Caracterización de la terminación voluntaria del embarazo en adolescentes / Characterization of the voluntary termination of pregnancy in adolescents

Introducción: el aborto es un problema de salud que compromete la salud sexual y reproductiva en la adolescencia.Objetivo: evaluar su comportamiento y correlacionar características biológicas, psicológicas y sociodemográficas de las jóvenes que asisten a este servicio del policlínico Hermanos Cruz de Pinar del Río.Métodos: se realizó un estudio descriptivo y transversal de las adolescentes que concurrieron a la consulta de regulación menstrual durante el período enero-mayo 2013. El universo lo conformaron 150 jóvenes, y se tomó una muestra aleatoria simple de 62 que decidieron participar en el estudio. Se les aplicó una encuesta. Se estudiaron variables como: edad, edad de la primera relación sexual, cantidad de compañeros sexuales, uso de anticoncepción y motivo de solicitud de la interrupción del embarazo. Los datos fueron procesados y analizados con medidas de frecuencias.Resultados: el grupo de edad predominante estuvo entre 18-19 años, 93,5 por ciento tuvo la primera relación sexual entre los 14 y 17 años, 64,5 por ciento ya había tenido 3 o más parejas, el 77,4 por ciento de las jóvenes eran solteras. El 45,1 por ciento usaba condón, 41,9 por ciento refirió embarazo por fallo del método y el motivo más frecuente de solicitud de interrupción fue: muy joven para asumir el rol de la maternidad (90,3 por ciento).Conclusiones: el inicio precoz de las relaciones sexuales, el inadecuado uso de anticoncepción, la promiscuidad, y la esperada inexperiencia para asumir el rol de la maternidad, hacen pensar que aún existen dificultades en la educación de la sexualidad en las adolescentes(AU)

Introduction: abortion is a health problem that involves the sexual and reproductive health in adolescence. Objective: to evaluate its behavior and correlate biological, psychological, and socio-demographic features of young people attending this service at Hermanos Cruz polyclinic in Pinar del Rio. Methods: a descriptive cross-sectional study was performed on adolescents who attended the consultation of menstrual regulation from January to May 2013. The universe was formed by 150 young persons. A simple random sample of 62 was chosen to participate in this study. A survey was given to them. Age, age at first intercourse, number of sexual partners, use of contraception and reasons for the request for termination of pregnancy using the variables studied. Data was processed and analyzed with frequency steps. Results: the predominant age group was between 18-19 years, 93.5 percent had their first sexual intercourse between 14 and 17 years, 64.5 percent have had 3 or more sexual partners, 77.4 percent were single. 45.1 percent used condoms, 41.9 percent reported pregnancy due to method failure and the most common reason for pregnancy interruption was being too young to assume the role of motherhood 90.3 percent. Conclusions: early initiation of sexual intercourse, inappropriate use of contraception, promiscuity, and expected inexperience to assume the role of motherhood suggest that there are still difficulties in sexuality education of adolescent(AU)

Intervención educativa en adolescentes del Policlínico Universitario Asdrúbal López Vázquez sobre conocimiento de aborto / Educational interventions in teenager at the Policlinic Asdrubal Lopez Vazquez about abortion

Se realiza un estudio de intervención, con el objetivo de evaluar el nivel de conocimiento sobre el aborto en adolescente del policlínico sur, en el período enero-diciembre de 2012. El universo es de 52 adolescentes y se tomó una muestra de 25 adolescentes. Se aplicó encuesta con previo consentimiento. Las variables estudiadas fueron: grupos de edades, edad de la primera relación sexual, conocimientos acerca del aborto, sus complicaciones y riesgos, y la conducta ante un aborto. Hubo predominio del grupo de edades de 15 a 19 años, la edad de la primera relación sexual fue a los 17 años. La mayoría no sabía qué era el aborto, ni sus complicaciones y riesgo hasta después de la intervención, y no tenían conocimientos sobre la conducta a seguir para evitar el aborto. Se emitieron conclusiones y recomendaciones (AU)

An intervention study was performed, in order to assess the level of knowledge about teen abortion at the policlinic Sur, from January to December 2012. The universe is 52 adolescents and a sample 25 of them. A survey was applied prior consent. The variables were studied: age group, age at first intercourse, knowledge about abortion, complications and risks, and conduct before an abortion. There was a predominance of the age group 15-19 years; the age of first sexual relation was at 17 years old. Most of them had not had knowledges about abortion, its complications and risk after the surgery and had not had knowledges of the actions to avoid abortion. Conclusions and recommendations were issued

Management of early pregnancy failure and induced abortion by family medicine educators.

BACKGROUND: Reproductive health care, including treatment of early pregnancy failure (EPF) and induced abortion, is an integral part of patient-centered care provided by family physicians, but data suggest that comprehensive training is not widely available to family medicine residents. The purpose of this study was to assess EPF and induced abortion management practices and attitudes of family medicine physician educators throughout the United States and Canada. METHODS: These data were collected as part of a cross-sectional survey conducted by the Council of Academic Family Medicine Educational Research Alliance that was distributed via E-mail to 3152 practicing physician members of Council of Academic Family Medicine organizations. RESULTS: The vast majority of respondents (88.2%) had treated EPF, whereas few respondents (15.3%) had provided induced medication or aspiration abortions. Of those who had treated EPF, most had offered medication management (72.7%), whereas a minority had provided aspiration management (16.4%). Almost all respondents (95%) agreed that EPF management is within the scope of family medicine, and nearly three-quarters (73.2%) agreed that early induced abortion is within the scope of family medicine. CONCLUSION: Our findings suggest that family physician educators are more experienced with EPF management than elective abortion. Given the overlap of skills needed for provision of these services, there is the potential to increase the number of family physician faculty members providing induced abortions.

Abortion law reforms in Colombia and Nicaragua: issue networks and opportunity contexts.

This article analyses two instances of abortion law reform in Latin America. In 2006, after a decades-long impasse, the highly controversial issue of abortion came to dominate the political agenda when Colombia liberalized its abortion law and Nicaragua adopted a total ban on abortion. The article analyses the central actors in the reform processes, their strategies and the opportunity contexts. Drawing on Htun's (2003) framework, it examines why these processes concluded with opposing legislative outcomes. The authors argue for the need to understand the state as a non-unitary site of politics and policy, and for judicial processes to be seen as a key variable in facilitating gender policy reforms in Latin America. In addition, they argue that 'windows of opportunity' such as the timing of elections can be critically important in legislative change processes.

A survey of providers' knowledge, opinions, and practices regarding induced abortion in Jamaica.

OBJECTIVE: To determine the stance of providers in Jamaica regarding the suggested change in abortion law and proposal to train providers. METHODS: A face-to-face anonymous survey of 35 obstetrician-gynecologists (Obs) and 228 general practitioners (GPs) in Kingston was used to assess knowledge, opinions and practice. RESULTS: Demand for abortion was high: 94.7% of GPs and 100% of Obs had been asked to perform an abortion. Although 50.7% of GPs and 70.6% of Obs had performed abortions, 81.2% and 88.6%, respectively, had referred women to another provider. Training was more likely for Obs (65.7% versus 52.2%; P<0.001). Patient assessment was appropriate, but written guidelines, counseling, and social services referral were uncommon. More Obs knew the laws (62.9% versus 42.5%; P=0.052). Most participants did not agree to abortion under any circumstance, but only 25.3% had moral or religious objections, and only 9.4% refused to perform abortions because they were illegal. Most providers felt that abortions should be made more accessible, and almost all felt that abortions should be performed only by Obs. CONCLUSION: Demand for abortions is high in Jamaica, but many doctors refer clients to another provider. Patient assessment is good, but support services need improvement.

Religion and attitudes toward abortion and abortion policy in Brazil.

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.

Politics, religion and gender equality in contemporary Mexico: women's sexuality and reproductive rights in a contested secular state.

This article explores the complexities of the interaction between politics, religion and gender equality in contemporary Mexico, by analysing recent developments in public debate, legal changes and implementation of government policies in two areas: 1) the inclusion of emergency contraception in public health services in 2004; and 2) the decriminalisation of abortion in Mexico City in 2008, which was followed by a massive campaign to re-criminalise abortion in the federal states. Three main findings emerge from our analysis: first, that women's sexual and reproductive autonomy has become an issue of intense public debate that is being addressed by both state-public policy and society; second, that the gradual democratisation of the Mexican political system and society is forcing the Catholic Church to play by the rules of democracy; and third, that the character and nature of the Mexican (secular) state has become an arena of intense struggle within which traditional political boundaries and ideologies are being reconfigured.

Pharmacy worker practices related to use of misoprostol for abortion in one Mexican state.

BACKGROUND: Pharmacies are important sites for access to health information and medications in Mexico. Most workers are not trained in health issues and may provide inaccurate information to consumers. Misoprostol is used by women throughout Mexico for early abortion and often is purchased from pharmacies. This study aims to understand the practices of pharmacy workers when asked for advice about and medications for abortion, in particular misoprostol. STUDY DESIGN: A random sample of pharmacies in both urban and rural areas of one state of Mexico included both chain and independent pharmacies (n=169). Two mystery clients (MCs) visited the pharmacies, requesting medication for "bringing down the period" and then asking for misoprostol. MCs recorded information about the interactions following each visit in standardized formats. Bivariate comparisons were made between spontaneous and prompted discussions of misoprostol. Associations were considered statistically significant at alpha<.05. RESULTS: Ninety percent of pharmacy workers attending to the MCs discussed misoprostol as an abortifacient, either spontaneously or after being prompted by the MCs. Misoprostol was for sale in most (61%) of these pharmacies. The majority of pharmacy workers (75%) did not request a prescription. Over 75% of all pharmacy workers provided the MCs referral to trained medical providers with whom they could seek a follow-up visit. Sixteen percent of pharmacy workers suggested a regimen consistent with evidence and recommendations for using misoprostol for early abortion. Regimens that were underdosages were common, and few workers recommended a potentially harmful overdosage. Instructions about side effects and risks were rare. The price of misoprostol ranged from 900 to 1800 pesos (US$83-167) for a bottle of 28 tablets (200 mcg each) or US$4.07 per tablet, on average. CONCLUSIONS: Pharmacy workers in both urban and rural areas of Mexico are increasingly becoming aware of misoprostol as an effective abortifacient and are willing to provide the information to consumers. However, their information is limited and often inaccurate. Strategies need to be developed so that they receive timely and correct information, consistent with evidence-based recommendations. The legal context of abortion in Mexico (with restrictions in every state, except Mexico City), the restricted registration of misoprostol as a therapeutic agent only for gastric ulcers and the fact that the majority of pharmacy workers are not considered to be health workers are among the most important barriers to advances in training pharmacy workers in the correct application of misoprostol.

Prevención del embarazo en mujeres con alto riesgo de aborto. Resultados de un proyecto de intervención en la comunidad / Pregnancy in women prevention with broad risk of abortion. Results of a project of intervention in the community

Objetivo: Es un estudio controlado, de cohorte e intervención en comunidad de bajo nivel socioeconómico, para determinar el efecto preventivo de la planificación familiar en el aborto provocado. Método: Se comparó tres comunidades muy similares. Una de ellas fue intervenida con alta calidad de servicios clínicos y seguimiento de las mujeres de alto riesgo de aborto. Otra comunidad sólo tuvo servicios de alta calidad sin seguimiento de las potenciales usuarias y la tercera comunidad fue de control, con los servicios habituales de atención. Las mujeres de las tres comunidades fueron entrevistadas antes de la intervención y 2 años después de iniciada la intervención. Se comparó ambas encuestas hechas a las mismas mujeres, en las tasas de aborto y fecundidad, de acuerdo al uso y no uso de anticonceptivos y al nivel riesgo de provocarse aborto. Resultados: La prevalencia de aborto desciende en forma significativa en la comunidad con alto riesgo de aborto y con intervención directa y total. Las tasas de fecundidad descienden en las tres comunidades, pero más en la comunidad no intervenida. Se concluye que los servicios de alta calidad en planificación familiar, en mujeres con riesgo de aborto y en un medio donde el aborto es totalmente penalizado, tienen un impacto significativo en su prevención, sin afectar la natalidad. Se recomienda aplicar esta metodología en programas de atención primaria para prevenir el aborto provocado clandestino.

Modificar conocimientos sobre aborto en las adolescentes que acuden a consulta de Regulación / - Modification to knowlegde on aborption in adolescents who attend the menstrual regulation consultation

Se realizó un estudio de intervención educativa con adolescentes que acuden a la consulta de Regulación Menstrual del Policlínico Comunitario Victoria de Girón en Palma Soriano ,en el período comprendido de Enero a Septiembre del presente año, con el objetivo de evaluar y modificar los conocimientos sobre el aborto en dichas adolescentes. La muestra estuvo constituida por 40 adolescentes que dieron suconsentimiento para la realización de la investigación .Para la recolección se utilizó el método de los palotes y el por ciento como medida de resumen.Se concluyó que los conocimientos de las adolescentes en el tema de aborto era inadecuado ,luego de la intervención fueron adecuados ,por lo que recomendamos el mejor funcionamiento de los Círculos de adolescentes para revertir esta situación(AU)

Aborto provocado: diferencas entre pensamento e acao / Induced abortion: diferences between thought and action

Sao apresentados resultados de uma pesquisa sobre aborto provocado, realizada em 1990, entre alunas e funcionarias de uma universidade do Estado de Sao Paulo. Foram distribuidos questionarios pre-testados para serem auto-respondidos e devolvidos pelo correio atraves de um envelope carta-resposta comercial, o que garantiu o sigilo. Foram recebidos 1987 questionarios respondidos pelas funcionarias. Os dados deste trabalho referem-se a 369 funcionarias que alguma vez pensaram em provocar aborto. Dessas 264 realmente o fizeram. Foram estudadas suas caracteristicas socio-demograficas por ocasiao da pesquisa. Ao analisar idade, total de gravidezes e estado marital, as maiores porcentagens foram observadas entre as mulheres que pensaram em abortar e realmemnte o fizeram. Setenta e sete por cento dessas tinham 40 anos ou mais, 80 por cento tinham cinco ou mais gravidezes e 85 por cento eram solteiras. Quanto ao grau de escolaridade, a maior porcentagem foi observada entre as mulheres com alguma educacao universitaria (80 por cento). Os resultados obtidos atraves da regressao logistica mostraram que, tanto ao estudar todas as mulheres que pensaram em abortar, quanto as que declararam ter alguma religiao, o aborto foi mais frequente entre as com menor numero de filhos vivos, maior numero de gravidezes, alguma...