Cambios en el uso de anticonceptivos, embarazos no planificados e hijos en adolescentes chilenas entre 1997 y 2018 / Changes in the use of contraceptives, unplanned pregnancies and children in Chilean adolescents between 1997 and 2018

INTRODUCCIÓN: El embarazo en las adolescentes ha persistido como un problema de salud pública y social en Chile, afectando a las adolescentes más vulnerables y reflejando las desigualdades. OBJETIVO: Describir los cambios en el uso de anticonceptivos, embarazos no planificados e hijos en adolescentes chilenas entre 1997 y 2018. MÉTODO: Estudio ecológico de series temporales entre los años 1997 y 2018. Se midió la asociación entre variables sociodemográficas y efectividad del método anticonceptivo para los años 2006 y 2018, mediante la prueba estadística de Rao-Scott. Se estimaron tendencias del porcentaje de uso de métodos anticonceptivos según su eficacia y presencia de embarazos no planificados e hijos con modelos de regresión lineal (método de Prais-Winsten). RESULTADOS: Se observó un aumento en la frecuencia de adolescentes sexualmente activas y en el uso de anticonceptivos, especialmente píldoras e inyectables. La serie temporal de uso de anticonceptivos fue no estacionaria, la tendencia fue creciente (coeficiente: 4,59; intervalo de confianza del 95% [IC95%]: 3,43-5,74; p = 0,001), aumentando 4,59% cada 3 años. Las series de embarazos no planificados y tener hijos fueron series temporales no estacionarias y ambas presentaron una tendencia decreciente (coeficiente: −4,78; IC95%: −6,32 a −3,24; p = 0,002; y coeficiente: −3,93; IC95%: −6,18 a −1,68; p = 0,008), disminuyendo un 4,78% y un 3,93%, respectivamente, cada 3 años. CONCLUSIONES: El aumento en el uso de anticonceptivos en adolescentes ha ido unido a una importante disminución en los embarazos no planificados y los hijos en esta población.

INTRODUCTION: Adolescent pregnancy has persisted as a public and social health problem in Chile, affecting the most vulnerable adolescents and reflecting inequalities. OBJECTIVE: To describe the changes in the use of contraceptives, unplanned pregnancies and children in Chilean adolescents between 1997 and 2018. METHOD: Ecological study of time series between the years 1997 and 2018. The association between sociodemographic variables and the effectiveness of the contraceptive method for the years 2006 and 2018 was measured using the Rao-Scott statistical test. Trends in the percentage of use of contraceptive methods were estimated according to their efficacy and presence of unplanned pregnancies and children with linear regression models (Prais-Winsten method). RESULTS: An increase in the frequency of sexually active adolescents and the use of contraceptives, especially pills and injectables, was observed. The time series of contraceptive use was non-stationary, the trend was increasing (coefficient: 4.59; 95% confidence interval [95% CI]: 3.43-5.74; p = 0.001), increasing 4.59% every three years. The time series, unplanned pregnancies and having children were non-stationary time series, both showed a decreasing trend (coefficient: −4.78; 95%CI: −6.32 to −3.24; p = 0.002; and coefficient: −3.93; 95% CI: −6.18 to −1.68; p = 0.008), decreasing 4.78% and 3.93%, respectively, every 3 years. CONCLUSIONS: The increase in the use of contraceptives in adolescents has been linked to a significant decrease in unplanned pregnancies and children in this population.

Motivos de discontinuación en el uso del implante subdérmico (IS) en dos centros de salud del Área Programática del Hospital Santojanni: Repensando estrategias locales de implementación para mejorar su adherencia

El implante subdérmico (IS) es un método anticonceptivo hormonal que actualmente forma parte de la estrategia de promoción de la anticoncepción de larga duración de la Coordinación Salud Sexual, Sida e ITS de la Ciudad de Buenos Aires. Desde su implementación hasta la actualidad el uso del IS en la Ciudad ha ido en crecimiento, principalmente en los efectores localizados en la zona sur. En el último año se observó la existencia de una proporción considerable de mujeres que desean extraerlo antes de los tres años o no renovar su uso una vez cumplido el plazo. Por la corta trayectoria de implementación del IS son escasas las investigaciones al respecto y a nivel local no se conocen cuales son las principales causas de su extracción anticipada y no renovación. En este marco, el presente proyecto se centró en el análisis de los principales motivos de discontinuación del implante subdérmico en relación con las expectativas depositadas en su elección, la información recibida por parte del equipo de salud y la modalidad de acceso al mismo, en mujeres que se atendieron en los centros de salud 4 y 7 del AP del Hospital Santojanni entre los meses de mayo y noviembre de 2020. (AU)

Analysis and new contraception frontiers with combined vaginal rings.

Combined vaginal rings (ethinylestradiol (EE)/desogestrel), indicated for contraception, are highly effective, comparable to other combined hormonal contraceptives, such as pills. In addition to this benefit, vaginal rings are easy to use, with a probable lower risk of forgetting, due to their non-daily, monthly schedule. Besides, for users with poor gastric tolerance to oral formulations, they represent a method with safety and comparable extraconceptive benefits. The latest generation rings have a novel polymeric structure, do not need special storage methods and do not generate accelerated initial release of EE, reducing the early increased systemic exposure to the synthetic steroids they contain. This review describes main aspects related to its use, efficacy, and safety for contraceptive purposes.

Desenvolvimento de tecnologia educacional digital sobre prática sexual segura e contracepção com adolescentes / Development of a digital educational technology about safe sexual practice and contraception with adolescents

Há altas taxas de gravidez na adolescência no Brasil e os recursos tecnológicos como os smartphones podem ser ferramentas importantes para abordar temas pertinentes aos adolescentes, como o uso de métodos contraceptivos. As pesquisas referentes ao uso de recursos virtuais voltados à educação sexual são incipientes e isto se afunila ainda mais quando se busca evidências referentes ao uso dos serious game sobre a temática voltado a esse público. Pensando em estratégias que possibilitem não só a informação, mas que sejam interativas e façam sentido no contexto de vida dos adolescentes, estimulando o aprendizado significativo, a mudança de comportamento e o amadurecimento pessoal, sentiu-se a necessidade de desenvolver um game em aplicativo mobile (app) para essa clientela. Assim, o objetivo geral deste trabalho foi desenvolver uma tecnologia educacional digital sobre a prática sexual segura e contracepção, com a participação ativa dos adolescentes. Trata-se de um estudo metodológico acerca da construção de um serious game sobre o tema voltado aos adolescentes. Foi realizado em duas etapas: 1) Desenvolvimento participativo da tecnologia, com grupos focais; 2) Avaliação do conteúdo e da usabilidade pelos especialistas e pelo público-alvo, os adolescentes. Utilizou-se o modelo User-Centered Design embasado no design participativo. Oito adolescentes de 15 a 17 anos de uma escola pública da cidade de São Paulo participaram ativamente no desenvolvimento da tecnologia. O estudo ocorreu no período de outubro/2015 a fevereiro/2019. Os temas discutidos nos encontros de grupo focal estavam acerca da prática sexual, métodos contraceptivos, gravidez, Infecções Sexualmente Transmissíveis e do app. Assim, desenvolveu-se o app Prinventon, um game que se passa em uma cidade virtual e trabalha a sexualidade na adolescência. O conteúdo e a usabilidade foram avaliados por seis profissionais da tecnologia, seis profissionais da área da saúde e quatro adolescentes. No geral, o app foi considerado pelos especialistas como relevante diante do tema tratado. Para os profissionais da tecnologia, faltou uma abordagem mais complexa como nos jogos de ação e aventura que se utilizam do sistema de fases e aumento das dificuldades. Já para os profissionais da saúde, o app é intuitivo, poderia explorar maiores conteúdos e alguns tiveram dificuldades após instalação. Os adolescentes avaliaram o app como interativo, de boa qualidade e com conteúdo suficiente, havendo grandes possibilidades de o recomendar. Acredita-se que o app desenvolvido é adequado aos adolescentes, pois visa abordar de maneira lúdica e realística a sexualidade na adolescência, com foco no sexo seguro e contracepção

There are high rates of teenage pregnancy in Brazil and technological resources such as smartphones can be important tools to address topics relevant to adolescents, such as the use of contraceptive methods. The researches regarding the use of virtual resources focused on sex education are incipient and this is further reduced when searching for evidence referring to the use of serious games about the theme addressed to this public. Thinking about strategies that not only enable information, but which are interactive and meaningful in the context of adolescents' lives, stimulating the meaningful learning, behavior change and personal maturation, there is a need to develop a mobile application game (app) for this clientele. Thus, the general objective of this work was to develop a digital educational technology about safe sexual practices and contraception, with the active participation of adolescents. It was an applied research of technological production on the construction of a serious game about the theme for adolescents. It was carried out in two stages: 1) Participatory technology development, with focus groups; 2) Evaluation of content and usability by experts and target audience, the adolescents. The User-Centered Design model based on participatory design was used. Eight adolescents aged 15 to 17 years of a public school in the city of São Paulo participated actively in the development of technology. The study took place from October/2015 to February/2019. The topics discussed at the focus group meetings were about sexual practice, contraceptive methods, pregnancy, Sexually Transmitted Infections and the app. Thus, the Prinventon app was developed, a game that happens in a virtual city and works the sexuality in adolescence. The content and the usability were evaluated by six technology professionals, six health professionals and four adolescents. Overall, the app was considered by experts as relevant to the topic being addressed. To technology professionals, a more complex approach was lacking, as in action and adventure games that use the system of phases and increased difficulties. For health professionals, the app is intuitive, could explore greater content and some had difficulties after installation. The teenagers rated the app as interactive, good quality and with enough content, with great possibilities to recommend it. It is believed that the app developed is suitable for adolescents, since it aims to approach the sexuality in adolescence in a playful and realistic way, focusing on safe sex and contraception

Participação masculina no planejamento familiar: revisão integrativa da literatura / Male involvement in family planning: an integrative literature review / Participación masculina en la planificación familiar: revisión integrativa de la literatura

Este artigo trata de uma revisão integrativa de literatura sobre a participação masculina no planejamento familiar. Foram analisados 15 artigos de pesquisas empíricas realizadas com homens, disponíveis no Portal de Periódicos Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Capes) e nas bases de dados US National Library of Medicine (Pubmed) e Scientific Electronic Library Online (SciELO), com recorte de 1995 a 2019. Os resultados foram organizados em cinco categorias: comportamento masculino em relação ao planejamento familiar (PF); quem deve ser responsável pelo PF versus envolvimento masculino atual; como os homens participam do PF; fatores que influenciam a participação; fatores que dificultam a participação. Evidenciou-se a limitada participação masculina no PF, porém com sinais de mudanças em culturas com relações de gênero mais igualitárias. Por esse e outros fatores, ressalta-se a necessidade de investimentos em políticas públicas que visem melhor inserção masculina no PF.(AU)

This article presents the results of an integrative literature review of male involvement in family planning (FP). We analyzed 15 articles of studies conducted with men between 1995 and 2019 available on CAPES' Journal Portal and the PubMed and SciELO databases. The results were organized into five categories: male behavior in relation to FP; who should be responsible for FP versus current male involvement; how men participate in FP; factors that influence involvement; and factors that hinder involvement. The findings showed that although male involvement in FP was limited, there are signs of change in culture resulting in greater gender equality. Our findings and other factors highlight the need to invest in public policies designed to increase male involvement in FP.(AU)

Este artículo contiene una revisión integrativa de literatura sobre la participación masculina en la planificación familiar. Se analizaron 15 artículos de investigaciones empíricas realizadas con hombres, disponibles en el Portal de Periódicos CAPES y en las bases de datos Pubmed y SciELO, con recorte de 1995 a 2019. Los resultados se organizaron en cinco categorías: comportamiento masculino con relación a la planificación familiar (PF): quién debe ser responsable por la PF versus envolvimiento masculino actual; cómo los hombres participan en la PF; factores que influyen en la participación; factores que dificultan la participación. Resultó evidente la limitada participación que ellos tienen en la PF, pero con señales de cambio cultural con relaciones de género más igualitarias. Por ese y otros factores, se subraya la necesidad de inversiones en políticas públicas con el objetivo de una mejor inserción masculina en la PF.(AU)

Cambios en prevalencias de conocimientos, actitudes y prácticas de sexualidad en adolescentes escolarizados, Bogotá, 2011-2015 / Changes in prevalence of knowledge, attitudes and practices of sexuality in teenage students, Bogotá, 2011-2015 / Mudanças na prevalência de conhecimentos, atitudes e práticas de sexualidade em adolescentes escolares, Bogotá, 2011-2015

RESUMEN Objetivo Presentar los cambios en las prevalencias de conocimientos, actitudes y prácticas en adolescentes escolarizados en torno a sexualidad luego de un proceso de intervención. Metodología Estudio descriptivo observacional. Se aplicó un cuestionario a 319 adolescentes, pertenecientes a tres colegios públicos, durante cinco años consecutivos a medida que avanzaban en los grados escolares (séptimo a undécimo). Se realizaron talleres de promoción de la salud. Se midieron los cambios de prevalencias de identificación del ciclo menstrual, de la anticoncepción de emergencia y de la protección del condón, así como de la aceptación de los padres a la planificación, de haber tenido relaciones sexuales, razones para hacerlo y si usó protección en la primera y última relación. Se compararon los resultados por género. Resultados La identificación de la anticoncepción de emergencia se incrementó del 52% en séptimo al 70% en undécimo; igualmente la certeza de protección del condón (del 45% al 62%, respectivamente). El promedio de la prevalencia de relaciones sexuales fue del 24%, el de protección en la primera relación fue del 52% y, en la última, el 81%; no se encontraron diferencias estadísticas de estas variables al compararlas por género. La percepción de la aceptación de la planificación por parte de los padres se incrementó del 45% al 79%. Conclusión El programa puso en evidencia la necesidad de fortalecer el proceso educativo a través de las prevalencias encontradas.(AU)

ABSTRACT Objective To present the changes in the prevalence of knowledge, attitudes and practices in high school adolescents in sexuality after an intervention process. Methodology Observational descriptive study. It was administered a questionnaire to 319 adolescents, attending three public schools, for five consecutive years as they progressed in school years (seventh to eleventh). Health promotion workshops were held. Changes in the prevalence were measured (identification of the menstrual cycle, emergency contraception and, condom protection, as well as parents' acceptance of contraception methods, having sex, reasons for do it and, whether they used protection in the first and last relationship). The results were compared by gender. Results The identification of emergency contraception was increased from 52% in seventh to 70% in eleven; also, the certainty of the condom protection (from 45% to 62%, respectively). The average of the prevalence of sexual intercourse was 24%, protection in the first relationship 52% and, in the last one was 81%; no statistical differences of these variables were found when comparing them by gender. Parents' perception of acceptance of planning increased from 45% to 79%. Conclusion The program results highlighted the need to strengthen the educational processes.(AU)

RESUMO: Objetivo Apresentar as mudanças na prevalência de conhecimentos, atitudes e práticas em adolescentes escolarizados em torno da sexualidade após um processo de intervenção. Metodologia Estudo observacional descritivo. Um questionário foi aplicado a 319 adolescentes, pertencentes a três escolas públicas, por cinco anos consecutivos, à medida que avançavam nas séries escolares (sétima a décima primeira). Foram realizadas oficinas de promoção da saúde. As mudanças na prevalência da identificação do ciclo menstrual, contracepção de emergência e proteção do preservativo foram medidas, bem como a aceitação do planejamento pelos pais, tendo tido relações sexuais, razões para fazê-lo e se ele usou proteção em o primeiro e o último relacionamento. Os resultados por sexo foram comparados. Resultados A identificação da contracepção de emergência aumentou de 52% no sétimo para 70% no décimo primeiro; também a certeza da proteção do preservativo (de 45% a 62%, respectivamente). A prevalência média de relações sexuais foi de 24%, a de proteção na primeira relação foi de 52% e, na última, de 81%; Não foram encontradas diferenças estatísticas para essas variáveis quando comparadas por gênero. A percepção dos pais quanto à aceitação do planejamento aumentou de 45% para 79%. Conclusão O programa destacou a necessidade de fortalecer o processo educacional por meio das prevalências encontradas.(AU)

Stagnant contraceptive sales after the Zika epidemic in Brazil.

OBJECTIVES: Our aim was to assess national hormonal and non-hormonal contraceptive sales in Brazil after the Zika virus outbreak. METHODS: Pharmaceutical companies based in Brazil provided data on monthly sales from September 2016 to June 2017. Data from both the public and private sectors were obtained about sales of registered, available modern contraceptive methods: combined oral contraceptive pill; progestin-only pill; vaginal and transdermal contraceptives; injectable contraceptives; long-acting reversible contraceptive (LARC) methods, including the copper-releasing intrauterine device, the levonorgestrel-releasing intrauterine system and the etonogestrel-releasing subdermal implant; and emergency contraceptive pills. RESULTS: Seventy-eight percent of sales comprised pills, patches and vaginal rings (11.1-13.8 million cycles/units per month), followed by emergency contraceptive pills (1.8-2.6 million pills), injectables (1.2-1.4 million ampoules) and LARC methods (6500-17,000 devices). CONCLUSIONS: The data showed much higher sales of short-acting methods compared with more effective LARC methods. The public sector needs to strengthen its focus on ensuring better access to LARC methods through a systematic approach ensuring regular supply, improved professional skills and better demand generation to couples wishing to avoid or delay pregnancy. In Zika virus-affected areas, many women of reproductive age may want to delay or postpone pregnancy by using an effective LARC method. The public sector should review its policies on LARC, as the need for these methods especially in Zika virus endemic areas may increase. A clear emphasis on quality in services, access and use is warranted.

Study protocol on establishment of sentinel sites network for contraceptive and abortion trends, needs and utilization of services in Zika virus affected countries.

BACKGROUND: ZIKV(Zika Virus) during pregnancy can result in many adverse events such as fetal deaths or newborns with congenital abnormalities including microcephaly and other neural irregularities. Due to these harmful outcomes of pregnancy associated with the Zika virus, we can expect to see a change in the type and scale of demand for family planning and safe abortion services in areas affected by the Zika virus. The monitoring and reporting capacities of the local health clinics in these areas could benefit from the introduction of infrastructural improvements necessary to establish a sentinel site network. Through these sites, the WHO will collect data on the situation from local health professionals to get real time information from the population group and act accordingly to mitigate the consequences of the Zika virus outbreak in a localized and culturally appropriate way. The objectives are to establish a sentinel sites surveillance network for reporting on uptake and utilization of contraception and safe abortion care services; to strengthen monitoring, and data quality assurance in the selected sentinel surveillance sites; and finally to assess the contraception and safe abortion care service utilization trends in the affected sites on a regular basis. METHODS: The proposal includes a set of objectives and actions that enable the creation of a set of criteria for the selection of the sentinel sites, as well the implementation of monitoring and reporting systems that will be used in data collection. DISCUSSION: The data collected will be used to better understand the changing demand for family planning and safe abortion needs. This will ultimately be used to inform local health workers and policy makers as to how best to track the continued Zika virus outbreak and mitigate the consequences. The learning from establishment of surveillance sentinel sites will help to strengthen health systems at regional and subregional levels that are more adaptable and capable of providing reproductive healthcare services and of responding to future emergencies.

Adolescent Contraception Before and After Pregnancy-Choices and Challenges for the Future.

Objective To determine methods of contraception used by adolescents before and after pregnancy. Methods A cross-sectional study was performed, and data were collected from medical records of all teens in puerperal consultation at the Hospital da Mulher - José Aristodemo Pinotti (Caism), Universidade Estadual de Campinas (CAISM), São Paulo, Brazil, between July 2011 and September 2013. The inclusion criterion was being 10 to 19 years old, and the exclusion criterion was having a first consultation 90 days after childbirth. Statistical analyses were performed with averages, standard deviations, percentages, correlations and Fisher's exact tests using the SAS program, version 9.4. Results A total of 196 adolescents in postpartum consultation were included (44 days after childbirth on average). The majority was older than 14 years (89%), with an average age of 16.2 years, and the most were exclusively breast-feeding (70%). Before pregnancy, the use of any contraceptive methods was mentioned by 74% adolescents; the most frequent use was combined oral contraceptive followed by condom. The main reason for abandoning the use of contraception was the occurrence of an unintended pregnancy (41%), followed by reports of side effects (22%), behavior issues (18%) and desire for pregnancy (16%). A positive correlation was found between the age of the adolescent at the moment of childbirth, the age of menarche (r = 0.3), and the first sexual intercourse (r = 0.419). Vaginal delivery occurred in 76% of the cases. After birth, depot medroxyprogesterone acetate (DMPA) was the contraception method most frequently used (71%), followed by oral contraceptives (11.8%) and intrauterine devices (IUDs, 11.2%). Conclusions The most prescribed contraceptive method before pregnancy in adolescents who had childbirth was combined oral contraceptives. Many of the study participants had an unintended pregnancy. After childbirth, the most used contraceptive method was DMPA. To improve contraception and reduce the chance of unintended pregnancies among adolescents, we should promote the use of long-acting reversible contraceptives (LARCS).

Adolescent Contraception Before and After Pregnancy-Choices and Challenges for the Future / Contracepção em adolescentes antes e depois do parto: escolhas e desafios para o futuro

Abstract Objective To determine methods of contraception used by adolescents before and after pregnancy. Methods A cross-sectional study was performed, and data were collected from medical records of all teens in puerperal consultation at the Hospital da Mulher - José Aristodemo Pinotti (Caism), Universidade Estadual de Campinas (CAISM), São Paulo, Brazil, between July 2011 and September 2013. The inclusion criterionwas being 10 to 19 years old, and the exclusion criterion was having a first consultation 90 days after childbirth. Statistical analyseswere performed with averages, standard deviations, percentages, correlations and Fisher's exact tests using the SAS program, version 9.4. Results A total of 196 adolescents in postpartum consultation were included (44 days after childbirth on average). The majority was older than 14 years (89%), with an average age of 16.2 years, and the most were exclusively breast-feeding (70%). Before pregnancy, the use of any contraceptive methods was mentioned by 74% adolescents; the most frequent use was combined oral contraceptive followed by condom. The main reason for abandoning the use of contraception was the occurrence of an unintended pregnancy (41%), followed by reports of side effects (22%), behavior issues (18%) and desire for pregnancy (16%). A positive correlation was found between the age of the adolescent at the moment of childbirth, the age of menarche (r = 0.3), and the first sexual intercourse (r = 0.419). Vaginal delivery occurred in 76% of the cases. After birth, depot medroxyprogesterone acetate (DMPA) was the contraception method most frequently used (71%), followed by oral contraceptives (11.8%) and intrauterine devices (IUDs, 11.2%). Conclusions The most prescribed contraceptive method before pregnancy in adolescents who had childbirth was combined oral contraceptives. Many of the study participants had an unintended pregnancy. After childbirth, the most used contraceptive method was DMPA. To improve contraception and reduce the chance of unintended pregnancies among adolescents, we should promote the use of long-acting reversible contraceptives (LARCS).

Resumo Objetivo Conhecer os métodos contraceptivos utilizados por adolescentes antes e após a gravidez. Métodos Estudo transversal, os dados foram coletados de prontuários médicos de todas as adolescentes em consulta puerperal do Hospital da Mulher - José Aristodemo Pinotti (CAISM), Unicamp, São Paulo, Brasil, entre julho de 2011 e setembro de 2013. O critério de inclusão foi idade entre 10 e 19 anos, e o critério de exclusão foi primeira consulta com mais de 90 dias após o parto. As análises estatísticas foram realizadas com médias, desvios-padrão, porcentagens, correlações e teste exato de Fisher utilizando o pro grama SAS, versão 9.4. Resultados Um total de 196 adolescentes em consulta pós-parto foram incluídas (em média 44 dias após o parto). A maioria tinha mais do que 14 anos (89%), com idade média de 16,2 anos, e estava em aleitamento exclusivo (70%). Antes da gravidez, o uso de quaisquer métodos anticoncepcionais foi mencionado por 74% das adolescentes; o mais frequente foi contraceptivo oral combinado seguido de preservativo. A principal razão para abandonar o uso de contracepção foi a ocorrência de gravidez indesejada (41%), seguido por relatos de efeitos colaterais (22%), problemas comportamentais (18%) e desejo de gravidez (16%). Uma correlação positiva foi encontrada entre a idade da adolescente no momento do parto, a idade da menarca (r = 0,3), e a primeira relação sexual (r = 0,419). O parto vaginal ocorreu em 76% dos casos. Após o nascimento, acetato de medroxiprogesterona de depósito (DMPA) foi o método de contracepção mais utilizado (71%), seguido do contraceptivo oral (11,8%) e do dispositivo intrauterino (DIU) (11,2%). Conclusões O método anticoncepcional mais prescrito antes da gravidez em adolescentes que tiveram parto no serviço foi contraceptivo combinado oral. Muitas participantes do estudo tiveram uma gravidez indesejada. Após o parto, o método contraceptivomais utilizado foi DMPA. Paramelhor contracepção e reduzir a chance de gravidez indesejada entre adolescentes, devemos promover e estimular o uso de contraceptivos reversíveis longa ação.

Honrar a Rosa Parks? Intentos de los sectores católicos conservadores a favor de los derechos en la América Latina contemporánea / Claiming Rosa Parks: conservative catholic bids for rights in contemporary Latin America / Honrar Rosa Parks? Tentativas dos setores católicos conservadores a favor dos direitos na América Latina contemporânea

Cuando en el año 2009 se otorgó en Argentina el Premio Rosa Parks a una senadora conservadora por su oposición abierta al uso de anticonceptivos, a la esterilización y al aborto, era evidente que algo extraño ocurría. En este artículo se documenta la apropiación de los discursos de "derechos humanos" por parte de los sectores católicos conservadores en América Latina, donde el éxito reciente de los movimientos sociales a favor de los derechos sexuales y reproductivos ha generado una reacción significativa. En particular, se indagan los esfuerzos por parte de académicos católicos especialistas en leyes para justificar lo que denominan "un enfoque distintivamente latinoamericano hacia los derechos humanos", dejando de lado décadas de activismo por los derechos humanos emprendido por otros sectores. Quienes se oponen a los derechos reproductivos y sexuales despliegan un discurso de derechos de forma selectiva y estratégica, utilizándolo como una cubierta secular para promover políticas pro-vida y pro-familia.

When the Rosa Parks Prize was awarded to a conservative Argentine senator in 2009 for her outspoken opposition to contraception, sterilisation, and abortion, it was clear that something odd was happening. This paper documents the appropriation of "human rights" discourses by conservative Catholics in Latin America, where the recent success of reproductive and sexual rights social movements has generated a significant backlash. It specifically traces an effort by Catholic legal scholars to justify what they term "a distinctively Latin American approach to human rights" while ignoring decades of human rights activism by others. Opponents of reproductive and sexual rights are deploying rights-talk selectively and strategically, I argue, using it as secular cover to advance pro-life and pro-family policies.

Quando se outorgou o Prêmio Rosa Parks na Argentina a uma senadora conservadora, no ano de 2009, por sua oposição aberta ao uso de anticoncepcionais, à esterilização e ao aborto, era evidente que algo estranho acontecia. Nesta exposição documenta-se a apropriação dos discursos de "direitos humanos" por parte dos setores católicos conservadores na América Latina, onde o êxito recente dos movimentos sociais a favor dos direitos sexuais e reprodutivos gerou uma reação significativa. Em particular, indaga-se sobre os esforços por parte de acadêmicos católicos especialistas em leis para justificar o que denominam de "um enfoque distintivamente latino-americano para os direitos humanos", deixando de lado décadas de ativismo pelos direitos humanos empreendido por outros setores. Quem se opõe aos direitos reprodutivos e sexuais desdobra ou faz um desdobramento de um discurso de direitos de forma seletiva e estratégica, em minha opinião, utilizando-o como uma coberta/divisória secular para promover as políticas pró-vida pró-família.

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

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.