of a selection of 80 presidents of medical sciences universities, senior executive managers in the legal system, forensic medicine and decision-makers in the health system and a number of top Muslim clerics, using a semi-structured questionnaire for data gathering. Content analysis revealed the results. There were considerable unwillingness and reluctance among the interviewees to participate in the study. The majority of participants fairly knew about the prevalence of illegal abortions and their complications. There was strong agreement on abortion when health of the mother or the fetus was at risk. Abortion for reproductive health reasons was supported by a minority of the respondents. The majority of them disagreed with abortion when pregnancy was the result of a rape, temporary marriage or out of wedlock affairs. Making decision for abortion by the pregnant mother, as a matter of her right, did not gain too much approval. It seemed that physical health of the mother or the fetus was of more importance to the respondents than their mental or social health. The mother's hardship was not any indication for induced abortion in the viewpoints of the interviewed policy-makers. Strengthening family planning programs, making appropriate laws in lines with religious orders and advocacy programs targeting decision makers are determined as strategies for improving women's health rights.

  2. Social stigma and disclosure about induced abortion: results from an exploratory study.

    PubMed

    Shellenberg, Kristen M; Moore, Ann M; Bankole, Akinrinola; Juarez, Fatima; Omideyi, Adekunbi Kehinde; Palomino, Nancy; Sathar, Zeba; Singh, Susheela; Tsui, Amy O

    2011-01-01

    It is well recognised that unsafe abortions have significant implications for women's physical health; however, women's perceptions and experiences with abortion-related stigma and disclosure about abortion are not well understood. This paper examines the presence and intensity of abortion stigma in five countries, and seeks to understand how stigma is perceived and experienced by women who terminate an unintended pregnancy and influences her subsequent disclosure behaviours. The paper is based upon focus groups and semi-structured in-depth interviews conducted with women and men in Mexico, Nigeria, Pakistan, Peru and the United States (USA) in 2006. The stigma of abortion was perceived similarly in both legally liberal and restrictive settings although it was more evident in countries where abortion is highly restricted. Personal accounts of experienced stigma were limited, although participants cited numerous social consequences of having an abortion. Abortion-related stigma played an important role in disclosure of individual abortion behaviour.

  3. Late abortions and the law.

    PubMed

    Smith, T

    1988-02-13

    The Abortion (Amendment) Bill in the British House of Commons would lower the maximum limit for termination of pregnancy from 28 to 18 weeks. Supporters of the bill assert that Britain allows termination of pregnancy later than any other European country, and that in Britain over 90% of all late abortions are of fetuses without phisical abnormality. The 28-week limit is considered anachronoistic by doctors since neonatal care has made possible survival at 24 weeks. A similar bill in the House of Lords would reduce the limit to 24 weeks. Making early abortions more easily available would help reduce late abortions. Statistics indicate that women who have abortions late in their pregnancies tend to be young. In 1986, 172,286 abortions were performed in England and Wales. Of these, 144,857, or 84%, were performed before the 13th week. A total of 8276 (5%) were performed after 18 weeks. Of these, 3688 (45% of late abortions) were on nonresidents who traveled to Britain because of legal restrictions in their own country. This means that 4594 late abortions were performed on residents of England and Wales in 1986. This was 3% of the total, with 14% of this number on grounds of fetal abnormality. About 40% of the rest were in women under the age of 20, with 6% (239) on girls under 16. A 1984 study concluded that more counseling and information should be provided for young women. Education in contraception for young women is less than ideal and likely to become less available as economic restraints reduce the number of family planning clinics. Postcoital contraception should be taught more as an emergency proceedure. Prompt, dispassionate physician counseling, wider provision of National Health Service facilities, and uniform service in all districts would also be beneficial.

  4. Surgical abortion in second trimester: initial experiences in Nepal.

    PubMed

    Shrivastava, V; Bajracharya, L; Thapa, S

    2010-01-01

    In spite of legalising abortion and making safe abortion available at affordable price at accessible distance to almost everyone, unsafe abortion especially second trimester abortion is still a big health problem in Nepal. The objective of the study is to fi nd the demographic profile, reasons for seeking abortion and to see the effectiveness of Misoprostol in preparing the cervix. A prospective study was done in the two second trimester abortion trainings conducted in Maternity hospital, Kathmandu. Total 57 clients had second trimester abortion performed. Information was collected from structured questionnaire and then data was analysed. Commonest reason for seeking abortion was, multiparity (61.4%). Common reasons for second trimester abortion were, completed family size with unwanted pregnancy (61.4%), unwanted pregnancy in married (10.52%) unwanted pregnancy in unmarried (5.26%). Second trimester abortion is one of the most common procedures performed in reproductive-aged women and when performed by a skilled provider in the appropriate setting, it is one of the safest surgeries, if it is well supported by change in policy of the country and acceptability of the people.

  5. Contraception and induced abortion in the West Indies: a review.

    PubMed

    Boersma, A A; de Bruijn, J G M

    2011-10-01

    Most islands in the West Indies do not have liberal laws on abortion, nor laws on pregnancy prevention programmes (contraception). We present results of a literature review about the attitude of healthcare providers and women toward (emergency) contraception and induced abortion, prevalence, methods and juridical aspects of induced abortion and prevention policies. Articles were obtained from PubMed, EMBASE, MEDLINE, PsychlNFO and Soclndex (1999 to 2010) using as keywords contraception, induced abortion, termination of pregnancy, medical abortion and West Indies. Thirty-seven articles met the inclusion criteria: 18 on contraception, 17 on induced abortion and two on both subjects. Main results indicated that healthcare providers' knowledge of emergency contraception was low. Studies showed a poor knowledge of contraception, but counselling increased its effective use. Exact numbers about prevalence of abortion were not found. The total annual number of abortions in the West Indies is estimated at 300 000; one in four pregnancies ends in an abortion. The use of misoprostol diminished the complications of unsafe abortions. Legislation of abortion varies widely in the different islands in the West Indies: Cuba, Puerto Rico, Martinique, Guadeloupe and St Martin have legal abortions. Barbados was the first English-speaking island with liberal legislation on abortion. All other islands have restrictive laws. Despite high estimated numbers of abortion, research on prevalence of abortion is missing. Studies showed a poor knowledge of contraception and low use among adolescents. Most West Indian islands have restrictive laws on abortion.

  6. Abortion and maternal mortality in the developing world.

    PubMed

    Okonofua, Friday

    2006-11-01

    Unsafe abortion is an important public health problem, accounting for 13% of maternal mortality in developing countries. Of an estimated annual 70,000 deaths from unsafe abortion worldwide, over 99% occur in the developing countries of sub-Saharan Africa, Central and Southeast Asia, and Latin America and the Caribbean. Factors associated with increased maternal mortality from unsafe abortion in developing countries include inadequate delivery systems for contraception needed to prevent unwanted pregnancies, restrictive abortion laws, pervading negative cultural and religious attitudes towards induced abortion, and poor health infrastructures for the management of abortion complications. The application of a public health approach based on primary, secondary, and tertiary prevention can reduce morbidity and mortality associated with unsafe abortion in developing countries. Primary prevention includes the promotion of increased use of contraception by women (and by men) at risk for unwanted pregnancy; secondary prevention involves the liberalization of abortion laws and the development of programs to increase access to safe abortion care in developing countries. In contrast, tertiary prevention includes the integration and institutionalization of post-abortion care for incomplete abortion and the early and appropriate treatment of more severe complications of abortion. Efforts to address these problems will contribute both to reducing maternal mortality associated with induced abortion and to achieving the Millennium Development Goals in developing countries.

  7. The Estimated Incidence of Induced Abortion in Ethiopia, 2014: Changes in the Provision of Services Since 2008.

    PubMed

    Moore, Ann M; Gebrehiwot, Yirgu; Fetters, Tamara; Wado, Yohannes Dibaba; Bankole, Akinrinola; Singh, Susheela; Gebreselassie, Hailemichael; Getachew, Yonas

    2016-09-01

    In 2005, Ethiopia's parliament amended the penal code to expand the circumstances in which abortion is legal. Although the country has expanded access to abortion and postabortion care, the last estimates of abortion incidence date from 2008. Data were collected in 2014 from a nationally representative sample of 822 facilities that provide abortion or postabortion care, and from 82 key informants knowledgeable about abortion services in Ethiopia. The Abortion Incidence Complications Methodology and the Prospective Morbidity Methodology were used to estimate the incidence of abortion in Ethiopia and assess trends since 2008. An estimated 620,300 induced abortions were performed in Ethiopia in 2014. The annual abortion rate was 28 per 1,000 women aged 15-49, an increase from 22 per 1,000 in 2008, and was highest in urban regions (Addis Ababa, Dire Dawa and Harari). Between 2008 and 2014, the proportion of abortions occurring in facilities rose from 27% to 53%, and the number of such abortions increased substantially; nonetheless, an estimated 294,100 abortions occurred outside of health facilities in 2014. The number of women receiving treatment for complications from induced abortion nearly doubled between 2008 and 2014, from 52,600 to 103,600. Thirty-eight percent of pregnancies were unintended in 2014, a slight decline from 42% in 2008. Although the increases in the number of women obtaining legal abortions and postabortion care are consistent with improvements in women's access to health care, a substantial number of abortions continue to occur outside of health facilities, a reality that must be addressed.

  8. Family planning is reducing abortions.

    PubMed

    Clinton, H R

    1997-01-01

    This news brief presents the US President's wife's statement on the association between use of family planning and a decline in abortions worldwide. Hillary Rodham Clinton attended the Sixth Conference of Wives of Heads of State and Government of the Americas held in La Paz, Bolivia. The conference was suitably located in Bolivia, a country with the highest rates of maternal mortality in South America. Bolivia has responded by launching a national family planning campaign coordinated between government, nongovernmental, and medical organizations. Half of Bolivian women experience pregnancy and childbirth without the support of trained medical staff. Mortality from abortion complications account for about half of all maternal deaths in Bolivia. Voluntary family planning workers teach women about the benefits of child spacing, breast feeding, nutrition, prenatal and postpartum care, and safe deliveries. Bolivia has succeeded in increasing its contraceptive use rates and decreasing the number of safe and unsafe abortions. Bolivia's program effort was supported by USAID. USAID provided technical assistance and funds for the establishment of a network of primary health care clinics. Mrs. Clinton visited one such clinic in a poor neighborhood in La Paz, which in its first six months of operation provided 2200 consultations, delivered 200 babies, registered 700 new family planning users, and immunized 2500 children. Clinics such as this one will be affected by the US Congress's harsh cuts in aid, which reduce funding by 35% and delay program funding by 9 months. These US government cuts in foreign aid are expected to result in an additional 1.6 million abortions, over 8000 maternal deaths, and 134,000 infant deaths in developing countries. An investment in population assistance represents a sensible, cost-effective, and long-term strategy for improving women's health, strengthening families, and reducing abortion.

  9. Conjoined twins and legal authorization for abortion.

    PubMed

    Nomura, Roseli Mieko Yamamoto; Brizot, Maria de Lourdes; Liao, Adolfo Wenjaw; Hernandez, Wagner Rodrigues; Zugaib, Marcelo

    2011-01-01

    To describe pregnancies with conjoined twins according to the request for legal termination of pregnancy. Retrospective review of pregnancies with conjoined twins, with no possibility of extrauterine survival or postnatal surgical separation, observed at a tertiary teaching hospital, between 1998 and 2010. Amongst 30 cases seen during the study period, six (20.0%) couples decided to continue with the pregnancy, termination of pregnancy was not requested due to advanced gestational age (> 25 weeks) in 5 cases (16.7%). Legal authorization to terminate the pregnancy was requested in 19 (63.3%) cases: permission was granted in 12 (63.2%), denied in five (26.3%) and information was missing in two (10.5%) cases. A successful vaginal delivery was performed in 83.3% of the cases undergoing termination of pregnancy and a cesarean section was performed in all the remaining cases (p < 0.01). In pregnancies with conjoined twins and without fetal prognosis, legal termination of the pregnancy is an alternative. Moreover, a successful vaginal delivery can be performed in most cases before the third trimester, further reducing maternal risks and parental suffering.

  10. International family planning fellowship program: advanced training in family planning to reduce unsafe abortion.

    PubMed

    Dalton, Vanessa K; Xu, Xiao; Mullan, Patricia; Danso, Kwabena A; Kwawukume, Yao; Gyan, Kofi; Johnson, Timothy R B

    2013-03-01

    Maternal mortality remains a huge problem in the developing world, especially in Sub-Saharan Africa.1 According to the World Health Organization, efforts intended to decrease maternal deaths need to recognize and address unsafe abortions as a significant contributor to the high rates of maternal mortality found in developing countries.2,3 In Africa, where abortions are highly restricted, 680 women die per 100,000 abortions, compared with 0.2-1.2 women per 100,000 in developed countries, where most abortions are legal.4.

  11. [Induced abortion: a comparison between married and single women residing in the city of São Paulo in 2008].

    PubMed

    de Souza e Silva, Rebeca; Andreoni, Solange

    2012-07-01

    The scope of this study was to evaluate the association between having had an induced abortion and marital status (being single or legally married) in women residing in the city of São Paulo. This analysis is derived from a broader population survey on abortion conducted in 2008. In this study we focus on the subset of 389 single and legally married women between 15 and 49 years of age. Logistic regression models were used to evaluate the association between induced abortion and being single or married, monitoring age, education, income, number of live births, contraceptive use and acceptance of the practice of abortion. Being single was the only characteristic associated with having had an induced abortion, in other words, when faced with a pregnancy single women were four times more likely to have an abortion than married women (OR=3.9; p=0.009).

  12. [Post-abortion contraception: effects of contraception services and reproductive intention].

    PubMed

    Borges, Ana Luiza Vilela

    2016-02-01

    Contraceptive counseling and the supply of contraceptive methods are part of post-abortion care and positively influence the subsequent use of contraceptive methods. Studies showing such evidence have been conducted predominantly in countries with no legal restrictions on abortion and with adequate care for women that terminate a pregnancy. However, little is known about contraceptive practices in contexts where abortion is illegal, as in Brazil, in which post-abortion contraceptive care is inadequate. The objective of this study was to analyze the effect of contraceptive care on male condom use and oral and injectable contraceptives in the six months post-abortion, considering reproductive intention. The results showed that contraceptive care only has a positive effect on the use of oral contraceptives in the first six months post-abortion, as long as the woman had a medical consultation in the same month in which she received information on contraception. One or the other intervention alone had no significant impact.

  13. Selective Abortion and the Diagnosis of Fetal Damage: Issues and Concerns.

    ERIC Educational Resources Information Center

    Cohen, Libby G.

    1986-01-01

    Legal rights of the fetus and selective abortion are the major focus of a review of legal cases and educational literature concerning fetuses that may be handicapped or have the potential to be handicapped at birth. Related issues include parental immunity, protection of an unborn child, and quality of life. (Author/JW)

  14. [Psychological aspects of induced abortion].

    PubMed

    Mouniq, C; Moron, P

    1982-06-01

    Results are presented of a literature review to identify social and psychological aspects of abortion. The literature does not provide a true profile of women requesting abortions, but some characteristics emerge. Reasons for requesting abortion include economic problems, difficult previous pregnancies, general medical contraindications to pregnancy, marital conflicts, feelings of loneliness, professional aspirations, problems with existing children, and feelings of insecurity about the future. However, the same feelings are found among women carrying their pregnancies to term. Unplanned pregnancies are more common during periods of depression. Most authors have found about 1/2 of women seeking abortions to be single and about 1/2 to be under 25 years old. Religion does not appear to be a determining factor. 1 study of psychological factors in abortion seekers found that a large number of single women seeking abortion had suffered traumatic experiences in childhood and were seeking security in inappropriate amorous relationships. Helene Deutsch stressed the destructive impulses latent in all pregnancies. Others have cited the ambivalence of the desire for pregnancy and feelings of loss after abortion. Studies published after legalization of abortion in the US and France however have stressed the nearly total absence of moderate or severe psychiatric symptoms after abortion. Responses immediately after the abortion may include feelings of relief, guilt, indifference, or ambivalence. Secondary affects appear minor to most authors. Psychological effects do not appear to be influenced by age, marital status, parity, intelligence, occupation, existence of a later pregnancy, or concommitant sterilization. "Premorbidity" and coercion by spouse or family were most closely associated with psychological symptoms. Numerous authors have found about twice as many negative reactions among women undergoing abortion for medical reasons. Most patients undergoing abortions for

  15. Reproductive rights on firmer ground with prochoice White House, Congress. Special report -- abortion and the 1992 elections.

    PubMed

    1992-11-12

    After 12 years, the US citizens elected a pro-choice president and preserved the already pro-choice Congress even though new people constitute 25% of the House of Representatives. The Congress gained even more pro-choice members. The abortion issue played an important secondary role (preceded by the economy) in the national elections, but was more important at the state level in many states. For example, voters overwhelmingly chose to preserve access to legal abortion in Arizona (69.31%) and Maryland (62.38%). In addition, 4 new women Senators and a Senator-elect from Colorado publicly proclaimed their pro-choice stance. The states of Missouri, North Carolina, and North Dakota elected pro-choice governors resulting in 30 pro-choice US governors and 20 antiabortion governors. President-elect Clinton can unilaterally repeal 2 of Bush's executive orders: the gag rule and the ban on fetal tissue transplantation research. He will need Congress' support to renew the Title X family planning program, to grant public funding for medically necessary abortions for poor women again, and the pass of the Freedom of Choice Act. Congress and the new president face the obstacle of convincing the public of the damage to basic rights done by the Supreme Court as evidenced by abortion rulings. They also need to lead the pro-choice groups to begin concentrating on how to prevent unwanted pregnancies so as to reduce the number of abortions and the needs of all women who want and need access to safe abortion. The Republican party's great hostility toward abortion and its intolerance for a variety of beliefs and life styles alienated most US citizens. Recent political losses are motivating the Republican party to reorganize but it depends on the moderates' ability and willingness to reclaim the party.

  16. Induction of fetal demise before abortion.

    PubMed

    Diedrich, Justin; Drey, Eleanor

    2010-06-01

    For decades, the induction of fetal demise has been used before both surgical and medical second-trimester abortion. Intracardiac potassium chloride and intrafetal or intra-amniotic digoxin injections are the pharmacologic agents used most often to induce fetal demise. In the last several years, induction of fetal demise has become more common before second-trimester abortion. The only randomized, placebo-controlled trial of induced fetal demise before surgical abortion used a 1 mg injection of intra-amniotic digoxin before surgical abortion at 20-23 weeks' gestation and found no difference in procedure duration, difficulty, estimated blood loss, pain scores or complications between groups. Inducing demise before induction terminations at near viable gestational ages to avoid signs of life at delivery is practiced widely. The role of inducing demise before dilation and evacuation (D&E) remains unclear, except for legal considerations in the United States when an intact delivery is intended. There is a discrepancy between the one published randomized trial that used 1 mg intra-amniotic digoxin that showed no improvement in D&E outcomes and observational studies using different routes, doses and pre-abortion intervals that have made claims for its use. Additional randomized trials might provide clearer evidence upon which to make further recommendations about any role of inducing demise before surgical abortion. At the current time, the Society of Family Planning recommends that pharmacokinetic studies followed by randomized controlled trials be conducted to assess the safety and efficacy of feticidal agents to improve abortion safety.

  17. Induced Abortion Practices in an Urban Indian Slum: Exploring Reasons, Pathways and Experiences.

    PubMed

    Behera, Deepanjali; Bharat, Shalini; Chandrakant Gawde, Nilesh

    2015-09-01

    To explore the context, experiences and pathways of seeking abortion care among married women in a minority dominated urban slum community in Mumbai city of India. A mixed-method study was conducted using a systematic random sampling method to select 282 respondents from the slum community. One fifth of these womenreported undergoing at least one induced abortion over past five years. A quantitative survey was conducted among these women (n = 57) using structured face-to-face interviews. Additionally, in-depths interviews involving 11 respondents, 2 community health workers and 2 key informants from the community were conducted for further exploration of qualitative data. The rate of induced abortion was 115.6 per 1000 pregnancies in the study area with an abortion ratio of 162.79 per 1000 live births. Frequent pregnancies with low birth spacing and abortions were reported among the women due to restricted contraception use based on religious beliefs. Limited supportfrom husband and family compelled the women to seek abortion services, mostly secretly, from private, unskilled providers and unregistered health facilities. Friends and neighbors were main sources of advice and link to abortion services. Lack of safe abortion facilities within accessible distance furtherintensifies the risk of unsafe abortions. Low contraception usage based on rigid cultural beliefs and scarcely accessible abortion services were the root causes of extensive unsafe abortions.Contraception awareness and counseling with involvement of influential community leaders as well as safe abortion services need to be strengthened to protect these deprived women from risks of unwanted pregnancies and unsafe abortions.

  18. A Safe Vaccine (DV-STM-07) against Salmonella Infection Prevents Abortion and Confers Protective Immunity to the Pregnant and New Born Mice

    PubMed Central

    Negi, Vidya Devi; Nagarajan, Arvindhan G.; Chakravortty, Dipshikha

    2010-01-01

    Pregnancy is a transient immuno-compromised condition which has evolved to avoid the immune rejection of the fetus by the maternal immune system. The altered immune response of the pregnant female leads to increased susceptibility to invading pathogens, resulting in abortion and congenital defects of the fetus and a subnormal response to vaccination. Active vaccination during pregnancy may lead to abortion induced by heightened cell mediated immune response. In this study, we have administered the highly attenuated vaccine strain ΔpmrG-HM-D (DV-STM-07) in female mice before the onset of pregnancy and followed the immune reaction against challenge with virulent S. Typhimurium in pregnant mice. Here we demonstrate that DV-STM-07 vaccine gives protection against Salmonella in pregnant mice and also prevents Salmonella induced abortion. This protection is conferred by directing the immune response towards Th2 activation and Th1 suppression. The low Th1 response prevents abortion. The use of live attenuated vaccine just before pregnancy carries the risk of transmission to the fetus. We have shown that this vaccine is safe as the vaccine strain is quickly eliminated from the mother and is not transmitted to the fetus. This vaccine also confers immunity to the new born mice of vaccinated mothers. Since there is no evidence of the vaccine candidate reaching the new born mice, we hypothesize that it may be due to trans-colostral transfer of protective anti-Salmonella antibodies. These results suggest that our vaccine DV-STM-07 can be very useful in preventing abortion in the pregnant individuals and confer immunity to the new born. Since there are no such vaccine candidates which can be given to the new born and to the pregnant women, this vaccine holds a very bright future to combat Salmonella induced pregnancy loss. PMID:20161765

  19. Abortion ethics.

    PubMed

    Fromer, M J

    1982-04-01

    of ensoulment. The fetus is owed some moral obligations because of its greatly increased potentiality. After a certain point it deserves legal and moral protection. A woman would have the right to be relieved of carrying the fetus, but she would not have the right to the death of the fetus. A significant moral difference exists in these 2 concepts, and it is this issue that forms the basis of the debate concerning the conflict between maternal and fetal rights. When the rights of the fetus and those of the pregnant woman come into direct conflict the rights of the fetus are always subordinated to those of the women. The 3rd ethical foundation of the abortion debate, that of circumstances of horror and hardship surrounding the pregnancy, is really a combination of the first two. A fetus that is known to suffer from disease or deformity has as many or as few rights vis-a-vis the pregnant woman as does a perfectly healthy fetus. The assignment and hierarchy of fetal rights is not dependent upon the circumstances of conception. The next concern is whether the state can enter the private social spheres to regulate the personal activities of individuals. The Supreme court has never made a statement regarding the moral permissibility of abortion. The Court simply has prevented individual states from interfering with a woman's action based on her personal convictions. This is an important difference, and no step should be taken to abrogate this fundamental civil right.

  20. The Estimated Incidence of Induced Abortion in Ethiopia, 2014: Changes in the Provision of Services Since 2008

    PubMed Central

    Moore, Ann M.; Gebrehiwot, Yirgu; Fetters, Tamara; Wado, Yohannes Dibaba; Bankole, Akinrinola; Singh, Susheela; Gebreselassie, Hailemichael; Getachew, Yonas

    2017-01-01

    CONTEXT In 2005, Ethiopia’s parliament amended the penal code to expand the circumstances in which abortion is legal. Although the country has expanded access to abortion and postabortion care, the last estimates of abortion incidence date from 2008. METHODS Data were collected in 2014 from a nationally representative sample of 822 facilities that provide abortion or postabortion care, and from 82 key informants knowledgeable about abortion services in Ethiopia. The Abortion Incidence Complications Methodology and the Prospective Morbidity Methodology were used to estimate the incidence of abortion in Ethiopia and assess trends since 2008. RESULTS An estimated 620,300 induced abortions were performed in Ethiopia in 2014. The annual abortion rate was 28 per 1,000 women aged 15–49, an increase from 22 per 1,000 in 2008, and was highest in urban regions (Addis Ababa, Dire Dawa and Harari). Between 2008 and 2014, the proportion of abortions occurring in facilities rose from 27% to 53%, and the number of such abortions increased substantially; nonetheless, an estimated 294,100 abortions occurred outside of health facilities in 2014. The number of women receiving treatment for complications from induced abortion nearly doubled between 2008 and 2014, from 52,600 to 103,600. Thirty-eight percent of pregnancies were unintended in 2014, a slight decline from 42% in 2008. CONCLUSIONS Although the increases in the number of women obtaining legal abortions and postabortion care are consistent with improvements in women’s access to health care, a substantial number of abortions continue to occur outside of health facilities, a reality that must be addressed. PMID:28825902

  1. Orion Launch Abort System Performance During Exploration Flight Test 1

    NASA Technical Reports Server (NTRS)

    McCauley, Rachel; Davidson, John; Gonzalez, Guillo

    2015-01-01

    The Orion Launch Abort System Office is taking part in flight testing to enable certification that the system is capable of delivering the astronauts aboard the Orion Crew Module to a safe environment during both nominal and abort conditions. Orion is a NASA program, Exploration Flight Test 1 is managed and led by the Orion prime contractor, Lockheed Martin, and launched on a United Launch Alliance Delta IV Heavy rocket. Although the Launch Abort System Office has tested the critical systems to the Launch Abort System jettison event on the ground, the launch environment cannot be replicated completely on Earth. During Exploration Flight Test 1, the Launch Abort System was to verify the function of the jettison motor to separate the Launch Abort System from the crew module so it can continue on with the mission. Exploration Flight Test 1 was successfully flown on December 5, 2014 from Cape Canaveral Air Force Station's Space Launch Complex 37. This was the first flight test of the Launch Abort System preforming Orion nominal flight mission critical objectives. The abort motor and attitude control motors were inert for Exploration Flight Test 1, since the mission did not require abort capabilities. Exploration Flight Test 1 provides critical data that enable engineering to improve Orion's design and reduce risk for the astronauts it will protect as NASA continues to move forward on its human journey to Mars. The Exploration Flight Test 1 separation event occurred at six minutes and twenty seconds after liftoff. The separation of the Launch Abort System jettison occurs once Orion is safely through the most dynamic portion of the launch. This paper will present a brief overview of the objectives of the Launch Abort System during a nominal Orion flight. Secondly, the paper will present the performance of the Launch Abort System at it fulfilled those objectives. The lessons learned from Exploration Flight Test 1 and the other Flight Test Vehicles will certainly

  2. Medical abortion options may advance in 1998.

    PubMed

    1997-12-01

    The US debut of mifepristone (RU-486) was delayed in 1997 by legal and manufacturer problems. However, the Population Council is searching worldwide for companies to produce mifepristone for the US market. In the meantime, women in a number of US cities can obtain mifepristone through clinical trials coordinated by the New York City-based Abortion Rights Mobilization. The trials are evaluating the effectiveness of a 200 mg dosage of the drug and will continue until there is a commercial product. New developments in medical abortion will be announced in 1998. Currently, 29 Planned Parenthood Federation of America (PPFA) affiliates are recruiting women for its study of methotrexate and misoprostol. By midsummer 1998, the organization expects to have data from what is the largest multicenter trial to date of a methotrexate and misoprostol medical abortion regimen.

  3. Vented Launch Vehicle Adaptor for a Manned Spacecraft with "Pusher" Launch Abort System

    NASA Technical Reports Server (NTRS)

    Vandervort, Robert E. (Inventor)

    2017-01-01

    A system, method, and apparatus for a vented launch vehicle adaptor (LVA) for a manned spacecraft with a "pusher" launch abort system are disclosed. The disclosed LVA provides a structural interface between a commercial crew vehicle (CCV) crew module/service module (CM/SM) spacecraft and an expendable launch vehicle. The LVA provides structural attachment of the module to the launch vehicle. It also provides a means to control the exhaust plume from a pusher-type launch abort system that is integrated into the module. In case of an on-pad or ascent abort, which requires the module to jettison away from the launch vehicle, the launch abort system exhaust plume must be safely directed away from critical and dangerous portions of the launch vehicle in order to achieve a safe and successful jettison.

  4. Comparison of Two Recent Launch Abort Platforms

    NASA Technical Reports Server (NTRS)

    Dittemore, Gary D.; Harding, Adam

    2011-01-01

    The development of new and safer manned space vehicles is a top priority at NASA. Recently two different approaches of how to accomplish this mission of keeping astronauts safe was successfully demonstrated. With work already underway on an Apollo-like launch abort system for the Orion Crew Exploration Vehicle (CEV), an alternative design concept named the Max Launch Abort System, or MLAS, was developed as a parallel effort. The Orion system, managed by the Constellation office, is based on the design of a single solid launch abort motor in a tower positioned above the capsule. The MLAS design takes a different approach placing the solid launch abort motor underneath the capsule. This effort was led by the NASA Engineering and Safety Center (NESC). Both escape systems were designed with the Ares I Rocket as the launch vehicle and had the same primary requirement to safely propel a crew module away from any emergency event either on the launch pad or during accent. Beyond these two parameters, there was little else in common between the two projects, except that they both concluded in successful launches that will further promote the development of crew launch abort systems. A comparison of these projects from the standpoint of technical requirements; program management and flight test objectives will be done to highlight the synergistic lessons learned by two engineers who worked on each program. This comparison will demonstrate how the scope of the project architecture and management involvement in innovation should be tailored to meet the specific needs of the system under development.

  5. Is curettage needed for uncomplicated incomplete spontaneous abortion?

    PubMed

    Ballagh, S A; Harris, H A; Demasio, K

    1998-11-01

    Spontaneous abortion occurs in 15% to 20% of all human pregnancies. Since the late 1800s, the management of incomplete spontaneous abortion has focused on using curettage to empty the uterus as quickly as possible. This practice began to reduce blood loss and infection and has been unquestioned for 4 decades. In today's medical climate, few spontaneous abortions are the resuslt of illegal manipulation, given the availability of legal pregnancy termination. Antibiotics and transfusions are available, should complications arise in conservatively managed cases. Two prospective randomized trials suggest that conservative management may be advantageous for women who have stable vital signs without evidence of infection. They will have fewer perforations and, possibly, fewer infections and uterine synechiae with expectant or medical management. Larger trials should be undertaken to critically assess surgical evacuation compared to medical management, factoring in the psychologic impact of treatment. We believe that medical management will prove to be the most appropriate treatment for uncomplicated spontaneous incomplete abortion in the 21st century.

  6. Access to abortion services: the impact of the European convention on human rights in Ireland.

    PubMed

    Daly, Brenda

    2011-06-01

    Abortion is unlawful in Ireland except where it is necessary to save the life of the mother. The right to life of the unborn child is safeguarded under Article 40.3.3 degrees of Bunreacht na hEireann (the Irish Constitution). In 2003 the European Convention on Human Rights was incorporated into Irish domestic legislation, subject to the provisions of the Irish Constitution. The aim of this paper is to consider the potential impact of the ECHR on access to abortion services within the State. This paper commences with discussion of the statutory prohibition on abortion and the Constitutional provisions concerning the protection afforded to the unborn child. It will then be necessary to examine the implications for Ireland of recent European Court of Human Rights' decisions, in particular the recent judgment in A, B & C v Ireland, regarding the right to legal abortions given the unique nature of the legal status of the ECHR and its relationship with the Irish Constitution.

  7. Men and talk about legal abortion in South Africa: equality, support and rights discourses undermining reproductive 'choice'.

    PubMed

    Macleod, Catriona Ida; Hansjee, Jateen

    2013-01-01

    Discursive constructions of abortion are embedded in the social and gendered power relations of a particular socio-historical space. As part of research on public discourses concerning abortion in South Africa where there has been a radical liberalisation of abortion legislation, we collected data from male group discussions about a vignette concerning abortion, and newspaper articles written by men about abortion. Our analysis revealed how discourses of equality, support and rights may be used by men to subtly undermine women's reproductive right to 'choose' an abortion. Within an Equal Partnership discourse, abortion, paired with the assumption of foetal personhood, was equated with violating an equal heterosexual partnership and a man's patriarchal duty to protect a child. A New Man discourse, which positions men as supportive of women, was paired with the assumption of men as rational and women as irrational in decision-making, to allow for the possibility of men dissuading women from terminating a pregnancy. A Rights discourse was invoked to suggest that abortion violates men's paternal rights.

  8. Living through some giant change: the establishment of abortion services.

    PubMed

    Schoen, Johanna

    2013-03-01

    This article traces the establishment of abortion clinics following Roe v Wade. Abortion clinics followed one of two models: (1) a medical model in which physicians emphasized the delivery of high quality medical services, contrasting their clinics with the back-alley abortion services that had sent many women to hospital emergency rooms prior to legalization, or (2) a feminist model in which clinics emphasized education and the dissemination of information to empower women patients and change the structure of women's health care. Male physicians and feminists came together in the newly established abortion services and argued over the priorities and characteristics of health care delivery. A broad range of clinics emerged, from feminist clinics to medical offices run by traditional male physicians to for-profit clinics. The establishment of the National Abortion Federation in the mid-1970s created a national forum of health professionals and contributed to the broadening of the discussion and the adoption of compromises as both feminists and physicians influenced each other's practices.

  9. Attitudes toward abortion among parents of children with cystic fibrosis.

    PubMed Central

    Wertz, D C; Rosenfield, J M; Janes, S R; Erbe, R W

    1991-01-01

    BACKGROUND: DNA prenatal diagnosis for cystic fibrosis (CF) has been available for parents of affected children since late 1985. METHODS: Using anonymous questionnaires, we surveyed 395 parents of children with CF at 12 New England CF centers with regard to 12 maternal or family situations and 11 fetal characteristics; 271 (68%) responded. RESULTS: The majority supported legal abortion in the first trimester for all 23 situations; 58% would abort for severe mental retardation (MR), 40% would abort for a genetic disorder leading to death before age five years, 41% for a child bedridden for life, 35% for moderate MR, 20% for CF and 17% for a severe incurable disorder starting at age 40 years. Few would abort for a disorder starting at age 60 years, for genetic susceptibility to alcoholism or for sex selection. Variables most strongly related to abortion for CF were attitudes of spouse, respondent's siblings, and CF doctor toward abortion for CF as well as infrequent attendance at religious services. CONCLUSIONS: Prenatal diagnosis may not reduce substantially the number of CF births to parents of CF children because most do not accept abortion for CF. PMID:1854017

  10. Medical abortion in early pregnancy: experience in China.

    PubMed

    Cheng, Linan

    2006-07-01

    When medical abortion was first introduced in China, prostaglandins (PGs) were used alone or in combination with Chinese herbs or steroid drugs, but the results were not satisfactory. Mifepristone is now produced in three companies in China and is commonly used with PGs for medical abortion. We performed a Chinese- and English-language literature review of medical abortion in early pregnancy in China. A large multicenter trial conducted in China showed that, when used with a PGF(2alpha) analogue, the complete abortion rate in women given multiple doses of mifepristone (total, 150 mg) was significantly higher than that in women given a single dose of 200 mg of mifepristone. Oral misoprostol (0.6 mg) with mifepristone is now the most commonly used regimen, with a complete abortion rate of over 93%. In China, medical abortion is currently restricted to pregnancies before 49 days, but some hospitals have recently extended the use of medical abortion to pregnancies beyond 49 days. Prolonged bleeding is the main medical abortion side effect and is more likely to occur if the blood levels of human chorionic gonadotrophin fall slowly or when the gestational sac is big. Prescription of testosterone propionate may reduce the duration of bleeding. Over 80% of Chinese women are satisfied with current medical abortion regimens and will choose medical abortion again if they need to terminate a future unwanted pregnancy. Currently, medical abortion is a safe, efficient and acceptable method for the termination of early pregnancy in China.

  11. Abortion law in Nepal: the road to reform.

    PubMed

    Thapa, Shyam

    2004-11-01

    In 2002 Nepal's parliament passed a liberal abortion law, after nearly three decades of reform efforts. This paper reviews the history of the movement for reform and the combination of factors that contributed to its success. These include sustained advocacy for reform; the dissemination of knowledge, information and evidence; adoption of the reform agenda by the public sector and its leadership in involving other stakeholders; the existence of work for safe motherhood as the context in which the initiative could gain support; an active women's rights movement and support from international and multilateral organisations; sustained involvement of local NGOs, civil society and professional organisations; the involvement of journalists and the media; the absence of significant opposition; courageous government officials and an enabling democratic political system. The overriding rationale for reforming the abortion law in Nepal has been to ensure safe motherhood and women's rights. The first government abortion services officially began in March 2004 at the Maternity Hospital in Kathmandu; services will be expanded gradually to other public and private hospitals and private clinics in the coming years.

  12. Psychological factors that predict reaction to abortion.

    PubMed

    Moseley, D T; Follingstad, D R; Harley, H; Heckel, R V

    1981-04-01

    Investigated demographic and psychological factors related to positive or negative reactions to legal abortions performed during the first trimester of pregnancy in 62 females in an urban southern community. Results suggest that the social context and the degree of support from a series of significant persons rather than demographic variables were most predictive of a positive reaction.

  13. [The reform of Spanish abortion law].

    PubMed

    Requero Ibáñez, José Luís

    2009-01-01

    The article focuses on the different factors and circumstances that have led to the reform of Spanish Abortion Law (1985). Judicial investigations of several abortion clinics have demonstrated that up until today there has been a widespread tendency of the clinics to practice beyond the limits established by the law. Nonetheless, the reaction of the government has not been to protect the life of the unborn. Its reaction has been, however, to cover the irregularities committed by the abortionists through the legalization of their abusive practices. Besides, the reform of the law has been inspired by elements of radical feminism. The author points out the major reasons that make this reform unconstitutional and offers alternative solutions for the protection of the mother and the unborn child.

  14. Decision-Making for Induced Abortion in the Accra Metropolis, Ghana.

    PubMed

    Gbagbo, Fred Yao; Amo-Adjei, Joshua; Laar, Amos

    2015-06-01

    Decision-making for induced abortion can be influenced by various circumstances including those surrounding onset of a pregnancy. There are various dimensions to induced abortion decision-making among women who had an elective induced abortion in a cosmopolitan urban setting in Ghana, which this paper examined. A cross-sectional mixed method study was conducted between January and December 2011 with 401 women who had undergone an abortion procedure in the preceding 12 months. Whereas the quantitative data were analysed with descriptive statistics, thematic analysis was applied to the qualitative data. The study found that women of various profiles have different reasons for undergoing abortion. Women considered the circumstances surrounding onset of pregnancy, person responsible for the pregnancy, gestational age at decision to terminate, and social, economic and medical considerations. Pressures from partners, career progression and reproductive intentions of women reinforced these reasons. First time pregnancies were mostly aborted regardless of gestational ages and partners' consent. Policies and programmes targeted at safe abortion care are needed to guide informed decisions on induced abortions.

  15. Abortion and politics in Mexico: 'context is all'.

    PubMed

    Lamas, M; Bissell, S

    2000-11-01

    A strong collective pro-choice mentality was recently manifested in Mexico when a legislative initiative to revoke the legal right of rape survivor to abortion in the state of Guanajuato awakened national indignation. Pro-choice values were expressed in public opinion with such force that it sparked off the passage of liberalising law reforms in Mexico City and the state of Morelos. In this paper we trace the development of these manifestations of pro-choice views, beginning with the Democratic Revolution Party's (PRD) refusal in 1999 to modify abortion legislation within the context of penal code reform, and moving through the events surrounding the Guanajuato reform, and the pro-choice response of Mexico City and Morelos legislators. This analysis allows us to recognise the emergence of a pro-choice consciousness and to understand that, when it comes to abortion, 'context is all'.

  16. Abortion, an increasing public health concern in Ecuador, a 10-year population-based analysis.

    PubMed

    Ortiz-Prado, Esteban; Simbaña, Katherine; Gómez, Lenin; Stewart-Ibarra, Anna M; Scott, Lisa; Cevallos-Sierra, Gabriel

    2017-01-01

    To describe the epidemiology of abortion in Ecuador from 2004 to 2014 and compare the prevalence between the public and the private health care systems. This is a cross-sectional analysis of the overall mortality and morbidity rate due to abortion in Ecuador, based on public health records and other government databases. From 2004 to 2014, a total of 431,614 spontaneous abortions, miscarriage and other types of abortions were registered in Ecuador. The average annual rate of abortion was 115 per 1,000 live births. The maternal mortality rate was found to be 43 per 100,000 live births. Abortion is a significant and wide-ranging problem in Ecuador. The study supports the perception that in spite of legal restrictions to abortion in Ecuador, women are still terminating pregnancies when they feel they need to do so. The public health system reported >84% of the national overall prevalence.

  17. "One Problem Became Another": Disclosure of Rape-Related Pregnancy in the Abortion Care Setting.

    PubMed

    Perry, Rachel; Murphy, Molly; Haider, Sadia; Harwood, Bryna

    2015-01-01

    We sought to explore the experiences of women who disclosed that their pregnancies resulted from rape in the abortion care setting, as well as the experiences of professionals involved in care of women with rape-related pregnancy. In-depth interviews were conducted with 9 patients who had terminated rape-related pregnancies and 12 professionals working in abortion care or rape crisis advocacy (5 abortion providers, 4 rape crisis center advocates, 2 social workers, and 1 clinic administrator). Transcribed interviews were coded and analyzed for themes related to the experiences of disclosing rape and the consequences of disclosure in the abortion care setting. Patients and professionals involved in care of women with rape-related pregnancy described opportunities arising from disclosure, including interpersonal (explaining abortion decision making in the context of assault, belief, and caring by providers), as well as structural opportunities (funding assistance, legal options, and mental health options). Whereas most patients did not choose to pursue all three structural opportunities, both patients and professionals emphasized the importance of offering them. The most important consequence of disclosure for patients was being believed and feeling that providers cared about them. Rape-related pregnancy disclosure in the abortion care setting can lead to opportunities for interpersonal support and open options for funding, legal recourse, and mental health care. Those working in abortion care should create environments conducive to disclosure and opportunities for rape survivors to access these additional options if they desire. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  18. Effects of Legislation Regulating Abortion in Arizona.

    PubMed

    Williams, Sigrid G; Roberts, Sarah; Kerns, Jennifer L

    2018-04-06

    Abortion is a common and safe procedure in the United States, the regulation of which varies by state. Since 2011, hundreds of state-level abortion restrictions have been enacted by legislatures across the country. This study describes the effects of two such regulations enacted in 2011 in Arizona, (A.R.S.) 36-2153 and 36-2155, that imposed a 24-hour waiting period requiring two separate in-person clinic visits before obtaining an abortion and banned advanced practice clinicians such as physician assistants, nurse practitioners, and nurse midwives from inducing medication abortions by prescribing mifepristone. We conducted a pre-post study to describe the effect of Arizona's scope of practice law on abortion provision by county. Using publicly available data, we compared patterns of abortion provision in 2009 and 2010 (before the laws) with 2012 and 2013. Our primary objective was to compare the proportion of abortions performed with medication by prescription of mifepristone (versus abortions performed surgically, known as aspiration abortions) before and after the laws were enacted. Our secondary objectives were to report the number of counties that lost an abortion provider and the change in the proportion of abortions performed before 14 weeks' gestation of pregnancy after the enactment of the laws. After enactment of the laws, the proportion of Arizona's 15 counties with abortion clinics decreased from 33% to 13%. Over this time, the proportion of abortions performed with medication in Arizona decreased by 17.4% (95% CI, 16.6%-18.3%; p = .0002), from 47.6% to 30.2%. Similarly, the proportion of abortions performed before 14 weeks' gestation in Arizona decreased by 3.3% (95% CI, 2.8%-3.8%; p = .0002) after the enactment of these laws. The proportion of abortions performed with medication and the proportion of abortion performed before 14 weeks' gestation in Arizona were negatively affected by the enactment of these laws. These findings are not explained

  19. Medical students are afraid to include abortion in their future practices: in-depth interviews in Maharastra, India.

    PubMed

    Sjöström, Susanne; Essén, Birgitta; Gemzell-Danielsson, Kristina; Klingberg-Allvin, Marie

    2016-01-12

    Unsafe abortions are estimated to cause eight per-cent of maternal mortality in India. Lack of providers, especially in rural areas, is one reason unsafe abortions take place despite decades of legal abortion. Education and training in reproductive health services has been shown to influence attitudes and increase chances that medical students will provide abortion care services in their future practice. To further explore previous findings about poor attitudes toward abortion among medical students in Maharastra, India, we conducted in-depth interviews with medical students in their final year of education. We used a qualitative design conducting in-depth interviews with twenty-three medical students in Maharastra applying a topic guide. Data was organized using thematic analysis with an inductive approach. The participants described a fear to provide abortion in their future practice. They lacked understanding of the law and confused the legal regulation of abortion with the law governing gender biased sex selection, and concluded that abortion is illegal in Maharastra. The interviewed medical students' attitudes were supported by their experiences and perceptions from the clinical setting as well as traditions and norms in society. Medical abortion using mifepristone and misoprostol was believed to be unsafe and prohibited in Maharastra. The students perceived that nurse-midwives were knowledgeable in Sexual and Reproductive Health and many found that they could be trained to perform abortions in the future. To increase chances that medical students in Maharastra will perform abortion care services in their future practice, it is important to strengthen their confidence and knowledge through improved medical education including value clarification and clinical training.

  20. Normatology: a review and commentary with reference to abortion and physician-assisted suicide.

    PubMed

    Brodie, H K; Banner, L

    1997-06-01

    This article opens with a review of the concept of "normatology," which was developed by Sabshin and Offer in four books published over a period of 30 years. Normatology seeks to produce an "operational definition of normality and health" over the life cycle. Such a definition can be used as a guideline in the deliver of health care. The importance of this field of study is highlighted when considering issues such as abortion or physician-assisted suicide. Fortunately, the proclivity of Americans to conduct public opinion polls helps researchers determine what is considered "normal" at any given time. Gallup Polls, which have posed the same question about the legality of abortion from 1975 to 1995, indicate that about half of all Americans continuously occupy the middle ground on this issue despite a somewhat liberalizing trend. In general, public opinion holds that it is normal to want to avoid giving birth to a damaged child, to place the mother's health and safety above that of the fetus, and to terminate a pregnancy resulting from rape. It is less normal to abort a healthy fetus on demand. Thus, abortion will likely continue to be a source of controversy and confusion in our society and among psychiatric patients. In comparison, psychiatrists express attitudes about abortion that are more liberal than normal. In the case of physician-assisted suicide, public approval has increased since 1950 as scientific advancements have facilitated the prolongation of unproductive and painful life. If legalized, physician-assisted suicide may depend upon psychiatric assessment of an absence of mental disease. Such an assessment is required in the Northern Territory of Australia, where voluntary euthanasia is legal, but not in the Netherlands, where it is government-regulated. Psychiatrists must understand public opinion in order to influence it or deal with it competently.