Interrupciones voluntarias de embarazos en un Hospital Universitario de Uruguay: reporte de situación 2019-2020 / Voluntary interruption of pregnancies at the University Hospital of Uruguay: situation report 2019-2020 / Interrupções voluntárias de gravidez no Hospital Universitário de Uruguay: relatório de situação 2019-2020

Objetivo: el objetivo de este estudio es conocer el estado de situación de los procesos de las usuarias que asistieron a la policlínica de interrupción voluntaria del embarazo en el Hospital de Clínicas en un período de agosto de 2019 a agosto de 2020. Metodología y materiales: estudio descriptivo y retrospectivo, a partir de la entrevista clínica de salud mental y una ficha de uso interno utilizada para relevar el proceso de toma de decisión. En muestra de 78 usuarias se analizan variables sociodemográficas, ginecoobstétricas y asociadas al proceso de interrupción, antecedentes psicológicos y/o psiquiátricos y motivos de interrupción. Resultados: el promedio de edad es de 25 años, la mayoría en pareja y ciclo básico educativo finalizado. El promedio de edad gestacional fue de 7,36 semanas. El 81% de las mujeres no había realizado un IVE. Un 65.4% de las mujeres no tienen antecedentes psicológicos y/o psiquiátricos. No existe relación significativa entre haber realizado un IVE previamente y tener antecedentes psicológicos y/o psiquiátricos.Utilizaban anticonceptivos 78.2%. Conclusiones: la interrupción del embarazo supone una situación vital estresante para quienes la transitan, se encuentran atravesadas por múltiples motivos que inciden en la toma de decisión de interrumpir. Se infiere que la realización de uno o más procedimientos de IVE no necesariamente está relacionada con tener un antecedente psicopatológico o cursar una psicopatología al realizar el proceso. Es pertinente promover la atención focalizada en las pacientes, integrando la perspectiva de género y derechos humanos, mejorar los procesos de atención, asesoramiento en salud mental, sexual y reproductiva de las usuarias y sus acompañantes.

Objective: The objective of this study is to know the status of the processes of the users who attended the polyclinic for voluntary termination of pregnancy at the Hospital de Clínicas in a period from August 2019 to August 2020. Methodology and materials: The study used descriptive and retrospective methods based on interviews with mental health professionals and a form that was used to ask about how people make decisions. In a sample of 78 users, sociodemographic, obstetric and gynecological variables associated with the discontinuation process, psychological and/or psychiatric history and reasons for discontinuation were analyzed. Results: The average age is 25 years, most people are married and have finished their elementary education. The average gestational age was 7.36 weeks. 81% of the women had not undergone an IVE. 65.4% of women have no psychological and/or psychiatric history. There is no significant relationship between having previously performed an IVE and having a psychological and/or psychiatric history. 78.2% used contraceptives. Conclusions: The interruption of pregnancy is a stressful life situation for those who go through it; they are faced with multiple reasons that influence the decision to terminate. It is inferred that carrying out one or more IVE procedures is not necessarily related to having a psychopathological history or experiencing psychopathology when carrying out the process. It is pertinent to promote patient-focused care, integrating the gender and human rights perspective, improve care processes, and provide advice on mental, sexual, and reproductive health of users and their companions.

Objetivo: O objetivo deste estudo é conhecer a situação dos processos das usuárias que compareceram à policlínica de interrupção voluntária da gravidez do Hospital de Clínicas no período de agosto de 2019 a agosto de 2020. Metodologia e materiais: estudo descritivo e retrospectivo, baseado na entrevista clínica de saúde mental e em formulário de uso interno utilizado para levantamento do processo de tomada de decisão. Numa amostra de 78 usuárias foram analisadas variáveis ​​sociodemográficas, obstétricas e ginecológicas associadas ao processo de descontinuação, histórico psicológico e/ou psiquiátrico e motivos de descontinuação. Resultados: a idade média é de 25 anos, a maioria vive em casal e completou o ciclo educativo básico. A idade gestacional média foi de 7,36 semanas. 81% das mulheres não realizaram IVE. 65,4% das mulheres não têm antecedentes psicológicos e/ou psiquiátricos. Não há relação significativa entre ter realizado EIV anteriormente e ter antecedentes psicológicos e/ou psiquiátricos, 78,2% faziam uso de anticoncepcional. Conclusões: a interrupção da gravidez é uma situação estressante de vida para quem passa por ela, pois se deparam com múltiplos motivos que influenciam na decisão de interrompê-la. Infere-se que a realização de um ou mais procedimentos de IVE não está necessariamente relacionada a ter histórico psicopatológico, ou vivenciar psicopatologia na realização do processo. É pertinente promover cuidados centrados no paciente, integrando a perspectiva de gênero e direitos humanos, melhorar os processos de cuidados e aconselhamento sobre saúde mental, sexual e reprodutiva dos utentes e dos seus acompanhantes.

Transitar el laberinto: trayectorias de cuidado entre mujeres que deciden abortar en el Ecuador / Traversing the labyrinth: Trajectories of care among women who decide to have an abortion in Ecuador

El acercamiento a las experiencias de mujeres que decidieron abortar en Ecuador, a partir de sus relatos biográficos, nos permitió comprender las trayectorias de cuidado por las que debieron transitar. Se desarrolló una metodología cualitativa, con enfoque biográfico narrativo, con la participación de 19 mujeres mayores de edad, residentes en diferentes provincias del Ecuador, un territorio con medidas restrictivas sancionatorias legales y morales alrededor del aborto. Encontramos que los contextos socio biográficos de las participantes se caracterizaron por la presencia de múltiples formas de violencia; sus decisiones en salud sexual y reproductiva constituyen una carga moral que las responsabiliza y les impone una serie de mandatos sociales en medio de grandes limitaciones y restricciones; sus trayectorias y búsqueda de cuidados se caracterizan por un Estado ausente como garante, lo que las lleva resguardarse en sí mismas o en algunas mujeres que construyen redes de soporte por fuera de la institucionalidad formal de protección, transitando rutas diversas donde el descuido y las violencia vuelven a ser predominantes. Estos hallazgos derivan en una serie de discusiones en torno a la vida de las participantes, como el tránsito por un laberinto donde las violencias que experimentan crean encrucijadas y rodeos difíciles de evadir y superar; por otra parte, la maternidad se presenta como una propuesta que enfrenta a las mujeres a tensiones permanentes, donde la decisión de abortar es una postergación de aquella más que su negación, tensiones como las mutaciones de la religiosidad, que no solo dan soporte del ideal femenino y de su rol básico de la maternidad, sino también un elemento de soporte para la decisión. Se concluye con la propuesta del Cuidado Sororo de la Salud Sexual y Reproductiva (SSR), inspirada en las teorías feministas y en los aportes de las organizaciones sociales que defienden los derechos sexuales y reproductivos de las mujeres. Dicha propuesta se deriva de las narrativas de las mujeres y se centra en su autonomía para reivindicar la importancia del cuidado desde una perspectiva más humanizada, respetuosa, solidaria y empática. (AU)

The approach to the experiences of women who decided to have an abortion in Ecuador allowed us to understand the care trajectories they had to go through, based on their biographical accounts. A qualitative methodology was used with a biographical narrative approach and the participation of 19 women of legal age, residents of different provinces of Ecuador, a territory with restrictive legal and moral sanctioning measures around abortion. We found that the socio-biographical contexts of the participants were characterized by the presence of multiple forms of violence; their sexual and reproductive health decisions constitute a moral burden that makes them responsible and impose a series of social mandates in the midst of great limitations and restrictions; their trajectories and search for care are characterized by an absent State as guarantor, which leads them to take refuge in themselves or in some women who build support networks outside the formal institutionality of protection, going through diverse routes where neglect and violence are once again predominant. These findings lead to a series of discussions about the life of the participants as the transit through a labyrinth, where the violence they experience creates crossroads and detours difficult to avoid and overcome; motherhood as a proposal that confronts women with permanent tensions, where the decision to abort is a postponement of it, rather than its denial and the mutations of religiosity that not only support the feminine ideal and its basic role of motherhood, but also an element of support for the decision. It concludes with the proposal of Sororo Care of Sexual and Reproductive Care (SRH), inspired by feminist theories and the contributions of social organizations that defend women's sexual and reproductive rights. This proposal is derived from women's narratives and focuses on their autonomy, to vindicate the importance of care from a more humanized, respectful, supportive and empathetic perspective. (AU)

¿Qué se preguntan las enfermeras/os sobre el aborto? Una revisión panorámica / O que as enfermeiras se perguntam sobre o aborto? Uma revisão panorâmica / What are nurses asking about abortion? An overview review

Objetivo: Analizar las preguntas, metodologías y tendencias en investigaciones realizadas por enfermeras/os, con el fin de identificar los intereses disciplinares y posibles derivaciones en el desarrollo del conocimiento y las prácticas de cuidado. Metodología: Revisión panorámica en las bases de datos: Scielo, BVS, PubMed y Redalyc, con una ventana de búsqueda de 2008 a 2020, en idiomas español, inglés y portugués. Se incluyeron 33 artículos, produc-to de la búsqueda con términos de: MeSH, Nursing Care, Abortion, Abortion Applicants. Además, se emplearon expresiones en español sobre: cuidado de enfermería; enfermería; el aborto; el aborto y cuidado de enfermería en la salud pública; aborto inducido y cuidado de enfermería sobre salud mental; aborto criminal y salud mental; y, cuidado de enfermería frente a solicitantes de aborto. Análisis: Se observó una relación entre el tipo de estudios y el contexto jurídico de los países en que se realizaron. Son relevantes los estudios respecto de las actitudes, creencias y prácticas de enfermería en torno al aborto, poniendo el foco en la subjetividad de los profesionales de la disciplina. Resaltan los estudios cualitativos, haciendo acopio de teorías y conceptos de procedencia multidisciplinar y solo marginalmente de aquel-la producida por la disciplina de enfermería. Conclusiones: Las preguntas más frecuentes que se hacen las enfermeras/os sobre el aborto se dirigen especialmente a examinar las formas en que se provee el cuidado de enfermería a las mujeres que pasan por esta experiencia; del mismo modo se evidencia el correlato en las experiencias emocionales y dilemas éticos para el personal de enfermería, constituyéndose en un fenómeno controversial. Lo expuesto anteriormente implica para la disciplina de enfermería ampliar el repertorio para el abordaje epistemológico de este fenómeno, con miradas críticas transdisciplinares, que consideren el contexto social, cultural y normativo, con el fin de enriquecer la investigación disciplinar, que tenga efectos sobre la práctica profesional y los procesos de formación

Objective: Analyze the questions, methodologies and tendencies made in nursing research, with the purpose of identifying the disciplinary interests and possible derivations in the de-velopment of knowledge and care practices. Methodology: Scoping review in the databases: Scielo, BVS, Pubmed and Redalyc, with a search window from 2008 to 2020, in Spanish, English and Portuguese. Thirty-three articles were included, resulting from the search of the terms: MeSH, Nursing Care, Abortion, Abortion Applicants. Furthermore, the following Spanish expressions were used: nursing care; nursing; abortion; abortion and nursing care in public health; induced abortion and mental health nursing care; criminal abortion and men-tal health; and, nursing care for abortion applicants. Analysis: A relationship was observed between the type of studies and the legal context of the countries in which these were con-ducted. The studies about the attitudes, beliefs and nursing practices regarding abortion are relevant, focusing on the subjectivity of the professionals of this discipline. The qualitative studies stand out, gathering theories and concepts from multidisciplinary sources, and only marginally those from the nursing discipline. Conclusions: The most frequently asked ques-tions that nurses have about abortion are specially directed to examine the ways in which nursing care is provided to women who undergo this experience; similarly, the correlation between the emotional experiences and the ethical dilemmas for the nursing personnel is evi-denced, constituting a controversial phenomenon. The forementioned implies for the nursing discipline to broaden the repertoire for the epistemological approach of this phenomenon, with transdisciplinary critical views, that consider the social, cultural and regulatory context, in order to enrich the disciplinary research, having effects on the professional practice and the training processes

Objetivo: Analisar as questões, metodologias e tendências nas pesquisas realizadas pelos enfermeiros, a fim de identificar interesses disciplinares e possíveis derivações no desen-volvimento de práticas de conhecimento e cuidado. Metodologia: Revisão panorâmica nas bases de dados: Scielo, VHL, PubMed e Redalyc, com uma janela de pesquisa entre 2008 e 2020, em espanhol, inglês e português. Foram incluídos 33 artigos, produto da pesquisa com termos: MeSH, Nursing Care, Abortion, Abortion Applicants. Além disso, foram utilizadas expressões em espanhol: cuidado de enfermería, enfermería, aborto, aborto e cuidado de enfermería e salud pública; aborto inducido e cuidado de enfermería e salud mental; aborto criminal e salud mental e cuidado de enfermería, solicitantes de aborto. Análise: Observou-se relação entre o tipo de estudo e o contexto jurídico dos países em que foram realizados. Estu-dos sobre atitudes, crenças e práticas de enfermagem em torno do aborto são relevantes, com foco na subjetividade dos profissionais da disciplina. Destacam-se estudos qualitativos, cole-cionando teorias e conceitos de origem multidisciplinar e apenas marginalmente produzidas pela disciplina de enfermagem. Conclusões: As perguntas mais frequentes das enfermeiras sobre o aborto visam especialmente examinar as formas como a assistência de enfermagem é prestada às mulheres que passam por essa experiência; da mesma forma, evidencia-se a correlação entre experiências emocionais e dilemas éticos para o pessoal de enfermagem, tornando-se um fenômeno controverso. Os achados implicam à disciplina de enfermagem ampliar o repertório para a abordagem epistemológica desse fenômeno, com perspectivas críticas transdisciplinares, que considerem o contexto social, cultural e normativo, a fim de enriquecer a pesquisa disciplinar, com efeitos na prática profissional e nos processos formativos

Abordaje integral de la Interrupción Voluntaria del Embarazo: (segunda entrega) / Comprehensive approach to the voluntary interruption of pregnancy: (second issue)

La legalización de la interrupción voluntaria del embarazo ha transformado la práctica médica con respecto a la atención de las pacientes que desean interrumpir la gestación hasta la semana 14 en Argentina. En la primera entrega, el equipo PROFAM compartió su punto de vista a través de una adaptación de su material educativo destinado, sobre todo, a aclarar los aspectos legales que hacen a la práctica cotidiana. En esta entrega se desarrolla en detalle el procedimiento para realizar un aborto farmacológico con misoprostol y mifepristona, así como las generalidades del aspirado manual endouterino. (AU)

The legalization of voluntary termination of pregnancy has transformed medical practice regarding the care of patients who wish to terminate a pregnancy up to 14 weeks in Argentina. In the first issue, the PROFAM team shared its point of view through an adaptation of its educational material aimed, above all, at clarifying the legal aspects of daily practice. In this issue, the procedure to perform a pharmacological abortion with misoprostol and mifepristone is developed in detail, as well as the generalities of manual uterine aspiration technique. (AU)

Aborto no punible: cuestiones filosóficas de un debate que nos trasciende / Non-punishable abortion: philosophical questions of a debate that transcends us

El avance de las sociedades postula desafíos y problemas que complejizan la vida comunitaria. Los cambios son vertiginosos. A veces, las acciones avanzan más rápido que las ideas o las propuestas destinadas a resolver los problemas que suscitan. El aborto ocupa un lugar destacado dentro del debate público. Implica aspectos fundamentales entre los que se cuentan: la vida, la muerte, la salud, la religión, la ética, la moral y sus límites, la capacidad de decidir por uno mismo y la potestad para decidir por alguien más. El aborto es una problemática socio-sanitaria que trasciende a sí misma y nos arrolla con su complejidad.

Creencias en torno al aborto inducido en un hospital público / Beliefs regarding the induced abortion in a public hospital

Establecer las prioridades psicométricas de un instrumento que pondera las creencias en torno al aborto inducido. Método: Se llevó a cabo un estudio correlacional y transversal con una muestra no probalística de 120 derechohabientes de un hospital público ubicado en una entidad del centro de país. Materiales: Se construyó una Escala de Creencias en torno al Aborto Inducido la cual incluyó 17 reactivos con dos opciones de respuesta: falso o verdadero. Resultados: Para establecer la confiabilidad se estimó una curtosis multivariable de -2,578 una alfa de 0,73 y esfericidad de 0,832 con adecuación significativa. Se estableció un modelo estructural reflectivo (x2=16,25; 11gl; p=0,055; GFI=,975; RMR=0,008) que se ajustó al modelo de medición (GFI=0,90; RMR=0,001). Discusión: Se recomienda la inclusión de otras variables tales como religión, usos y costumbres locales para explicar posibles modelos regionales de prácticas abortivas inducidas legalmente...

Plantas medicinais abortivas utilizadas por mulheres de UBS: etnofarmacologia e análises cromatográficas por CCD e CLAE / Abortive medicinal plants used by women of Basic Health Units: ethnopharmacology and cromatographic analysis by TLC and HPLC

O emprego de plantas medicinais refere-se a uma prática milenar, seja na medicina alternativa para cura de diversas doenças, ou como método abortivo. No entanto, a população em geral desconhece os grandes riscos que a cometem. Neste sentido este trabalho teve como objetivo avaliar o índice de consumo de plantas medicinais por mulheres de uma Unidade Básica de Saúde (UBS), na tentativa de identificar quais as espécies mais frequentemente ingeridas inclusive em período gestacional. Através de um questionário de caráter explorativo com 48 mulheres observou-se que a maioria das entrevistadas tinha filhos e as plantas medicinais mais citadas foram "boldo" (Peumus boldus), "carqueja" (Baccharis trimera) e "sene" (Cassia angustifolia), as quais eram empregadas principalmente em dores estomacais ou como digestivos (53%), para resfriados (23%), cólicas menstruais (4%) ou para menstruar (2%). Outra parte do trabalho constituiu a análise visual e química de espécies de plantas medicinais citadas pelo público feminino entrevistado, bem como, outras utilizadas popularmente com propriedades abortivas. Análises visuais comparativas de amostras de plantas medicinais de quatro estabelecimentos comerciais diferentes denominadas Grupo A-C, mostraram a ausência de controle de qualidade com relação às especificações nas embalagens, e separação do material vegetal a ser consumido. Através de análises dos perfis químicos destas amostras por cromatografia em camada delgada (CCD) e cromatografia líquida de alta eficiência (CLAE) indicaram que aquelas pertencentes ao Grupo C diferiram significativamente em relação àquelas de mesma identificação, exceto no que se refere ao boldo do Chile, cujas amostras apresentaram-se bastante similares com relação à constituição química.

The use of medicinal plants corresponds to an ancient practice, either as an alternative medicine for the cure of several diseases, or as a method of abortion. Nevertheless, the population in general does not know the risks involved in the use of medicinal plants. In this sense, the purpose of the study was to evaluate the consumption rate of medicinal plants by women in a Basic Health Unit (BHU), on order to identify which plant species have been most frequently consumed by them, including during the pregnancy. Through an exploratory questionnaire with 48 women, it was observed that most part of the interviewees had children and the most of them cited Peumus boldus, Baccharis trimera and Cassia angustifolia, which were mainly used for stomach aches or digestives (53%), for colds (23%), menstrual cramps (4%) or to menstruate (2%). The remaining part of the study consisted in the visual and chemical analysis of the plant species cited by the interviewees, including other species that have been popularly used as a method of abortion. Comparative visual analysis of medicinal plants (Group A-C) from four different shops showed the absence of quality control concerning packing specifications and the separation of the plant material to be consumed. The analysis of the chemical profiles of these samples by thin layer chromatography (TLC) and high performance liquid chromatography (HPLC) indicated that those species belonging to the Group C were significantly different from those plants having the same identification, except for Peumus boldus, whose samples were similar in terms of chemical composition.

Antecipação terapêutica do parto do feto anencéfalo: uma discussão necessária / La anticipación de la terapia de natalidad del feto anencefálico: un debate necesario / Anticipation Of Childbirth Therapy For Anencephalic Fetus: A Necessary Discussion

A partir das ideias de crime e problema de saúde pública, levantados em análise da literatura, o presente artigo propõe uma reflexão crítica acerca da relação entre a dignidade da pessoa humana e a antecipação terapêutica do parto de feto anencéfalo. Aponta possíveis caminhos na discussão deste dilema, considerando a recente decisão do Supremo Tribunal Federal, bem como as normas constitucionais e infraconstitucionais brasileiras.

A partir de las ideas de crimeny problema de salud pública, indicadas a partir de revisión de la literatura, este arơculo propone una reflexión crítica sobre la relación entre la dignidad humana y la anticipación terapéutica del parto de feto anencefálico, lo que indica posibles caminos en la discusión de este dilema, teniendo en cuenta la reciente decisión de la Supremo Tribunal Federal, así como las normas constitucionales e infracons-titucionales Brasileñas.

From the ideas of crime and public health problems, raised during the analysis of the bibliography, this article proposes a critical reflection on the relationship between human dignity and therapeutic anticipation of the anencephalic fetus delivery. It suggests possible ways for the discussion of this dilemma, considering the recent decision of the Federal Supreme Court (STF), as well as the constitutional and infra-constititutional standards in Brazil.

Factores asociados con la búsqueda del servicio de interrupción legal del embarazo en la Ciudad de México, 2010 / Factors associated with the seeking of legal induced abortion services in Mexico City in 2010

OBJETIVO: Identificar factores asociados con la búsqueda del servicio de interrupción legal del embarazo (ILE) en la Ciudad de México. MATERIAL Y MÉTODOS: Se utilizó un diseño casos-controles. Usuarias del servicio de ILE fueron definidas como casos, y usuarias de control prenatal con 13 o más semanas de gestación con un embarazo no deseado constituyeron los controles. Se ajustaron modelos de regresión logística condicional. RESULTADOS: Los años de escolaridad (RM=1.47, IC:1.04-2.07), la ocupación (estudiante, RM=7.31, IC:1.58-33.95; tener empleo remunerado, RM= 13.43, IC:2.04-88.54) y número de interrupciones de embarazo previas (RM=11.41, IC:1.65-79.07) se asociaron con la búsqueda de ILE. El factor de mayor peso fue la ocupación; las mujeres que trabajan tuvieron 13.4 veces mayor posibilidad de demandar el servicio de ILE. CONCLUSIONES: En el contexto de la Ciudad de México, mujeres con más educación y participación laboral activa utilizan más los servicios de ILE. Se requieren estrategias dirigidas a incrementar el uso de estos servicios por mujeres menos favorecidas.

OBJECTIVE: To identify factors associated with the seeking of the legal-interruption-pregnancy (LIP) services in Mexico City. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSIONS: 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.

O aborto inseguro é um problema de saúde pública / Unsafe abortion is a public health problem

A prática do aborto provocado, ou também denominado intencional, sempre esteve presente na humanidade. Pode-se dizer que essa prática é tão antiga quanto a existência humana.No Brasil, o aborto inseguro é considerado um problema de saúde pública, pois representa a quarta causa de morte materna. Muitas vezes o aborto provocado é visto apenas como um problema médico, e os aspectos psicológicos e sociais são negligenciados. Esta revisão teve como objetivo analisar as pesquisas que abordam o aborto provocado ou inseguro no Brasil. Este estudo trata de revisão da literatura, exploratória e retrospectiva, utilizando o tema aborto provocado. As estatísticas de aborto inseguro no Brasil e no mundo apresentam semelhanças no que se refere a uma grande diminuição do número de abortos provocados nas últimas décadas. Entretanto, o aborto provocado, pela sua ilegalidade e pelas condições inseguras em que são realizados, constitui uma questão de saúde pública neste país.

The practice of induced abortion, or also called intentional, was always present in the humanity. We can say that this practice is as old as human existence. In Brazil, abortion is considered a public health problem because it represents the fourth leading cause of maternal death. Often abortion is seen as only a medical problem, and the psychological and social aspects are neglected. This review aimed to analyze the researches that approach the unsafe abortion in Brazil. This study deals the literature review, exploratory and retrospective studies, using the unsafe abortion issue. The statistics of unsafe abortion in Brazil and around the world have similarities with regard to a large decrease in the number of induced abortions in recent decades. However, induced abortion, by its illegality and the unsafe conditions in which they are made, constitutes a public health issue in this country.

Características socio demográficas de las mujeres con abortos inducidos en un Hospital Público de Bucaramanga / Socio-demographic characteristics of females who had undergone induced abortion in a public hospital in Bucaramanga

Objetivo Analizar desde la perspectiva bioética de la justicia distributiva las características socio-demográficas de las mujeres que consultan por aborto provocado en el Hospital Local del Norte de Bucaramanga. Métodos Se realizó un estudio descriptivo y transversal con una muestra por conveniencia, tomada entre las pacientes que consultaron en Urgencias de Gineco-obstetricia del Hospital Local del Norte de Bucaramanga entre el 1° de marzo de 2008 y el 28 de febrero del 2009 con diagnóstico de aborto en cualquiera de sus presentaciones. Resultados La muestra total fue de 93 pacientes de las cuales 16 aceptaron haberse inducido un aborto. Los factores asociados con este hecho fueron: pertenecer a un estrato socio-económico bajo, carecer de adecuada atención sanitaria y educativa en planificación familiar, carecer de pareja estable o que esta fuera disfuncional y que la pareja presionara inducir el aborto por motivos económicos o paternidad satisfecha. Un contraste de estos resultados con la legislación sanitaria vigente desde la perspectiva bioética de equidad en salud, revela que la aplicación de la normatividad es deficiente tanto en cobertura como en acciones educativas en salud sexual y reproductiva. Conclusiones Facilitar a las pacientes que ejerzan su sexualidad de manera responsable y mejorar las oportunidades para acceder a mejores opciones económicas, puede disminuir la presencia de abortos provocados en la población que habita en la Comuna Norte de Bucaramanga.

Objectivo To evaluate the socio-demographic characteristics of females who admitted to having previously undergone induced abortion who were attended at Hospital Local del Norte in Bucaramanga from the viewpoint of distributive justice. Methods This was a descriptive, cross-sectional study of a convenience sample of patients who consulted the Hospital Local del Norte's Emergency Gynaecology-Obstetrics Service in Bucaramanga between March 1/2008 and February 28/2009 who had a diagnosis of abortion in any of their presentations. Results The sample involved 93 patients, 16 of whom accepted that they had undergone an induced abortion. Factors associated with the event were belonging to a low socioeconomic stratum, lacking adequate health care and education in family planning, lack of a stable partner or that their relationship was dysfunctional and that the couple had pressured for an induced abortion for economic reasons or that their desire for parenting had already been satisfied. Contrasting these results with existing health legislation bioethics from a social justice in health viewpoint revealed that current legislation is deficient in both its coverage and extension to educational activity regarding sexual and reproductive health. Conclusions Enabling patients to enjoy their sexuality responsibly and improving opportunities for access to better economic options may reduce induced abortions in the population living in Bucaramanga's northern commune.

Consentimiento informado y aborto en España / Consentimento informado e aborto na Espanha / Informed consent and abortion in Spain

El presente artículo repasa la legislación y jurisprudencia española sobre el consentimiento informado, centrándose en el consentimiento de la mujer embarazada a la realización del aborto. Analiza especialmente las previsiones de la LO 2/2010, de 3 de marzo, de salud sexual y reproductiva y de la interrupción voluntaria del embarazo sobre la información que se debe facilitar a la mujer que solicita el aborto.

Spanish legislation and case law on informed consent are reviewed in this article, with a focus on a pregnant woman’s consent to having abortion. Specifi cally, it looks at the provisions in LO 2 / 2010 of March 3 concerning sexual and reproductive health, and voluntary abortion in terms of what information must be provided to women seeking an abortion.

Este artigo analisa a legislação e a jurisprudência espanholas sobre o consentimento informado, enfocando-se no consentimento da gestante ao aborto. Particularmente, examina as previsões da LO 2/2010 de 3 de março, de saúde sexual e reprodutiva e dainterrupção voluntária da gravidez, sobre a informação a ser dada às mulheres que procuram o aborto.

As mulheres brasileiras e o aborto: uma abordagem bioética na saúde pública / Brazilian women and abortion: a bioethical approach to public health care

O objetivo deste trabalho é refletir criticamente sobre a criminalização do aborto no Brasil. Utilizou-se uma abordagem metodológica orientada pelo trabalho de revisão bibliográfica a partir de análise bioética que contemplou a análise do tema proposto. Verificou-se que a gestação indesejada, a violência doméstica e a dificuldade de acesso ao sistema de saúde são fatores que expõem a mulher ao dano acessório. Concluiu-se que biopolítica embasada no patriarcalismo e no princípio da sacralidade da vida continua a exercer o controle sobre o corpo e a sexualidade da mulher, e se relaciona à proibição da indução do aborto, o que constitui um problema de saúde pública. Este trabalho, a partir do uso das ferramentas da bioética, volta-se a promover o desenvolvimento das relações humanas dentro dos conceitos de justiça, dignidade e igualdade, pelo uso da dialética entre os argumentos contra e a favor do aborto.

Prevalencia del intento de interrumpir el embarazo y factores asociados en una comunidad urbano marginal de Lima-Perú, 2006 / Prevalence of the attempts to stop pregnancy and associated factors in a marginal suburban comunnity in Lima-Peru, 2006

Objetivos. Estimar la prevalencia y determinar los factores asociados al intento de interrumpir el embarazo en mujeres con antecedente de embarazo. Material y métodos. Se realizó un estudio transversal durante el año 2006. La muestra incluyó a 1057 mujeres con antecedente de embarazo que habitaban en Pamplona Alta, seleccionadas a través del muestreo probabilístico sistemático. Se realizó análisis estadístico descriptivo e inferencial, incluyendo un modelo deregresión logística. Resultados. La prevalencia de la intención de interrumpir su embarazo fue 13,9 por ciento (IC99 por ciento: 11,1- 16,7). Al efectuarse un análisis multivariado, se encontró que los factores asociados fueron: embarazo no deseado (OR=5,7; IC: 1,9-16,7), la falta de atención prenatal (OR=4,7; IC: 1,8-12,2), la prostitución (OR=11,4; IC: 1,5-87,9), tener menos de 20 años (OR=2,9; IC: 1,1-7,9) y tener más de dos parejas (OR=3,3; IC: 1,1-10,2). Conclusiones. La prevalencia estimada del intento de interrumpir el embarazo en mujeres con antecedente de embarazo en una zona urbano marginal de Lima es baja si se compara al estimado nacional de abortos. Los factores asociados al intento de interrumpir el embarazo son: el embarazo no deseado, prostitución, tener menos de 20 años, tener más de dos parejas y la falta de atención prenatal.

Objectives. To estimate the prevalence for the attempts to stop pregnancy among women with history of previouspregnancies, and to determine the factors associated. Material and methods. A cross-sectional study was performed during 2006. Samples included 1057 women with background of pregnancy, living in Pamplona Alta, selected by a systematic random sampling. We applied descriptive and inferential statistics, including a logistic regression model. Results. The prevalence for the attempt to stop pregnancy was 13.9 per cent (99 per cent CI: 11.1-16.7). The factors associated identified by multivariate analysis were: Unwanted pregnancy (OR=5.7; CI: 1.9-16.7), lack of pre-natal care (OR=4.7; CI: 1.8-12.2), prostitution (OR=11.4; CI: 1.5-87.9), age below 20 years (OR=2.9; CI: 1.1-7.9), and having more than two partners (OR=3.3; CI: 1.1-10.2). Conclusions. The estimated prevalence for the attempt to stop pregnancy among women with history of previous pregnancies in a marginal suburban area from Lima was low when compared to the national estimated prevalence of abortion. The associated factors identified for the attempts to stop pregnancy are: unwanted pregnancy, prostitution, age below 20 years, having more than two partners and lack of pre-natal care.

Socio demographic Characteristics of Pregnant Abortion-minded Clients versus Pregnant Non-abortion-minded Clients at a Pregnancy Crisis Center

Purpose: The purpose of this study is to compare the socio-demographic characteristics of pregnant abortion-minded women to those of pregnant non-abortion-minded women who had consulted a pregnancy crisis center in Montgomery County, Ohio. The findings will be used to help develop public health prevention programs for unintended pregnancies to decrease the number of abortions. Methods: A database sample of 581 records collected by a pregnancy crisis center in Montgomery County was used for this study. Criteria for inclusion were women who tested positive for pregnancy and whose pregnancy intentions were assessed as being either abortion-minded or non-abortion-minded. Socio-demographic characteristics such as age, marital status, household income, education, religious preference, race, number of previous pregnancies, number of previous live births, number of previous abortions, number of sexual partners, and age at their first sexual experience were compared to pregnancy intentions. Results: In this study, women who were more abortion-minded were single (p value = < 0.0001), Black (p value = < 0.020), women with an income level under $10,000 (p value = < 0.0001), younger women (mean age 22.6 years, p value = 0.0008), women who had their first sexual encounter at a younger age (mean age 15.6 years, p value= 0.0009), and women who had a higher number of previous abortions (mean number of abortions =0.3, p value...

Aborto inducido y embarazo no planeado en Guatemala / Induced abortion and unintended pregnancy in Guatemala

Contexto: aunque la legislación guatemalteca permite el aborto inducido solamente para salvar la vida de la mujer, con frecuencia muchas mujeres obtienen abortos, en condiciones de riesgo y en respuesta a un embarazo no planeado. Estudios recientes indican que el aborto inseguro es un factor clave que contribuye a la morbilidad y mortalidad materna en el país; sin embargo, no existen datos a nivel nacional sobre la incidencia del aborto...

Safe abortion services in Nepal: some insights.

This study attempts to ascertain the reasons that lead women to abortion and assess the extent of the involvement of their husband or male partner in the pregnancy decision making. A total 304 of women who received safe abortion services during the eight-month period from 8 clinics of Family Planning Association of Nepal (FPAN) constitute the sample size of the study. Maternal education was a strong predictor of abortion. The most cited reason for resorting to abortion was that the women had no desire for additional child. Just more than half of the clients were accompanied by their husband. Almost one-third of the women were not practicing any contraception method prior to terminating their pregnancy. Enhancing the access of women to contraceptives and providing a wide choice of methods may offset the rise in demand for abortion. Men should be targeted in all reproductive health and right programs.

Factors in relation to repeated abortions among unmarried young people in Shanghai / 中华流行病学杂志

<p><b>OBJECTIVE</b>To study the factors related to repeated abortions among unmarried young people, and to standardize the services as informed choice counseling and post abortion, and to reduce the repeated abortion rate.</p><p><b>METHODS</b>A cross-sectional survey using anonymous questionnaire was conducted among unmarried young women who requested termination of early pregnancy in 10 hospitals in Shanghai.</p><p><b>RESULTS</b>2343 subjects responded to the questionnaires. Results showed that the repeated abortion rate was 38.5%, repeated abortion rate within 1 year was 23.5%, and the high risk factors of abortion accounted for 40.2% . Subjects who were older than 19, unemployed, with poor education background, cohabitating and boyfriends being elder were more likely to have repeated abortions (OR > 1). Subjects who did not change boyfriend or use no contraception were more likely to have repeated abortions 1 year after abortion (OR > 1).</p><p><b>CONCLUSION</b>No reliable contraception used after abortion seemed to be the main reason for repeated unwanted pregnancy. Being socially disadvantaged women such as unemployed or with poor education background, meanwhile cohabitating with boyfriends or boyfriends being elder etc. they should be viewed as the key population for intervention. Male involvement and reliable contraceptive methods use among young people should be emphasized as key steps for intervention. 1 year after abortion fell into the key period for intervention. Reinforcement on factors including: training for service providers to improve their skills, setting up standard technical process and monitoring systems to carry out the basic principle of 'Informed Choice', and widely launching post-coital contraception programs including emergency contraception, luteal phase contraception and menstrual induction should be stressed.</p>