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)

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.

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.

Estudio hospitalario del aborto ilegal en Bolivia / A hospital study of illegal abortion in Bolivia

A causa del caracter ilegal del aborto provocado, es dificil determinar el grado en que este se practica en América Latina. En el caso de Bolivia, a la fecha no existen datos sobre el problema. Por este motivo, se decidio estudiar las caracteristicas sociodemograficas y obstétricas de una muestra de 4.371 mujeres bolivianas internadas por complicaciones del aborto en 11 hospitales urbanos en un período de un ano (1 de julio de 1983 a 30 de junio de 1984). Los datos se recogieron con ayuda de un calendario rellenado por los medicos tratantes y se interpretaron desde el punto de vista de la planificacion familiar. Una cuarta parte (22,7 por ciento) de los abortos fueron ilegalmente provocados. Las mujeres que deliberadamente pusieron fin a su embarazo se caracterizaron por ser en general jóvenes, nuliparas y solteras. En total, 65,0 por ciento de los abortos fueron provocados por personas con adiestramiento medico, la mayor parte de las veces mediante raspado uterino; en 30 por ciento fue provocado por personas sin adiestramiento medico y en 5 por ciento por la propia mujer, y en estos casos el medio mas comun fue la introduccion de un cuerpo extrano en el utero. Las mujeres con mayor escolaridad tendieron a recurrir a personas con adiestramiento medico. Ademas, cuando el aborto fue provocado por raspado uterino hubo menos probabilidades de sufrir fiebre y lesiones genitales, pero fue mas prolongada la estadia hospitalaria promedio...