The Shift From Criminalization to Legalization of Abortion in Argentina.

This Viewpoint discusses passage and implementation of Law 27.610, which legalized abortion in Argentina under certain circumstances, and examines the ongoing clinical issues and legal challenges to the law.

Indiciamento das mulheres pela prática do abortamento: a (des)continuidade do discurso punitivista / Indictment of women for the practice of abortion: the (dis) continuity of the punitive discourse / Incriminación de mujeres por la práctica del aborto: la (dis)continuidad del discurso punitivo

Resumo O objetivo deste trabalho foi analisar os argumentos empregados na condenação ou absolvição das mulheres acusadas de abortamento, especialmente os processos que foram suspensos. Analisamos sentenças e acórdãos referentes ao autoaborto (art. 124 do Código Penal) dos Tribunais de Justiça dos estados de São Paulo e de Minas Gerais. Como resultado do levantamento, constatamos a reiterada concessão da suspensão condicional do processo ou da pena, o que poderia ser considerado medida despenalizadora, por acarretar a extinção da punibilidade. No entanto, ante a aceitação e devido cumprimento das condições impostas pelo prazo fixado, o conteúdo das decisões de suspensão (de processo e de pena) explicita o caráter moral das sentenças, bem como a discriminação de gênero e a violência institucional. Assim, discute-se os fins da criminalização do abortamento e as consequências para o exercício pleno dos direitos sexuais e reprodutivos das mulheres.

Abstract This article's objective was to analyse the arguments used for the conviction or acquittal of women accused of abortion, especially in processes that were suspended. We analysed judicial decisions from the Justice Courts of São Paulo and Minas Gerais States. As a result of the analysis of these materials, we note the repeated granting of conditional suspension of the process or penalty, which could be considered a decriminalizing measure. However, as it entails the extinction of punishment, once accepted and respected the conditions imposed by a fixed term, the content of the concessive decisions exhibit the explicit moral judgement of the convictions, as well as gender discrimination and institutional violence. Thus, we discuss the overall aim of the criminalisation of abortion and the consequences for the full exercise of women's sexual and reproductive rights.

Resumen El objetivo de este trabajo fue analizar los argumentos utilizados en la condena o absolución de mujeres acusadas de aborto, especialmente los procesos que fueron suspendidos. Analizamos sentencias relacionadas con el aborto autoproducido (art. 124 del Código Penal brasileño) de los Tribunales de Justicia de los estados de São Paulo y Minas Gerais. Como resultado de la investigación, se observa el reiterado otorgamiento de suspensión condicional del proceso o sanción, lo que podría ser considerado una medida despenalizadora, ya que resulta en la extinción de la pena. Sin embargo, ante la aceptación y debido cumplimiento de las condiciones impuestas por el plazo fijado, el contenido de las decisiones de suspensión (de proceso y sentencia) hace explícito el carácter moral de las sentencias, así como la discriminación de género y la violencia institucional. Así, se discute el propósito de criminalizar el aborto y las consecuencias para el pleno ejercicio de los derechos sexuales y reproductivos de las mujeres.

The Politicization of Abortion and Hippocratic Disobedience in Islamist Sudan.

In Sudan's Islamist state, abortion is politicized through its association with illegal pregnancy. Fornication is a crime against God punishable with 100 lashes, and pregnancy outside a marriage contract constitutes sufficient evidence of a woman's immorality. This enables a strong link between the crime of fornication and the crime of illegal abortion, to the extent that our interviewees often conflate the two in the term "illegal pregnancy." While abortion does not appear in the domestic political debate on women's reproductive and maternal health and is not on the agenda of the national women's movement, it has become politicized in the implementation of the law. A number of bureaucratic barriers, in addition to a strong police presence outside maternity wards in public hospitals, make it difficult for unmarried women to access emergency care after complications of an illegal abortion. These women put themselves at risk of arrest for fornication and illegal abortion. However, many doctors, honoring the Hippocratic oath, disobey state policy and refrain from reporting such crimes to the police to protect unmarried and vulnerable women from prosecution.

Evidence on factors influencing contraceptive use and sexual behavior in South Africa: A systematic scoping review protocol.

BACKGROUND: Contraceptive use and sexual health behavior remain a prominent public health concern in South Africa. Despite many government interventions, unplanned pregnancies, number of abortions, and maternal mortality remain relatively high. Due to high pregnancy levels and the stigma associated with termination of pregnancy, more women turn to unsafe and illegal abortions despite the risks involved. Risky sexual behavior pose a serious risk of contracting HIV/AIDS. The main objective of this study is to map evidence on factors influencing contraceptive use and sexual behavior in South Africa. METHODS: We will conduct a scoping review guided by framework by Arksey and O'Malley. This study will search for eligible literature from peer-reviewed articles and grey literature. Databases such as PubMed/MEDLINE, American Doctoral Dissertations via EBSCO host, Union Catalogue of Theses and Dissertations (UCTD) and SA ePublications via SABINET Online and World Cat Dissertations, Theses via OCLC, and Google Scholar will be searched. Websites such as the World Health Organization (WHO) and governmental websites and statistics institutions will be explored for policies and guidelines on contraceptive use and sexual behavior. The review will be conducted on studies that were published from January 1990 to 2018. The PCC framework will be employed in this study to determine the eligibility of research question. The PRISMA chart will be utilized to report the screening of results. The MMAT Tool version 11 will be used to determine the quality of the included primary studies. RESULTS: We anticipate finding a considerable number of published articles presenting evidence on contraceptive use and sexual health behavior in South Africa. Findings of this scoping review will be disseminated electronically, in print, and through peer presentation, conferences, and congresses.

Bioética, aborto y políticas públicas en América Latina / Bioethics, abortion and public policies in Latin America

La bioética en América Latina está fuertemente influida por creencias religiosas, lo que resulta en la regulación más restrictiva del orbe en salud sexual y reproductiva y, muy señaladamente, en aborto. Los impedimentos legales no disuaden a las mujeres que optan por interrumpir embarazos no deseados; cada año tienen lugar más de 4 millones de abortos ilegales en los que las latinoamericanas más pobres arriesgan su salud y su vida. Este texto recupera el sentido que V. R. Potter -creador del término- dio a la bioética: "una ética basada en el conocimiento científico". Propone el gradualismo -modelo sustentado en la evidencia científica que aportan la embriología, la genética y la neurofisiología- como el idóneo para la regulación del aborto en América Latina. El gradualismo respeta el derecho de toda mujer a decidir sobre su maternidad y es el modelo adoptado por los países con los índices más altos en salud sexual y reproductiva. América Latina está urgida de medidas efectivas para prevenir los embarazos no deseados, que son la causa principal del aborto: educación en salud sexual y reproductiva, acceso a anticonceptivos modernos, y penas severas contra el abuso sexual de mujeres, adolescentes y niñas (AU)

Bioethics in Latin America is strongly influenced by religious beliefs, leading to the most restrictive regulation globally of sexual and reproductive health and, most particularly, of abortion. Legal obstacles do not dissuade women from terminating unwanted pregnancies; each year more than 4 million illegal abortions take place, in which the poorest Latin American women risk their health and lives. This text employs the term bioethics within the meaning given to it by its creator, V. R. Potter: "ethics based on scientific knowledge". It proposes gradualism, sustained on scientific evidence contributed by embryology, genetics, and neurophysiology, as the most appropriate model for the regulation of abortion in Latin America. Gradualism respects every woman’s right to decide on questions related to maternity and holds sway in countries with the highest levels of sexual and reproductive health. Latin America urgently needs effective measures to prevent unwanted pregnancies, which are the main cause of abortion: education on sexual and reproductive health; access to modern and effective contraceptives; and severe sanctions for sexual abuse of women, adolescents and girls (AU)

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

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

Legal abortion worldwide in 2008: levels and recent trends.

CONTEXT: Periodic assessments of abortion incidence are essential for monitoring trends in unintended pregnancy and gaps in contraceptive services and use. METHODS: Statistics and estimates of legal induced abortions in 2008 were compiled for 64 of the 77 countries in which legal abortion is generally available; these 64 are home to 98% of women aged 15-44 who live in the countries eligible for inclusion. Data sources included reports or completed questionnaires from national statistical offices and nationally representative surveys. The completeness of official figures was assessed by in-country and regional experts. Trends since 1996 and 2003 were examined. RESULTS: Of the 77 countries with liberal abortion laws, 36 are in the developing world. In 2008, abortion rates in the 25 countries with complete records-all of which were developed-ranged from seven (Germany and Switzerland) to 30 (Estonia) per 1,000 women aged 15-44. Abortion rates declined in most of the 20 countries with consistently reliable information on trends between 1996 and 2008; declines were generally steeper than increases, although the pace of decline slowed after 2003. The highest observed abortion rates were in developing countries with incomplete estimates. For most developing countries that had liberal laws, the reported abortion rates were incomplete and varied widely. CONCLUSIONS: High abortion rates in some countries, and small increases in rates in others, indicate a great need for more effective family planning services for these populations. Reliable data collection systems, needed to ensure that trends can be effectively monitored, are lacking in many countries.

Global perspective of legal abortion - Trends analysis and accessibility.

There are significant variations in the legalisation, restrictions and legal abortion rates worldwide. This undoubtedly influences the provision and accessibility to abortion services. Although there have been changes to the laws in several countries over the last decade, this has not yet been translated into practice in the provision of safe abortion in these countries. In countries where abortions are permitted without restriction; the majority of abortions are carried out by trained practitioners in approved facilities. In contrast, in countries where restrictions are imposed, the majority of abortions performed are considered to be unsafe and therefore associated with significant morbidity and mortality. This article discusses the most recent data available regarding worldwide legal abortion rates, trends over the last ten years and issues related to specific regions which may influence the provision of safe abortion services in the future.

The estimated incidence of induced abortion in Ethiopia, 2008.

CONTEXT: Unsafe abortion is an important health problem in Ethiopia; however, no national quantitative study of abortion incidence exists. In 2005, the penal code was revised to broaden the indications under which induced abortion is legal. It is important to measure the incidence of legal and illegal induced abortion after the change in the law. METHODS: A nationally representative survey of a sample of 347 health facilities that provide postabortion or safe abortion services and a survey of 80 professionals knowledgeable about abortion service provision were conducted in Ethiopia in 2007-2008. Indirect estimation techniques were applied to calculate the incidence of induced abortion. Abortion rates, abortion ratios and unintended pregnancy rates were calculated for the nation and for major regions. RESULTS: In 2008, an estimated 382,000 induced abortions were performed in Ethiopia, and 52,600 women were treated for complications of such abortions. There were an estimated 103,000 legal procedures in health facilities nationwide--27% of all abortions. Nationally, the annual abortion rate was 23 per 1,000 women aged 15-44, and the abortion ratio was 13 per 100 live births. The abortion rate in Addis Ababa (49 per 1,000 women) was twice the national level. Overall, about 42% of pregnancies were unintended, and the unintended pregnancy rate was 101 per 1,000 women. CONCLUSIONS: Unsafe abortion is still common and exacts a heavy toll on women in Ethiopia. To reduce rates of unplanned pregnancy and unsafe abortion, increased access to high-quality contraceptive care and safe abortion services is needed.

Estimates of induced abortion in Mexico: what's changed between 1990 and 2006?

CONTEXT: In Mexico, where abortion remains largely illegal and clandestine, reliable data on induced abortion and related morbidity are critical for informing policies and programs. The only available national estimate of abortion is for 1990, and demographic and socioeconomic changes since then have likely affected abortion incidence. METHODS: This study used official statistics on women treated for abortion-related complications in public hospitals in 2006 and data from a survey of informed health professionals. Indirect estimation techniques were used to calculate national and regional abortion measures, which were compared with 1990 estimates. RESULTS: In 2006, an estimated 150,000 women were treated for induced abortion complications in public-sector hospitals, and one in every 5.8 women having an induced abortion were estimated to have received such treatment. The estimated total number of induced abortions in 2006 was 875,000, and the abortion rate was 33 per 1,000 women aged 15-44. Between 1990 and 2006, the abortion rate increased by 33% (from a rate of 25). The severity of morbidity due to unsafe abortion declined (as seen in shorter hospital stays), but the annual rate of hospitalization did not-it was 5.4 per 1,000 women in 1990 and 5.7 in 2006. The abortion rate was similar to the national average in three regions (34-36), but substantially lower in one (25 in the South/East region). CONCLUSIONS: Clandestine abortion continues to negatively affect women's health in Mexico. Recommended responses include broadening the legal criteria for abortion throughout Mexico, improving contraceptive and postabortion services, and expanding training in the provision of safe abortion, including medical abortion.

El derecho a la objecion de conciencia en el supuesto del aborto / The right to the objection of conscience in the assumption of aAborto

La objeción de conciencia consiste en el incumplimiento de una obligación de naturaleza legal, cuya realización produciría en el individuo una grave lesión de la propia conciencia. Desde los mismos orígenes del Estado de Derecho, el respeto a la libertad de conciencia ha sido considerado uno de los derechos más fundamentales, ya que se presupone que la libertad y la dignidad humanas se encuentran por encima del mismo Estado.El derecho a la objeción de conciencia puede entenderse como la dimensión externa de la libertad ideológica y de conciencia. Este derecho, pilar esencial en todo Estado de Derecho, posee especial relevancia en el debate bioético, al tratarse de una vía muy adecuada para solucionar, en un sistema democrático, los inevitables conflictos que genera la tensión entre legalidad y justicia.En las últimas décadas, el derecho a la objeción de conciencia ha desarrollado toda su virtualidad en aquellos países en los que se han aprobado leyes despenalizadoras del aborto. Las profesiones sanitarias tienen un horizonte y un sentido claros: el cuidado y el respeto de la vida, la salud y la integridad de todos los seres humanos. En consecuencia, cuando una norma legal vulnera o contradice este principio, surgen sólidas razones para fundamentar el derecho a la objeción de conciencia de los sanitarios

[International cooperation in implementation of the program of reproductive health protection in the Samara region]. / Mezhdunarodnoe sotrudnichestvo v realizatsii programmy okhrany reproduktivnogo zdorov'ia naseleniia Samarskoi oblasti.

A concept of strategic development of territorial service of maternity and childhood protection has been developed in the Samara region making use of international experience. The results indicate improvement of qualitative parameters of the service activities after introduction of international programs.