Abstract : Este trabajo tuvo como objetivo general identificar valores/ imaginarios y practicas respecto a la iniciación de la actividad sexual, la ocurrencia de un embarazo/ el proceso de decisión que lleva a la crianza, a la interrupción del embarazo o a la entrega en adopción y la valoración posterior de la experiencia desde la perspectiva de las protagonistas. Se busco un acercamiento a la diversidad de la vivencia sexual y reproductiva, producto de diferentes entornos y circunstancias culturales/ sociales y materiales.
Web site : http://orientame.org.coAbstract : This report provides a secondary analysis of the 1987 Guatemala Demographic and Health Survey (DHS), a study prepared by the Division of Reproductive Health of the Center for Disease Control, at the request of USAID/Guatemala and Guatemalan family planning agencies. This report reexamines the data covering women 15-44 years of age (an additional report will cover the young adult module). The report covers selected topics not included in the previous analyses of the 1987 DHS data, as well as more detailed analysis of topics previously examined. The report addresses the following topics: 1) knowledge, prevalence, and source of contraception; 2) preventive health care and behavioral risk factors; 3) planning status of last pregnancy, premarital conceptions, and desire for more children; 4) surgical contraception; 5) characteristics of women in need of family planning services; and 6) spontaneous and induced abortion. Some of the main findings include: Ladino women have a far higher knowledge of contraceptive methods than Indigenous women; contraceptive prevalence is low ; 23.2% among all currently married women and 5% among Indigenous women in the Interior; there has been little change in contraceptive prevalence since 1983; a large proportion of Indigenous women in the Interior do not approve of family planning promotion through the media; 1/3 of all married women reported ever having had a gynecological examination; 25.8% of currently married women were estimated to be at risk of an unintended pregnancy; the interest in surgical contraception is high among currently married women desiring no more children who are Ladino or who live in the Department of Guatemala, but it is low among Indigenous women living in the Interior.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 070247Abstract : This 1998 annual report of the International Center for Research on Women (ICRW) presents the contribution of the organization, particularly in the research and implementation of youth-centered programs. In this year, ICRW has promoted the increased recognition of the relation between sexual and reproductive well being of adolescents and the social and economic conditions. This report includes projects aimed at enhancing employment and poverty reduction, nontraditional skills training, implementation of environmental policy regulations, feeding programs, health promotion and disease control, safeguarding of rights and protection from violence, promotion of adolescent health and well being, and fostering of community and women participation. This document compliments 3 organizations which successfully transformed the situation into brighter futures: the Women and AIDS Support Network in Zimbabwe; Las Dignas in El Salvador; and the collaboration between the Centre for Women's Development Studies and Nari Bikas Sangha in India. Presented also are the 1998 project descriptions, publications, collaborating institutions and financial statements.
Notes : Inglés/anglais/EnglishAbstract : The efficacy and safety for induced abortion of 25 or 50 mcg of oral methotrexate followed 7 days later by 800 mcg of vaginal misoprostol were assessed in a study of 310 women from Havana, Cuba, with pregnancies of 56 days' gestation or less. The misoprostol dose was repeated after 48 and 96 hours if abortion did not occur. The difference in the success rate between the methotrexate dose groups was not significant. Successful abortion occurred in 135 of the 148 women (91%) who were allocated to receive 25 mcg of methotrexate followed by misoprostol and in 139 of 154 women (95%) who received 50 mcg of methotrexate followed by misoprostol. There were no significant differences between groups in vaginal bleeding and spotting. The most common side effects in both groups were nausea and dizziness. Since the efficacy and safety of the two treatment regimens did not differ, use of the regimen with the lowest methotrexate dose (25 mcg) is recommended.
Web site : http://content.karger.com/ProdukteDB/produkte.asp?Aktion=JournalHome ProduktNr=223845 ContentOnly=falseAbstract : El nombre original de la Campaña 28 de septiembre fue: "Dia por el Derecho al Aborto de las Mujeres de América Latina y el Caribe" implementado durante la celebración del V Encuentro Latinoamericano y del Caribe de 1990.
Web site : http://www.gire.org.mx/Abstract : According to a survey, 68% of the Brazilian population want the continuation of the law banning abortion. Only 24% favor liberalization. The penal code stipulates a jail term of 2-8 years for abortion. The survey was carried out in 1991 involving 7018 persons aged >16 in 15 municipalities. 71% who approved the ban lived in the northeast north, and central-east regions. 68% in the south and 65% in the southeast were in favor of the prohibition. 74% in the small towns endorsed this law. 73% with up to 5 times the minimum monthly salary were against abortion, 65% of those with incomes between 5-10 times the minimum salary and 57% of those earning more than 10 times the minimum salary condemned abortion. 72% of women and 64% of men were against it. 73% of young people aged 16-25 wanted the continuation of the ban, compared to 66% of those aged 26-40 and 65% of people 41 or over. 72% of those with up to primary school education, 65% with secondary school education, and 48% with higher education approved the ban. Among those who favored liberalization, 27% lived in the southwest region, 31% were inhabitants of large cities, 36% earned more than 10 times the minimum income monthly, and 39% had obtained higher education.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 068641Abstract : According to a survey, 68% of the Brazilian population want the continuation of the law banning abortion. Only 24% favor liberalization. The penal code stipulates a jail term of 2-8 years for abortion. The survey was carried out in 1991 involving 7018 persons aged >16 in 15 municipalities. 71% who approved the ban lived in the northeast north, and central-east regions. 68% in the south and 65% in the southeast were in favor of the prohibition. 74% in the small towns endorsed this law. 73% with up to 5 times the minimum monthly salary were against abortion, 65% of those with incomes between 5-10 times the minimum salary and 57% of those earning more than 10 times the minimum salary condemned abortion. 72% of women and 64% of men were against it. 73% of young people aged 16-25 wanted the continuation of the ban, compared to 66% of those aged 26-40 and 65% of people 41 or over. 72% of those with up to primary school education, 65% with secondary school education, and 48% with higher education approved the ban. Among those who favored liberalization, 27% lived in the southwest region, 31% were inhabitants of large cities, 36% earned more than 10 times the minimum income monthly, and 39% had obtained higher education.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 068641Abstract : At February's Cairo+5 proceedings at the Hague, the Center for Reproductive Law and Policy (CRLP) called a press conference to discuss changes in abortion laws around the world since the International Conference on Population and Development in Cairo in 1994. According to the director of CRLP's International Program, 9 countries have modified their abortion laws since Cairo. Of those, 7 liberalized their laws, while Poland and El Salvador further restricted legislation. The CRLP supports the liberalization of abortion laws for all women in all countries. Abortion law has been liberalized in South Africa since Cairo, with the enactment in 1997 of the Termination of Pregnancy Act. In contrast, however, anti-choice groups in Poland successfully challenged the legality of abortion in 1996 by declaring it against the Polish Constitution. Abortion is prohibited in Chile in all circumstances, even to save the life of the woman. However, despite the illegality of abortion in that country, half of all pregnancies in Chile end in abortion. Unsafe abortion contributes to the 50% maternal mortality rate in Nepal. Abortion in the country is punishable by a 20-year prison sentence, regardless of the age of the woman.
Web site : http://www.reproductiverights.org/ab_siteindex.htmlAbstract : A 10-year review of maternal mortality was conducted at the Municipal hospital Miguel Couto in Rio de Janeiro. 32 deaths occurred between January 1978-December 1987. In the same period, there were 18,071 livebirths, giving an overall maternal mortality ratio of 177/100,000 livebirths. Maternal mortality increased from 128/100,000 livebirths in 1978 to 462/100,000 in 1987. Abortion-related deaths accounted for 47% of the total mortality, followed by toxemia (19%), and hemorrhage (13%). The contribution of abortion-related mortality to maternal mortality increased 172% over the 10-year period studied. These results indicate that maternal mortality has been increasing in a population of urban poor and that the leading cause of death is induced abortion. In a setting where access to abortion is highly restricted and desire to regulate fertility is high, death due to illegal abortion is a major contributor to maternal mortality. The rise in abortion-related mortality over the past 10 years is attributed to a lack of family planning services in conjunction with urban socioeconomic conditions conducive to smaller families. (author's)
Web site : http://www.sciencedirect.com/science/journal/00297844Abstract : This article discusses the effects of the alliance between the Church and the Argentine state on women's reproductive rights. Several commentators have criticized how President Carlos Menem used the campaign against abortion for his own political interest. He issued a presidential decree on antiabortion campaign: the Day of the Unborn Child. This decree was announced on December 8, 1998, and the day of observance is March 25 of every coming year. Although the Argentine government does not have a law that explicitly regulates family planning method for the last two decades, many Argentines find the action of the president selfish. The initiation of this presidential decree was the culmination of Menem's manipulation of church and state to secure clerical support for his political regime. Even if statistics is providing him with data concerning the effects of unclear reproductive health laws, he and the church still has chosen not to focus on reproductive rights exclusively, but have concerned themselves primarily with other social and economic issues. While Menem uses the Vatican's pro-life rhetoric and his presidential power to protect fetal life, Argentines will have to contend with the existing Menem policies, which compromise the health of women and children.
Web site : http://www.catholicsforchoice.orgwww.catholicsforchoice.org/conscience/archives/default.aspAbstract : Se compararon tres modelos de atención de postaborto que se usan actualmente en el Instituto Mexicano de Seguridad Social. Un total de 251 mujeres fueron tratadas con aspiración endouterina manual, orientación general con interacción con el proveedor y orientación específicamente de planificación familiar. Un total de 270 mujeres fueron tratadas con legrado uterino instrumental y recibieron orientación interactiva y servicios de planificación familiar. Un total de 282 mujeres fueron tratadas con legrado uterino instrumental y recibieron información preestructurada sin el componente interactivo y sin los servicios de planificación familiar. La muestra estaba integrada por mujeres que habían sido tratadas por aborto inducido y espontáneo a las 12 semanas o menos de embarazo. Un total de 803 mujeres fueron entrevistadas antes de ser dadas de alta, 610 fueron objeto de seguimiento siete días más tarde y 353 fueron entrevistadas al cabo de seis meses. Las mujeres de los tres grupos tenían características sociodemográficas y un historial reproductivo similares. Menos de la mitad de las mujeres de cada grupo notificaron que el embarazo había sido planificado, pero más de 70% dijeron que lo deseaban. Los datos indican que ambas técnicas son comparables en cuanto a tasas de complicación durante el procedimiento y después de este. La proporción de pacientes con evacuación uterina completa y sin complicaciones obstétricas fue significativamente superior con la técnica de aspiración manual (98,7% frente a 96,7% y 94,6%). Los resultados también indican que el manejo del dolor debe mejorarse en los tres modelos. Los dos grupos de pacientes que recibieron orientación e información notificaron haber recibido información más completa. En los mismos dos grupos hubo proporciones más elevadas que aceptaron un método anticonceptivo y siguieron usándolo. La duración de la hospitalización de los tres grupos fue similar.
Web site : http://www.popcouncil.orgAbstract : In Brazil, induced abortion is considered a crime in the majority of cases, the result being that there is little official data on the subject. Little is known about the conditions under which abortions are induced This research was designed to shed light on the characteristics of the women who had had an abortion and to study the reasons why and conditions under which it occurred. The sample consisted of all employees (7,359) and students (2,231) in a university program in São Paulo who were mailed a self-administered survey. Accompanying the questionnaire was a letter and self-addressed stamped envelope. 27% of the employees and 42% of the students returned the questionnaires. Of these, 1,314 employees and 138 students had had at least one pregnancy. The results presented in this study show that 465 of the employees and students ar some point had thought of having an abortion. They were divided into two groups: those who had had an abortion and those who had nos. The objective was to analyze the association of some characteristics of the women with their decision to have/not have an abortion and how they felt when faced with this decisiva. The proportion of women who had had an abortion was significantly lower among married women than singles. A larger percentage of women who had talked with a friend and/or husband/partner/boyfriend had decided to have an abortion than those who had talked to a parent or had not talked to anyone. More women who said they were not prepared to raise/educate a child had had an abortion as compared to those giving other reasons. Almost half of the women undergoing an abortion said that they felt bad emotionally and physically afterwards. Among those who had not had an abortion, almost two-fifths reported that they felt good, were happy, relieved, and did not regret their decision. The conclusion drawn from the population studied was that emotional and social factors played a signicant role in the Decision making process for women considering an abortion.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X1995000100016 lng=en nrm=isoAbstract : To be effective and acceptable, family planning programs must directly confront sexual and reproductive health needs. In turn, this requires creation of an environment conducive to raising and discussing questions in this area through the provision of education, counseling skills, and support to staff. At greatest need of attention to sexual issues are unmarried women under 20 years of age. Over 50% of young women in sub-Saharan Africa and Latin America give birth before the age of 20 years, and pregnancy-related complications are the leading cause of death among teenagers in these regions. Unsafe abortion is especially prevalent among Latin American teenagers, but is preventable through sexual and contraceptive education and services and the legalization of safe abortion. In addition, family planning programs have a responsibility to promote condom use among young girls to prevent sexually transmitted diseases and the sequelae of pelvic inflammatory disease, infertility, and greater susceptibility to human immunodeficiency virus infection. Finally, family planning programs in Egypt and parts of Africa must make the elimination of female genital mutilation an integral effort given its tremendous threat to women's physical and psychological health.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 092203Abstract : Context: The legal status of induced abortion helps determine the availability of safe, affordable abortion services in a country, which in turn influences rates of maternal mortality and morbidity. It is important, therefore, for health professionals to know both the current status of abortion laws worldwide and the extent to which those laws are changing. Methods: Abortion-related laws in 152 nations and dependent territories with populations of one million or more were reviewed, and changes in these laws since 1985 were documented. Results: Currently, 61% of the world's people live in countries where induced abortion is permitted either for a wide range of reasons or without restriction as to reason; in contrast, 25% reside in nations where abortion is generally prohibited. However, even in countries with highly restrictive laws, induced abortion is usually permitted when the woman's life is endangered; in contrast, even in nations with very liberal laws, access may be limited by gestational age restrictions, requirements that third parties authorize an abortion or limitations on the types of facilities that perform induced abortions. Since 1985, 19 nations have significantly liberalized their abortion laws; only one country has substantially curtailed legal access to abortion. Conclusions:A global trend toward liberalization of abortion laws observed before 1985 appears to have continued in more recent years. Nevertheless, women's ability to obtain abortion services is affected not just by the laws in force in a particular country, but also by how these laws are interpreted, how they are enforced and what the attitude of the medical community is toward abortion.
Web site : http://www.agi-usa.org/pubs/journals/2900603.html.Abstract : The WHO defines adolescence as a transition phase from the state of dependency to that of relative autonomy. Adolescence in Brazil has been in the limelight apart from the physical and psychological implications because of its cultural ramifications. In the past century the 12-18 age group in Brazil was considered suitable for marriage and early procreation because later age at marriage could thwart their chance for marriage. The urbanized middle classes devoted the age range of 12-20 years to education when children depended economically on their parents. On the other hand, those in the lower strata of society cannot follow this life pattern, especially in recent years because of severe economic conditions. There are also significant differences with respect to adolescent pregnancy between middle and lower class populations. Among risk factors for adolescent pregnancy, age is a factor because of pregnancy complications owing to lack of prenatal care, complications of delivery, anemia, hemorrhage, and cephalo-pelvic disproportion. National and foreign studies have analyzed the attendant difficulties: fear, insecurity, despair, and disorientation at the time of discovering the fact of pregnancy. A 1992 investigation interviewed health professionals who cared for adolescents in Sao Paulo. The major conclusion was that the attitudes of adolescents had been studied very little in regard to their desires and dilemmas when facing motherhood. Adolescents aged 17-19 often referred to pregnancy as a burden, since they had to leave school temporarily. A University of Minnesota specialist in adolescent health wrote in 1992 that American adolescents who get pregnant do not want to get married, nor get an abortion, and they do not use contraceptives. Pregnancy among 15-year-old girls is on the rise. Only 40% of married adults stay married, only 10% of those who got married at age 17 stay married, and at the age of 18 years 25% of women get pregnant.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 112441Abstract : This is a study of the history of fertility regulation throughout the world and is based on two premises. "The first is that there have always been societies, or at least important groups within them, who have for one reason or another, at some periods in their history, taken steps to limit their progeny....The second premise...is that reproductive decisions are of greater significance to women than to men....In each of the book's seven chapters ; devoted to the Greek world, the Roman Empire, the Christian west, the Middle Ages, early modern Europe, the industrializing west and the twentieth century ; the intent has been to flush out the intended and unintended consequences of fertility control and the relationship to changing family forms and gender roles." (EXCERPT)
Notes : Inglés/anglais/English, nbsp;popline 091098Abstract : An indirect method for calculating marital induced abortion rates from observed marital fertility and contraceptive prevalence, and modeling the impact of substituting contraception for abortion on fertility in the future is presented. Estimates for Belo Horizonte, Brazil, Lima, Peru, and La Paz, Bolivia are generated using this method. The model for proximate determinants of fertility uses the same data and statistical assumptions. Observed marital fertility equals an assumed biological maximum adjusted multiplicatively by an index of postpartum infecundability or postpartum abstinence, less the sum of births averted by contraception and induced abortion. The theoretical maximum fertility rate, or the total fecundity rate, is assumed to be an average of 15 live births for sexually active women aged 15-49, which will overestimate induced abortion rates. The findings of the country analyses were that the inferred abortion rates were quite high for all 3 countries. The lifetime abortion range was 6 in La Paz to >4 in Belo Horizonte and Lima. The highest rates were 6.5 for Social Security Beneficiaries in La Paz. Demographic and Health Survey data indicated 1.5 abortions/woman. An explanation of the difference in rates is provided which adjusts for the differences in contraceptive prevalence and effectiveness, and yields a 4.04 or 5.52 average/woman. An analysis of rates of hospitalization from abortion complications shows working women in La Paz with a higher rate. However, using age-specific ratios of observed complications to inferred total abortions for all 3 countries was not an effective validity check. The results of projecting the impact of substituting contraception for abortion were that .4 fewer lifetime births/woman would be averted. If induced abortion rates are stable, increases in contraceptive prevalence and effectiveness should generate a reduction in total marital fertility of 24%, i.e., from 5.89 to 4.45 births. If the total marital rate is decreased by 26% or from 1.48 abortions to 1.08 abortions as contraceptive prevalence increase, the decline in fertility would be 17.5% or from 5.89 births to 4.86 births. Although the inferred abortion levels for the 3 countries were high, Tietze and Bongaarts demonstrated similarly high figures for countries in the course of demographic transition. Resource allocation should take into account both current abortion levels and potential substitution with contraception.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 070846Abstract : PAC programs have demonstrated to be an effective intervention to address unsafe abortion. PAC started as pilot studies, but now most countries are in the process of scaling up, which requires an effective and efficient approach for decentralization and quality assessment. This paper presents the results of implementing a model to scaling up PAC services in a large, rural, impoverished area in Peru. The project was conducted applying the TEAM approach (train, equip, advocate and measure). Site training for general practitioners and midwives from 92 rural facilities (8 hospitals, 29 health centers, and 55 primary level centers) was complemented by provision of basic medical equipment, health service reorganization and quality of care continuous monitoring using simple screening tools. By the end of the project, 100 % of hospitals and 78% of health centers had staff trained to offer PAC. Manual vacuum aspiration (MVA) was use to perform uterine evacuations in 65% of indicated cases of incomplete abortions, delay in providing surgical treatment was reduced from 23.3 to 4.1 hours, and postabortion contraceptive acceptance was increased from 21.1% to 42.8% of PAC patients treated.Our results showed how an inexpensive and innovative model of intervention supported by information was effective for PAC scaling up. Monitoring tools identified gaps in service provision and quality, and also provided useful data for advocacy and system planning. Learning Objectives: At the conclusion of the session the participant will be able to: 1.Describe a useful approach to scaling up PAC services; Identify useful data for monitoring service provision and quality, and also for advocacy and system planning.
Notes : Inglés/anglais/EnglishAbstract : During 1996 and 1997, the theme of abortion was regularly present in the main pages of the country's newspapers. During that period, a research study named "Abortion and the Media" followed the daily coverage of the abortion theme in the newspapers Folha de São Paulo, O Estado de São Paulo, Jornal do Brasil and O Globo. In 1996, 368 articles were published in these large newspapers dealing exclusively with abortion, which occupied the space equivalent to 34 newspaper pages. In 1997, the number of articles dedicated to the theme doubled, with the appearance of 767 articles in the four newspapers, which, if added, would occupy 83 newspaper pages. (excerpt)
Web site : http://www.cfh.ufsc.br/~refAbstract : When examining the issue of human reproduction in Brazil and its historical determinants it must be stated that even primitive societies were regulating fertility, but planning of human reproduction as a movement started around 1922 in the United States through the militancy of Margaret Sanger. This was a time of radical ideological transformation as a result of industrialization and urbanization in North America, which changed the role of women and that of the family. In Brazil the discussion of fertility regulation started in the early 1960s, when the Kennedy administration conditioned its economic assistance to Latin America on the adoption of population control programs, which was not well-received in these Catholic countries. The neo-Malthusian population concept originated in the international agencies, who saw fertility control as a solution to global economic problems. It also found acceptance among elite conservatives in Brazil because of the fear that the growth of poor people could subvert the prevailing social order. Since national interest arguments did not work in Brazil, the programs invoked arguments such as how high parity and high-risk pregnancies would affect the health of the mother; the disproportion between the number of children and family income of the poor; and the control of induced abortion. The economic development in Brazil in the 1950s was the basis of accepting neo-Malthusian reasoning. The debate about these programs involved the whole society. The Catholic Church, however, was the major opponent of a government-supported fertility control program. The capitalist state has assigned to women the role of reproducer and primary socializer of children, regarding motherhood as their principal role, and the control of access to contraceptives meant the continued subordinated of women in capitalist and patriarchal societies.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 083686Abstract : Objectives. This study assessed youth health in the Caribbean Community and Common Market countries and describes the prevalence of health-related factors. Methods. We used a self-administered classroom questionnaire; questions addressed general health, health care, nutrition, sexual history, drug use, mental health, violence, family characteristics, and relationships with others. Results. Most youths reported good health; however, 1 in 10 reported a limiting disability or significant health problems. Violence was a pervasive concern. Of those who reported history of sexual intercourse, many reported that their first intercourse was forced, and nearly half reported that they were aged 10 years or younger when they first had intercourse. Conclusions. Although most young people are healthy, problems indicate the importance of monitoring trends and designing effective youth health programs.
Notes : Inglés/anglais/EnglishAbstract : The objective of this study was to prospectively determine whether unplanned pregnancies are associated with adverse pregnancy outcomes among users of natural family planning (NFP). Women who became pregnant while using NFP were identified in five centers worldwide: there were 373 unplanned and 367 planned pregnancies. Subjects were followed up at 16 and 32 weeks gestation and after delivery. The risks of spontaneous abortion, low birth weight, and preterm birth were estimated after adjustment by logistic regression. The women with unplanned pregnancies were more likely to be at the extremes of age, to report more medical problems before and during the index pregnancy, and to seek antenatal care later in gestation than the women with planned pregnancies. However, women with planned pregnancies reported a higher rate of spontaneous abortion in prior pregnancies (28.8%) than did women with unplanned pregnancies (12.9%, p < 0.001). There were no significant differences in the rates of adverse pregnancy outcomes in the two groups. The adjusted odds ratios (OR) and 95% confidence intervals (CI) associated with unplanned pregnancies were 0.80 (CI, 0.43-1.51) for spontaneous abortion, 0.90 (CI, 0.24-3.44) for low birth weight, and 0.57 (CI, 0.23-1.43) for preterm birth. The authors concluded that there was no increased risk of adverse pregnancy outcomes observed among women who experienced an unplanned pregnancy during NFP use.
Notes : Inglés/anglais/EnglishAbstract : En este artículo se analiza el proceso político de discusión y toma de decisiones en relación a la cuestión del aborto en el Congreso Nacional de Brasil, tratando de identificar la presencia del Poder Ejecutivo y, principalmente, la presión de los grupos políticos y sociales en este proceso. El debate sobre el tema es analizado desde que éste se inició en la legislación, a comienzos de 1946, hasta el presente, privilegiando la discusión más reciente. Seexaminan los documentos parlamentarios de la Cámara de Diputados y del Senado Federal deBrasil, sobre todo los proyectos de ley. Finalmente se constata que, en relación a esta materia, losintereses de la Iglesia Católica, los de segmentos de la profesión médica, los del movimientofeminista y los de las iglesias evangélicas se ven reflejados en el Congreso Nacional.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : A randomized trial conducted in the US and Cuba assessed whether moistening misoprostol in advance of vaginal insertion enhances the efficacy of medical abortion after methotrexate administration. 240 abortion seekers from Pittsburgh, Pennsylvania (US), and Havana, Cuba, with pregnancies of 49 days' gestation or less were randomized either to dip the four 200-mcg misoprostol tablets in water before administration (group 1) or to insert the tablets dry (group 2). The misoprostol dose was repeated in 1-2 days if abortion did not occur. There were no statistically significant differences between groups 1 and 2 in the cumulative rate of abortion after the first misoprostol dose (73.0% vs. 71.3%), after the second misoprostol dose (84.1% vs. 81.1%), or by 35 days after methotrexate administration (95.2% vs. 91.8%). The proportion of women with a continuing pregnancy, defined as the presence of embryonic cardiac activity 2 weeks after methotrexate injection, was slightly but nonsignificantly higher in group 2 (5.7%) than in group 1 (2.4%). The immediate success rate in Pittsburgh was greater, although not significantly, for women who moistened the misoprostol (87% vs. 76%); in Havana, the opposite trend was observed (82% vs. 86%). Cramping began a mean of 2.8 hours after the first misoprostol administration in group 1 and a mean of 3.5 hours later in group 2. Women in group 1 had significantly more diarrhea (36% vs. 21%) and fever/chills (44% vs. 30%) than those in group 2, but rates of nausea, vomiting, dizziness, and headache did not differ. These findings suggest that moistening misoprostol before vaginal application does not significantly improve the efficacy of methotrexate abortion.
Web site : http://www.sciencedirect.com/science/journal/14700328Abstract : This document is the second chapter in a book that examines the quality of reproductive health care from a feminist perspective by considering the extent to which reproductive rights are realized in eight countries that have ratified the UN Convention on the Elimination of All Forms of Discrimination Against Women (Bangladesh, Kenya, Mexico, Nigeria, Thailand, Bolivia, Finland, and the Netherlands). This chapter evaluates how well the population policies of the eight countries respect reproductive rights. Research involved examination of the policies and programs of governmental and nongovernmental agencies providing family planning (FP) services to uncover objectives, targets, and restrictions. Some population policies are still tied to demographic goals (Bangladesh and Kenya), others have demographic and health goals (Mexico, Nigeria, and Thailand), and some countries lack a formal population policy (Bolivia, Finland, and the Netherlands). Restrictions embedded in national FP policies in several of the countries include requirements for spousal consent for sterilization. Access is also denied through a lack of programs targeting adolescents and the existence of gender biases. Access to abortion is restricted in the six developing countries, and only Kenya and Mexico mention male responsibility in FP (but the specific male role remains unclear). Kenya and Mexico also provide exceptions to the general failure to mention quality of FP care in policy documents (Kenya has formulated clinic service goals to enhance quality of care), but Thailand incorporates specific training requirements for FP personnel (an aspect of quality of care) in its population policy. Quality of care concerns are addressed by professional associations and service provider organizations. The target orientation of most of the population policies reviewed, however, could be expected to reduce quality of care. Despite these targets, services are often limited to married women.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 127729Abstract : Since 1991, Argentina has had provincial reproductive health laws, a far-reaching national programme and strong public consensus in support of reproductive health policies. Nevertheless, the challenges of strengthening public services, increasing the number of programme sites and resisting conservative attacks remain. This article describes an assessment of the reproductive health programme of the city of Buenos Aires, passed in 2000, whose objectives are to prevent unwanted pregnancies and sexually transmitted diseases/HIV and to train health personnel. The programme operates in every public hospital and primary health care centre in the city. The assessment was conducted jointly by the Ombudsperson's Office of Buenos Aires and the Centre for the Study of State and Society (CEDES). Hormonal contraceptives, IUDs and male condoms were mostly available, but emergency contraception, female condoms and other barrier methods were not. Some health professionals and service users were knowledgeable about the new laws and the reproductive rights recognised under the law. Over 90% were satisfied with quality of care in service delivery but many professionals described excessive workloads, deficient infrastructure, and shortages of supplies and staff. Wanting help to obtain a tubal ligation was the most frequent reason for the claims lodged with the Ombudsperson's Office, followed by HIV, quality of care, and abortion. Information and training for both health care providers and women's and human rights NGOs was carried out.
Web site : http://www.rhmjournal.org.uk/Abstract : A study of sexual behavior among teenagers was carried out in a random sample of 884 second degree school (high school) students of Porto Alegre (South Brazil) by means of a self-reported questionnaire. The students' ages ranged from 13 to 22 years old, and 59% of them were females. The students believed themselves well-informed about physiologic phenomena involved in human reproduction (95.2%; 95% confidence interval [CI]: 93.5-96.5) and sexually transmitted diseases (STD; 82.1%; 95% CI: 79.1-84.7). In addition, 42.4% (95% CI: 39.0-45- 45.8) said that they had had a sexual relationship. However, 51.5% (95% CI: 45.9-57.0) did not use contraceptive precautions systematically, and 12% (95% CI: 7.2-19.0) of girls had already undergone an abortion. Considering these results, it is important to stimulate programs for sexual education strictly focused on teenagers. (author's)
Web site : http://www.adolescenthealth.org/journal.htmAbstract : Sexuality, contraception, and pregnancy are inseparable, yet they are a taboo subject both for the whole country and for adolescents. The ever-earlier awakening of sexuality requires educational mechanisms that assign fundamental importance to the implementation of social, psychological, and cultural protection strategies. The resolution of pregnancy is dependent on income just as maternity is secondary to financial independence. The majority of rich adolescents get an abortion, while poor adolescents carry to term their undesired pregnancies. Adolescence is a phase of confusion with peculiar psychosocial and cultural aspects. In the low-income population the start of formal education is precarious and delayed, an important factor in the discrepancies between well-to-do and poor social classes. Pregnancy and abortion rates vary according to economic conditions, however, their resolution clearly shows ethical, religious, and moral subjectivity. The media, rural exodus, increasing urbanization, and the economic crisis make maternity a less dominant aspect of women's lives. Young people do not obtain the necessary information for safeguarding their fertility because of the lack of specialized services, thus they are uncertain about what the health care system can provide. Much opportunity is lost because professionals are too busy or too disinterested to listen to these alienated youngsters. Preconceived notions, disinformation, and uncertainty coupled with emotional obstacles and noncooperation of the partner result in the use of contraceptives becoming a complex and difficult problem to resolve. It is necessary to alter our perceptions of adolescent sexual development. In Brazil, where more than half of the population is young, it is indispensable to devise collective programs not restricted to conventional medical practices to reach all adolescents.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 102152Abstract : Información actualizada para que la población pueda prevenir las enfermedades, reconocer su cuerpo y su fisiología de una manera más sencilla y práctica, combatir la automedicación y la dependencia hacia los fármacos, así como proponer el uso alternativo de la medicina natural y transformar hábitos higiénicos
Notes : Español/espagnol/SpanishAbstract : Reporte mundial que presenta las actividades de varones y mujeres hacia temas cruciales como el aborto, la fertilidad, la participación política y económica y la fuerza de trabajo; con el fin de colaborar con los gobiernos de los países para comprender mejor las necesidades específicas de género y plantear políticas que vayan de acuerdo con el status actual de la mujer en cada caso. Los datos proceden de las Encuestas Mundiales sobre los Valores 1990 1991
Notes : Español/espagnol/SpanishAbstract : The 1988 Brazilian Constitution defined the right of married individuals to family planning (FP). In 1981 ABEPF (the Brazilian Association of Family Planning Entities) was established in order to unite the private entities that were engaged in FP work. ABEPF has been working in a responsible manner without profit since then, and has earned the right to be granted the title of public federal utility. However, it is paradoxically because of its FP work that ABEPF is not given this title. The opponents of FP continue to obstruct the realization of Paragraph 7 of Article 226 of the Constitution. Public federal utility is an extremely important appellation because of the benefits and status conferred. ABEPF is already recognized as a public utility in the state of Rio de Janeiro. Previous attempts to acquire the title were turned down without justification by Dr. Zilda Arns, the director of CNBB. Then, the director of ABEPF and Dr. Zilda Arns met on December 7, 1992, when another application looked more promising. However, it was vetoed again, with Arns claiming that ABEPF might potentially become a proabortion body. In reality, those who refuse to help a broad, safe, and responsible FP program are themselves accountable for the high abortion rate. With its hypothetical arguments about the potential proabortion image of ABEPF, the representative of CNBB in the Ministry of Health arrogates the right to create all kinds of obstacles to preclude ABEPF from getting this title. While this obstruction continues, hundreds or thousands of fake organizations have falsely benefitted from public resources, and those who have created the obstacles have not done anything against this pattern. The issue here is the destiny of FP and the population policy of this country, because the federal authorities do not want a confrontation with the bishops.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 102150Abstract : It has been suggested that abortion is the largest single cause of maternal death in Latin America, responsible for one-third of maternal deaths in the region. Abortion is recognized as the third or fourth cause of maternal mortality in Mexico, but significant underregistration of maternal deaths in general and abortion deaths in particular make exact conclusions difficult. The cost of treating abortion complications absorbs up to 60% of the obstetric and gynecologic budgets in some Latin American hospital systems. Mexican health institutions attended over 111,000 abortions in 1991. Population growth, limited access to effective family planning services, and legal restrictions on abortion will probably ensure that abortion complications will remain a serious public health problem in Mexico. A 1990 study found that the three most important interventions for preventing maternal deaths were providing family planning, improving treatment for obstetrical complications, and providing safe and legal abortion. Basic interventions to improve the quality of care for abortion at the level of the hospital or health facility include using more appropriate technology (especially that of endouterine aspiration rather than instrumental curettage), training of medical personnel, reorganization of systems in accordance with the needs of women, development and implementation of treatment protocols, and improved access to services. Family planning services should be linked to treatment of abortion complications as a means of breaking the cycle of repeat abortions. Postabortion patients are highly motivated to accept a contraceptive method, but very frequently they are discharged from the hospital without even a referral to a family planning service. Factors preventing the joining of abortion treatment with family planning include the physical separation of services, abortion complications being treated in secondary or tertiary level hospitals while family planning services are offered in primary care centers. The emergency nature of treatment of abortion complications is another obstacle.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103326Abstract : Although abortion in many countries of the Third World is responsible for more than one third of maternal mortality, abortion is a denied and neglected issue in international health and assistance projects. In 1987 the World Health Organization (WHO) launched the Safe Motherhood initiative at a conference in Nairobi, where the goal was to reduce maternal mortality by half before the year 2000. However, so far no significant diminution of the rate has been reported. The 1993 report of the World Bank, "Investing in Health," discussed the connection between maternal mortality and illegal, unsafe abortions. Current knowledge about international trends in abortion dates back to 1973, when the demographer Christopher Tietze published the first of series of books with data. In the end of the 1980's WHO initiated studies on maternal mortality, including health risks related to abortion, and supported the development of safe abortion methods. In general statistics are underreported both with regard to legal and illegal abortions. Illegal abortions performed in private clinics are not reported. The total abortion figure annually was estimated in 1990 at 40-60 million. A large number of abortions take place in Japan, the former Soviet Union, and China. In Scandinavia, Italy, Canada, and Australia, one out of four pregnancies is terminated. Illegal abortion occurs mostly in poor countries, where it is banned by law and where contraception is restricted (Latin America, former Soviet Union, south and southeast Asia, and Africa). WHO data indicate that 500,000 women die worldwide in connection with pregnancy and delivery every year. 25-40% of this mortality is caused by complications of induced abortion, 99% in developing countries. Abortion laws vary from strict ban to free choice. The ban in Rumania resulted in a maternal mortality rate of 140/100,000 live births, which dropped to 60 after liberalization in 1990.
Notes : Sueco/suédois/Swedish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 099677Abstract : Documentación con datos estadísticos sobre la frecuencia de mortalidad por abortos inseguros en el mundo, presentado por la organización mundial de la salud. Se reporta que los abortos inseguros son caracterizados por las inadecuadas condiciones para su atención, las técnicas con riesgos y áreas insalubres. Se estima que 20 millones de abortos inseguros ocurren en los países en desarrollo donde el riesgo de muerte se estima uno por cada 250 abortos. Presenta información y descripción sobre el método y materiales desde donde obtuvieron los datos
Web site : http://www.who.int/Abstract : Purpose: To understand which adolescents in Havana, Cuba, seek abortions and reasons for pregnancy termination.Methods: The sample included all adolescents (n = 248) under the age of 20 years who sought pregnancy termination over a 1-month period in 1995. The participants completed a questionnaire exploring a range of issues including age of onset of sexual intercourse, pregnancy history, and reasons for pregnancy termination.Results: There was no difference in age of onset of sexual intercourse between pregnant adolescents who did and did not seek an abortion. Three fourths of all adolescents who aborted a pregnancy were students, and interruption of studies was a major reason for pregnancy termination. Other reasons included being a single mother and poor socioeconomic conditions. More than half of those who sought to terminate their pregnancy did so at a clinic outside of the community in which they lived.Conclusion: As in other countries, in Cuba, concerns over education interruption remain the predominant reason for abortion. Likewise, while abortion has been legal and widely available in Cuba since 1969, there remains sufficient stigma so that over half of young women seek pregnancy termination outside their community of residence.
Web site : http://www.adolescenthealth.org/journal.htmAbstract : The finding that adolescents comprised 16.4% of 2588 cases of women with post-abortion complications treated at a Sao Paulo, Brazil, hospital during 1978-92 led to an analysis of the biological and demographic factors associated with induced abortion among women under 20 years of age. Compared to abortion patients 20 years of age and above, adolescents in this study were more likely to be single, work in domestic service, to opt for abortion rather than pregnancy continuation, and to delay abortion to 14-20 weeks of gestation. The average age at menarche in the study population as a whole was 13.4 years, with a range of 9-19 years. 81.4% initiated sexual intercourse before the age of 14 years (range, 10-39 years). The average difference between age at menarche and age at first intercourse was 2.8 years for adolescent abortion seekers compared to 5.9 years for older women, while the difference between age at first intercourse and age at onset of first pregnancy was 1.3 years among adolescents compared to 4.8 years for older women. The finding that young women are at risk of an unwanted pregnancy soon after menarche should be considered in the design of adolescent health care services.
Web site : http://www.freundpublishing.com/International_Journal_Adolescent_Medicine_Health/adolspecial.htmAbstract : The objective of the study was to descrive the profile of women who declared having induced abortions, and also the profile of the women who have been submittted to sterilizations, according to the following variables : Age at first sexual relation; Marital status; Economic activity; Contraceptive method used at the time of the interview; Years of study; Number of children born alive and Race/Color. The data used were collected by the Survey on Reproductive Health, Contraception and Abortion, carried in 1993, in the City of São Paulo. The conducted analysis revealed that the profile of the women who have aborted opposes to that of the women which were sterilized. The first ones, recurred to abortion when faced with a non-wished pregnancy, and the others were submitted to sterilization, mainly to keep the number of children within the wished limit. In this way, the results prove that the offspring regulation, in Brazil, has been achieved trough a process called " perverse modernity ", which includes a pattern sequence of inadequate use of pills which lead to non desired pregnancies and illegal abortions and finally, the definitive sterilization, usually done through unnecessary cesareans. The women that are highly motivated to control their fertility recur to modern contraception, and also, when necessary, to induced abortion.
Notes : Inglés/anglais/EnglishAbstract : This article presents a review of abortion-related issues that suggests that worldwide abortion will remain a form of fertility regulation. It is estimated that about 2 in 10 maternal deaths occur worldwide due to unsafe abortion practices, which are mostly in developing countries and in countries where abortion is illegal. The 1994 International Conference on Population and Development was the first forum to focus in a global way on the serious health threat to women from unsafe abortion. In the US, about 60% of all pregnancies are unwanted or mistimed and about 50% are aborted. In most European countries, about 66% of women had at least one unintended pregnancy. The annual worldwide abortion rate is estimated to range from 32 abortions/1000 women to 46/1000 women aged 15-44 years. In most developed countries the abortion rate varies from 1 to 30/1000. The Netherlands has the lowest rate (5/1000) and the most liberal abortion laws. The former USSR has the highest rate (112/1000), although some central regions of European Russia have a higher rate of 186/1000. Variation in abortion rates by country can be accounted for by contraceptive prevalence and use-effectiveness, prevailing fertility preferences, laws and policies relating to abortion and contraception, and the relationship between abortion and contraception. Contraceptive usage is a key factor. For example, in the US, 7% of sexually active women aged 15-44 years, who were not using contraception nor seeking to become pregnant, accounted for 53% of unintended pregnancies. Developing countries shifting from high to low fertility may experience a rise in abortions. Where contraceptives are unavailable to adolescents, abortion rates are high and increasing. Women seek abortion for many reasons. Abortion laws vary widely by country. Vacuum aspiration is considered the safest, simplest, and most medically and economically effective way of inducing first-trimester abortions or treating incomplete abortions. The issue of abortion is complicated by political, religious, and moral concerns.
Web site : http://www.thelancet.com/Abstract : Since the beginning of recorded history, women have attempted to terminate unwanted pregnancies. Despite the safety of modern techniques of abortion, many women throughout the world still have to resort to unsafe abortions, placing themselves at considerable risk. The World Health Organization estimates that there are approximately 20 million unsafe abortions performed each year, and estimates of maternal deaths as a result of abortion range between 60,000 and 100,000 per year. With free and legal access to safe abortions, rates of complications and mortality drop dramatically. There is an urgent need for efforts to prevent unwanted pregnancies in order to reduce the need for abortion; for the early identification of abortion complications and easy access to treatment for women suffering those complications; for expansion of safe abortion availability; and for proper training and resources for providers of abortion services.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : A strong collective pro-choice mentality was recently manifested in Mexico when a legislative initiative to revoke the legal right ofrape survivor to abortion in the state of Guanajuato awakened national indignation. Pro-choice values were expressed in public opinion with such force that it sparked off the passage of liberalising law reforms in Mexico City and the state of Morelos. In this paper we trace the development of these manifestations of pro-choice views, beginning with the Democratic Revolution Party's (PRD) refusal in 1999 to modify abortion legislation within the context of penal code reform, and moving through the events surrounding the Guanajuato reform, and the pro-choice response of Mexico City and Morelos legislators. This analysis allows us to recognise the emergence of a pro-choice consciousness and to understand that when it comes to abortion, 'context is all'.
Web site : http://www.rhmjournal.org.ukAbstract : This case study of a woman who wants to terminate her pregnancy but does not have access to safe services explores the technical, ethical, and legal effects of the Mexico City Policy (Global Gag Rule) on health care providers working in developing countries. This woman's self-induced termination resulted in an incomplete abortion, and she sought care from a midwife. The current Mexico City Policy effectively limits a health care provider's ability to offer abortion services and counseling, even when these services are legal. The policy has an adverse impact on women's access to safe care. The provision of comprehensive postabortion care, not restricted by the Mexico City Policy, is the key to preventing abortion-related morbidity and mortality.
Notes : Inglés/anglais/EnglishAbstract : Women's struggle for the right to terminate an unwanted or mistimed pregnancy through access to safe, dignified abortion services is currently at a crossroads. Today, we need empowered actions based on effective strategies, permanent coordination of our efforts and a great deal of political will. Towards the end of the 1970s and through the early 1980s when the feminist movement unfurled this political banner, our discourse focused on criticizing the criminalization of abortion which leads to the inhumane treatment of women who have resorted to clandestine abortions. This approach led to a criticism aimed at governments for failing to fulfill their obligation to respect women's rights to life, liberty, and to control their own bodies, a perspective not yet explored by in formal jurisprudence. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 180989Abstract : Reproduction and motherhood are among the most important components of women's identity throughout Mexico and, for many women, are the only vehicles for gaining recognition and status in the family and community. At the same time, however, abortion is a central experience in the lives of many women and carries with it the complexities and contradictions of women's reproductive and sexual health. This paper presents results from an ethnographic study conducted with midwives in one rural township of Morelos, Mexico to understand their conceptualizations of and practices related to abortion and postabortion care. Overall, midwives viewed miscarriage as a woman's failure to fulfill her primary role as mother and induced abortion as a grave sin or crime. Nevertheless, under certain circumstances induced abortion was justified for many midwives. Helping women to "let down the period" in situations when a woman's menstrual period was delayed was acceptable to midwives as it was not viewed as abortion and enabled women to regain health and well-being.
Notes : Inglés/anglais/EnglishAbstract : There is most likely no issue which touches upon medicine, ethics, and law which is more controversial and difficult to resolve than the issue of abortion. First, the abortion debate has gone beyond scholars and health professionals to be part of the common social discourse. Second, the abortion debate has become highly partisan, with firmly entrenched, ideologically bent camps on either side of the issue. That the roots of the anti-abortionist position are in religion is the third reason why it has not been possible to reach agreement on the ethics of abortion. Abortion and religion, rights and personhood, a consequentialist ethical analysis, justice and access to abortion, and attitudes and practices in Bangladesh, the Philippines, Mexico, Chile, and Argentina are discussed.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 119219Abstract : Since the Pinochet regime abortion laws have been reflective of Chilean law, but anti-abortion Senator Hernan Larrain fights for stricter punishments. This is all in an effort to end what conservatives consider to be an "abortion industry" which accounts for 160,000 illegal abortions in a country of 15 million people. As with all Latin American countries, abortion is illegal. In 1931 a law allowed abortions only in the effect that the woman's life may be endangered. However, near the end of Gen. Augusto Pinochet's ruling term in 1989, he repealed the law. About four million abortions are performed in Latin America each year, or one of every 11 worldwide. The highest rate is in Chile were one in three woman have an abortion, and more than 100 women die each year from abortion-related cases. The proposed law, which is expected to pass in the Senate, would increase the penalities for those performing aboritons. Currently, a three to five year sentence ca n be imposed on a woman who has received an abortion, which is often reduced. If the new legislation passes, the sentence would not increase, but the woman is encouraged to testify against the medical practitioner in exchange for a reduced sentence or penalty.
Notes : Inglés/anglais/EnglishAbstract : This paper examines the abortion decisions of Hispanic women who reside in the Texas counties that border Mexico. We hypothesize that ethnicity as well as geographic location may capture differences in assimilation to the U.S. culture that, ultimately, influence fertility-control decisions. We concentrate on the connection between the abortion decision and provider availability as measured by distance to the nearest abortion provider. The empirical model uses a logit specification to compare the abortion decisions of border Hispanics to both Hispanic and Anglo women residing in nonborder regions of Texas. The data consist of all births and abortions for women 20 years old and older for 1993 in Texas. We find characteristic differences among the abortion decisions of Texas women by ethnicity and geographic location. In particular, Hispanics along the border region are quantitatively more responsive to variations in the availability of abortion providers, poverty rates, female employment rates, and urbanization. The abortion decisions of nonborder Hispanics appear to more closely resemble those of Anglo women rather than those of their Hispanic counterparts in the border region. Also, economic development in the Texas-Mexico border region is likely to have a significant impact on abortion and fertility rates in the region
Web site : http://www.blackwellpublishing.com/journal.asp?ref=0038-4941Abstract : The author proposes going 'Beyond attitudes' (Potter and Wetherell 1987) to a more nuanced assessment of doctors' discursive variations. Through an application of Gilbert and Mulkay's (1984) interpretative repertoires, she defined three voices - technical, normative and pragmatic - in which Bolivian doctors spoke of abortion. In State and Social Security hospital contexts, doctors hastened to express compliance with government policy and institutional norms regulating abortion and postabortion care. However, technical and pragmatic considerations often entered into conflict with established rules. When contradictions became apparent in their own discourse, doctors regularly drew on the Saving Women device. This accounting strategy enabled them to save face as up-to-date professionals through justifying temporary deviance from norms in terms of benefit to women treated. The author describes her development of the repertoires, their validation with different medical audiences, and doctors' critical appropriation of the model to explain their own discursive variations.
Notes : Inglés/anglais/EnglishAbstract : This article introduces a collection of papers which provides an anthropological perspective upon abortion from various parts of the world. The countries considered, Greece, Turkey, China, Nigeria, Jamaica, and Romania, vary in their policies and laws as well as the historical context concerning abortion, in the extent to which the state supports or restricts access to abortion and contraceptives, and in prevailing cultural ideologies concerning these and related issues of sexuality, fertility, family, and gender roles. In each of these countries, however, women are concerned about unplanned pregnancies and how they affect their social and familial roles, economic resources and work, the welfare of their children, their social relationships, and their social status. Women act upon those concerns by regulating their fertility through various means, including either legal or illegal abortion. This article places the various papers in the collection into a broader context by presenting a brief, selective overview of past research on abortion from a crosscultural perspective ( PIP 115079)
Web site : http://www.sciencedirect.com/science/journal/02779536Abstract : In Argentina, unsafe abortions are the primary cause of maternal mortality, accounting for 32% of maternal deaths. During reform of the National Constitution in 1994, the women's movement effectively resisted the reactionary government/church position on abortion. Health professionals, including obstetrician-gynaecologists, played conflicting roles in this debate. This article presents results from a study carried out in 1998-1999 of the views of 467 obstetrician-gynaecologists from public hospitals in Buenos Aires and its Metropolitan Area, focus group discussions with 60 of them, and interviews with heads of department from 36 of the hospitals. The great majority believed abortion was a serious public health issue; that physicians should provide abortions which are not illegal; that abortion should not be penalised to save the woman's life, or in cases of rape or fetal malformations; and that women having illegal abortions and abortion providers should not be imprisoned. Some 40% thought abortion should not be penalised if it is a woman's autonomous decision. Those who were better disposed towards the de-penalisation of abortion cited a combination of public health reasons and the need for social equity. The women's health and rights movement should do advocacy work with this professional community on women's needs and rights, given the prominent role they play in reproductive health care provision and in the public sphere.
Web site : http://www.rhmjournal.org.ukAbstract : Abortion is illegal in Brazil except when performed to save the woman's life orin cases of rape. This paper gives a brief history of parliamentary and extra-parliamentary efforts to change abortion-related legislation in Brazil in the past 60 years, the contents of some of the 53 bills that have been tabled in that time, the non-governmental stakeholders involved and the debate itself in recent decades. The authorities in Brazil have never assumed full public responsibility for reproductive health care or family planning, let alone legal abortion; the ambivalence of the medical profession is an important obstacle. Most politicians avoid getting involved in the abortion debate, but the majority ofbills in the 1990s have favoured less restrictive legislation. Incremental legislative and health service changes could help to improve the situation for women. Advocacy is probably the most important action, to promote an environment conducive to change. Clandestine abortion is a serious public health problem in Brazil, and the inadequacy of family planning services is one of the causes of this problem. The solutions should be made a priority for the Brazilian public health system.
Web site : http://www.rhmjournal.org.ukAbstract : Save for rare exceptions represented by feminist bioethics researchers, the subject of abortion is dealt with as an issue of insoluble moral conflict, that is, a situation in which bioethics serves as a mere instrument of reflection rather than as an instrument of political intervention
Web site : http://www.anis.org.br/serie/artigos/sa32(diniz)abortion.pdfAbstract : In Latin America, there is an extremely high rate of unwanted pregnancies and clandestine abortions. As a result, induced abortion is one of the leading causes of maternal mortality in the region. In view of this, Catholics for a Free Choice/Latin America promotes women's right to choose as competent moral agents and their right to disagree with the Church's positions as an ethical option. The members defend access to safe and effective contraceptive methods and abortion as expressions of freedom of conscience and as fundamental human rights of all people. It is noted that for the last 20 years Latin American and Caribbean women have taken part in the struggle for sexual and reproductive rights, committing themselves to the continuance of forming and fostering the liberating Church and recognizing that, in order to fulfill this mission, changes in the existing structure of the Catholic Church are essential.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : For North Americans, the abortion debate is one of rights: the fetus' right to be born versus the mother's right to control her body. But for Latin American women, debating rights is a luxury that has little to do with the brutal reality of becoming pregnant and knowing it will be impossible to feed yet another child, says Sylvia Marcos. A Mexican psychotherapist who has taught at Harvard University, Marcos works with women in squatters' camps throughout Mexico. "If you want to end abortion in Latin America, you will have to change the whole economic system," said Marcos in an interview. Unfortunately, Marcos said, abortion foes have failed to come up with answers to the poverty that drives Latin American women to have what she estimates are 12 million illegal abortions a year. Women in Latin America, most of them Catholic, are expected to marry young and have many children. Most women choose abortion only after having many children and deciding it would be impossible to feed another, Marcos said. The combination of Catholicism and culture ; extolling the virtues of large families ; and women's utter lack of means to provide is devastating psychologically and physically, she said. Furthermore, about 1/2 of all Latin American women are raising children alone. "It's so unjust," said Marcos. The 12 million abortions reflect desperation ; not an anti-life orientation, she said. "When you are hungry, you do not debate the ethics of when life begins," said Marcos. "If we had enough to eat, then we could care." Women who have abortions continue to call themselves Catholic but often quit going to communion. "Not only do they have a hard time recovering physically from illegal abortions, but they are denied spiritual enjoyment," Marcos said. Trapped in desperate situations, women ignore church teachings about abortion ; particularly if they are Indians who still identify strongly with traditions that uphold different ideas about when life begins. Both prochoice and prolife forces in North America, said Marcos, have tended to look at the abortion issue from a North American perspective and have not formed a broader analysis that takes into account the concrete realities of poor women ; the majority in Latin America. "It's very American to start with an abstract moral principle," she said. (full text modified)
Web site : http://www.catholicsforchoice.org/conscience/archives/default.aspAbstract : Opposition to legal abortion has continued despite the passage of law in the late 1970s to legitimate abortion clinics. The Catholic Church is the primary antagonist to family planning and legal abortion. A study of legal abortion initiated in 1991 provided data on 10 private abortion clinics and 371 women receiving services. Preliminary findings were released at the same time as an initiative to amend the Penal Code to limit the right to abortion. Controversy over the proposed amendments arose, and the study researchers at PRO MUJER, the Women's Studies Project at the University of Puerto Rico, distributed their findings as widely as possible to schools and universities, scientific bodies, and other entities. The resistance to abortion became evident. The findings showed that 96% of abortions occurred during the first trimester of pregnancy, which conflicted with anti-abortion propaganda. Most of the women seeking abortions were religious and had made the decision jointly with their partners. The population was aged over 20 years, and most had one or more children. The population was married, divorced, or widowed. The unintended pregnancies happened through failure of the contraceptive method chosen: 50% through periodic abstinence or withdrawal. Two major reasons for abortion decisions were economic difficulties and lack of facilities for caring for a newborn baby. The mothers reflected a group that was conscientious and responsible in their approach to motherhood. The study women were unaware of the legality of abortion, the availability of abortion facilities, or the variation in prices for abortion among facilities. The Family Planning Division of the Department of Health in 1992 conducted another study which found that 60% of pregnant women who used the public health system did not intend their pregnancies. PRO MUJER authors thought that the lack of sex education and access to family planning were key factors in the incidence of unwanted pregnancies. The Catholic Church posture against abortion and family planning was also blamed.
Web site : http://www.rhmjournal.org.ukAbstract : A 1991 research project initiated by the Women's Studies Project of the University of Puerto Rico provided, for the first time, a scientific estimate of the extent of abortion in Puerto Rico. Utilized in the study was a sample of 371 women who visited 10 of the 13 abortion clinics in the country. Extrapolation from this sample suggests that there are 17,000 abortions each year in Puerto Rico, or that 20% of pregnancies are terminated. Only 9% of these procedures involve women under 20 years of age. The average abortion seeker is married (71%) and has one or more children (68%). 73% are Catholic. The reasons most frequently cited for the abortion decision were: financial instability (68%), inability to assume the responsibility for a child (68%), and child care problems (57%). 59% of abortion seekers had used a contraceptive method during the month they became pregnant; 32% had recently discontinued use due to side effects. Although abortion has been legal in Puerto Rico since 1973, accessibility is severely limited and only 2 of the country's health regions have full-time abortion clinics. These clinics perform 95% of total procedures. Moreover, regulations imposed on abortion clinics by the Department of Health are more restrictive in terms of facility and equipment specifications than those in US. As in the US, Penal Code amendments and other legislation aimed at restricting abortion further are under consideration. Pro-choice groups in Puerto Rico are insisting that abortion should be regulated like any other medical procedure, not through the Penal Code.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 084465Abstract : This paper situates the current abortion practice and policy in Puerto Rico within the historical, political, and economic context of the colonial domination of the United States (US) over Puerto Rico. In particular, we pay attention to the hurdles that women face to obtain abortion services in Puerto Rico as a result of its colonial legality. Of particular significance is the overall low abortion ratio, and differential abortion ratio and access issues faced by women when grouped by an age-ethnicity category: unmarried teenagers, adult Puerto Rican women and, adult immigrant women from the Dominican Republic. The present hurdles to abortion access ; related to information, abortion providers, economic situation, and government policies ; are discussed within the colonial legality of abortion based on the US Supreme Court decision Roe v. Wade. Puerto Rico's case is situated within its broader history of population policies developed by the State since the 1930's. Of particular relevance is the antagonism that State managers have had towards abortion in spite of its legality. In this sense, abortion in Puerto Rico continues to be an unfinished business, in spite of its legality.
Notes : Inglés/anglais/English, nbsp;9642718Abstract : As a colony of the United States, abortion became legal in Puerto Rico, as a consequence of the US Supreme Courtrulingin Roe v. Wade, rather than as a consequence of intemal political developments. In spite of a wide variety of foreign-sponsored population experiments and policies, developed with the active participation of government, opposition to abortion emerged in Puerto Rico and women's right to abortion has not been fully accepted by government officials or health professionals. Using data from a survey carried out in 1991-1992 of women attending 10 of the 13 private abortion clinics, and other sources of historical information, this paper examines the current practice of abortion and the hurdles women face to obtain this service, taldnginto consideration the impact of colonial subordination. The colonial legality of abortion in Puerto Rico has both supported and deterred Puerto Rican women's right to abortion, and other means of ensuring that right need to be found.
Web site : http://www.rhmjournal.org.ukAbstract : Este libro presenta los resultados de veintidós estudios - la mayoría llevados a cabo en países del tercer mundo donde el aborto es ilegal y por lo tanto inseguro. El libro tiene como enfoque central presentar las experiencias de mujeres que confrontando un embarazo no deseado decidieron terminarlo, en la mayoría recurriendo a abortos en la clandestinidad. Los capítulos incluyen las opiniones y perspectivas de mujeres, y en algunos casos, de proveedores de aborto sobre esta práctica, que tiene consecuencias sumamente negativas no solo para la mujer, sino para su familia y por lo tanto para la sociedad en general. Como uno de los impactos mas fuertes del aborto clandestino inseguro es sobre la salud de la mujer, y a veces sobre su vida, el libro da suma importancia a las motivaciones, los procesos de toma de decisión, las condiciones económicas y los contextos sociales y de servicios que conducen a la toma de esta decisión, incluso cuando la mujer conoce los riesgos que esto implica. Los capítulos sobre situaciones en América Latina, por ejemplo Chile, México, República Dominicana, entre otros, dan mucho énfasis a este aspecto. Otros, por ejemplo, China, Cuba, Turquía, donde el aborto es legal, se concentran sobre los determinantes que llevan a un aborto, tal como la falla de un método anticonceptivo, o razones para no usar, falta de acceso a servicios de planificación familiar y otros temas que puedan explicar el porqué de esta opción. Las opiniones de los proveedores y su actuación confrontando una demanda creciente de aborto son también importantes y se exploran en México, Indonesia, Filipinas, Sri Lanka. Muchos de los estudios que se incluyen - todos apoyados por la Organización Mundial de la Salud - utilizaron métodos cualitativos en su metodología de investigación, solo en el caso de Colombia se utilizó una encuesta nacional. Los métodos empleados en los estudios son comentados en un capítulo especial al igual que la importancia de estos estudios para la formulación de políticas de salud. Los estudios cubren tanto mujeres casadas como adolescentes solteras, proveedores en contextos donde la práctica es legal como en donde no lo es, personal de servicio de salud y planificación familiar, y otros. El libro está organizado alrededor de los siguientes grandes temas: la relación entre el aborto y la anticoncepción; la calidad de los servicios de aborto, que incluye secciones sobre perspectivas de las mujeres y de los proveedores; la sexualidad de adolescentes y el aborto; y, finalmente, la investigación y sus implicancias para políticas de salud.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : Abortion is not a modern aberration, but a practice common to human communities throughout history. Historically, early abortion was tolerated by the Church, and for centuries it was not punished under English common law. Nations which have passed abortion laws have done so for a variety of reasons, such as concern for women's health, the demands of the medical profession, demographic fears, religious beliefs, etc. Restrictive abortion legislation does not lead to a low abortion rate. The data from Romania when it prohibited abortion, from Italy before its liberalized abortion law, and from Latin America, the Middle East, Africa and other developing countries show that the abortion rate is high in countries in which abortion is illegal. Whether legal or not, every year millions of individual women around the world- of all cultural, religious, and economic backgrounds- seek out abortion when they cannot carry a pregnancy to term. History has proved that laws do not stop abortion. It is the number of maternal injuries and deaths, not abortions, that is most affected by restrictive legal codes. Abortions performed outside the law have a higher rate of complications and deaths, the majority of which are entirely preventable. Worldwide, more than one third of the estimated 50 million annual abortions are illegal abortions, occurring mainly in the developing world. Researchers estimate that 70,000 to 200,000 women a year around the world die from illegal and unsafe abortions. Doing away with such purposeless human suffering has been one of the main motives behind the movement to liberalize abortion laws the world over. At present almost two thirds of the world's women live in countries where abortion may be legally obtained for a broad range of social, economic or personal reasons. When abortion is made legal, available and safe, women's reproductive health improves. Abortion-related mortality is reduced by at least 25% and related illness by far more.199 Where abortions are safe and affordable, by far the largest percentage of women terminate their pregnancies within the first trimester. When women can avoid births which are unwanted, mistimed, or too numerous, their children are more likely to survive and be healthy.200 The incidence of infanticide and child abandonment typically go down when abortion is legalized. Even in countries where the abortion law seems "liberal", it cannot be assumed that every woman has an equal chance of getting an early, safe abortion if she needs one. Lack of medical facilities or personnel, women's low status in society, cultural taboos, restrictive regulations and financial roadblocks can effectively curtail access to legal abortion and contraception, especially for disadvantaged and young, unmarried women. Changes in laws, while necessary, are not themselves sufficient for widespread access to family planning and safe abortion services. It has long been recognized that the number of abortions can be effectively reduced by educating people on human sexuality and family planning, and making safe, appropriate and effective contraception available. Empowering women in society, as well as involving men more in reproductive issues, are also important to reducing the rate of unwanted pregnancy and hence abortion.Even in countries where the abortion law seems "liberal", it cannot be assumed that every woman has an equal chance of getting an early, safe abortion if she needs one. Lack of medical facilities or personnel, women's low status in society, cultural taboos, restrictive regulations and financial roadblocks can effectively curtail access to legal abortion and contraception, especially for disadvantaged and young, unmarried women. Changes in laws, while necessary, are not themselves sufficient for widespread access to family planning and safe abortion services.201At the September, 1994 U.N. International Conference on Population and Development (ICPD) in Cairo, representatives from over 180 nations met and developed the ICPD Programme of Action, which had this to say about abortion:"All Governments and relevant intergovernmental and non-governmental organizations are urged to strengthen their commitment to women's health, to deal with the health impact of unsafe abortion as a major public health concern and to reduce the recourse to abortion through expanded and improved family planning services."It has long been recognized that the number of abortions can be effectively reduced by educating people on human sexuality and family planning, and making safe, appropriate and effective contraception available.202 Empowering women in society, as well as involving men more in reproductive issues, are also important to reducing the rate of unwanted pregnancy and hence abortion.
Web site : http://www.cbctrust.com/history_law_religion.phpAbstract : This web site contains a database of summaries and excerpts of legislation, constitutions, court decisions, and other official government documents from every country in the world relating to abortion policiesfor differents countries. The period covered by the database is 1974 through the present (2004-).
Web site : http://annualreview.law.harvard.edu/population/abortion/abortionlaws.htmAbstract : The country reports of national policies concerning induced abortion presented in Volume I of "Abortion Policies: A Global Review", covers abortion policies from Afghanistan to France. This document aims to provide objective information on the nature of abortion laws and policies at the end of the 20th century which include information on the social and political settings, ways in which they have been formulated, and their evolution over time. Chapter 1 presents major dimensions of abortion policies with a discussion on challenges in the practical and conceptual context, as well as on the conformity of written law or policies with practices. Chapter 2 outlines the description of the variables identified in each country profile, namely: grounds on which abortion is permitted; reproductive health indicator, and abortion policies and their national context. The third chapter details country profiles, which are arranged alphabetically.
Web site : http://www.un.org/esa/population/publications/abortion/index.htmAbstract : This is the second of three planned volumes presenting a country-by-country examination of national policies concerning abortion. Information in this volume is provided in alphabetical order from Gabon to Norway, and concerns each country's abortion policy, the fertility and mortality context in which abortion policy has been developed, and statistics on induced abortion. (ANNOTATION)
Web site : http://www.un.org/esa/population/publications/abortion/index.htmAbstract : This is the third of three volumes presenting a country-by-country examination of national policies concerning abortion. This volume concerns countries in alphabetical order from Oman to Zimbabwe. The information regards abortion policy, the fertility and mortality context in which abortion policy has been developed, and selected statistics on induced abortion. (ANNOTATION)
Web site : http://www.un.org/esa/population/publications/abortion/index.htmAbstract : Unsafe clandestine abortion is responsible for an estimated 100-200,000 deaths among women in developing countries each year and accounts for 25-50% of all maternal deaths in some regions, especially Latin America. A third of the population of the Third World lives in countries where abortion is illegal or permitted only in extreme cases. Mortality from clandestine abortions in developing countries may be as high as 400/100,000 procedures compared with 6/200,000 in situations where abortion is legal. Even when women survive the procedure, there are numerous possible physical complications (incomplete abortion, pelvic infection, hemorrhage, shock, and secondary sterility), emotional sequelae, and enormous costs to the health care system for treating abortion complications. Given professed concern with improving maternal health, the refusal of so many governments to liberalize their abortion laws seems inconsistent. Even international conferences on maternal health generally refrain from issuing recommendations that safe, legal services for terminating unwanted pregnancies be offered as an integral part of national primary health care systems. Countries that have passed liberal abortion laws are reluctant to require all health care facilities to perform abortions. The US Government's decision to refuse to fund family planning programs that include abortion represents a major setback to women's reproductive rights and has forced many private voluntary organizations in the Third World to choose between continuing to provide safe, legal abortion and losing their funding. Since family planning has been defined as a basic human right in international documents, there is an urgent need for governments and medical institutions to examine the legal, medial, and ethical principles upon which they base their restrictive, discriminatory abortion policies.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 062897Abstract : In Cuba, abortion at up to 12 weeks gestation is freely available on request in hospitals. Up to 45 days of amenorrhea, it is performed by means of manual vacuum aspiration with Karman syringe, without anesthesia. However, women who request an abortion at more than 12 weeks gestation must first have their case reviewed by a special medical committee of the hospital if the reason is medical and by a social worker if the reason is socioeconomic. This cross-sectional study examined the factors that influence abortion practice in a municipality of Havana, Cuba. It also looked at the relationship between abortion practice and contraceptive use and the important socioeconomic and psychological factors influencing abortion. A total of 1965 women 13-34 years old were included in the study. The abortion rate was highest among women under 20 years old, women with low levels of education, and unemployed women. Moreover, abortion is highest among women in consensual unions, those not living with their partners, and those living in female-headed households. Among households with the lowest and highest per capita income, abortion rates was low. Although Cuban women have a very high level of awareness of contraceptive methods, they have only a basic knowledge of how the methods actually work or are used. Major changes in family planning services in Cuba are recommended to reduce the abortion rate.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : Small island exigencies and a legacy of colonial jurisprudence set the stage for this three-year study in 2001-2003 of abortion practice on several islands of the northeast Caribbean: Anguilla, Antigua, St Kitts, St Martin and Sint Maarten. Based on in-depth interviews with 26 physicians, 16 of whom were performing abortions, it found that licensed physicians are routinely providing abortions in contravention of the law, and that those services, tolerated by governments and legitimised by European norms, are clearly the mainstay of abortion care on these islands. Medical abortion was being used both under medical supervision and through self-medication. Women travelled to find anonymous services, and also to access a particular method, provider or facility. Sometimes they settled for a less acceptable method if they could not afford a more comfortable one. Significantly, legality was not the main determinant of choice. Most abortion providers accepted the current situation as satisfactory. However, our findings suggest that restrictive laws were hindering access to services and compromising quality of care. Whereas doctors may have the liberty and knowledge to practise illegal abortions, women have no legal right to these services. Interviews suggest that an increasing number of women are self-inducing abortions with misoprostol to avoid doctors, high fees and public stigma. The Caribbean Initiative on Abortion and Contraception is organising meetings, training providers and creating a public forum to advocate decriminalisation of abortion and enhance abortion care.
Web site : http://www.rhmjournal.org.uk/Abstract : On August 4, 1994, a specially convened Congress met in Argentina to incorporate changes in the Constitution imposed by the 1969 American Convention on Human Rights. Article 4 of that Convention, which was not ratified by Congress until March, guarantees respect and protection for every person's life, beginning at conception. Abortion has been illegal in Argentina since 1921, except in cases of rape where the victim is mentally incapacitated and in cases where the mother's life is in extreme danger. Persons performing abortions face jail terms of 10-15 years; patients receive 4 years. A decree in 1974 by Isabel Peron prohibited the offering of information about contraception and sterilization; this was overturned in 1987. Responsible parenthood campaigns in Buenos Aires, where a quarter of the country's population of 34 million is situated, have targeted groups of women at risk and offered free advice and female contraceptives. The World Health Organization estimates that 365,000 illegal abortions are performed annually in Argentina. According to a study conducted in Buenos Aires between July, 1991 and December, 1993, abortion is the third most important cause of death in females aged 10-49 after acquired immunodeficiency syndrome (AIDS) and pregnancy complications (not including deaths due to accidents). Although pro-choice groups failed to block the heavily qualified changes in the Constitution, demonstrations continued, including one on August 9 in Buenos Aires that was conducted by members of the national Human Rights Committee.
Web site : http://www.thelancet.com/Abstract : Data for this study of Jamaican women's experiences with abortion, pregnancy, and menstrual regulation and ethnomedical and other cultural beliefs are from fieldwork collected during 1988 and 1989 in a coastal village east of Port Antonio and other urban research. A brief description is presented of Jamaican economic, social, and historical conditions. Abortion is viewed as a subversion of the social and moral order and as a "backward" practice. Abortion is "uncivilized" and against the teachings of civilized Christian religion. It is argued that ethnographers must focus both on the value of children as well as the value of parenting in rural Jamaica in order to fully explain reproductive practices such as abortion. Jamaica is described as a country with a pronatalist ideology and strong beliefs about caring for others that arise from beliefs about kinship and social adulthood. Abortion is practiced within this context. It is estimated that about 20-30% of pregnancies resulted in abortions in 1981. In 1989, 55% of pregnancies were reported to be mistimed and 20% were unwanted. The use of abortion requires a shift away from kinship and parenting ideals. Women both expect their sons to be irresponsible and denounce "baby fathers" who do not offer support. Male irresponsibility is given as one reason for abortion. Other reasons involve economic pressures and tense gender relations. Abortion is also viewed as the removal of "blockage" or undesirable matter from the "belly" of the woman. The "blood tie" between the baby's mother and father and kinship obligations are severed. Conception is viewed as a lengthy process, and the use of medicinal purges to "wash out the fetus" may not be considered an abortion but as a "clearing of perceived sickness." Jamaican women are aware of a variety of abortifacients. Abortion is identified with late term expulsion of the fetus. "Bush doctors" and spiritual healers, whose numbers are declining, may be consulted for reasons of privacy and effectiveness.Abortion is not condoned in Jamaica. Its meaning is linked to the meanings of kinship and parenthood, which are expressed through procreation and involve altruism and the assumption of responsibility for the well-being of others. Abortion subverts these ideals but indigenous methods for it are known and are secretly used. The inconsistencies between abortion talk and abortion practice are examined, and the structural functions of abortion (and of its culturally constructed, ideological meaning) are discussed. The distinction--and the overlap--between abortion as such and menstrual regulation is explored. The use of the culturally constructed `witchcraft baby' syndrome to justify abortion is also investigated.
Web site : http://www.sciencedirect.com/science/journal/02779536Abstract : A descriptive of the efforts to liberalize abortion law in Mexico are provided; in addition, the political climate and the evolution of population policy are characterized. Current abortion law stipulates the legal abortion may be performed due to risk to a mother's life, risk of congenital abnormality, and the pregnancy as a result of rape. Feminist groups have been active, since the formation in 1976 of the Coalition of Feminist Women (CFW), in working toward decriminalization of abortion. The issue of abortion was carefully researched in 1976 and a book on abortion was published. The First National Meeting for the Liberalization of Abortion was held in September 1976. A feminist journal devoted entirely to abortion issues was begun in January 1977. CFW began distribution of the pamphlet Voluntary Motherhood and the Right to Free, Legal Abortion in October 1978. The National Front for the Struggle for the Liberation and Rights of Women was created in March 1979. Discussions, meetings, demonstrations, and political lobbying were conducted through the years. The earthquakes in 1985 precipitated an intensification of the issues. Repression of the issues was also occurring. Security policy stormed an abortion clinic in March 1989. Conservative forces supported this action and asked for stricter enforcement. In this climate, the state of Chiapas approved the decentralization of abortion for up to 90 days of pregnancy for family planning reasons. Within 2 weeks, Pro Life forces exerted sufficient influence on the Congress to overturn the new legislative measure. Feminists believe that the abortion bill was part of a national government strategy to see the political effects if a policy change. A history of population policy reveals the pronatalist stance after the revolution and the gradual concern about providing resources for families to make informed choices about family planning. Contraceptive use was 53% in 1987; the availability of reproductive services has not changed the estimated 1 million abortions performed annually. The result is maternal mortality or complications, which are not recognized politically. The results of the demographic survey in 1993 and national elections will play an important role in the future abortion debate. Decriminalization will not be achieved through recognition of the tight of women to voluntary motherhood, or public health reasons.
Web site : http://www.rhmjournal.org.uk/Abstract : OBJECTIVE: If properly trained, medical students could become future opinion leaders in health policy and could help the public to understand the consequences of unwanted pregnancies and of abortions. The objective of this study was to analyze the frequency of unwanted pregnancies and induced abortions that had occurred among women who were first-year medical students at a major public university in Mexico City and to compare the experiences of those women with the experiences of the general population of Mexican females aged 15 to 24. METHODS: In 1998 we administered a cross-sectional survey to all the first-year medical students at the National Autonomous University of Mexico, which is the largest university in Latin America. For this study we analyzed 549 surveys completed by female students. RESULTS: Out of the 549 women, 120 of them (22%) had been sexually active at some point. Among those 120 sexually active students, 100 of them (83%) had used a contraceptive method at some time, and 19 of the 120 (16%) had been pregnant. Of those 19 women who had been pregnant, 10 of them had had an illegal induced abortion (in Mexico, abortions are illegal except under a small number of extenuating circumstances). The reported abortion rate among the female medical students, 2%, was very low in comparison with the 11% rate for women of similar ages in the Mexican general population. CONCLUSIONS: The lower incidence of abortion among the female medical students indicates that when young Mexican women have access to medical information and are highly motivated to avoid unintended pregnancy and abortion, they can do so. [Journal Article; In English; United States]
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S1020-49892003000700008 lng=en nrm=isoAbstract : The objectives of this pilot study were: to provide qualitative data for the design of policies and strategies that will modify sexist attitudes and practices, and to identify viable strategies for strengthening the training of health personnel in the areas of culture, gender, and sexual and reproductive rights. The following are among the conclusions based on the information gathered in the study: In 36% of cases studied, the provider did not ask the woman to give a reason for the visit. From a gender perspective, the woman's word is nullified from the first moments of the interaction, resulting in her feeling timid throughout the consultation and predisposing her to an attitude unfavorable to the expression of her health needs and service requests. The prevalence of many suppositions about the lives of women suggests that the actual needs of women are not taken into account. Women's stories are not valued as significant in relation to medical facts. Attitudes demonstrated by health center providers could result in low rates of use of services by women; this would indicate that a large proportion of health needs requiring prevention and treatment are not being met. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 173297Abstract : Unsafe abortion as a public health issue represents a serious concern to the World Health Organization (WHO). Treatment of complications of such abortions uses a disproportionate share of hospital resources in developing countries, and poorly performed procedures lead to reproductive tract infections and infertility. Data on unsafe abortion, defined as "an abortion not provided through approved facilities and/or persons," are scarce and unreliable given legal constraints. This document presents a complication of available data on the frequency of unsafe abortion and associated mortality extracted from WHO's Maternal Health and Safe Motherhood Program database. The estimates, which must necessarily be viewed as "best guesses," were obtained from hospital studies and adjusted to take into account the country's abortion law. The annual incidence on unsafe abortions worldwide is set at 20 million, for a ratio of one unsafe abortion to seven births. 90% of these procedures occur in developing countries. About 70,000 women die each year from complications of unsafe abortion, and 13% of pregnancy-related deaths are attributable to this procedure. The rate of unsafe abortions/1000 women aged 15-49 years is 26 in Africa, 12 in Asia, 2 in Europe, 41 in Latin America, 17 in Oceania, and 30 in Russia. The rate of mortality from unsafe abortions/1000 live births is 83 in Africa, 47 in Asia, 4 in Europe, 48 in Latin America, 29 in Oceania, and 10 in Russia. Governments are urged to examine the health impact of unsafe abortion, reduce the need for abortion through expanded family planning programs, and frame abortion legislation on the basis of women's health and well-being.
Web site : http://www.who.int/Abstract : The objectives of this study were: to provide information and analytical elements that would facilitate the making of public policy and strategies for sex education; and to determine the prevalence of abortion in the university population. The data collected reflect the contradictions inherent in the social and cultural life of the country and particular regions. Among the findings and recommendations of the study are the following: Abortion is a practice generalized among the study population, which included people from capital cities and rural areas, established and circumstantial couples, persons who live in family groups and those who live alone, and people of different religions. The marked contradictions between the level of information and knowledge about contraception and the use of contraception reveal a need for integration of information, education and care in reproductive heath services. Abortion is being practiced under inadequate conditions and, even though it is most often performed by health personnel (and particularly physicians), there are physical and psychological consequences. Only 57% of women who had abortions received counseling on family planning. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 173298Abstract : Adoption of Colombia's 1991 Constitution has sparked debate on issues such as abortion, and the rulings of Constitutional Court judges, while still anti-abortion, have begun to reflect divided opinions about women's reproductive freedom. Abortion remains illegal and, in the past 2 years, the Court has decided two cases in favor of punishing women who had abortions, even in cases of rape. In reaching these conclusions, six of the nine judges argued that the constitution fails to protect reproductive rights, that women's dignity is not compromised by continuing a pregnancy caused by rape, and that the criminalization of abortion does not violate a couple's right to decide the number of their children. The dissenting opinion, however, held that a fetus has no juridical existence and cannot be protected by fundamental rights, that the right of reproductive autonomy is related to Constitutional norms, and that it is unjust to force a woman to continue a pregnancy resulting from rape. The judges holding the minority opinion accused the majority of exhibiting a lack of impartiality by adopting the official Roman Catholic position about abortion. The addition of three high court judges to those who are calling for decriminalization of abortion has stimulated increased objective debate about abortion in Colombia.
Web site : http://www.rhmjournal.org.ukAbstract : An estimated 25-50% of the 500,000 maternal deaths that occur in the world each year are associated with unsafe abortion. In Latin America, illegal abortion is the most common cause of maternal mortality. Unsafe abortion has devastating consequences for both the individual women who risk mortality or long-term damage such as infertility, but also for the distribution of resources within overburdened health care systems. Fundamental to this phenomenon is the low economic and social status of women. As a result of poverty and sex discrimination, women's reproductive health is given low priority. The trauma associated with unsafe abortion is part of a chain of injustice that characterizes the lives of poor women in developing countries.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 107636Abstract : This book is the first in a series of volumes that examine a major public policy issue using an explicitly comparative approach. It discusses the statutes, policies, and public attitudes of countries worldwide concerning the issue of abortion. This book comprises five chapters. The first chapter consists of a brief discussion of the historical background of abortion. The second chapter reports on the current abortion statutes in a sample of countries in Western and Eastern Europe, Asia, Australia, Africa, the Middle East, Latin and Central America, and North America. The chapter also provides information about the history and background of the statutes, the criteria employed in their formulation, the conditions surrounding their implementation, and the punishments for violation of them, together with data on the number of abortions reported annually. The third chapter discusses public opinion about abortion. The chapter assesses public support for the statutes by examining national poll data in 31 countries. Chapter four focuses on the relationships between a government's policies ; or lack of them ; vis-a-vis population and the laws and statutes concerning abortion. The last chapter provides commentary on each country's abortion statutes and policy recommendations.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 141851Abstract : This article answers several questions relating to the moral issue of abortion, the value of life, and the rights of women. Women all over the world have been having abortions, legal or illegal, since time immemorial for reasons which are difficult to document. While legal and safe abortions do not compromise the physical and psychological health of the woman, more than ten thousand women suffer and die from complications of illegal abortions especially in countries where women are denied of their reproductive rights. Though abortion remained illegal in many countries such as Brazil and Latin America, legal restrictions do little to reduce the incidence of abortion. Meanwhile, the question on when the fetus has life is viewed differently by the scientific, medical, legal and religious communities. But even with the conviction that abortion involves taking the life of a person, it is indeed a responsibility to respect the views of other religions. Finally, although the decision to have abortion should belong to the couple, the last word should belong to the woman.
Web site : http://www.catholicsforchoice.org/conscience/archives/default.aspAbstract : Complications from unsafe abortions account for approximately 40% of maternal deaths worldwide; more than 200,000 women die every year from the consequences of unsafe abortions. In developing countries, where 99% of maternal deaths occur, 50% of hospital budgets are spent on treatment of abortion complications. Christopher Tietze and John Bongaarts concluded in a 1975 report that, regardless of its legal status, abortion is used with similar frequency in all countries: criminalizing abortion does not reduce the abortion rate. In Latin America where abortion is legally restricted induced abortion rates are still among the highest in the world. In contrast, in Scandinavian countries abortion is legal and yet abortion and unwanted pregnancy rates are the lowest in the world. The latter countries have legal abortion, universal access to family planning services, and sex education. Tietze and Bongaarts also concluded that no population was likely to have attained a total fertility rate of 2.2 or less without the use of induced abortions, legal or illegal, and that, while widespread use of contraception reduces the need for abortion, currently available contraceptives cannot eliminate abortion. They estimated that, assuming a 95% contraceptive usage rate, 7 out of 10 women would require 1 abortion at some point in their lives to achieve fertility of 2 births per woman. Thus, the strengthening of contraceptive services is essential to reduce the number of unwanted pregnancies, as is the implementation of FP programs to assist women to remain free of diseases and bear healthy children. The experience of India, Zambia, Turkey, Tunisia, and the US has demonstrated that legalization of abortion is not enough, universal access to FP services is crucial. The problem of unsafe abortion requires postabortion contraceptive services to prevent more abortions; quality pregnancy counseling and referral with pregnancy testing; and the documentation of the public health nature of the problem by demographic and health research on abortion as well as postpartum counseling and contraceptive services.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 110030Abstract : On November 26-28, 1992, the Latin American and Caribbean Women's Health Network convened a meeting in Uruguay entitled, "Abortion in Latin America: Perspectives and Strategies." The first session was devoted to discussion of a paper that argues that a feminist ethic must be developed to counteract the dominant patriarchal ethic, which fails to improve women's lives. The next session covered the World Bank's concerns about the economic consequences of illegal abortion. The third session included descriptions of the experiences of the coordinator of the Sao Paulo Municipal Women's Health Program and of the new Argentine National Women's Health Network. Debate and discussion were generated by the next speaker, who presented a legislative proposal for the decriminalization of abortion in Latin America and noted that restrictive policies, which have failed to reduce abortion rates, will be difficult to change. It was proposed that regional campaigns be launched to legalize abortion as a first step in achieving reproductive rights for women. After a review of abortion-related activities in the region during the past year, participants composed a five-year plan of action in the areas of research, data centralization, petition campaigns, and publication of a review of abortion legislation. Finally, it was proposed that a counselor training course in sexual and reproductive rights be developed.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : This review discusses the problem of abortion in adolescents across the world and highlights the gaps in knowledge. It also examines the need for adolescent-friendly services. [Journal Article, Review, Review, Tutorial; 10 Refs; In English; England]
Web site : http://www.sciencedirect.com/science/article/B6WVB-4GX16V7-34B/2/3bffdd305e4c4a44a3f82f93861d6b62Abstract : Introducción ; Historia ; Actual situación legal en el mundo ; Panorama legal argentino ; Interrupción del embarazo ; Anticonceptivos ; Conclusiones.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Replantea la cuestión del aborto partiendo de considerar la situación de los que ya estamos en este mundo antes de ver la de los que están por venir, sosteniendo la importancia de la salud de la mujer y las posibilidades deatención a un nuevo ser
Notes : Español/espagnol/SpanishAbstract : Qué es el aborto? ; Antecendentes historicos ; El aborto y la legislación mexicana ; El homicidio y sus agravantes ; Ensayo político? ; El caso Chiapas ; Nuevas formas antinaturales de concepción ; El aborto hoy ; Razones ; Las mexicanas opinan ; La Biblia y el aborto ; Transplantes y donación de órganos.
Notes : Español/espagnol/SpanishAbstract : Apesar de medidas governamentais que lograram a ampliação do acesso à anticoncepção por parte de mulheres de baixa renda, persiste na Bolívia a prática generalizada do aborto clandestino e inseguro, responsável por cerca de quatro em cada dez mortes maternas e por metade das internações ginecológicas em hospitais públicos. O presente estudo realizou-se em um distrito sanitário da periferia de El Alto, quarta maior cidade boliviana, onde convivem aymaras e criollos, buscando identificar atitudes e práticas de resistência ao uso de métodos anticoncepcionais e frente a gravidez indesejada, através da observação de interações entre provedores do serviço de saúde e usuárias. O padrão de atendimento observado denota escassa eficiência do serviço e desvalorização da usuária, não se oferecendo informação suficiente nem adequada sobre a anticoncepção, entre outros aspectos negativos detectados. Propõem-se recomendações para mudanças no comportamento do pessoal médico, de modo a oferecer um serviço que atenda às necessidades e direitos das usuárias.
Notes : Portugués/portugais/PortugueseAbstract : At least 10% of abortions throughout the world are in women aged 15-19, and the proportion is increasing. One-third of pregnancies in Latin America are believed to end in abortion. It is difficult to estimate the incidence of abortion in adolescents in Peru because of its illegality and clandestine nature. A survey of students in metropolitan Lima indicated that 40% of pregnancies end in abortion, of which an estimated 88% are induced. In 1999, 424 abortions in women under age 19 were attended at the Maternal Perinatal Institute. Adolescents wait longer to seek medical assistance in case of complications, increasing the risk of serious complications. Induced abortion is usually the result of an unwanted pregnancy resulting from early sexual activity, deficient sex education, lack of information on contraception, lack of communication, poor use of free time, alcohol consumption, or drug addiction. The significance of the pregnancy to the adolescent, the partner's support or absence, the family's attitude, the adolescent's plans for the future, available economic support, self-esteem, and values are factors in the decision to end the pregnancy. The post-abortion period is an opportunity for treating the problems that contributed to the unwanted pregnancy, and for managing feelings of guilt and raising the self-esteem and assertiveness of the patient. A great percentage of adolescents who abort are from disintegrated or dysfunctional homes. Efforts should be made to reintegrate the adolescent into the home if the family has rejected her. Postabortion counseling should be provided on contraception and sexually transmitted diseases. Abortion in adolescence is a traumatic process biologically, psychologically, and socially. Integral care should involve management of the three components by a trained multidisciplinary team.
Web site : http://www.fhi.org/en/Youth/YouthNet/Publications/FOCUS/ProjectHighlights/redess-jovenesperu-span.htmAbstract : Entendiendo la necesidad de profundizar en la realidad del aborto, en varios países de América Latina, entidades y grupos de investigación que trabajan desde una perspectiva de género o a partir de una epistemología feminista, se han dado a la tarea de recoger las percepciones, sentimientos y construcciones culturales en torno a sus experiencias con el aborto inducido desde las mujeres, haciendo uso de técnicas cualitativas.
Notes : Español/espagnol/SpanishAbstract : Informe de las reuniones sobre aborto, Río de Janeiro, diciembre del 2001Contenido: Introducción ; Presentación ; Apertura ; 1. Aborto en América Latina y el Caribe: derechos de las mujeres frente a la coyuntura mundial ; 2. Estrategias sobre el marco legal a la luz de la coyuntura mundial ; 3. Estrategias para la visibilidad del tema del aborto en los medios de comunicación ; Carta de Guanabara ; Acto público ; Mujeres del mundo por el derecho a decidir ; Reunión de los puntos focales y redes ; Anexos : Campaña 28 de septiembre en el II Foro Social Mundial ; Relación de participantes ; Informe de la Coordinación Regional ; Informe financiero.
Notes : Español/espagnol/SpanishAbstract : 561 lower class women in the Buenos Aires metropolitan area were interviewed in the Reproductive Health Survey between November 1992 and January 1993 concerning their desire for the most recent pregnancy and their feelings about induced abortion. Public sector family planning services in Argentina are inadequate. Poor women encounter greater difficulty in obtaining quality family planning services than do wealthier women, and also more frequently suffer the consequences of unsafe and illegal abortions. The survey data indicated that 10.4% of the 404 women who had children or were pregnant had not desired the last pregnancy at the time it occurred, and 49.0% did not desire the pregnancy at all. Only 41.6% who did not desire pregnancy were using any form of contraception. 138 of the 477 women ever in union reported a total of 221 abortions or stillbirths. 20% reported two pregnancy losses and 14% reported three or more. The total corresponded to 15.8% of the reported live births. The number of reported pregnancy losses increased with age and number of children and was higher for less educated women. Separated, widowed, and divorced women had 104.0 reported pregnancy losses per 100 women, but the number of cases was small. The 561 respondents were asked in which of nine different situations they would approve of abortion. Over 60% of women in all age, educational, marital status, and contraceptive usage groups except nonusers of contraception stated they would approve of abortion if the pregnancy endangered the mother's life or resulted from rape. Around 50% in most groups would approve abortion if pregnancy would damage the mother's health. Around 40% in most groups would approve abortion if the child would be malformed. Between 20 and 40% would approve abortion if the mother did not want the child or the family was not economically able to support the child. Women never using contraception were less likely to approve abortion for economic reasons. Under 20% of most groups approved of abortion if the mother were a minor, considered the family complete, or had no partner. Women never using contraception were more likely to approve of abortion if the mother considered the family complete. Almost 14% of the 561 respondents did not approve of abortion under any conditions and 3.4% approved in all cases. Only 25% approved of more than four conditions.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100711Abstract : In Brazil, induced abortion is a controversial subject and some consider it to be a serious public health problem. There are few data available about its frequency and general characteristics. The difficulty of obtaining reliable information is explained by the illegality of abortion, which inhibits women from talking about it. Most studies are carried out in hospitals and thus identify only those women who have complications. A study was carried out in 1990 regarding the frequency of miscarriage and abortion in a population of female graduate students and employees of a university in the state of Sao Paulo. Data were obtained by mail through pretested questionnaires, 1992 of which were answered by employees and 937 by students anonymously. Significantly more students than employees were less than 25 years old (85% and 13.7%, respectively); fewer students were married or in a common-law union (11% of students vs. 56% of employees) and four times fewer students than employees had never been pregnant (15% vs. 65%). 9.7% of the students and 25.4% of the employees had had at least 1 abortion (p < 0.0001). When only ever pregnant women were taken into consideration, 65.9% of the students and 38.2% of the employees had had an abortion (p < 0.0001). In the age group under 24 years, 74% of students had had an abortion compared to 35.7% of employees (p < 0.0001). In contrast, the respective percentages for the age group over 24 years were 56.7% and 38.8% (p < 0.00591). Differences between the two groups both for miscarriage and abortion were maintained when considered by age. Students who were under 25 years of age presented a significantly higher percentage of induced abortion.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89101993000200006 lng=en nrm=isoAbstract : This is a collection of works examining levels and trends in induced abortion in Chile. Topics include the regulation of fertility in Latin America, medical consequences of abortion in Chile, reproductive behavior from an anthropological perspective, the male role in abortion decisions, and the legality of abortion worldwide. (ANNOTATION)
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND 8024607Abstract : Introducción ; Objetivos y metodología ; Principales resultados ; Opiniones favorables por edad ; Opiniones favorables por estado conyugal ; Opiniones favorables por nivel educacional ; Opiniones favorables por condición de uso de anticonceptivos ; Análisis multivariado ; Bibliografía
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Introducción ; La relación individuo-sociedad ; Las ideas ; Conclusiones ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Although abortion is commonly practiced throughout the world, it is a subject that arouses controversy because it raises fundamental questions about human existence, such as when life begins, the right of women to control their own bodies, sexuality, the nature of the State's duties in this matter, and the tension between secular and religious views of human life. This debate allows to make visible the fact that there are no homogencous or unchanging views on these subjects. In that sense, although in many countries the practice of abortion is iIlegal, the issue remits us more to the level of moral and ethical principles. In this article we discuss some of the implications of these controversies and provide information about the incidence of abortion, as well as of the consequences of both unsafe abortion and legalization of the practice. Finally, we analyze the implications of the laws that criminalize abortion on behalf of the fulfillment of some fundamental rights, such as the respect to differences, freedom of choice, self-determination and tolerance.
Web site : http://www.scielo.sa.cr/scielo.php?script=sci_arttext pid=S1409-00152002000200008 lng=es nrm=isoAbstract : This paper examines the practice of abortion, especially induced abortion among low income women. The discussion is based on survey data collected between 1984 and 1985 in seven slum communities (favelas) situated in the metropolitan area of Rio de Janeiro, Brazil. Despite restrictive law, induced abortion is extremely frequent. Among married women 21.4 per cent reported experience of induced abortion. Most abortions were performed by physicians, however the quality of care of these procedures can be questioned since almost all induced abortions are illegal there is no possible supervision by health authorities. The incidence of post-abortion complication is very high, especially for those performed by traditional midwifes or by the woman herself. More than 60 per cent of the women were not using contraception at the time of pregnancy. About, 21 per cent reported that they were using the pill. Such a high pill failure rate is inacceptable, and probably was related to incorrect use. This points to the need for a better access to family planning care within the health services. The consequences of the restrictive abortion laws in Brazil are also discussed. Restrictions that in practice prove to have little impact on the practice of induced abortion, appear to be very effective in brooding even more the social-economic inequalities.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0102-311X1991000200009 lng=en nrm=isoAbstract : El aborto inseguro atenta contra la salud y la vida de la mujer. En este artículo se revisan diversos factores legales, sociales y de servicios de salud que coadyuvan a su existencia en la región de América Latina y el Caribe. Las restricciones legales al aborto en la mayoría de países latinoamericanos resultan en la carencia de un sistema de salud que proporcione a las mujeres servicios seguros de interrupción. Ante esta situación, las mujeres con embarazos no deseados optan por prácticas clandestinas que pueden potencialmente resultar en una alta morbilidad y mortalidad maternas. Dentro de lo social, diversos factores asociados, como violencia, han sido identificados en mujeres que abortan. Presentamos diversas propuestas de prevención como la reducción de embarazos no deseados entre adolescentes y la organización de servicios de abortos legales. Además, identificamos aspectos del aborto inseguro que necesitan ser exploradas en América Latina y el Caribe.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : Abortion in Nicaragua is legally permissible only in cases of immediate threat to the mother's life and requires a legal document approved by three medical specialists. To study induced abortion in Nicaragua and its associated factors, a prestructured questionnaire was administered to the 949 women admitted to a hospital in Leon, Nicaragua, in 1992 with a diagnosis of abortion. Ten of the 30 women who reported that their abortion was induced were interviewed in greater depth in their homes several weeks after their hospital discharge. During the confidential interviews, 584 (61.5%) of the women reported that their abortions were induced, although the hospital records showed 62% with spontaneous abortions, 34.6% with septic abortions, and only 3.5% with induced abortions. Most of the women were aged 20-35. 65.9% were married and 56.3% were housewives. 77.7% were urban. 36.8% had had two or three previous pregnancies and 97 were in their first pregnancy. Of the 487 women with living children, 58.4% had an interval of under 18 months since the most recent birth. Over half the women had one to three living children. 119 of the 584 women reported previous abortions, of which 78 were illegal. Half the women reported not using contraception. Contraceptive usage was similar for all age, marital status, and residence groups. Various types of abortifacient maneuvers were reported with application of an intrauterine sound the most common. Many women reported repeated attempts. Only 12.6% of the 584 women who reported a history of induced abortion were given information on family planning on discharge from the hospital.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100714Abstract : Observamos que as hierarquias dos diferentes organismos religiosos articulam-se e organizam-se de forma a exercer influência nos espaços da sociedade política e civil na busca de resultados legislativos ou administrativos que favoreçam suas próprias tendências ideológicas. Este caderno, com o intuito de contribuir para uma melhor compreensão da atuação da Igreja Católica no Congresso Nacional, descreve a articulação do Grupo Parlamentar Católico em sua atuação junto ao Congresso Nacional.
Notes : Portugués/portugais/PortugueseAbstract : In this review, we describe the most relevant aspects of the different pharmacologic alternatives for interruption of pregnancy, including their mechanisms of action, efficacy, potential side effects, complications, and medical contraindications, with special emphasis on indications and regimens of misoprostol. Advantages and disadvantages of medical methods, their acceptability among patients and health care providers, as well as their potential role in management of abortion, particularly in developing countries, are also discussed.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : Introducción / Martha Inés Rosenberg ; El embarazo forzado y el aborto terapeútico en el marco de los derechos humanos / Susana Chiarotti; Mariana García Jurado; Gloria Schuster ; Deber del Estado 319 y derechos reproductivos, marco jurídico y social / Marcelo Antonio Avila; Claudia Nora Laudano ; María Ester en el país de las pesadillas o de cómo rescatar nuestros cuerpos / Mabel Alicia Campagnoli ; Historia de Ana / Alejandra Oberti; July Edith Cháneton ; Cómo pensar el aborto terapeútico / Laura Klein
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : O livro é uma releitura bioética e jurídica da interrupção da gravidez por anomalia fetal no Brasil. O argumento central é que o denominado aborto por anomalia fetal incompatível com a vida não tipifica crime, sendo, portanto, uma antecipação terapêutica de parto, sem qualquer repercussão jurídico-penal, por faltar-lhe o suporte fático exigido pela lei. As idéias discutidas no livro são resultado de uma parceria intelectual bem-sucedida entre os autores.
Notes : Portugués/portugais/PortugueseAbstract : Esta publicación pretende introducir, tanto a los especialistas en derecho como a los legos comprometidos con la salud de la mujer, en la discusión sólidamente sustentada de las políticas y normatividad vigentes sobre el aborto y la violación sexual, poniendo como eje para la reflexión a la mujer como sujeto de derechos humanos. Una de las principales contribuciones de este trabajo consiste en la sistematización de los avances conceptuales relativos a la salud sexual así como a los derechos sexuales y reproductivos, ubica a éstos como derechos humanos y los considera componentes básicos de las políticas de desarrollo. Asimismo, propone una argumentación ética orientada a una comprensión más humana del problema de la interrupción de las gestaciones no deseadas, como problema de la sociedad peruana. A partir de la revisión y análisis de los instrumentos legislativos - tanto nacionales como internacionales - estedocumento plantea la argumentación jurídica que ubica el aborto en el terreno de un conflicto de valores e intereses jurídicos donde es necesario y posible optar jurídicamente.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : A pesar de que el uso de métodos anticonceptivos aumentó considerablemente en los últimos 20 años, los estudios internacionales también revelan que el aborto inducido, tanto legal como ilegal, creció concomitantemente. La información local, al igual que las estimaciones nacionales, sugieren que Brasil está incluído en este patrón de control de la fecundidad. Si bien los médicos son actores importantes en este drama, se han realizado pocos estudios para investigar cómo este grupo vivencia la confrontación entre la prohibición legal y las prácticas reales para controlar la fecundidad. Este artículo incluye un análisis preliminar llevado a cabo en cuatro hospitales públicos de Río de Janeiro. Los resultados muestran que la mayoría de los profesionales consideran al aborto como un problema de salud pública, y defiende tanto la legalización como un mayor acceso al aborto legal. Un tercio de la muestra informa que se sometieron al aborto inducido en sus vidas privadas en los casos de embarazos no deseados.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : In the course of a year, 38 septic abortions occurred out of 316 abortions performed in the Central Military Hospital, Mexico, and 278 of nonseptic cases were used as controls for comparison. The septic cases were treated with antibiotics (high-dose crystalline penicillin and kanamycin) for 10 days postoperatively. there was very little difference in the age of septic cases (25.3 +or- 6.4 years) and controls (26.7 +or- 6.6). 39.4% of septic patients were not married (single or divorced) compared with 6.8% of controls, a significant difference (p > .01). 26 (72.2%) septic patients had a history of treatment for abortion. The average parity in the septic group was 2.3 +or- 2.1, but 31.6% of women had 3-7 children. 13 patients had undergone abortion with an average of .5 +or- .9 abortions. The average duration of pregnancy was 10.2 +or- 2.7 weeks compared with 11.9 +or- 3.7 weeks in controls. 32 patients underwent operations 24 hours after antibiotic treatment, 3 of them earlier because of incipient septic toxic shock and grave hemorrhage. 1 woman underwent bilateral salpingo-oophorectomy because of uterine perforation and pelvic infection. 19 patients required pre- and postoperative blood transfusion of 1 or 2 units (4 patients because of hemorrhage and anemia). The postoperative hospital stay for septic abortion cases was 4.9 +or- 2.5 days compared with 3.1 +or- 2.2 days for controls (p > .01). Although septic abortion was not a special health problem in this sample, its total elimination could be achieved by intensified family planning campaigns and the decriminalization of abortion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 077908Abstract : Induced abortion is viewed in different ways: as a crime, as a free choice, as a desperate response to a difficult situation, or as a routine means of family planning. Abortion is the oldest method of fertility control. It is practiced everywhere, in all social and economic groups, and an abortionist can always be found. An estimated 20-30% of pregnancies worldwide end in abortions, at least half of which are illegal. Bolivia has the highest maternal mortality rate in South America, and at least 30% of maternal deaths result from abortion. Abortion legislation throughout the world has been substantially modified over the past four decades. Abortion in the first trimester is quite freely available in 20 countries containing 2/3 of the world's population. At the other extreme, abortion is not permissible under any circumstances in 25 countries. Statistics on frequency of abortion in Bolivia are unreliable because most abortions are illegal. An estimated 60 women die per 10,000 abortions in Bolivia, and the situation is similar elsewhere in Latin America. Providing free access to family planning information and services constitutes an essential step in combating abortion. Bolivia's total fertility rate in the 1982 fertility survey was 5.2, the highest in Latin America, but the average number of children desired was only 3.2. 30.3% of women in union use a contraceptive method. 12.2% use a modern method. In urban areas, 39.1% use any method and 17.9% use a modern method. Among women in union currently using a modern method, 39.3% use IUDs, 36.1% female sterilization, 15.5% pills, 5.7% injectables, 2.5% condoms, and 0.8% diaphragms. 89.4% of those using traditional methods use periodic abstinence. 67.5% of women in Bolivia know about some modern method of contraception. 48% of Bolivian women do not want more children, and another 10% do not want another child in the near future.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 107091Abstract : Anti-abortion volume by leading "right to life" activist of Sonora, focusing on the defeat of Sonora's recent state legislation which would have permitted abortion in the cases of rape, incest or a threat to the life of the mother.
Notes : Español/espagnol/SpanishAbstract : El aborto inducido ; Evolución y tendencias ; Riesgo y morbimortalidad ; Tensiones socioculturales ; ¿Mantener la penalización?
Notes : Español/espagnol/SpanishAbstract : ¿Cuántas mujeres uruguayas abortan por año? ¿Qué edades tienen? ¿Dónde lo hacen? ¿Con qué métodos? ¿En qué condiciones? ¿Cuánto pagan en dinero? ¿Cuánto pagan en salud? ¿Cuántas llegaron al aborto por falla de otros métodos; para cuántas el aborto es un método anticonceptivo? Cualquier pregunta acerca de las interrupciones voluntarias de la gravidez en Uruguay está destinada, por ahora, a quedar sin una respuesta cierta basada en datos consistentes.
Web site : http://www.bitacora.com.uyAbstract : Os argumentos em jogo ; Desequilibrio entre as fontes de informaçao ; No horizonte a Gag Rule ; Referencias bibliográficas.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : De un total de 291 Gineco-Obstetras se tomó una muestra aleatoria de 182 Gineco-Obstetras, lo que constituye un 62% del universo. 108 de ellas/os optaron por llenar la encuesta, lo que corresponde a 37% del universo, que se puede tomar como valor representativo. El 99,1% de las/os Gineco-Obstetras dijo haberse encontrado con abortos incompletos o complicaciones de los mismos. El 80,6% de las/os Gineco-Obstetras ve por lo menos una razón que justifica una indicación medica para un aborto, siendo las más importantes el cáncer, otras enfermedades cardiacas y malformaciones en el feto. 69,5% de los/as Gineco-Obstetras opinaron que la indicación médica para realizar una aborto contribuiría a reducir la mortalidad materna. 78,7% de las/os Gineco-Obstetras está a favor de una despenalización. Salvar la vida de la mujer, daños del producto y violación/incesto fueron las razones más mencionadas. En suma, se puede constatar que 4/5 de médicas y médicos gineco-obstetras en Honduras expresa razones medicas que justifican la interrupción de un embarazo y casi el la misma cantidad estaría de acuerdo con una despenalización del aborto en Honduras.
Web site : http://www.derechosdelamujer.org/html/PUBLICACIONES/Cuaderno%20ABORTO.pdfAbstract : This study focused on the knowledge and opinions of physicians regarding legal and ethical aspects of abortion. A self-administered questionnaire was filled out by 57 physicians working in the emergency rooms of two hospitals in Ribeirão Preto, São Paulo State, Brazil in 2001. The questionnaire had 38 questions on general knowledge, legislation, and attitudes towards abortion. Interviewees' mean age was 28.3, most were females, 52.6% were single, 42.1% were married, 54.4% were Catholic, and 21% were Spiritists. Although most of the physicians had a good level of overall knowledge on abortion (70%), one in five was not aware that abortion is the main cause of maternal mortality in Brazil. Most accepted the prevailing legal conditions for performing an abortion in Brazil but would also include fetal malformation incompatible with life, while opposing decriminalization of abortion on other grounds. Limited knowledge is revealed by misconceptions concerning enforcement of the prevailing legislation in practice. The study strongly suggests that many physicians lack knowledge or face difficulties in conforming to the Brazilian legislation on abortion.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X2004000300004 lng=en nrm=isoAbstract : Sesenta mujeres que solicitaban tratamiento postaborto en Bogotá fueron entrevistadas a fondo para saber cuáles son los factores socioculturales, familiares y personales que influyen en sus decisiones sobre el aborto. Se examinaron sus percepciones del papel que desempeñan como mujeres y como madres, sus actitudes respecto al aborto y las intenciones y prácticas anticonceptivas para uso en un futuro.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 160519Abstract : A table showing the current status of abortion in the world based on two recent and detailed studies is presented. Countries are categorized according to whether they totally prohibit abortion, permit it to save the mother's life, permit it to preserve her physical health or mental health, permit it for maternal socioeconomic reasons, or provide it at the mother's request. The countries are grouped into 5 geographic areas: America and the Caribbean; Central Asia, Middle East, and North Africa; East and South Asia and the Pacific; Europe; sub-Saharan Africa. The trend toward liberalization of laws is clear. The development of abortion laws is moving in the direction of complete legalization, that is, the creation of health norms that facilitate abortion for all women, with guarantees of medical safety. There are still countries that move to restrict access to abortion, and in a few cases, such as Colombia and Poland, legalization and prohibition have alternated depending on the social and political circumstances of the moment. In the past 12 years, 28 countries liberalized their laws in some way, while 4 countries with close ties to the Vatican restricted or prohibited access.
Web site : http://www.gire.org.mx/Abstract : El aborto es uno de los temas de mayor controversia en la medicina actual por las repercusiones psicosociales, médicos-legales política, económicas y morales que conlleva. Este fue un estudio prospectivo, de carácter principalmente descriptivo, que entrevistó a 1158 pacientes con diagnóstico de aborto y/o sus variantes. Se abordaron tres aspectos fundamentales : características sociodemográficos, clínicas y económicas. Los casos de aborto fueron clasificados en tres áreas: aborto espontáneo, sospechoso y provocado en donde la mayoría de las mujeres entraron en la categoría de " aborto sospechoso o provocado" , las que admitieron (27%) haber utilizado diferentes métodos abortivos. La gran parte de la muestra estaba entre los 20 -29; 21% eran adolescentes. El inicio de vida sexual se ubicó entre 15 y 19 años y más de la mitad de las mujeres admitió no utilizar métodos anticonceptivos, a pesar de que conocían sobre estos: los más referidos fueron la pastilla y el DIU. En esta investigación se observó que el aborto era usado como método de planificación familiar, ya que la gran mayoría de estas mujeres tenían antecedentes de abortos espontáneos y un grupo admitió haberse provocado abortos intencionalmente. La decisión de abortar fue tomada, en mayor parte, por la misma paciente o aconsejado por una amiga. El aborto fue realizado por personal de salud ( personal de enfermería, ya fueran enfermeras jubiladas o estudiantes o auxiliares). El método mayormente usado fue la sonda, seguida de brevajes tradicionales. El diagnóstico de ingreso fue catalogado, en mayor parte, como abortos sépticos. El curetaje o legrado uterino con o sin dilatación cervical previa, fue el procedimiento utilizado en la mayoría de los casos; se presentaron casos en donde se requirió Histerectomía por complicaciones. En el aspecto económico, la investigación detectó que los procedimientos de aborto provocados representan altas erogaciones en el presupuesto del Hospital, debido a la gran inversión de medicamentos, estancia intra-hospitalaria, entre otros.
Notes : Español/espagnol/SpanishAbstract : De un total de 291 Gineco-Obstetras se tomó una muestra aleatoria de 182 Gineco- Obstetras, lo que constituye un 62% del universo. 108 de ellas/os optaron por llenar la encuesta, lo que corresponde a 37% del universo, que se puede tomar como valor representativo. El 99,1% de las/os Gineco-Obstetras dijo haberse encontrado con abortos incompletos o complicaciones de los mismos. El 80,6% de las/os Gineco-Obstetras ve por lo menos una razón que justifica una indicación medica para un aborto, siendo las más importantes el cáncer, otras enfermedades cardiacas y malformaciones en el feto. 69,5% de los/as Gineco-Obstetras opinaron que la indicación médica para realizar una aborto contribuiría a reducir la mortalidad materna. 78,7% de las/os Gineco-Obstetras está a favor de una despenalización. Salvar la vida de la mujer, daños del producto y violación/incesto fueron las razones más mencionadas. En suma, se puede constatar que 4/5 de médicas y médicos gineco-obstetras en Honduras expresa razones medicas que justifican la interrupción de un embarazo y casi el la misma cantidad estaría de acuerdo con una despenalización del aborto en Honduras.
Web site : http://www.derechosdelamujer.org/html/PUBLICACIONES/Cuaderno%20ABORTO.pdfAbstract : Introdução, 7 ;Gravidez e aborto, 8;Visibilidade e ilegalidade, 10Queda da fecundidade total, 13;Morbidade e procedimentos hospitalares, 15; Corrigindo o sub-registro, 18; Variação da morbidade por zona de residência, 19; Custos de procedimentos hospitalares relacionados ao aborto, 20; Morbidade e diagnóstico de internação, 21; Variação da morbidade por faixa etária, 22Mortalidade por aborto, 23; Série histórica por regiões, 23; Morte por aborto versus idade, 25; Óbito por aborto, segundo fontes específicas ou bases especiais, 26; Intencionalidade ou não do aborto, 27; Intencionalidade do aborto versus faixa etária, 29; Morte por aborto versus raça/etnia, 30; Morte por aborto versus situação conjugal, 30; Morte por aborto versus escolaridade, 30; Morte por aborto versus ocupação, 31; Morte por aborto versus número de gestações, 31; Morte por aborto, uma realidade cruel, 31; Conclusão, 33; Anexo 1: Aborto, propostas para um consenso, 34; Anexo 2: Recomendações do IX Fórum Interprofissional abortamento; inseguro como forma de violência contra a mulher, 36; Anexo 3: Serviços de atendimento às mulheres vítimas de; violência sexual e aborto previsto em lei, 37; Anexo 4: Proposições sobre aborto em tramitação no Congresso Nacional, 40; Anexo 5: Relato, 44; Referências bibliográficas, 45Páginas na Internet, 46
Web site : http://www.redesaude.org.br/dossies/assets/docs/revista_05.pdfAbstract : El aborto inducido se encuentra tipificado como delito en la legislación penal boliviana. Sin embargo, muchos embarazos no deseados terminan en abortos, la gran mayoría realizados en condiciones precarias y de alto riesgo, configurando una realidad que cobra la vida de miles de mujeres en Bolivia. A pesar de la existencia de una normatividad que penaliza la interrupción voluntaria del embarazo, ésta no consigue cumplir con la finalidad que tiene la pena dentro del modelo penal. En efecto, su interdicción no logra disminuir o frenar la incidencia del número de abortos practicados. La penalización del aborto no surte los efectos disuasivos que persigue, puesto que un gran número de mujeres recurre a dicha práctica. En la realidad social, lo que logra su criminalización es generar un mercado especulativo, ilícito y clandestino, además de ocultar la dimensión del problema. En la investigación, planteada desde una perspectiva crítica al tratamiento del aborto en la legislación penal vigente, se propuso reunir y sistematizar información sobre el aborto en los registros de salud y en las diferentes agencias del sistema penal: policía, órgano judicial y penitenciaria, de la ciudad de Santa Cruz de la Sierra, enfocando la mirada hacia los discursos de sus actores y operadores.
Notes : Español/espagnol/SpanishAbstract : This monograph provides information on abortion as an integral phenomenon in nature and human history. Abortion is defined and medial and empirical abortion techniques are described. The incidence of abortion worldwide and in Mexico is assessed, as are the physiological, psychological, and legal consequences. Attitudes toward abortion in antiquity and in different religions are discussed, with emphasis on the evolution of Catholic doctrine.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 168156Abstract : This work discusses various views of abortion and presents data on the legal aspects and incidence of abortion in Mexico as a contribution to a more productive dialogue on the problems of abortion. It is very difficult to deter women who have decided to seek an abortion, regardless of whether the procedure is legal or even safe. In the state of Sinaloa, Mexico, an abortion has not been punishable since 1939 if it caused by "imprudence", if the woman is a victim of rape, or if the woman's life is endangered by pregnancy. The penal codes of most Mexican states and the Federal District contain similar provisions. In October 1990, the state of Chiapas decriminalized abortion for most indications in the 1st 90 days of pregnancy on the basis that the fertility and growth rates were too high, many children were in situations of extreme poverty, and the widespread practice of illegal abortion led to high rates of maternal morbidity and mortality. The decree legalizing abortion in Chiapas was suspended in early 1991 by the Congress of Chiapas and is currently under further study by the National Commission on Human Rights. UNICEF estimates that in 1990, some 100,000 illegal abortions occurred daily in the world. 150,000-200,000 women may die each year as a result of illegal abortions. Today some 300 million couples throughout the world do not want more children but lack access to family planning. UNICEF estimates that the world rate of population growth would decline by 30% if all couples not desiring children practiced effective contraception. A large number of illegal abortions are believed to occur annually in Mexico. Abortions in Mexico are most common among married women of lower or lower middle class who already have children and who wish to avoid the economic hardships of a new baby. Perhaps because of their illegality, abortions represent a significant expense for a household. Unsafe abortions may cause serious health and fertility problems for women. The Mexican Institute of Social Security estimates that the rate of abortion has declined by about 25% between 1982-1990. Currently 1 of every 10 pregnancies is believed to end in induced abortion. Family planning programs have led to declines in the rates of both pregnancy and abortion in Mexico. The number of fertile-aged women attended in Social Security facilities for abortion complications declined from 11.5/1000 in 1982 to 8.8 in 1990. The extremes of opinion about whether abortion should be made safe and legal appear irreconcilably opposed. From a national perspective, abortion is a public health problem that needs to be addressed by the health sector. Existing laws permitting abortion under some circumstances should be made more explicit. The point of view of society should be respected, but women should also be protected.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 066039Abstract : Material para decidir y formarse un criterio ético sobre el aborto desde el marco de la iglesia católica; plantea respuestas y reflexiones candentes en torno al tema: si el feto es o no una persona y el aborto puede o no considerarse un asesinato; la formación de la conciencia y el sentimiento de culpabilidad, la forma de tomar decisiones y la vida sexual responsable
Notes : Español/espagnol/SpanishAbstract : This book contains 13 specially commissioned articles by prominent people representing various positions in the debate over abortion, which is illegal in Uruguay. They are grouped under the following topics: the definition of abortion and concept of life, the legislative history of abortion in Uruguay, the reality of abortion, the current debate, and statistics. (ANNOTATION)
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND RH68030Abstract : Fecundidad, anticoncepción y aborto en la Argentina ; ¿Por qué y cómo se llega al hospital? ; Las mujeres frente al servicio de salud ; Reflexiones finales ; Bibliografía - Referencias.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Basándose en un estudio de egresos por complicaciones post-abortivas en cinco hospitales del área metropolitana de Buenos Aires, el presente libro propone una reflexión sobre el aborto desde el ángulo de los derechos reproductivos y como problema de salud pública. Entendiendo que dicha reflexión requiere un enfoque integral e interdisciplinario, las autoras recorren esta problemática que abarca aspectos sanitarios, sociales, demográficos, psicológicos y jurídicos como aporte a un campo de conocimiento en el que integran las dimensiones éticas, religiosas y políticas. Su énfasis en la salud reproductiva aspira a una apertura 314 hacia la aceptación de la necesidad de prevenir la morbimortalidad de las mujeres a causa del aborto por parte de la sociedad y del Estado, al mismo tiempo que a desplegar la conciencia acerca de sus derechos reproductivos como derechos humanos y de su lugar social en este fin del milenio.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This study focuses on the more common side effects experienced by women having early medical abortion or surgical abortion. A group of 1373 women with unwanted early pregnancies in China, Cuba and India were enrolled in a multi-center comparative trial. Data on side effects came from women's reports at each clinic visit, providers' observations during the clinic visits, and symptom diaries maintained during the study period. Medical abortion clients at all sites experienced more side effects than their surgical counterparts. The disparity between the two groups was particularly pronounced for bleeding and pain. Despite this, assessments of well-being and reports of satisfaction at the exit interviews were similar in both groups. (full text)
Web site : http://www.rhmjournal.org.ukAbstract : The number of couples in the world who want access to modern contraception is expected to increase by over 60% in the next decade, from 505 million to close to 795 million. Whether this need is met is, in large part, dependent on the availability in developing countries of free or low-cost contraception. Of concern is a trend to shift family planning service delivery to the private sector, or to make government-sponsored family planning programs self-sustainable by charging acceptors a modest fee, at a time when dramatic increases in contraceptive prevalence are needed to Latin America, Asia, and Africa to reduce high rates of population growth. The main chart presented in this document shows the percentage of couples in each country in the world with ready access to moderately priced contraception (condoms, pills, IUD, or injectables, and sexual sterilization) and abortion through public and private sources. If known, the percentage of couples with access to free or heavily subsidized public sector services is also depicted. A second chart sets forth the costs in each country of condoms, oral contraceptives, IUDs, and female sterilization in the private sector as well as the cost of that method of fertility control as a percentage of the gross national product (GNP) per capita. In a small number of developing countries, public sector subsidization of private providers has reduced the relative cost of contraception to levels found in Western countries (i.e., under 1% of average per capita GNP). However, in the vast majority of Third World countries ; especially those in Africa, where the need for contraception is greatest ; fewer than 25% of couples have access to affordable public-sector services, and contraceptives obtained through the private sector can exceed 50% of average per capita GNP.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 067032Abstract : Countries are grouped by the nature and extent of access to legal abortion. The categories include abortion on demand, for social reasons, for health reasons, for rape or incest or to save a mother's life, and only to save a mother's life. Abortion on demand is available for about 40% of the world's population and may have restrictions, such as parental consent or approval of state committees or physicians. There are 22 countries in Europe, 12 in the former Soviet Union, four in Asia, four in the Americas, one in the Middle East (Turkey), and one in Africa (Tunisia) which provide access to early abortion on demand. Abortion for social and economic reasons is available to 21% of the world's population in five countries in Asia, three in Europe (Great Britain, Finland, and Hungary), and one in Africa (Zambia). Abortion for health reasons is available to 16% of the world's population located in 21 countries in Africa, eight in the Americas, seven in Asia, five in Europe, and four in the Middle East. Laws governing about 5% of the world's population permit abortion only in the case of rape, incest, or when a mother's life is in danger (Brazil, Mexico, and Sudan). 18% of the world's population is covered by laws which permit an abortion only when a mother's life is in danger; this includes 19 countries in Africa, 11 in the Americas, nine in Asia, seven in the Middle East, and one in Europe (Ireland).
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 091458Abstract : Métodos ; Resultados ; Selección de un método ; Momento y lugardel aborto médico ; Tasas de falla ; Efectos secundarios ; Aceptabilidad entre las pacientes ; Aceptabilidad entre los proveedores ; Análisis ; Referencias.
Web site : http://www.guttmacher.org/Abstract : A survey was conducted among 3021 employees from the Mexican Federal Government regarding their acceptance or rejection of abortion in five different circumstances. Socioeconomic information was obtained from the interviewed and the result was that 23% totally rejected abortion, and 6% accepted abortion in any situation. Abortion was accepted by 61% in case of pregnancy threatens the mother's life; 63% in case a single woman has been raped; 41% if there are so many children and such situation implies economic problems for the family; 13% if the couple prefers to wait for an economic improvement; and 18% if the couple has decided to have no more than two kids. Also from the interviewed, 16% pointed out that abortion must be an exclusive decision from the woman and 29% thought it must be a shared decision with the partner. Abortion is better accepted by young people, by couples with few children or living in free union and by people with higher education level and higher income. It is also better accepted by people with no religion, or people who do not attend religious services or by whom religion does not affect their decisions in life.
Web site : http://scielo-mx.bvs.br/scielo.php?pid=0300-9041 script=sci_serialAbstract : A review of evidence from the United States and Europe is presented to support the view that desired public health outcomes are best achieved with comprehensive family planning programs that include safe, legal abortion. Attention is also directed to the special needs of adolescents, who are at the highest risk for unwanted pregnancy. An international study of adolescents access to contraception in the US and Scandinavia concluded that the key factor required for reducing unintended pregnancy was contraceptive use among unmarried adolescents. The lowest rates of unintended pregnancy have been found in countries which provide access to contraceptive services for teenagers. Open discussion of sexuality and birth control in the Netherlands has ben linked with their low teenage birth and abortion rates. The approach emphasized early introduction to issues, that are reinforced throughout the life cycle. Privacy is afforded teenagers visiting family planning clinics. The higher rates in the US have been linked to the lack of openness about sexual matters and lack of access to services. In the US, those women aged <25 years account for 61% of abortions compared to only 40% in the Netherlands. In the US, between 1982 and 1988, contraceptive use increased among teenagers and sexual activity increased, yet the rate of pregnancy has remained constant. Additional features of unintended pregnancy are the high rates of failure of contraception: 26% for women aged <20 years versus 20% for all women. In the former Soviet Union, quality of abortion services has been highly variable, and, in 1988, 3.4 deaths per 100,000 abortions occurred in state hospitals. Poor quality of care has contributed to increased use of illegal Russian abortion providers. For example, 20% of all abortions of women without children were performed illegally in Russia. Women's health has been found to be improved when abortion services are included in accessible reproductive health services. Government objectives to improve the public health are best achieved through broad access to a full range of family planning methods.
Web site : http://www.rhmjournal.org.ukAbstract : Since human sexuality is an integral part of the person, its appropriate exercise in accordance with his/her biological, psychological and social characteristics may give a satisfactory life. The investigations of the attitudes toward sexuality are very important in the adolescence, because a little convenient attitude could change the appropriate and pleasured sexual exercise; with consequences that could affect the individual's future life. The theme of the investigation "The 'J Adolescents' Sexuality" and the question, "Which are the attitudes of adolescents have toward some aspects of their sexuality?" come from the same problem, an irresponsible attitude toward sexuality. This is a camp and exploratory study. It was made to establish descriptions of the attitudes that the adolescents (females and males) have toward: premarital coital relations, virginity, contraception, adolescent's pregnancy, abortion, masturbation, homogenred preference, HIV/AIDS, and pornography, to obtain a general view, since it is impossible to investigate all about sexuality. The investigation took place on a group of 1208 students of Half Superior Level (CBTis) of the State of Chiapas, Mexico, because it's a representative group of the state area. By means of an applied questionnaire as an instrument of the investigation with a R. Linkert scale, we obtained very interesting results that show the necessity to give a subject in sexuality by sexology teachers in this population. (author's)Ya que la sexualidad humana es parte integral del individuo, el apropiado ejercicio de la misma, de acuerdo a las características biológicas, psicológicas y sociales del sujeto, le proporcionará una vida más plena y gratificante. La investigación de la actitud en torno a la sexualidad es de gran importancia sobre todo en la adolescencia, ya que es un grupo de alto riesgo en el cual una actitud poco responsable, o bien, inadecuada, puede condicionar patrones conductuales que alterarían el adecuado y placentero ejei'cicio de la sexualidad, con consecuencias que a veces pueden afectar el funcionamiento posterior del individuo. Por lo que a partir del problema que significa en términos generales una actitud poco responsable, surge como tema de investigación "La Sexualidad de los y las Adolescentes" y de éste el problema a investigar es: "Cuáles son las actitudes que los y las jóvenes tienen ante determinados aspectos de su sexualidad". El presente trabajo de investigación es un estudio predominantemente de campo, exploratorio a fin de establecer una descripción de las actitudes que los y las adolescentes tienen acerca de: relaciones coitales premaritales, virginidad, anticoncepción, embarazo adolescente, aborto, prostitución, masturbación, preferencia homogenérica, VII-I/SIDAy pornografía, pata tener una panorámica general, ya que no es posible investigar a la sexualidad en su totalidad. Esta investigación se realiza en una población de 1208 estudiantes del Nivel Medio Superior (CBTis) del Estado de Chiapas, se ha tomado como universo a está población por creer que es bastante representativa de la población estudiantil de esta entidad federativa. Mediante la aplicación de un cuestionario como instrumento de investigación del tipo de la escala de R. Líkert, se obtuvieron resultados por demás interesantes y que en detalle se muestran en el Capitulo respectivo y que avalan la necesidad de contar con la materia de la sexología impartida por sexólogos educadores a la población estudiada. (del autor)
Web site : http://www.metabase.net/docs/las-dignas/00575.htmlAbstract : This article shows how the adolescents with a great academical success think, feel and experience sexuality. Specifically it analyses such themes like : the sexual identity, the relationship between boys and girls, the friends relationshps, the sexual intimacy, the virginity, the pregnancy, the contraception, the abortion, the sexual transmission illness and the prostitution
Web site : http://www.campus-oei.org/cr2.htmAbstract : The subproject, "An Operations Research Project to Test an Integrated Hospital Based Model for Treatment of Abortion Complications and Delivery of Family Planning in Peru", completed data collection for final evaluation and preliminary analysis of data in December 1997. Although the subproject duration was extended through the end of February 1998, additional support was necessary to set up a dissemination plan for its results. Therefore, a new activity was approved to help organize dissemination meetings and other comparable activities not foreseen in the subproject proposal. Five major activities were carried out: 1) a seminar for the personnel of Peru US Agency for International Development Mission; 2) a presentation of results of the subproject at the Global Meeting on Postabortion Care: Advances and Challenges in Operation Research; 3) a seminar for the representatives of Cooperating Agencies, international organizations and officials of the Ministry of Health; 4) a seminar for the department heads of obstetrics and gynecology of a selected group of principal hospitals in Lima and other regions of the country and chiefs of obstetrics and gynecology department of a selected group of medical faculties in Lima and other regions of the country; 5) a seminar for 60 officials and managers of hospitals in Lima and other regions of the country. This dissemination program was proven to be an important activity, which evidenced a great interest among participants to replicate this model and its future expansion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 137579Abstract : Esta ponencia fue preparada para el Seminario Regional sobre Monitoreo de la Atención de las Complicaciones Postaborto en Hospitales Públicos, organizado por el Foro por los Derechos Reproductivos en Buenos Aires en abril de 2003. Presenta un análisis crítico del manejo de la información estadística sobre aborto y mortalidad materna. Concluye que la correlación de fuerzas políticas en ese año, en Bolivia y desde los EE.UU. con la Regla de Obstrucción Global, fue altamente negativa para el ejercicio de los derechos sexuales y reproductivos, el derecho a decidir y el acceso al aborto seguro y legal.
Notes : Español/espagnol/SpanishAbstract : Evaluación de la calidad de atención a la salud en un marco conceptual con elementos fundamentales. Provee una estructura para evaluar varios aspectos relacionados con el tratamiento del aborto
Web site : http://www.ipas.orgAbstract : A study of the knowledge and utilization of contraception by adolescents is presented. This analysis was carried out on data collected from interviews with and recorded case histories of 78 puerperal adolescents (childbirth or abortion), assisted by an obstetric service in the county of Cotia, Brazil between May 1-July 31, 1986. Of all the adolescents examined, 61.5% had some knowledge of contraceptive methods. Findings showed that such knowledge was influenced by factors such as age, school background, parity, and marital status. The main sources of information on contraception were friends, relative, and partners, in that order; those least sought for in this regard were health professionals. Only 1 in 10 adolescents made use of some contraceptive measure, the most prevalent methods being OCs, the Ogino-Knauss method, condoms, and coitus interruptus. In all cases of utilization of these methods, the same has been recommended by those belonging to the adolescents' social group and had been acquired in shops, without any health controls. (author's modified) (summaries in SPA, ENG)
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89101990000600009 lng=en nrm=isoAbstract : Introducción ; Marco teórico: adolescencia ; Adolescencia ; Adolescencia y sexualidad ; Salud sexual y reproductiva ; Nuestra investigación ; Resultados ; Características generales de los adolescentes ; La sexualidad ; La iniciación sexual ; Edad y circunstancias ; Análisis estadístico en relación a las hipótesis de trabajo ; Los factores asociados a la iniciación sexual ; Modelo multivariado ; Conclusiones y recomendaciones ; Bibliografía ; Anexos.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This study aims to estimate the prevalence of adolescent pregnancy (AP) in three Brazilian cities - Salvador, Rio de Janeiro, and Porto Alegre - and to examine the profiles of pregnant girls and their partners in relation to pregnancy outcomes. Data for a retrospective assessment of AP were collected using an interview-based household survey applied to a stratified sample of males and females aged 18-24. A total of 4,634 individuals were interviewed (85.2 % of the eligible individuals). 21.4% of males and 29.5% of females aged 20-24 reported AP, but few such pregnancies had taken place before age 15 (0.6% and 1.6%). Pregnancy between adolescent partners was reported by 55.1% of males and 27.9% of females. 79.8% of the latter became pregnant while involved in a stable relationship with an older partner. AP levels varied inversely to schooling and income levels. 72.2% of females and 34.5% of males carried their first AP to completion, and more cases of induced abortion were reported by male partners in pregnancies (41.3%) than by females (15.3%). With the birth of the first child, 25.0% of women interrupted their studies temporarily and 17.3% definitively. However, 42.1% of primiparous mothers were already outside school before pregnancy. (author's)
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0102-311X2003000800019 lng=en nrm=isoAbstract : This study analyzed the most recent Demographic and Health Survey data available for 43 developing countries (20 in sub-Saharan Africa, 10 in Latin America, 5 in North Africa and the Near East, and 8 in Asia) to document current levels and recent trends in the rate of adolescent childbearing, the timing of first births, and births to unmarried women. The study also considered 1) socioeconomic differentials arising from urban or rural residence and educational attainment, 2) whether births to adolescents are planned, and 3) the consequences of unsafe abortion. In some developing countries, adolescent childbearing is increasing while in others it is decreasing, and more countries are recognizing the problems associated with adolescent childbearing. The analysis revealed that some sub-Saharan countries are experiencing a reduction in the rate of adolescent childbearing, but the proportion of adolescent births will continue to increase unless unmarried couples adopt contraception. Unexpected small decreases and increases in adolescent childbearing occurred in Latin America. The largest and most uniform declines in early childbearing occurred in North Africa and Asia along with increases in the age at first marriage. Increasing opportunities for girls to achieve secondary education and postpone marriage lengthen the period when women risk unmarried pregnancy and sexually transmitted diseases. Available evidence points to the need to address unplanned pregnancy and abortion among adolescents.
Web site : http://www.popcouncil.org/publications/sfp/default.htmAbstract : In 1995 there will be 512 million young people aged 15-19; 426 million of them will be living in developing countries. The pregnancy rate among adolescents is increasing. In certain parts of Latin America and Africa, 30-40% of all adolescent females experience motherhood before the age of 18. In some Sub-Saharan African countries, 1/5 of adolescent females gives birth each year. Among developed countries, the United States of America has one of the highest rates of adolescent pregnancies: 89/1000. In England and Wales, the pregnancy rate among women aged 15-19 was, in 1990, 56/1000: 40% of these pregnancies ended in abortion. Contraceptive use among adolescents is much lower than among married adults. In Bangladesh, where 66.8% of adolescents are married, only 9% of them use contraceptives, compared with 19.1% married adults. In Egypt, where 40% of adult women use contraception, the comparative figure among married adolescents is 6%. Complications of pregnancy and childbirth and unsafe abortion are among the main causes of death in adolescents. They suffer from toxemia, prolonged labor and cephalopelvic disproportion, anemia, cervical trauma, premature birth, and death. Adolescents aged 15-19 account for at least 10% of the 50 million induced abortions that occur each year throughout the world. According to the World Health Organization, at least half of those infected with HIV are under the age of 25. The highest rates of STDs are often observed in the 20-24 age group, followed by those aged 15-19. The most common among teenagers are gonorrhea, chlamydia, syphilis, herpes, genital warts and HIV. People who are in their twenties now who have AIDS became infected with the HIV when adolescents. An estimated two million girls are subjected to female genital mutilation every year, mainly in North Africa, Middle East, Sub-Saharan Africa and some countries in Asia. Sex education programs need to take into account the adolescents' right to sexual health and provide easy access to competent staff with information on risks of unprotected sex.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : The aim was to determine social and behavioral consequences of pregnancy and how these differed according to the pregnancy outcome (live birth or abortion) 1 year after the event. This was a prospective study of two groups of young women aged 12-18 years, one attending prenatal services and the other admitted for abortion complications at the same hospital in northeast Brazil. Adolescents who gave birth were subsequently classified as having intended or unintended pregnancies, and those who aborted were divided between those who terminated their pregnancies and those who miscarried. Baseline data were collected between 1995 and 1997 from all teens who met the eligibility criteria. Information was collected through one-on-one interviews using a questionnaire that was structured and precoded. Multiple logistic regression was used to identify characteristics that predicted outcomes at 1 year. Teens who terminated their pregnancies were the most likely to be in school or working 1 year later. They also showed the greatest increase in self-esteem. The young mothers, however, had the highest self-esteem but perceived the impact of pregnancy on their lives as being more negative than they did initially. Group affiliation was not associated with the quality of partner relationships, which tended to deteriorate over time. The young mothers used contraception at 1 year at higher rates and had experienced fewer subsequent pregnancies than the two abortion groups. The experience of adolescent pregnancy for this group of teens produced mixed findings, some more negative than others. Interventions to decrease the adolescent's desire to have a baby will have to be tailored differently from those designed to prevent an unintended pregnancy, but both are needed. (author's)
Web site : http://www.adolescenthealth.org/journal.htmAbstract : Births to female adolescents comprise almost 13% of total births in Chile each year, for a total of approximately 38,000 live births to adolescent girls annually in the country. Girls in contemporary Chilean society have a range of possible options if they become pregnant. They may get married, live with their partner outside of marriage, be a single mother, give their child up for adoption, or abort the fetus. Although this latter option is illegal in Chile, research indicates that there are 130,000-150,000 clandestine abortions in the country per year. One-third of abortions produce complications requiring hospitalization. The proportion of women under age 24 hospitalized for abortion-related complications increased from 36% of the total in 1970 to almost 49% in 1985. The authors investigated the consequences of each option pregnant girls have from working class strata in Santiago. Findings are based upon group discussions with 85 young mothers and interviews with two young women who had opted for abortion and two who had given their babies for adoption. Participants were aged 10-19 years. Each option following adolescent pregnancy has risks, obstacles, and challenges requiring a significant degree of sacrifice. The girls fear the loss of their future, of self-esteem, and of the affection of their partners, parents, and friends. The girls also fear that their child will ultimately reject them when they learn of their mother's premarital pregnancy. Young mothers have their rights curtailed and their access to work and school restricted or denied.
Web site : http://www.rhmjournal.org.ukAbstract : Socioeconomic conditions are the precipitating factor in adolescent pregnancy in Latin America and the Caribbean. Teenage pregnancy is a result of lack of knowledge about family planning, lack of access to contraception, and lack of reproductive health services, as well as sociocultural factors: the subordination of women and the inability of adolescents to plan their lives. Getting pregnant is a way of gaining status within the peer group, and the link between maternity and feminine identify is reinforced in the media and by cultural ideas. The masculine identity is linked to the uninhibited expression of sexuality and fertility, regardless of the outcome. The scope of the problem is largely unknown, but a recent survey did report that 75% of adolescent pregnancies in Ecuador were unwanted. In Mexico City, 40% of pregnant, adolescent respondents were single and 60% were in unstable common law or marital unions. In Cuba, adolescent births were 10.4% of all live births, during 1950-55 an increased to 25% during 1985-90. Biomedical risks have been identified as increased maternal morbidity and mortality, perinatal problems, low birth weight, and perhaps learning and behavioral problems and malnutrition. They psychosocial consequences can be another early pregnancy, a hazardous abortion, discontinuation of school, hasty marriage, and/or decreased opportunity for training or employment. Because there are multiple factors involved, there is a need for cultural and structural changes in society. Women's conditions and status, male ideology, and gender relations need to be transformed. Structural changes could involve retaining girls and adolescent women in school, and creating more economic and income-generating opportunities. Ideological changes might provide women with increased training in planning, offer alternative models for women to identify with, provide comprehensive sexuality and family life education, and use mass media to promote messages of social change. Immediate solutions are provision of comprehensive pregnancy and postabortion care, adolescent health prevention programs, and high quality reproductive and sexual health services.
Notes : Inglés/anglais/EnglishAbstract : This article reports the risks of unwanted pregnancy and unsafe abortion relative to HIV/AIDS by adolescent women. Data presented at the XI International Conference on AIDS indicated that adolescents aged 15-19 years form the highest risk group for newly acquired HIV infections and also with the highest rate worldwide of unwanted pregnancy. Contributing factors of this high rate includes physical violence and other forms of coercion; an earlier age of sexual initiation for girls than boys; so-called "sexual mixing", wherein young girls may have sex with older men for a variety of cultural and economic reasons; social pressures faced by young girls; the lack of access to formal education including sex education; the lack of access to contraception and reproductive health services; the high-risk sexual behavior of adolescent female partners; and young women's lack of power to negotiate terms of sex with their partners. When faced with an unwanted pregnancy, adolescent women have always found it difficult to obtain appropriate services to meet their needs, including safe abortion care. The AIDS epidemic exacerbates these difficulties and adds new medical, legal and ethical dimensions to the practice of unsafe and illegal abortion procedures that put young women's health and lives in danger.
Notes : Inglés/anglais/EnglishAbstract : Three groups of adolescents are compared with regard to their own considerations of abortion and when they believe abortion is justified. One group of adolescents terminated their pregnancies (n=95), a second became pregnant and carried their pregnancies to term but considered abortion (n=68), and the third also carried their pregnancies to term but did not consider abortion (n=204). The study was carried out between 1995 and 1998 in Fortaleza, Brazil. Adolescents were interviewed at the time of their hospitalization or their first prenatal visit and again at 6 weeks and 1 year post-abortion or postpartum. Friends and family recommended abortion to at least half of the teenagers in each group. Teenagers who aborted were more accepting of abortion than those who did not abort, while those who considered abortion found the practice more justified than those who did not consider abortion. Teenagers who aborted became less accepting a year later, while those who did not consider abortion became more accepting. A better understanding of adolescent attitudes towards abortion and their decision making process should help adults and professionals meet the needs of adolescents for support in the process and in the reduction of the number of unintended pregnancies in the future. (author's)
Web site : http://www.cambridge.org/uk/journals/journal_catalogue.asp?historylinks=ALPHA mnemonic=JBSAbstract : An ongoing 3-year study at the Servico de Adolescentes offered by the Maternidade Escola Assis Chanteaubriand in Fortaleza, Brazil is comparing the characteristics and experiences of 375 adolescents seeking prenatal care with 197 who sought emergency treatment for incomplete abortion. Prenatal subjects are being interviewed during their first clinic visit, at week 35 of pregnancy, at 45 days postpartum, and at 1 year postpartum. Abortion patients are being interviewed at hospitalization, 45 days later, and 1 year later. Preliminary findings show that 64% of the prenatal patients perceived nothing bad about the pregnancy, while 41% of the induced abortion group perceived nothing good. While most mothers, friends, and partners were supportive of the pregnancies in the prenatal groups, this was not the case in the abortion group. Most of the subjects would have preferred to delay pregnancy, but 46% of the prenatal clients and 13% of the abortion patients wanted to become pregnant when they conceived. The abortion patients were slightly older and less likely to be in a stable union than the prenatal clients. Both groups became sexually active at about age 15, but the abortion patients had more sexual partners and these partners were older than those of the prenatal clients. Most respondents in both groups had been in a relationship for a fairly long time, and each group reported low use of contraception. Almost 25% of the prenatal group considered abortion, and 39% of these attempted to abort. At least 40% in both groups had a mother or older sister who became pregnant during adolescence.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 134797Abstract : 135 million young people 10-19 years old live in Canada, the US, the Caribbean, and Latin America. Studies in the region have show that sexual activity is occurring at every earlier ages. In Latin America, more than half of the young women are sexually active before age 20. In Mexico, 13% of adolescent girls 15-19 years old and 44% of adolescent boys reported having engaged in premarital sex. Contraception was used during first sexual intercourse by only 17% of adolescents in Latin America, 22% of women and 31% of men in Mexico, 10% of women (52% of these used withdrawal or rhythm) and 13.4% of men (15-24 years old) in Ecuador, and 21% of women and 19% of men (15-24) in Chile. The consequences of this behavior are that 15% of women in Latin American give birth by age 18 and 50% by age 20. In the US, 20% give birth by age 20. 39% of the Latin American adolescent pregnancies occur in girls no more than 17 years old, and abortion and childbearing are among the top 5 causes of death for Latin American teenage girls. Early childbearing often results in poverty for the mother and child, more births for the mother, and puts the health of mother and child in jeopardy. The illegality of abortions in most Latin American and Caribbean countries is associated with 36% of maternal deaths in Chile and 35% in Argentina. In response to this situation, many programs have been devised. Peer counselors are being used; model sex education programs are being devised; adolescents are being involved in the design, implementation, and monitoring of their own programs; outreach programs are attempting to reach populations-at-risk such as school drop-outs; entereducate efforts are underway using the media; telephone hotlines are in place; life planning education is being adapted for use with special populations such as the rural poor; parents, teachers, and youth workers are being trained in communication and education techniques; FP services are being offered to adolescents through special clinics, special clinic hours, mobile clinics, coupons for use with private doctors, special postpartum and postabortion programs, special programs for young women with negative pregnancy tests, and special social marketing campaigns; HIV/AIDS preventions programs are targeting high-risk youth; and teen-agers are being invited to sit on FP boards or teen advisory boards.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 097897Abstract : Globally, 19 million women are estimated to undergo unsafe abortions each year. Age patterns of unsafe abortion are critical for tailoring effective interventions to prevent unsafe abortion and for providing post-abortion care. This paper estimates the incidence and the rate of unsafe abortion among women aged 15-44 in the Africa, Asia (excluding Eastern Asia), and Latin America/Caribbean regions, where a woman is likely to have close to one unsafe abortion by age 44. For developing regions as a whole, two-thirds of unsafe abortions occur among women aged 15-30 and 14% among women under age 20. The age pattern of unsafe abortions differs markedly between regions, however. Almost 60% of unsafe abortions in Africa are among women under age 25 and almost 80% are among women under 30. In Asia 30% of unsafe abortions are in women under 25 and 60% in women under 30. In Latin America and the Caribbean, women aged 20-29 account for more than half of unsafe abortions with almost 70% in women under 30. Over 40% of unsafe abortions among adolescents in the developing world occur in Africa, where one in four unsafe abortions takes place during adolescence. Young (under age 25) women in Africa, those over age 25 in Asia and women aged 20-35 years in Latin America and the Caribbean are in the greatest need of interventions to prevent unsafe abortion and good quality post-abortion care.
Web site : http://www.rhmjournal.org.ukAbstract : El aborto en la adolescencia es un problema que se presenta en las diferentes clases sociales, tanto a nivel nacional como internacional. Las implicaciones sociales que conlleva tiene un gran alcance en las diferentes clases sociales, ya que tenemos gran cantidad de adolescentes que no han alcanzado sus metas, además de mencionar los riesgos a que están sujetas las jóvenes que abortan. Este estudio describió y exploró características de adolescentes hospitalizadas con diagnóstico de aborto. La edad media estuvo entre los 18 y 19 años; gran parte de estas mujeres eran solteras o unidas. El 61% de los abortos fueron incompletos y 22% se encontraban infectados, lo que hizo suponer que eran abortos inducidos. Antes de presentarse la gestación, la gran mayoría ya había abandonado el colegio; igualmente sus parejas ya no estaban en la escuela. Tanto la adolescentes como su compañero solo lograron alcanzar la secundaria incompleta. Más de la mitad de la muestra desconocía la planificación familiar, lo cual supone la no utilización de métodos anticonceptivos. Aquellas de mayor edad eran la que, algún momento, usaron anticonceptivos. El Centro de Salud fue identificado como la mayor fuente de información de sexualidad. De las embarazadas, un poco más de la mitad acudió a consulta médica por problemas salud y un 45% lo hacía por controles prenatales ; un 32% de las adolescentes no sabía que estaba embarazada. Los datos gineco-obstétricos indicaron que 36% experimentaban su primer embarazo; la amenorrea fue el principal signo para sospechar el embarazo. Un 66% deseaba el embarazo; un 30% desconocían las complicaiones que generaba un aborto. La mayor parte de estas jóvenes manifestaron que habían abortado después de un trauma (caída o golpe) y otra parte dijo que había sido por exceso de trabajo. Luego del aborto, las adolescentes manifestaron conocer medios por los cuales evitar futuros embarazos, aunque la mayoría de ellas indicaron desear embarazarse nuevamente en menos de un año, posterior al aborto.
Notes : Español/espagnol/SpanishAbstract : Morbidity and mortality, the gravest medical consequences of abortion, are also its most serious social consequences. Unsafe abortions are estimated to lead to some 200,000 deaths annually, 99% of them in developing countries. 25% of the world's abortions are believed to occur in Latin America. Abortion mortality declined significantly in many countries after liberalization of their abortion laws. Abortion mortality and morbidity produce serious problems for the existing children of the affected mothers, and occasion an unprofitable use of resources by health systems. The cost of abortion may represent an important share of a poor family's budget, especially if complications occur. Grave social and emotional imbalance upsets the family if the woman dies. Women able to obtain legal abortions may have fairly positive experiences, but those forced to seek illegal abortions in unsafe conditions may develop serious health or emotional problems. Most of the considerable number of studies of reactions to abortions carried out in the 1970s concluded that induced abortion did not cause serious negative reactions. Women at greater risk of negative reactions to abortion included those with a history of psychiatric problems, those undergoing abortion for medical indications, those at later gestational ages, those with ambivalent feelings, young adolescents, and those in contexts in which abortion is strongly condemned. The attitude of the abortion practitioner or health worker may also influence the reaction to abortion. Findings of a longitudinal Czechoslovakian study of children whose mothers were twice denied legal abortions in 1960 suggests that children suffer lasting effects of being unwanted. There is some evidence that the widespread belief that contraceptive usage always reduces recourse to abortion may be oversimplified. More educated women and women using contraception may in some cases actually have a greater recourse to abortion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 094100Abstract : Some very general reflections on abortion as a problem through history as well as on its juridical aspects in Cuba are made. An alternative and participative
Web site : http://scielo.sld.cu/scielo.php?script=sci_arttext pid=S0864-21252001000300013 lng=es nrm=isoAbstract : The 1994 International Conference on Population and Development defined reproductive health as general physical, mental, and social well-being. Ideally reproductive health services should embrace family planning, prenatal care, postpartum care, responsible parenthood, prevention and treatment of infertility and sexually transmitted diseases, and sex education. The concept of reproductive health is inextricably connected to reproductive rights. The situation of reproductive health in Peru in 1995 was represented by the figure of slightly more than 6.1 million women of reproductive age, 51.5% of all women. 55% of these were married, while another 15% were sexually active although not living with a partner. Thus, 70% of women were at risk of pregnancy who required information and reproductive health services. The problems of reproductive health concern sexually transmitted diseases (30-40% of patients attending public health clinics were afflicted with trichomoniasis, bacterial vaginosis, pelvic inflammatory disease, nongonococcal urethritis, condylomas, or intraepithelial cervical neoplasias), abortion (60% of all pregnancies were unplanned in 1992, 30% of which ended in abortion), and maternal mortality (261 deaths per 100,000 live births). The official population policy is still erratic in many respects: the National Council of Population faced difficulties in completing its mission, the government did not assign priority to the issue of population, and even in early 1995 the national program of the population for 1991-95 had not been promulgated; the authorities tended to take extreme positions regarding reproductive health; the regulations on population were developed without interinstitutional coordination; the standards of reproductive health had not been implemented; and the authorities were ambivalent about sex education.In Peru, the average number of children a woman bears has declined from 6.5 to 3.5 in 22 years (a record), but the ideal number is 2.5. Although the demand for modern contraceptive methods is growing, the lack of contraceptive choices and accessibility creates limitations and deficiencies, and the contraceptive continuation rate is low. Behind the fertility decline there exists a "culture of death," in that induced abortion and infanticide have been and still are considered to be real solutions to a large sector of the population. A study has shown that of 905,400 pregnancies in 1992, 30% ended in induced abortion and another 30% resulted in unwanted births.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 115698Abstract : It was made a review of the historical and social aspects of the practice of abortion from the beginning of humanity to the current trends in the world, as well as of the position of our country on this regard. Emphasis was made on the need to use the available contraceptive methods so as to reduce the morbidity and mortality caused by the use of abortion as a birth control method
Web site : http://scielo.sld.cu/scielo.php?script=sci_arttext pid=S0138-600X2002000200012 lng=es nrm=isoAbstract : We revised ethical concepts related to abortion from the points of view of the mothers; life, health, and considerations are made concerning the embryo or fetus as a biological, ontological, moral, and potential person. Certain religious matters on abortion are described and commented on. Effects of abortion penalization in Mexico and the legislation in the Mexican states are examined, as well as the motives of depenalization in certain countries.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : Findings are presented of the descriptive and exploratory research project "Social Determinants and Consequences of Induced Abortion in the Dominican Republic." 309 women of marginal social status treated for abortion complications in Santo Domingo's largest maternity hospital and 43 primarily working class women treated for abortion complications in a Santo Domingo social security hospital were interviewed in early 1992. Interviews in greater depth with 19 lower class and 13 middle class women who had had induced abortions supplemented the hospital data. Because of the reluctance of women to admit to having induced abortions, all the hospital abortions were assumed to be illegally induced, even though up to 25% might have been spontaneous. 18% of women treated for abortion but 25% of those delivering babies at the larger hospital were adolescents. The women interviewed were primarily young. 78% were in union, 84% had children, 83% had work experience, and 65% desired more children in the future. Neither occupational status nor educational level nor any of the other social determinants studied were significantly associated with reproductive behavior. In the absence of a strictly comparable population of nonaborting women, it is methodologically impossible to propose correlations between specific variables and behavior. Contraceptive usage appeared to be the most interesting study variable. Great contradictions were observed in the contraceptive usage and reproductive intentions of the women, who demonstrated interest in fertility regulation and who had considerable contraceptive experience. The prevailing pattern of contraceptive usage in the Dominican Republic combines late initiation with unsystematic use based on the expectation of early sterilization. Although high percentages of the women knew of contraceptive methods, the study data confirm that they lacked detailed knowledge of characteristics, correct use, and secondary effects of different methods. Two-thirds of women using contraception in the Dominican Republic are sterilized. The small proportion of women using reversible methods at any given time indicates that large population groups do not use contraception for spacing. Most of the women had a high degree of motivation to control their fertility, frustrated by deficient practice of contraception.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100712Abstract : This brief article summarizes statistics from a WHO document that estimates that women undergo almost 20 million unsafe abortions worldwide each year. The document shows that unsafe abortions occur in practically every region of the world, though they are much less likely in places where abortion is legal, safe and accessible. Nearly 95% of unsafe abortions take place in developing countries. Moreover, almost 80,000 women die annually as a result of unsafe abortion, which accounts for 13% of pregnancy-related deaths. A review of UN sub-regions shows that unsafe abortion is highest in eastern Africa, South America, western and central Africa, and Central America. The number of deaths from unsafe abortion is the highest in Asia and Africa and Latin America and the Caribbean. In this regard, the WHO states that prevention of unwanted pregnancies must always be given the highest priority and all attempts should be made to eliminate the need for abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 164088Abstract : This essay does not pretend to cover exhaustively the history of Catholic ideas on abortion, but rather challenges the current belief that the Catholic Church always considered abortion to be murder. Perceiving dissension among theologians in relation to the issue of abortion throughout the history of Catholicism provides a different perspective on the current discourse of the Catholic hierarchy which is presented as the product of a lineal and monolithic history. This is simply not true. The Vatican doctrine on abortion is not one of the issues on which the Pope is declared infallible. Instead, it is an issue for ecclesiastical legislation related to penitence and therefore can and must be discussed by Catholics. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 180991Abstract : Actualización y adaptación del documento "América Latina: La transición demográfica en sectores rezagados" presentado por los autores a la conferencia internacional de población de la Unión Internacional para el Estudio Científico de la Población, Beijing, octubre de 1997 (Schkolnik y Chackiel, 1998).
Web site : http://www.eclac.cl/publicaciones/Poblacion/7/LCL2097P/LCL2097.pdfAbstract : Structured interviews were conducted with 52 lower- and middle-class men aged 20-46 years in Mexico City who had been involved in at least one abortion of a wife, lover, or casual sexual partner. The objective was to analyze the forms of responsibility assumed by the men according to the relationship and degree of emotional involvement. 29 of the men were single, 18 married, and 5 divorced. 22 reported no religion and 29 were Catholic. 36 had no children and 9 had 1 child. 17 were aged 20-25 and 19 were 26-29. In 43 cases the man had been involved in one abortion. Most of the women were girlfriends or wives. In most cases the man reported loving the woman greatly. At the time of the abortion(s), 16 of the men were aged 18-20, 26 were 21-25, 10 were 26-30, and 13 were 31-41. 43% reported having taken no responsibility for contraception. The men were more likely to cooperate in contraception with girlfriends or wives and with women to whom they were emotionally attached. 90% reported they assumed responsibility for financing the abortion in whole or in part. Women in nonformal relationships or who were less loved received less financial and other assistance. In 52% of cases, the male either decided on the abortion or made clear to the woman that he would have no role in supporting the child. The form in which men assumed or did not assume responsibility for the abortion reflected overall social relations defining asymmetrical rights and obligations for men and women.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 140048Abstract : El objetivo de este proyecto es generar capacidad entre quienes realizan actividades para mejorar o incrementar el acceso al aborto, ya sea a través de la reforma de la ley, o de la ampliación del acceso y la calidad de los servicios. El proyecto ofrece ejemplo del activismo iniciado en el sur, que tiende puentes y facilita el aprendizaje entre regiones y países del norte y del sur
Notes : Español/espagnol/SpanishAbstract : Drawing on the work of G. Rodrigues J. Cleland ("Modelling Marital Fertility by Age and Duration: An Empirical Appraisal of the Page Mode," Population Studies, 1988, 42, 2, 241-257), an alternative model for measuring the impact that changes in marriage, contraceptive use, postpartum infecundability may have on changes in total fertility is presented. The model is built on age-specific fertility schedules based on the age structure of marital fertility proportions ever married, on the assumption that, in the absence of deliberate birth control, marital fertility follows a typical age pattern termed natural fertility. Drawing on survey data from Latin American Caribbean countries on Demographic Health Survey project data, the proposed approach to decomposing the changes in fertility rates in terms of several of its proximate determinants is discussed. Changes in fertility in five Latin American countries are discussed in terms of various contributing factors. 11 Tables. Adapted from the source document.
Notes : Inglés/anglais/EnglishAbstract : Bolivia has one of the highest rates of maternal mortality in Latin America, with the single greatest cause attributed to complications of unsafe abortion. An earlier study entitled "Feasibility Study for the Introduction of Manual Vacuum Aspiration (MVA)," conducted by the Bolivian Ministry of Health and Social Welfare, indicates strong support among both health authorities and providers for incorporation of MVA in emergency services for the treatment of incomplete abortion. An equally important step considered by the Ministry is the implementation of a diagnostic study to assess the availability, quality and cost of postabortion care (PAC) services in the public sector. Five data collection instruments were applied at the primary, secondary and tertiary levels of the health system in the form of administrative, client, and provider interviews; infrastructure inventory and logbook checklist, and observation of patient services, including a time-motion study of PAC costs. Initial baseline study results were disseminated through a conference on PAC operations studies in Bolivia in July 1998 and have been accepted for presentation at the American Public Health Association annual meeting in November 1998. While data analysis has not yet been completed, the researchers reveal the following preliminary conclusions: 1) demand for PAC services varies by geographic region, with some areas experiencing demand that exceed capacity, whereas services in other areas are severely underutilized; 2) many facilities not presently offering PAC services have the capacity to do so; and 3) a large proportion of women experienced spontaneous abortion of a wanted pregnancy.
Web site : http://www.popcouncil.orgAbstract : Bolivia has one of the highest rates of maternal mortality in Latin America, with the single greatest cause attributed to complications of unsafe abortion. An earlier study entitled "Feasibility Study for the Introduction of Manual Vacuum Aspiration (MVA)," conducted by the Bolivian Ministry of Health and Social Welfare, indicates strong support among both health authorities and providers for incorporation of MVA in emergency services for the treatment of incomplete abortion. An equally important step considered by the Ministry is the implementation of a diagnostic study to assess the availability, quality and cost of postabortion care (PAC) services in the public sector. Five data collection instruments were applied at the primary, secondary and tertiary levels of the health system in the form of administrative, client, and provider interviews; infrastructure inventory and logbook checklist, and observation of patient services, including a time-motion study of PAC costs. Initial baseline study results were disseminated through a conference on PAC operations studies in Bolivia in July 1998 and have been accepted for presentation at the American Public Health Association annual meeting in November 1998. While data analysis has not yet been completed, the researchers reveal the following preliminary conclusions: 1) demand for PAC services varies by geographic region, with some areas experiencing demand that exceed capacity, whereas services in other areas are severely underutilized; 2) many facilities not presently offering PAC services have the capacity to do so; and 3) a large proportion of women experienced spontaneous abortion of a wanted pregnancy.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 136439Abstract : Objetivos: avaliar a mortalidade evitável de mulheres em idade reprodutiva, residentes em Campinas, SP, comparando os qüinqüênios de 1985-89 com 1990-94. Métodos: foram estudadas 3.086 declarações de óbito de mulheres de 10 a 49 anos, que foi o número total de mortes no período de janeiro de 1985 a dezembro de 1994. Foram aplicados os critérios de evitabilidade, segundo medidas preventivas, medidas de diagnóstico e tratamento precoces, medidas de saneamento e medidas mistas. Foram ainda classificadas de causa dificilmente evitável, as mal definidas e as por outras causas. Procedeu-se ao cálculo dos coeficientes de mortalidade específicos para cada período de cinco anos e da razão entre estes coeficientes. Resultados: houve aumento na taxa de mortalidade evitável em 20% na comparação entre os dois períodos. As maiores falhas ocorreram no grupo de causas evitáveis por medidas preventivas e de saneamento. O maior aumento em causa de morte por medidas preventivas foi resultado da AIDS. Dentre as mortes evitáveis por medidas mistas, deve-se ressaltar o aumento de 50% tanto para mortalidade materna por aborto, quanto nas mortes violentas, principalmente homicídios. Conclusões: houve aumento na proporção de mortes por causas evitáveis. Medidas para prevenção da AIDS, do aborto provocado e para redução das mortes violentas, principalmente homicídios, deveriam ser prioridades político-sociais no país.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0100-72032000000900007 lng=en nrm=isoAbstract : This study aims at learning about and identifying the causes leading to maternal death. Data were obtained from the Ribeirão Preto Committee for Studies and Prevention of Maternal Death and from obituaries. It is an exploratory study in which 72 maternal deaths occurring in Ribeirão Preto were analyzed from 1991 to 1995. In 1995, the maternal death rate was 60.3 in 100,000 births, with the predominance of avoidable causes, such as hemorrhage (33.3%), other causes (26.4%), hypertension (15.3%), abortion (11.1%), infection (8.3%) and puerperium (5.6%). Maternal death is a public health problem which must be faced by government authorities.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0104-11692001000300011 lng=en nrm=isoAbstract : 308 women in reproductive age (15-44) who were sexually active but not pregnant were studied. Data were collected between April 1989 and January 1990 by a questionnaire on demographic aspects, present and previous reproductive life, and contraceptive use. 43.1% of subjects were in the 20-29 age group. 177 women were married, and 92 women lived with a steady companion. 169 were not employed outside the home, they were taking care of children. 112 worked as domestics and cleaning women. 215 had not completed elementary education, 29 were illiterate, and only 8 women had completed secondary school. 155 lived on more than 2 minimum salaries, but 42.8% had less than 2 minimum salaries as incomes. 82.6% had the 1st sexual intercourse before 19 years of age, and 11.4% started their sex lives before the age of 15. 59.6% had their 1st child as adolescents; 4.4% of these at or before the age of 14. In this population there were 919 pregnancies, most in the 20-29 age group; and 101 resulted in abortion. There were 232 pregnancies before 20 years of age. 192 had up to 3 living children, 31 had more than 6 children, and 38 women did not have any children. The average parity was 2.6, the average number of living children was 2.5, and the average pregnancy was 2.9/woman. 69 women had a history of abortion, 34.8% of these had the 1st abortion between 20 and 24 years of age; 27.2% had their 1st abortion during adolescence; and 16.6% had it after 29 years of age. 18 had induced abortions and 80 had spontaneous abortions. More than one-half of induced abortions occurred between 15 and 24 years of age. Causes of spontaneous abortions were congenital anomalies, maternal health, and lack of prenatal care aggravated by socioeconomic conditions. There was a strong association between education and the number of children (p < .01). Women who had their 1st child before age 20 had more children than those who were over age 20 when the 1st child was born (p < .01).
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 080185Abstract : Investiga los métodos anticonceptivos y abortivos en el mundo de la antigüedad y actualmente. Define y tipifica el aborto legal y médico, presentando los argumentos médicos y jurídicos. Abunda sobre el delito del aborto específicamente en el código penal mexicano y en particular en Morelos, presenta la legislación mundial al respecto y un panorama histórico. Discute las consecuencias sociales de su penalización. Incluye las encuestas aplicadas a las mujeres, los médicos, los hombres en general que sirvieron de base a su investigación. Ofrece propuestas concretas para su despenalización, tomando en cuenta aspectos de educación sexual formal/informal, creación de centros especializados, y otros
Notes : Español/espagnol/SpanishAbstract : A study was conducted at the General Hospital Aurelio Valdivieso in Oaxaca, Mexico, to evaluate the impact of improved postabortal services on the cost of treatment. The program was initiated in February 1996. In collaboration with the Population Council, the hospital established a service model including use of manual endouterine aspiration, family planning counseling, provision of contraceptive methods, seminars and discussion groups for the obstetric and gynecological personnel, and print media with basic information for patients. The study examined the hypothesis that the new model will result in more efficient use of available resources and a savings for the hospital, while the quality of services is not affected or is improved. 11 patients were observed during 20 days in January 1996 to calculate pre-intervention costs, and 25 patients were followed in July 1997 to calculate post-intervention costs. 132 patients were interviewed before the intervention and 207 were interviewed using the same instrument after the intervention. The average duration of hospital stay declined by 35% after the intervention. The cost of treatment per patient was reduced from US$264.57 before the intervention to US$180.22 after the intervention, for a savings of US$94.25.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 153737Abstract : La realidad de las prácticas de los jóvenes, sus creencias, las posibles explicaciones para tendencias aparentemente contradictorias, como el incrememnto de los embarazos adolescentes tras años de oferta de métodos anticonceptivos, son parte de los temas tratados en la obra.
Notes : Español/espagnol/SpanishAbstract : Este trabajo analiza un asunto que suele ser muy polémico, que despierta pasiones y que ha generado y seguira generando airadas discusiones tanto a nivel personal como publico: el aborto. No obstante, el centro de esta investigación no es la práctica misma del aborto, sino la forma cómo la prensa presentó este tema en una coyuntura específica. Esta coyuntura surgió en la ciudad de Mexicali, Baja California, a finales del año 2000, cuando se hizo de conocimiento público el " caso Paulina ", en el que una adolescente, embarazada a raíz de una violación, solicitó permiso para tener un aborto y, aunque lo obtuvo, no logró interrumpir su embarazo debido a que algunos funcionarios y médicos actuaron para evitarlo, argumentando razones religiosas a pesar de ser funcionarios de un estado que estó separado de la iglesia desde el siglo XIX. Cuando inicié esta investigación colaboraba en el Grupo de Información en Reproducción Elegida, GIRE, una Organización No Gubernamental dedicada a la defensa y promoción de los derechos reproductivos. Gire se ha especializado en el tema del aborto compilando y difundiendo información sobre esta práctica en México y haciendo un importante trabajo de cabildeo y de relación con los medios de comunicación. Pero aunque esta organización reconoce la importancia de que se hable del aborto en los medios de comunicación, apenas ha comenzado a evaluar la forma en que se presenta el tema en los medios, así como los métodos disponibles para realizar este análisis.
Notes : Español/espagnol/SpanishAbstract : El aborto provocado es un delito contra la vida de las personas. En opinión de la autora, dentro del vientre materno existe un organismo , está vivo y es un ser humano. La suma de estas tres realidades da como resultado una sola realidad científica : desde el instante de la concepción hay un ser humano, que es el feto o embrión. Este estudio presenta el análisis del aborto provocado con consentimiento, incluyendo en este la distinción entre voluntad y consentimiento, las causas de justificación y el consentimiento en el Código Penal Panameño y sus consecuencias. Aborda también el consentimiento por parte de la madre, el aborto sin el consentimiento materno y como influye el consentimiento para eximir de responsabilidad según la Ley. La aceptación del aborto provocado no puede ser considerado como un avance jurídico y social, y por consiguiente, su despenalización en todos o algunos casos en base a cuestiones de política criminal, dado que el ser humano vivo, es un todo que no admite relativismo. La Ley penal vigente indica que el aborto provocado de la mujer es una acción típica, pero antijurídica, cuando la acompaña requisitos de validez del consentimiento, exigidos por la ley para que se efectúe el aborto (artículo 144, Código Penal, Panamá). Los requisitos de validez del consentimiento son: discernimiento, intención y libertad; si faltara uno de los tres , el consentimiento no es válido. El consentimiento en el aborto es elemento constitutivo del delito y debe ser voluntariamente otorgado, es decir, que la mujer tenga representación del alcance de su comportamiento y pleno conocimiento de la situación de hecho. Esto da por entendido que la mujer tiene el consentimiento viciado para ser responsable penalmente, mas consideramos que la pena de prisión para la mujer no es efectiva para combatir la práctica del aborto clandestino, ni mucho menos es una "solución" para la mujer, si el objetivo primordial es el resocializarla. Las eximentes de responsabilidad consagradas en el aborto (eugenésico, terapéutico) no son, a juicio personal, auténticos casos de estado de necesidad, ni en otro caso justifican tal actuación. El caso de violación carnal tampoco justifica el aborto. Algunas propuestas en torno al aborto serían el considerar a la mujer legalmente como auténtica víctima junto a su hijo, y enfocar las sanciones contra los terceros, que son los verdaderos culpables, puesto que inducen, presionan, convencen, engañan, facilitan los medios y practican el mismo aborto. Incorporar delitos que castiguen al abortista que realmente debe responsabilizarse del delito cometido. Deben adoptarse medidas que favorezcan el trámite de adopciones y obligar a comunicar a las mujeres toda la verdad científica sobre el origen de la vida.
Notes : Español/espagnol/SpanishAbstract : Maternal deaths occurring between 1987 and 1989 in 15 public and private hospitals throughout Haiti were reviewed to assess the extent and principal causes of maternal mortality. Deaths occurring outside the hospitals were excluded. 402 maternal deaths occurred in 116,509 live births in the 3 years, for a maternal death rate of 345/100,000 live births. The maternal mortality rate was 365/100,000 in 1987, 325.8 in 1988, and 348.8 in 1989. The highest proportion of deaths were in women 25-29. Between 30% and 35% of maternal deaths were in primiparas. The proportion declined through parity 3 and increased for the 4th and subsequent births. 37.1% of the 402 deaths were due to hemorrhage, 21.1% to eclampsia, 13.9% to septicemia, 11.9% to abortion, 12.2% to intercurrent illness, and 3.7% to other causes. Among the 149 deaths due to hemorrhage, 62 resulted from postpartum hemorrhage, 45 from uterine rupture, 30 from premature separation of the placenta, 9 from ectopic pregnancy and 3 from placenta previa. Abortion accounted for 5.5% of maternal deaths in 1987, 12.9% in 1988, and 15.9% in 1989. About 3/4 of births in Haiti are attended by traditional midwives. The high rate of maternal mortality results from the low socioeconomic level and inadequate prenatal care of the population.
Notes : Francés/français/French, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 079424Abstract : This document reproduces the Declaration that arose from the 1993 Andean Safe Motherhood Conference. After a short introduction, the Declaration 1) outlines the dimensions of maternal mortality in the Andean region, where 5000 of the 22 million women of reproductive age die each year of generally avoidable maternity-related causes and 2) notes that state mechanisms have not effectively protected women from culturally inspired violence and discrimination. The next section, which discusses reproductive health services, maintains that health services are created with no regard to the culturally specific health experiences of the communities and, therefore, fail to serve pregnant women adequately or to provide comprehensive reproductive health care. Deficiencies are noted in the provision of family planning, efforts to reduce the prevalence of abortion, efforts to prevent adolescent pregnancy, and sex education. The first set of 16 recommendations to redress these deficiencies is then directed to governments, specifically Ministries of Health, and nongovernmental and international organizations. The next set of seven recommendations is addressed to parliamentarians who can promote compliance with laws and health policy, create appropriate legislation to minimize reproductive health risks, provide funding, and promote reproductive health programs and policies. The Declaration concludes by stating the determination of Conference participants "to improve the social and health conditions of women in our countries" and to recognize health as a basic human right.
Notes : Inglés/anglais/EnglishAbstract : Peruvian women had 2.5 children on average in 1991. Women in metropolitan Lima had 2.1, rural women had 6.2, illiterate women had 7.1, and those with higher education had 1.9. 11% of all women 15-19 years old had children or were pregnant, but the proportion was 39% for illiterate adolescents, 25% in rural areas, and 30% in the departments of Loreto and San Martin. 47% of adolescent mothers stated that the pregnancy was undesired. 41% of reproductive-age women did not use contraception. The proportion rose to 59% in rural areas and 65% among illiterate women. 33% of reproductive-age women used modern contraceptive methods, while 26% use traditional methods, including 21% who use rhythm. 50% of women in the sierra and 73% in metropolitan Lima use some form of contraception. 71% of adolescent women in union use no contraception, although 42% state they want no more children. The average desired family size is 2.5. 30% of children born between 1985 and 1990 were not desired by their mothers, and another 26% were desired but for a later time. An estimated 85,000 abortions occurred in Peru in 1982. Abortion in Peru, except for therapeutic indications, is a crime punishable by up to two years imprisonment. On average one person per month was sentenced to prison in the Chorillos jail in Lima for the crime of abortion. 27% of maternal deaths in the Lima Maternity Hospital between 1978 and 1987 resulted from infections occurring after abortion. Between 1975 and 1984, 50% of maternal deaths from direct obstetric causes resulted from septic abortions. 8% of women treated at the hospital for abortion died.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 094101Abstract : In 1992, the International Planned Parenthood Federation (IPPF) celebrates its 40th anniversary. Its Annual Report discusses status of member family planning associations (FPAs) by region: Africa, Arab countries, East and South East Asia and Oceania, Europe, South Asia, and the Western Hemisphere. Quality care is the theme of the special report. The IPPF President urges FPAs to bring more attention to the effect unsafe abortions have on maternal health. Unsafe abortion accounts for 25-50% of maternal deaths in developing countries. More FPAs should enlist the help and gain the support of volunteers to achieve goals. Even though IPPF and its FPA members have accomplished much since 1952, they have much more work to accomplish. For example, about 50% of the population living in 60% of developing countries (about 500 million women) still do not have access to family planning. 75% of women in Latin America who do not use family planning would like to use it. Unmet needs are especially evident in Africa where illegal abortions occur regularly and cause much mortality and infertility. They also exist among the 17 million US adolescents who experience >600,000 unplanned pregnancies each year of which >50% terminate with abortion. The government of the Netherlands is committed to providing adolescents family planning information resulting in the world's lowest pregnancy rate (14/1000) with few adolescent abortions. Colombia's FPA (Profamilia) has instituted perhaps the most successful family planning efforts in the world. Between 1965 and the present, family size has decreased from >7 to <3 children in a predominantly Catholic country. Some reasons for this success are that Profamilia provides clients quality care and it is creative and flexible. Family planning should be available to all who wish it not only because it saves lives, improves health, and liberates women and their families but because it is a basic human right.
Web site : http://www.ippf.org/Abstract : A multi-centered qualitative study was conducted in Brazil, Chile, and Mexico to assess the acceptability of emergency contraception both among potential users and possible providers, authorities, and opinion-makers, and to identify (according to participants' perceptions) factors facilitating or hindering the method's use and the most appropriate strategies to disseminate information and provide the method. Data were collected through semi-structured interviews, group interviews, and discussion groups, which were tape-recorded and transcribed. A thematic analysis of this material was conducted. Acceptability of emergency contraception was high among participants, who also felt that there were no barriers towards its acceptance by the population. Participants felt that the method's acceptability would be greater if it were included in reproductive health programs, emphasizing its prescription for emergency situations. Participants highlighted that strategic components in Brazil would be training of providers and inclusion of the method in family planning services.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-11X2001000400038 lng=es nrm=isoAbstract : La anticoncepción de emergencia representa una excelente opción para la prevención de embarazos no deseados y de abortos inducidos. A este respecto, el aborto inseguro es responsable de la muerte de miles de mujeres en edad reproductiva, especialmente en países en vías de desarrollo, muchas de ellas prevenibles si se proporciona la información y acceso apropiados a este método para el control de la fertilidad. En esta revisión se discuten los métodos utilizados y sus mecanismos de acción con la finalidad de contribuir desde la perspectiva biomédica al mejor conocimiento, usos y beneficios de la anticoncepción de emergencia.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : The proportion of women aged 15-19 in Colombia who are mothers declined from 14% in 1985 to 10% in 1990, but the actual number of cases increased due to population growth. Some 1,780,000 adolescents who have had children or are pregnant require family planning services. An additional, unknown number of adolescent pregnancies are terminated by abortion. It is estimated that 95% of adolescent pregnancies diagnosed or followed by PROFAMILIA's center for young people were unwanted. Reasons for making family planning services available to adolescents include the ever young age at initiation of sexual activity, the very low rates of contraceptive usage among sexually active adolescents, the lack of information of adolescents concerning reproduction and contraception, and their fear and guilt surrounding their sexual activity and contraceptive usage. Obstetrical services appear reluctant to furnish adolescent mothers with information on contraception, and the pharmacists and their employees who provide such information may not be aware of contraindications for this age group or whether adolescents are adequately instructed in use of the method. The rising age at marriage increases the span of time that adolescents are at risk of unwanted pregnancy. Adolescents who are well informed about sexuality and contraception and trained in decision making, self-esteem, and responsible parenthood are likely to postpone sexual activity. Information on contraception and family planning services needs to be made available to adolescents in a way that will actually motivate use. Information on sex and contraception should be made available at puberty and should include the form of use, contraindications, and advantages and disadvantages of all methods appropriate to adolescents. Orientation and assistance in selecting the best method should be individually tailored and should be provided in schools or other places accessible to young people, in a language they can understand. Rhythm and withdrawal are relatively ineffective for inexperienced adolescents and should be replaced by more effective methods. Abstinence should be promoted, especially among the youngest adolescents. Young people should be shown that abstinence is not abnormal and does not imply homosexuality, and that other avenues of sexual expression are available. Condoms and spermicides are the ideal methods for adolescents because of their availability, low cost, absence of side effects, and protection against sexually transmitted disease. Promotion of condom and spermicide use requires combatting some misconceptions about sex and contraception, such as that relations should not be planned or that the genitals should not be touched.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 081916Abstract : Este libro presenta los resultados de una investigación realizada en Colombia, cuya investigadora principal fue Margoth Mora Téllez. El estudio comparó los componentes de orientación y suministro de métodos anticonceptivos de un servicio de atención post-aborto, denominado "Tratamiento Ambulatorio del Aborto Incompleto". Los objetivos de la investigación fueron: 1) identificar los factores que inciden en las decisiones anticonceptivas postaborto; 2) establecer las estrategias de atención más apropiadas y acordes con las neceSIDAdes y preferencias de las mujeres; y 3) implementar y evaluar las nuevas estrategias de atención. Para establecer las carencias del modelo de anticoncepción post-aborto y comprender el rol de cada participante en la prestación del servicio, se obtuvo una amplia gama de información proveniente de las usuarias, los proveedores, la estructura del servicio y los registros clínicos. Con tal fin se combinaron técnicas de investigación cualitativas y cuantitativas. Entre las conclusiones se señala que las actitudes y preferencias personales de los proveedores en la provisión del servicio pueden inducir la decisión final de las usuarias a favor de un determinado método, o por el contrario, el no uso o el abandono del método cuando no ofrecen el apoyo necesario a las usuarias que lo necesiten. Por ello, se sugiere que periódicamente se debería propiciar la actualización de conocimientos y la revisión de valores y actitudes de los proveedores respecto a los diferentes métodos. Por otro lado, el ofrecimiento y el suministro de una mayor diversidad de métodos anticonceptivos dentro del servicio, facilita a las mujeres la elección más adecuada a sus gustos y neceSIDAdes, la obtención de un anticonceptivo y la prevención de nuevos embarazos inoportunos y abortos. Entre los factores que dificultan la práctica anticonceptiva de las parejas, tiene un papel importante su creencia de que los métodos anticonceptivos son "nocivos para la salud", especialmente los anticonceptivos hormonales y el DIU. Esta idea, que ha sido mencionada en los resultados de varios estudios, persiste fuertemente. Se recomienda a los proveedores dar explicaciones a las usuarias, tratando de erradicar este concepto muy común.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This work discusses the prevalence of illegal abortion and its consequences in Mexico and describes the most effective reversible contraceptive methods appropriate for postabortal use according to the official norms of the Mexican Ministry of Health. The high incidence of abortion in Mexico is one of the most serious problems for maternal and child health. Although postabortal women are highly motivated to use contraception, only a few hospitals have made family planning methods available, with varying degrees of success. The lack of adequately trained personnel and the reluctance of physicians to consider IUDs for postabortal use are obstacles to program development. All the oral and injectable hormonal methods can be used postabortally as long as the usual contraindications are respected. Combined oral contraceptives (COCs) and injectables are appropriate for most women with no cardiovascular contraindications who are not heavy smokers, hypertensive, or diabetic. COCs are known to provide other health benefits, such as protection against some cancers. Different estrogens are employed in combined injectables and COCs, and their secondary effects may differ. Progestin-only contraceptives, available in the form of pills, injectables, and implants, are appropriate for postabortal use in women who can tolerate menstrual irregularity. Unexplained vaginal bleeding and breast cancer are the only absolute contraindications. Norplant subdermal implants are strongly indicated for postabortal use and can be inserted immediately after abortions at any gestational age without regard to genital infection. Adequate patient counseling helps users tolerate menstrual irregularity in the first months of use. The copper 380A IUD currently used in public sector family planning programs in Mexico is appropriate for postabortal women at low risk of sexually transmitted diseases. Septic abortion, pelvic inflammatory disease, sexually transmitted diseases, vaginal bleeding of unknown cause, and pelvic tuberculosis are contraindications.
Web site : http://scielo-mx.bvs.br/scielo.php?pid=0300-9041 script=sci_serialAbstract : Un total de 907 mujeres de 13 a 34 años de edad residentes del municipio más poblado de La Habana fueron encuestadas en 1993 y 1994 para establecer la prevalencia, las diferencias, la eficacia y los factores relativos al abandono de los métodos anticonceptivos. Un número de 314 mujeres recibieron exámenes ginecológicos y 294 fueron entrevistadas acerca de trastornos ginecológicos. Un total de 385 de sus compañeros fueron entrevistados. El 4,3% de las mujeres eran menores de 20 años. El 7,4% de ellas habían recibido sólo educación primaria. El 60,2% de ellas tenían trabajo remunerado, la mayoría como profesionales o técnicas. La mitad estaban casadas y 5,1% nunca habían estado en unión. El 25,9% no tenían hijos. El 69,9% de ellas usaban anticoncepción, y los DIU representaban más del 60% de la prevalencia de uso total. Los resultados de las altas tasas de prevalencia de uso de anticonceptivos y la predominancia del DIU y la píldora son similares a los de otros estudios en Cuba. Los resultados son un indicio claro de las dificultades en el uso de los anticonceptivos debido a las limitaciones financieras y de recursos que se interponen a la calidad y la elección de los métodos. La baja eficacia y la tasa elevada de abandono del DIU y la píldora indican que hay problemas en la disponibilidad de otros métodos. Un número considerable de mujeres usan métodos anticonceptivos inapropiados para sus circunstancias maritales o etapa en la vida, en especial las mujeres sin compañeros sexuales estables que usan el DIU porque no hay otro método disponible. Las mujeres que adoptaron medidas para controlar el embarazo desde el inicio de sus vidas sexuales tuvieron que recurrir con menos frecuencia al aborto, tuvieron menos necesidad de cambiar de método y su fecundidad fue más baja. Las infecciones del aparato genital inferior fueron un problema común, agravado por el uso de métodos anticonceptivos que no ofrecían protección. Los problemas de salud y los fallos de los métodos son factores que perjudican el uso de los anticonceptivos. La mayoría de los hombres que fueron encuestados demostraron actitudes positivas con respecto al aborto y la anticoncepción, pero en la práctica son las mujeres las que asumen la responsabilidad de la planificación familiar.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159708Abstract : Capítulo 1. El problema y su abordaje: introducción ; Antecedentes y ubicación del problema ; Organización de la presentación del trabajo ; Características sociodemográficas de las encuestadas ; Capítulo 2. Fecundidad: fecundidad y escolaridad ; Fecundidad y edad a la primera unión ; Número de hijos de la madre ; Aspectos relativos a la mortalidad de los hijos nacidos vivos ; Capítulo 3. Anticoncepción: condición de uso de anticonceptivos ; El primer método usado por las usuarias actuales ; Usuarias actuales por edad, número de hijos y método ; Ventajas y desventajas del método actual ; Capítulo 4. Aborto inducido: oportunidad del último embarazo ; Opiniones favorables al aborto ; Opiniones favorables por edad ; Capítulo 5. Opiniones con respecto a la práctica reproductiva: lo imaginado y lo real - Número deseado de hijos: comparación entre las situaciones ideales y reales ; Intervalo entre la unión y el primer nacimiento ; Mejor edad para comenzar a tener hijos ; Intervalo entre el primer y el segundo hijo ; Mejor edad para comenzar a tener hijos ; Mejor edad para terminar de tener hijos ; Opiniones sobre la autonomía femenina ; Capítulo 6. Servicios de salud: tipo de cobertura ; Perfil de las mujeres que realizaron consultas ginecológicas u obstétricas ; Prevención de la salud ; Capítulo 7. Conclusiones ; Referencias bibliográficas.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : A World Health Organization report states that contraceptive usage increased by ten times in the past 25 years in developing countries while remaining constant in industrialized countries. Experts explain the increased demand in terms of rapid cultural change, political orientation, or socioeconomic pressure. Whatever the reason, over 500 million persons throughout the world seek effective and safe contraception. Family planning activities in Chile are integrated into the Maternal and Perinatal Program of the National Health Service. The principal objective of family planning education and counseling is to enable women to participate actively in their own health care. Family planning activities were first offered in 1964 as a means of combating abortion and maternal and infant mortality. The proportion of fertile-aged women using contraception increased from 3.0% in 1964 to 23.4% in 1976. It has subsequently fluctuated between 21 and 25%. The official program provided access to contraception for women who previously had no recourse except abortion. The reduction of abortion mortality from 11.7/10,000 live births in 1964 to 1.0/10,000 in 1990 and the decline of maternal mortality in general from 28.3/10,000 live births to 4.0/10,000 demonstrates that the objective of improving maternal health has been met. The fertility decline reduced the number of pregnancies among higher parity women and those over age 35. The decline in infant mortality resulting from the reduction in births most at risk has been estimated at more than 30%.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100897Abstract : The development of the antiprogestin RU-486, and its current use in France and the UK, potential other application, politics in the US, and future are presented. Ru-486, as commonly known by its company code name, rather than its generic name mifepristone, is an analogue of a progestin used in oral contraceptives, with an added chemical group that allows it to link up with the progesterone receptor, but prevents progesterone's effects. It was approved in France in 1988, and has been used for early abortion up to 7 weeks LMP on >80,000 women. French women, after an initial diagnostic appointment, take 3 200 mg tablets of RU-486, then 36-48 hr later return for a Sulprostone (prostaglandin) injection, and are checked up 4-6 weeks later. About 96% abort completely. Some have nausea, vomiting, or pain. Bleeding averages 9 days, and <1% require treatment for bleeding. 2 cardiovascular events and 1 heart attack have been associated with the prostaglandin, now contraindicated in smokers or women >35. In England, RU-486 abortions began in late 1991, for pregnancies up to 9 weeks, using a gentler prostaglandin, Gemeprost, in a vaginal suppository. Only company-trained doctors may order the drug. Research continues on lower doses of RU-486, other prostaglandins, and effects on the fetus if abortion fails. While there is no known basis for a teratogenic effect of the antiprogestin, strong uterine contractions brought on by prostaglandins, such as misoprostol, as abused for illegal abortion in Latin America, may cause birth defects. RU-486 is expected to be useful for inducing labor, dilating the cervix, emergency contraception, pre-surgical management of Cushing's syndrome, brain cancers with profesterone receptors, among other conditions. Several of the 400 or so antiprogestins known are being tested clinically, notably HRP 2000 by WHO. Political controversy is so intense in the US that Roussel, the maker of RU-486, has no intention of marketing it, and even research supplies are unreliable. Meanwhile, pro-choice groups are innovating ways to test and market antiprogestins legally, perhaps inside state lines. It is expected that a suitable prostaglandin, misoprostol, licensed for peptic ulcer, will be available soon, and even RU-486 will become generic by 1998 when its patent expires.
Web site : http://www.guttmacher.org/Abstract : Contenido: 1ra. parte: Fundamentos de ética: Moral fundamental. Nociones preliminares; La moral cristiana. Sus características; El hecho moral. La libertad; La conciencia moral; Ética normativa. La ley; Las fuentes de la moralidad; el pecado y la conversión ; 2a. parte: El aborto; Demografía; Bioética, eutanasia y dignidad de la muerte; Fecundación in vitro con transferencia del embrión ; 3a. parte: Sexualidad; Pornografía; Homosexualidad; Anticonceptivos; Métodos naturales de regulación de la fertilidad
Web site : http://www.gire.org.mx/Abstract : El Código Penal dominicano sanciona de manera total la práctica del aborto. No obstante, como se ha comprobado también en otros países en el mundo, eso no evita que las mujeres aborten, únicamente aumenta las cifras de mortalidad materna. Las mujeres organizadas estamos desarrollando nuestra campaña por la despenalización de la interrupción del embarazo en condiciones especiales.
Web site : http://www.cladem.org/espanol/regionales/CADENAS/repdomi-aborto.aspAbstract : Explica la situación de las mujeres andinas de los sectores populares de Cusco, para motivar cambios frente a inadecuados servicios de salud, relaciones sociales opresivas y mitos discriminatorios sobre la salud femenina
Notes : Español/espagnol/SpanishAbstract : This work...examines the cultural dimension of sexuality and fertility of women from [low-income] sectors in Peru. It intends to explain the cultural processes that fall into the intermediate variables of fertility, such as marriage rate, contraception, breastfeeding and...abortion. These dimensions of sexual and reproductive life are analyzed according to two explanatory dimensions: generation and cultural context of socialization. The general hypothesis is that a cultural process of homogenization of the values and behaviors has been taking place over sexuality, in such a way that the younger generations will show similar standard behaviors and values no matter their context of socialization; in the meantime, in the older groups there will exist contextual differences in these dimensions. (SUMMARY IN ENG) (EXCERPT)
Web site : http://www.colmex.mx/centros/ceddu/revista/datgen.htmAbstract : Abortion rates in Peru have increased in response to economic crisis, lack of availability of contraceptives, and women's lack of power relative to men. Through case studies and systematic empirical analysis, high social and economic costs of abortion are analyzed. Abortion represents a public health problem, which is made worse through legal restriction of abortion. Availability of health care and education about sexuality and reproduction are more effective alternatives.
Notes : Español/espagnol/SpanishAbstract : Cuba ha sido uno de los países en que la fecundidad ha tenido uno de los descensos más pronunciados en las últimas décadas; se caracteriza además este proceso por una homogeneización de sus niveles por grupos sociales, territorios y otros indicadores. Esto ha traído una transición demográfica muy avanzada, en la cual también, como resulta inherente, se presenta un descenso de sus niveles de mortalidad que se manifiesta, entre otros indicadores, en una alta esperanza de vida al nacer y una baja mortalidad infantil. Sin embargo, la fecundidad cubana ha mostrado en los últimos años valores altos en las mujeres más jóvenes, a lo que se une una recurrencia al aborto también alto que, en primer instancia, parecen ser contradictorios 92 con los niveles alcanzados en educación, salud, y la cobertura y gratuidad de los programas de planificación de la familia. En este documento se incluyen cuatro artículos que abarcan desde aspectos generales de la fecundidad y la planificación familiar en Cuba hasta temáticas específicas sobre determinantes próximos, abortos, y la relación de la fecundidad con la vivienda. Estos temas son analizados con relativa amplitud y los avalan informaciones estadísticas recogidas en forma de anexo.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Some current directions of action and research concerning women's reproductive rights in Latin America are examined, with particular emphasis on the institutional context created by the Catholic Church, which has exhibited little flexibility in regard to the processes of reproductive self-determination. In the past 15 years, the concepts of health and reproductive rights have transformed representations and social practices related to reproduction. The work begins by analyzing several terms that preceded health and reproductive rights, attempting to demonstrate how they have helped perpetuate the subordination of women. The terms birth control, family planning, responsible parenthood, and maternal and child health have reflected contemporary social practices, playing a role in establishing reproductive norms and standards of care. The questioning by women's groups of the activities of family planning organizations is examined in this light. The doctrines of the Catholic Church pertaining to reproductive self-determination, and some progressive alternatives to official doctrine from within or outside the Church, are next analyzed. The work of groups of Catholics in Brazil and elsewhere who are struggling to reconcile Church teachings with alternative visions of autonomy and human rights in the reproductive sphere are described. Current research is described on attitudes of Catholic women in different contexts who question the relevance of Church teachings on reproduction, contraception, and abortion to their problems of daily life.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 109878Abstract : Entorno socio sexual. - Significado del matrimonio en el ciclo de vida marital. Martha Patricia Bonilla Muñoz, Alba Hernández Robledo y Patricia Andrade Palos (México). . Homosexualidad en el Istmo Zapoteco. Marinella Miano Borruso (Italia).Entorno pedagógico. Evaluación de conocimientos y actitudes hacia el SIDA y prácticas sexuales en estudiantes de colegios secundarios nacionales de Chiclayo. Víctor Alberto Soto Cáceres y Eduardo Gotuzzo Herencia (Perú). Investigación y educación de la sexualidad en la educación básica. Raúl Calixto Flores (México). Entorno clínico. Generalidades, diagnóstico de la persona transexual y propuestas de trabajo psicoterapéutico desde la guestalt. José Luis Suárez Gallardo (México)Potts, Malcom, 1997. "Sex and the birth rate: human biology, demographic change, and access to fertility-regulation methods", Population and Development Review, volumen 23, Nº 1, págs. 1-39. Exito, en términos evolutivos, significa contribuir a la próxima generación un número mayor de progenie sobreviviente que la de los individuos competidores de la misma especie en la misma población. La concepción humana es un evento probabilístico que ocurre contra un fondo de actos sexuales frecuentes, generalmente infecundos, que facilitan la unión de los padres. En los seres humanos el acto sexual y el nutrir y cuidar de los hijos, cuando éstos llegan, es un impulso innato, pero no existe en ellos una predisposición biológica por un número específico de hijos. En sociedades prealfabetas donde faltan los medios artificiales de regulación de los nacimientos, los embarazos son espaciados varios años por mecanismos fisiológicos inconscientes basados en la lactancia materna. En sociedades prealfabetas, y en las urbanas preindustriales, los individuos con éxito social ordinariamente tenían familias más grandes que el término medio. Una vez que las personas gozan de libre acceso a una gama de opciones de regulación de los nacimientos (incluyendo el aborto seguro), el tamaño de la descendencia decrece en todos los grupos y en todas las sociedades. En tal contexto, se tiende a asociar el éxito social más bien con la acumulación de riquezas materiales que con tener más hijos. Existe por lo tanto una falla en el argumento de que el desarrollo causa un descenso de la fecundidad pues las personas no pueden seleccionar el tamaño de la familia sin tener un acceso real a las tecnologías de regulación de los nacimientos, y tal acceso es históricamente reciente y permanece limitado geográficamente. En los casos en que el acceso a la regulación de los nacimientos es restringido, los más ricos y con mejor educación pueden generalmente superar mejor las barreras entre ellos y las tecnologías necesarias, de ahí la relación comúnmente inversa entre el ingreso y el número de hijos. Se examinan las políticas que se derivan de esta perspectiva.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This chapter on Argentina is part of a comprehensive examination of the laws and policies that affect the reproductive lives of women in nine Latin American and Caribbean countries. Each report begins with a page of statistical information on population, the economy, status of women, and reproductive health and a brief summary of the nation's recent history. The first main section describes the country's legal and political framework, including the structure of national and local governments and national and international sources of laws. The second section examines laws and policies regarding health and population. The objectives of national health policy and the financing, infrastructure, and regulation of health services and patients' rights are analyzed. Population policy, legislation affecting reproductive health, and government- provided family planning services are then examined. Discussions of contraception, abortion, and HIV/AIDS and sexually transmitted diseases examine relevant legislation and prevalence. The third major section assesses the social and juridical status of women as an influence on the exercise of their reproductive rights, including civil rights within marriage, socioeconomic rights, and the right to physical integrity. The characteristics of marital and family relations and their educational level, access to economic resources and legal protection determine women's possibilities of satisfying their reproductive health needs and rights to services. The final major section examines the rights of adolescents in the areas of reproductive health, marriage, sexual crimes against girls and young women, and sex education. Efforts to improve observation of the reproductive and other rights of adolescents are important for self-determination and health of women in general.
Web site : http://www.crlp.org/Abstract : Zulema Yoma, ex-wife of Argentine president Carlos Menem, publicly declared that she had a clandestine abortion in 1969 with her husband's support. Abortion is only permitted in Argentina in case of rape or risk to the woman's life and with a judicial order. Earlier this year, Menem was awarded a medal from the Vatican for his position against abortion, and during his October election campaign he condemned the opposition's support for abortion. Menem refused to comment on Yoma's statement.Source: RedeSaude, Boletim Eletronice Saude Reprodutiva na Imprensa, September 15-30, 1999, e-mail: saudereprodutiva@uol.com.br
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : This article summarizes the results of an evaluation of health services infrastructure and maternal mortality in the La Matanza part of Buenos Aires in 1990. About 50% of maternal mortality was unreported. Clinical diagnosis of causes of deaths were flawed. Many of the low-income women suffered from abortion-related complications. The health system was not prepared to deal with the needs of poor women and did not reach out to women in need. Screening for women at risk was lacking in most health facilities, and referral procedures did not exist for all but one facility. Municipal government did not have a policy on maternal and child health. Recommendations are to establish program goals for maternal health, to abolish barriers to use of prenatal care, to train obstetricians in continuous risk management and in meeting the special needs of poor women, and to establish interdisciplinary teams for reaching poor women in need. Suggestions are to personalize approaches, improve the referral system, and improve primary health care. The study population comprised 9% of the total Buenos Aires provincial population and 3.5% of Argentina's total population. 41.5% of the study population were women 10-54 years old. Service provision had not kept pace with population growth. Demand for obstetric hospital beds exceeded the available supply. Four private hospitals are inadequately equipped for maternal care. The data collection process uncovered 29 female deaths, of which 21 were confirmed as maternal deaths and about 10 were unregistered as maternal deaths. All deaths were to women who lived in the poorer sections. Almost 50% of family members disagreed with the physician-designated cause of death, and about 40% thought that the deaths were preventable. Almost 25% of family members considered pregnancy services "good." 1167 cesarean sections were recorded in 1990, of which 32% were performed in private facilities. 26% of all private sector deliveries (a high figure) were by cesarean section. The ratio of professionals (for example, obstetricians) to maternity patients was 1:2,106 women of childbearing age. 81% of admissions to municipal and private hospitals were related to abortions. 4625 newborns were registered for 7644 deliveries, or under-registration of 39%.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 108417Abstract : The medical aspects of illegal abortion have been amply documented in the Colombian medical literature of the past two decades, and the characteristics of legal abortion as practiced in most of the world have also been reported. The increasing recognition of undesired pregnancy as the origin and precursor of induced abortion, and of the not strictly medical aspects of abortion, have opened a new perspective. This work discusses the aims and nature of medical ethics and formulates a series of questions intended to create interest among obstetricians and gynecologists in analysis of the multiple facets of abortion in contemporary society. Medical ethics is defined as a discipline for developing procedures useful in decision making in difficult medical situations. Medical ethicists take into consideration social, political psychological, and legal aspects, attempting to identify the underlying ethical problems, analyze available options, select from the alternatives, and justify the selection. Ethics recognizes that there is not always an absolute answer to each moral question. Questions important in analyzing the ethical aspects of abortion concern the woman's motivation; the possibility of alternatives; the gestational age; and values regarding sexuality, contraception, undesired pregnancy, and abortion. Why the woman became pregnant against her will and why she rejects the pregnancy must be considered. Gestational age is clearly crucial; at some point abortion becomes untenable.
Web site : http://www.scielo.org.co/scielo.php?script=sci_serial pid=0034-7434 lng=pt nrm=isowww.fecolsog.org/ShowChannel.asp?ChannelId=300Abstract : Abortion appears to be the surgical procedure of greatest antiquity on record. The codes of all the ancient civilizations mentioned abortion, and abortion has been intricately linked to complex religious and moral debates. Bolivian indigenous society prior to the coming of the Spanish condemned abortion and believed that an unpunished abortion would bring vengeance and calamity upon the entire community. The Spanish Conquerors shared the natives' opposition to fertility control, yet a pattern of differential fertility attests to the existence of fertility control practices, especially among the elite. In recent times the desire to control fertility has spread throughout the society. Studies in several Bolivian hospitals have shown that nearly half of maternity beds are occupied by women recuperating from abortion. A 1989 workshop seminar on combating abortion roundly condemned the procedure and concluded that prevention would require improving the level of living of the population and increasing the accessibility of family planning information and services, among other actions. In certain specific circumstances, abortion in Bolivia is not punishable. The mother's consent and the agreement of a panel of physicians (for therapeutic abortions) or a judge (for abortions following rape or other crimes) are required, and the procedure must be performed by a physician. Abortions are produced either by use of abortifacient agents or by direct manipulation. The inexpert and unhygienic circumstances of illegal abortions result in high complication rates.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 104433Abstract : Pregnancy, abortion, delivery, and contraception are aspects of adolescence that are of concern throughout Latin America. In an effort to shed light on medical aspects of adolescent reproductive behavior, the records of 250 previously interviewed adolescent mothers were studied in a maternity hospital in Asuncion, Paraguay. 30% of the mothers experienced menarche before age 13. 31% were age 15 or younger. 73% had been pregnant once; 24%, twice; and 3%, 3 or more times. 16 reported having had 1 abortion, and 2 reported having had 2. 90% obtained prenatal care, 37% in the first trimester and 87% from a physician. 82% reported no problems or illnesses during pregnancy. Among the 46 reporting problems, 10 mentioned hypertension and 9 mentioned bleeding. 20% of the births were preterm. 32% were cesarean, about the same proportion for all women in the hospital, which is a referral center. Mortality and morbidity of adolescents can be similar to those of older mothers if adequate prenatal care and attendance at delivery are provided. Hypertension, nutrition problems, anemia, parasites, urinary and genital tract infections, and threatened prematurity are the most common problems. 14% of all women admitted to the service for abortion are adolescents. Pathologies of delivery are more common in younger adolescents. Feto-pelvic disproportion, prolonged labor, lesions, and postpartum hemorrhage are common. An estimated 5% of adolescents experience postpartum complications. The most common problem among infants born to adolescents is low birth weight, often associated with prematurity. Neonatal jaundice, infection and sepsis, and asphyxia are also more common in adolescents. Adolescents should be provided with postpartum or postabortal contraception to delay the next birth. Care for pregnant adolescents should be integrated and multidisciplinary.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 154248Abstract : El concepto de aborto provocado o inducido tiene su origen en el campo médico, por ello todas las definiciones legales sobre el aborto, contienen una relación con los conceptos médicos. Este estudio analizó la figura delictiva del aborto provocado , desde la perspectiva del aspecto legal. El aborto es visto como un delito cuando es realizado por cualquier medio, mecánico o físico, fuera de las excepciones legales: no existe interrupción ilegítima cuando se trate de salvar la vida de la mujer embarazada, puesto que esta figura pertenece al estado de necesidad que consagra el Código Penal Panameño en Libro II, capítulo III, artículo 144. El Código Penal señala (art. 143) que si como consecuencia del aborto o los medios usados para provocarlo, sobreviene la muerte de la mujer, la sanción será de 5 a 10 años de prisión. Si el procedimiento es realizado con el consentimiento de la mujer (artículo 142 del Código Penal), ésta será sancionada con prisión de 3 a 6 años. Cuando el procedimiento se realice sin el consentimiento o en contra de la voluntad de la mujer, la persona que lo realice será sancionada con prisión de 4 a 8 años y si por dicho procedimiento sobreviene la muerte de la mujer, la sanción ascenderá de 5 a 10 años (artículo 143). El Código Penal vigente señala cuáles son los tipos de aborto permitidos en Panamá (cuando la vida de la madre o del producto de la concepción se encuentren en grave peligro de muerte y en ocasión de que la mujer haya sido víctima de violación carnal o de incesto) y las penas de prisión para los autores, cómplices o participes de este ilícito.
Notes : Español/espagnol/SpanishAbstract : Algunos aspectos metodológicos de la investigación sobre experiencias de aborto inducido / Magdalena León T. ; Metodología para estimar el aborto enducido en Costa Rica / Breda Muñoz ; Incidencia y características del aborto inducido en Sao Paulo / Rebeca de Sousa e Silva ; Metodología usadas para estudar frequência e questoes relativas ao aborto provocado : principais problemas e vantagens / Rosely Gomes Costa, María José Duarte Osis y Ellen Hardy ; Representatividad, confiabilidad y significación : problemas prácticos de la investigación sobre aborto inducido / Lucero Zamudio, Norma Rubiano y Lucy Wartenberg.
Notes : Español/espagnol/SpanishAbstract : Rescata extractos de trabajos presentados en diversos encuentros y seminarios por la autora, en temas de salud y derechos sexuales y reproductivos en Chile.
Notes : Español/espagnol/SpanishAbstract : Sensível ao sofrimento do grande número de mulheres que, com freqüência, enfrenta o dilema do aborto, o padre uruguaio Luiz Pérez Aguirre aponta a legitimidade ética da consciência, como última instância, na hora de tomar decisões. O exercício da liberdade torna-se ainda mais legítimo e necessário em assuntos a respeito dos quais existe dúvida. Para fazer esta afirmação, o autor parte da Sagrada Escritura, da tradição cristã e do Concílio Vaticano II.Com esse texto, Católicas pelo Direito de Decidir quer oferecer elementos éticos de reflexão a mulheres cristãs para que se sintam confortadas em sua fé religiosa no momento de tomar decisões.
Notes : Portugués/portugais/PortugueseAbstract : After reviewing the reasons that stimulated the interest of scholars in adolescent fertility, this article reviews the current knowledge on social aspects that affect differences in adolescent maternity in Latin America. The macrosocial aspects include public policies, and aspects of the immediate social context include the place of residence of the young women, the availability of resources for reproductive health services and contraception, the family structure and the interaction with parents, other adults and the peer group. Individual characteristics are also considered, including age, socioeconomic group, level of education and ethnic groups. Lastly, the effect on adolescents' reproductive behaviour of their perceptions, attitudes and knowledge with regard to reproduction and contraception areanalyzex, and the paper concludes with a brief consideration of the possible reasons for the relatively slow decline in adolescent fertility.
Web site : http://www.eclac.cl/publicaciones/Poblacion/9/LCG2229P/lcg2229-p1.pdfAbstract : La Aspiración Manual Endouterina (AMEU) es una técnica desarrollada para el tratamiento del aborto y sus complicaciones. En la actualidad existen numerosos estudios que demuestran la eficacia y eficiencia del método, en comparación con el Legrado Uterino Instrumental (LUI), así como una sustancial mejora la calidad de la atención y disminución en el uso de recursos. Sin embargo, siguen existiendo todavía barreras, que han impedido su implementación en los hospitales de la región Centroamericana. Se realizó un estudio longitudinal, prospectivo, de intervención deliberada en paralelo de forma aleatoria, en 4 hospitales de la República de Panamá, el cual tomó como universo todas las pacientes que tuvieran un tamaño uterino menor o igual a 12 semanas de gestación, que aceptaran firmar consentimiento informado y pacientes cuyo contenido uterino fueran ubicado en ASA I y ASA II, y que no contravinieran el egreso temprano de la paciente o se diagnostiquen como embarazo molar. Se recolectó una muestra de 641 casos: 291 procedimientos de AMEU, 347 de LUI y 3 procedimientos con ambas técnicas. Estos representaron 9% de los casos que se atiende anualmente en el país. La edad gestacional promedio fue de 9.25 semanas de embarazo, aunque la mayoría se centró entre las 5 y 13 semanas con el 80%. La edad promedio de las pacientes fue de 27 años; entre la totalidad de los casos atendidos, se observó que se presentaron dos tipos de complicaciones: el sangrado abundante y la perforación uterina, las cuales se dieron más en el LUI que en el AMEU. La evolución de la paciente por medio del control de consulta externa, se presentaron sólo en 2 hospitales participantes, y los datos indicaron que las pacientes a las que se les practicó el AMEU tuvieron mayor incidencia de visita que las de LUI. Para evaluar el uso de los recursos, se tomaron en cuenta dos indicadores de eficiencia: estancia hospitalaria y el uso de medicamentos. Se demostró que el AMEU requirió un menor uso de recursos, tanto en el tipo de medicamentos e insumos como en la duración de la estancia hospitalaria del AMEU en contraste con el LUI (0.97 días cama para AMEU / 1.66 días cama para LUI).
Notes : Español/espagnol/SpanishAbstract : Se propone un marco conceptual para la calidad de la atención a mujeres en situación de aborto, cuyo objetivo es organizar los servicios de salud asegurando su atención oportuna y con calidad para reducir la morbilidad y mortalidad materna relacionada con esta causa. Los y las prestadores de servicios de salud suelen encontrarse con mujeres con abortos espontáneos, con embarazos no deseados, con embarazos forzados producto de situaciones de violencia o bien, mujeres con abortos "espontáneos" que son violentadas durante el embarazo. La frecuencia de estos casos, así como las implicaciones que tiene para la salud de las mujeres, es un llamado a fortalecer la atención de sus necesidades y no del aborto en si. Es importante atender tanto los aspectos clínicos, como identificar las circunstancias de las mujeres en situación de aborto para brindarles servicios apropiados. Actualmente, la Aspiración Manual Endouterina (AMEU) es la primera opción para el tratamiento del aborto incompleto recomendada por la Federación Internacional de Ginecología y Obstetricia (FIGO), y avalada por la Organización Mundial de la Salud (OMS). La AMEU es una técnica segura, efectiva, rápida, con menor pérdida de sangre y menos dolorosa que el legrado uterino instrumental. La AMEU se asocia con niveles más bajos de complicaciones, como perforación uterina, sangrado excesivo, infección pélvica y las lesiones cervicales que se presentan con el legrado.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : These are the results of a prospective, multicentric study carried out in five institutional hospitals in Sonora and Sinaloa, using Karmann syringe and cannulae for manual intrauterine aspiration in cases of incomplete abortion, dead and retained ovum, hidatiform mola and endometrial biopsy. Management data in 1046 patients, are described; methodology is shown, and demonstrating that it converts uterine emptying is a simple, efficacious and economical procedure, with a very low risk and it allows these patients management in an ambulatory way. From these results, and as it is demonstrated in the study, institutions may increase their programable resources as to amount of disposable beds, for other type of patients, and the offering of attention by surgeon, anesthetist, nurse and medication, as their hospital stay is minimal, and in most of the cases active anesthetist participation is not required. In the same way, it permits the patient a better relationship with the personal of the institution, and so, a more human care and the possibility of reintegrating the patient to a familiar environment, rapidly, and in good psychical and physical conditions.
Web site : http://scielo-mx.bvs.br/scielo.php?pid=0300-9041 script=sci_serialAbstract : Manual vacuum aspiration (MVA) is a method proposed for uterine evacuation in cases of incomplete abortion, using a syringe of plastic material to produce negative pressure. With this technique, the authors treated 122 cases of different types of abortion at the Instituto Nacional de Perinatologia, and results obtained were compared with those of 126 women treated with standard dilation and curettage (D C). The sociodemographic characteristics of the two groups were similar. Molar pregnancy and blind ova were more frequent in cases treated with MVA. Types of anesthesia used were similar in both groups, with the exception of 10 cases of MVA that received paracervical block. Four surgical complications occurred, one of hemorrhage in each group and two cases of incomplete evacuation in the MVA group. Histopathological examinations using morphometric techniques showed similar proportions of fetal parts, villi, decidua, myometrial cells, and blood clots in both groups. It was concluded that MVA is as effective and safe as D C, that it is easy to perform, and that it is not associated with important complications. It can be used as an advantageous option for the evacuation of a molar pregnancy. (author's)
Web site : http://scielo-mx.bvs.br/scielo.php?pid=0300-9041 script=sci_serialAbstract : Published by the Alan Guttmacher Institute, this report looks at ways of measuring the costs and benefits of sexual and reproductive health interventions. A review of current studies reveals that poor sexual and reproductive health accounts for two-thirds of the healthy life years lost due to illness or death among women of childbearing age in sub-Saharan Africa. Adolescent girls, both married and unmarried, are worst affected. The authors question whether it is appropriate to focus solely on benefits to the population as a whole when some groups are at such disproportionate risk. They also argue that current approaches to cost-benefit analysis largely fail to recognise the non-medical benefits of sexual and reproductive health interventions, particularly contraceptive services, and thus undervalue these interventions. The authors present a comprehensive framework for measuring costs and benefits - including those benefits that are hard to measure - which can be used by researchers and policymakers. They then demonstrate the partial application of the framework to contraceptive services and supplies. Other recommendations include assessments of key population groups to guide priority-setting and address inequity, and assessment of the relative benefits of sexual and reproductive health interventions compared with other health interventions for poor women. The authors call for more research into these areas alongside increased standardisation of methodologies for cost-benefit studies.
Web site : http://www.guttmacher.org/pubs/2004/12/20/or11.pdfAbstract : El folleto está dirigido a las parteras, contiene información básica sobre el aborto, las formas clínicas y características en que se puede presentar, qué hacer y qué no hacer ante la posible pérdida de un embarazo en los primeros cuatro meses
Notes : Español/espagnol/SpanishAbstract : El estado del arte de la perinatología en torno al embarazo de alto riesgo, dirigido a médicos como referencia para la práctica actualizada de la medicina materno fetal
Notes : Español/espagnol/SpanishAbstract : Abortos hospitalizados : entrada y salida de emergencia / Silvia Ramos y Anahí Viladrich ; Algunos resultados de la encuesta sobre opiniones acerca del aborto clandestino realizada por el Instituto Alan Guttmacher en Brasil, Chile, Colombia, México, Perú y Repblica Dominicana / Mónica Weismer ... [et al.] ; Factores condicionantes y costos del aborto / Dina Li y Virgilio Ramos ; El aborto dentro del sistema nacional de salud : su organización en el municipio de la Ciudad de la Habana / María Teresa Martínez Pérez ; Informe preliminar sobre la caracterización de los casos y costos del tratamiento del aborto hospitalizado en Santiago de Chile / Pablo Lavin ... [et al.] ; Costos y utilización de recursos para el tratamiento de complicaciones de aborto en México / Janie Benson ... [et al.].
Notes : Español/espagnol/SpanishAbstract : Suggestions are presented for improving postabortion care in primary level facilities. Three sections describe the evolution of postabortion care in the region, describe the analysis and recommendations of an international technical work group meeting in Nicaragua to discuss postabortion care, and present the discussion guides and other materials used in the meetings as well as policy statements of institutions important in the field.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 171138Abstract : OBJETIVO: Avaliar o funcionamento de serviços públicos de atendimento a mulheres vítimas de violência sexual. MÉTODOS: Estudo de natureza qualitativa realizado em dois serviços públicos de atendimento às mulheres vítimas da violência sexual. Foram realizadas entrevistas com 42 mulheres, sendo 13 que buscaram os serviços e 29 profissionais que trabalhavam nas equipes. A avaliação teve por referência as categorias: acolhimento, acesso, resolutividade e responsabilidade sanitária. RESULTADOS: A análise das entrevistas por categorias revelou haver acolhimento em ambos os serviços, dificuldade de acesso por falta de informação da existência desses serviços, resolutividade de qualidade com equipe multiprofissional. Quanto à responsabilidade sanitária, ela existe nesses serviços especializados, mas é deficiente nos pronto-socorros e unidades básicas de saúde. Muitas mulheres desconhecem os direitos que lhes garantem serviço especializado. Muitas vezes chegam tardiamente aos serviços comprometendo sua eficácia. Há deficiência na referência e contra-referência. CONCLUSÕES: As conclusões permitem ratificar a importância desses serviços de atendimento, a necessidade de sua ampliação descentralizada e a inserção da temática da violência sexual nas graduações dos cursos de saúde.
Notes : Portugués/portugais/PortugueseAbstract : The objectives of the study were: to evaluate the experience of authorities and health services providers in the introduction of new reproductive health technologies; to discover the attitudes and perceptions of authorities and health services providers on abortion as a cause of maternal mortality; to assess the management of information on manual vacuum aspiration (MVA) technology and the disposition toward receiving additional information about it; and to assess the predisposition to accept or reject a pilot program on the use of MVA in the public health services of the country. Among the findings and results are the following: There is consensus that abortion is a public health problem and is one of the principle causes of the high maternal mortality rate in the country. Eighty-nine percent of those interviewed agree with the introduction of MVA in Bolivia. The authorities and health services providers consider the introduction of new technologies in health to be beneficial. There is a willingness among authorities and health service providers to accept a pilot program on the use of MVA in the public health services of the country. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 173305Abstract : 193 internists, pediatricians, gynecologists, and neurologists employed at one of four Mexican National Institutes of Health answered a self-administered questionnaire about their attitudes on induced abortion with normal fetuses and fetuses known to have an abnormality in various degrees. The majority of physicians were male, over age 35 years, religious, and without experience with genetic diseases. 20% of internists and pediatricians approved of abortion when pregnancy is normal. However, only 7% of gynecologists and neurologists were in agreement in such cases. Overall, 60% of the physicians sanctioned the abortion of a malformed fetus, and 80-90% agreed in cases of severe or lethal genetic disease. The physicians did not have consistent answers and agreement for abortion was influenced by religious values.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : During the past decade, there has been considerable discussion in Mexico about abortion, and some progress has been made in improving legislation in line with agreements made at the International Conference on Population and Development held in Cairo in 1994. The attitude of physicians toward abortion is a topic of interest throughout the world. In particular, this is due to the fact that in many places physicians play the role of gatekeeper, controlling women's access to safe abortion services. This article explores the attitudes among medical residents in obstetrics and gynecology in Mexico City regarding abortion. Most residents accept that abortion services should be provided to women who become pregnant as a result of rape; to women for whom pregnancy could be life-threatening; or in case of severe fetal malformation. The majority believed that public health systems should offer abortion services for legal indications. However, few of the medical professionals interviewed said that they would personally provide abortion services. (author's)
Web site : http://www.oxfam.org.uk/what_we_do/issues/gender/gad/Abstract : Está frente a ustedes una mujer, que lucha para que todas las mujeres de Colombia, tengamos derecho a tener el derecho de decidir libremente, de decidir sobre nuestro cuerpo sin que leyes como las que ustedes proponen y firman interfieran y que la iglesia no llene nuestros espíritus de culpas y miedos por decidir lo mejor para nuestra vida, nuestro cuerpo y nuestra salud...
Web site : http://www.despenalizaciondelaborto.org.co/data/documentos/200511011543590.PONENCIA%20ESPERANZA%20RAMIREZ.docAbstract : El trabajo está enmarcado en la investigación "Condena, tolerancia, negación. El aborto en Uruguay", aquí se centra en las mujeres, su decisión de abortar, algunos elementos de la concresió del aborto y del silencio posterior.A partir de entrevistas se definen las principales razones consideradas por las mujeres al tomar sus decisiones de interrumpir su embarazo. En relación a esto se discute el lugar de la autonomía en un marco de relaciones de dominación, donde el cuerpo y la sexualidad de las mujeres parecen ocupar un lugar central, y donde las tradiciones y la doxa asignan roles yprácticas a hombres y mujeres. De modo que tomar la decisión de abortar implica subvertir un cierto orden social. Esta decisión generalmente tomada en soledad es el inicio de un caminotambién transitado en soledad: la concresión del aborto. Las políticas públicas (por ausencia) y las tradiciones culturales se aúnan en la constitución de la situación de vulnerabilidad en que se encuentran las mujeres.Las mujeres callan sus abortos, los callan por múltiples motivos: culpa, censura social, miedo...Este silencio no es permite compartir sus experiencias, unirse en construcciones colectivas, sino que por el contrari, las mantiene aisladas y refuerza la subordinación.
Web site : http://www.ciesas.edu.mx/lerin/doc-pdf/Rostagnol-20.pdfAbstract : Presentación ; Capítulo I: Sexualidad y reproducción en la adolescencia ; Maternidad adolescente: estrategias conyugales, reproductivas y de crianza de los hijos / Graciela Irma Climent; Diana Beatríz Arias; Cecilia Spurio y Maritza Muzillo ; Género y sexualidad adolescente: problemas frente a la reproducción y la prevención del VIH-SIDA / Mabel Bianco; María Inés Re y Laura Pagani ; Encantadas, convencidas o forzadas: iniciación sexual en adolescentes de bajos recursos / Edith Alejandra Pantelides y Rosa Noemí Geldstein ; Anticoncepción, sexualidad y vida: la historia convertida en cuerpos adolescentes / Nestor J. Mendieta ; Capítulo II: Anticoncepción: mujeres, médicos e instituciones ; La diversidad de discursos y prácticas médicas en la salud reproductiva, que se dice, a quién y cómo? / Elsa López y Liliana Findling ; El comportamiento reproductivo de las mujeres pobres urbanas de la ciudad de Bahía Blanca y la posibilidad de apropiarse de la información para el uso de métodos anticonceptivos / Edith Alvarez; Nieves Goicochea; María del Carmen Iribar; Adriana Leiva; Daniela Milano y Alejandra Verdinelli ; Representaciones de la sexualidad femenina y sus influencias en el uso del método anticonceptivo D.I.U en mujeres participantes del Programa de Orientación Sexual y Planificación Familiar del Hospital Materno Provincial de Córdoba / Rosa Filomena del Valle Almada y Elizabeth Andrea Zabala ; Orientación en anticoncepción post-aborto / Margoth Mora Téllez y Martha Stella Castaño ; Capítulo III: El rol de los varones en la reproducción ; Amor y pareja en la responsabilidad de los hombres ante el aborto / Elsa S. Guevara Ruiseñor ; Ser hombre, ser padre: un estudio sobre las representaciones sociales de la paternidad / Ana Lía Kornblit; Mónica Petracci y Ana María Mendez Diz ; EL varón en las relaciones de género: reflexiones para la intervención en sexualidad y reproducción / Alejandro Marcelo Villa ; Capítulo IV: Sexualidad ; Peripecias del placer en el embarazo y el puerperio / Virginia Martínez Verdier ; Modelos eróticos / Graciela Sikos ; Estudio etnográficos rápido de la cultura sexual local y la situación de SIDA en Chiclayo, Cusco e Iquitos (Perú)/ Carlos F. Cáceres; Carmen Yon; Ana María Rosasco y Carlos Cabezudo ; Capítulo V: Limitaciones y avances en los métodos de investigación ; Población, pobreza y salud reproductiva: propuesta para una herramienta de apoyo para la planificación en salud reproductiva / Mariska Meurs ; Dificultades operacionais no desenvolvimento de uma pesquisa qualitativa multicentrica no campo da saúde reprodutiva / Graciana Alves Duarte; Ellen Hardy; María José Duarte Osis; Magalí Possan y Ximena Espejo ; 238 Capítulo VI: Derechos sexuales y reproductivos ; Tras las huellas de un porvenir incierto: del aborto a los derechos sexuales y reproductivos / Teresa Durand y María Alicia Gutiérrez ; Ciudadana del mundo: el ejercicio de los derechos sexuales y reproductivos como parte de la identidad política / Cristina Zurutuza ; Políticas públicas, sexualidad y salud reproductiva / Alejandra López Gómez y Susana Rostagnol ; La anticoncepción de emergencia, un aporte para los derechos sexuales y reproductivos de las mujeres / Zulema Palma ; Capítulo VII: Representaciones y realidades del aborto ; Cuando digo aborto... / July Cháneton y Alejandra Oberti ; Me lo quiero sacar: discursos y sentimientos de las mujeres cuando van a abortar / Andrea Diez ; O corpo do aborto, falas e escritas, versoes e metaforas / Danielle Ardaillon ; Acerca de las instituciones organizadoras.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : El libro es el informe de una consultoría realizada en el contexto del "Programa 2002-2004 de los Derechos Sexuales y Reproductivos" de DAWN (Development Alternatives for Women for a New Era), con el propósito de contribuir a la definición y desarrollo de una agenda de investigación sobre reformas de salud y mortalidad materna (con énfasis en la problemática del aborto) en Bolivia. El documento incorpora la revisión cualitativa y cuantitativa de información demográfica; análisis de las políticas públicas relacionadas con la mortalidad materna y el aborto; análisis de actores; e identificación de preguntas, temas clave y tendencias generales. Incluye un acápite específico de conclusiones sobre el aborto. Hace notar que Bolivia pasó de euna política conservadora en Salud Sexual y Reproductiva a una de las más avanzadas en el continente después de la Conferencia de El Cairo, para retornar a un período de estancamiento y tibieza respecto a los Derechos Sexuales y Reproductivos.
Notes : Español/espagnol/SpanishAbstract : En Amerique centrale, l'avortement et la contraception ne sont pas seulement une tragedie dans la vie de nombreuses femmes, c'est aussi une question qui embarrasse partis revolutionnaires et chretiens progressistes
Notes : Francés/français/FrenchAbstract : This paper reports findings from a two-year study of reasons for unwanted fertility and barriers to use of family planning services in La Paz and El Alto, Bolivia. Thirty Aymara market women and eight men were interviewed, survey responses taken from 800 market women, and client perspective descriptions provided of women's experiences in family planning service facilities. The study found that, contrary to common belief, cultural norms among urban Aymara support fertility regulation. Women who do not avoid getting pregnant may be routinely criticized for having too few children, having children too early, or having too many children. Prevailing social and cultural norms can, however, also make fertility regulation difficult to achieve. Barriers to family planning include norms discouraging the discussion of sexual matters and contraception with other family members, friends, or health care providers; widespread stories and rumors about the harmful effects of modern family planning methods; deeply ingrained fear and suspicion of modern medicine and medical practitioners; and taboos against medically induced abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 096704Abstract : Colombia in recent decades has been exposed first-hand to a broad spectrum of important medical advances ranging from organ transplants to techniques for assisting human reproduction. It has also confronted an array of modern problems ; including the abortion issue and the AIDS epidemic. Many of these matters have bioethical implications. This article describes the more important measures that have been and are being taken in Colombia to deal with those implications.
Web site : http://publications.paho.org/english/moreinfo.cfm?Product_ID=557Abstract : Se presentan los estudios que se analizaron en la Conferencia Desarmando la crítica del Cairo. Cinco años después en Cocoyoc, Méx. en 1998, se le da seguimiento a la gestoría y defensa que garanticen la salud y los derechos sexuales y reproductivos en el contexto de los derechos humanos y el desarrollo sostenible
Notes : Español/espagnol/SpanishAbstract : Over half of couples in developing countries lack access to family planning services and are at risk of unwanted pregnancy, illegal abortion, and maternal mortality. Improvement of the reproductive health and quality of life of couples are considered the main goals of family planning. Barriers hampering access to family planning may be of many kinds. Among the most frequent medical barriers are prohibition of oral contraceptives (OCs) to women over 35, limitation of progestin-only OCs to breast feeding women, delaying initiation of use by waiting for a menstrual period or a prolonged postpartum interval, and requiring unnecessary laboratory tests or an excessive number of visits. Extensive application procedures for sterilization, exaggerated contraindications in establishing age or parity limits for specific methods, and excessive requirements for family planning personnel, such as restricting prescription of OCs or insertion of IUDs to physicians, constitute other barriers. Many medical barriers to family planning originate in a lack of adequate information among program officials and failure to recognize outdated or erroneous information, such as the belief that OCs increase risks of gynecological cancers. Peruvian family planning legislation regards abortion and sterilization as similar when in fact they are not. Among steps to reduce barriers to family planning should be improved provision of information to health workers and the general population, increasing the variety of methods available, improving access to family planning, revising standards and norms of care as necessary, and improving the quality of services.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 110518Abstract : Despite strong opposition from the Catholic Church and after more than a year of debate, the Argentine Senate passed a law granting women free access to contraceptives and establishing campaigns to prevent teenage pregnancy, abortion, sexually transmitted diseases, and breast and genital cancer. The lower house of Congress approved the law in April 2001. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 173463Abstract : In Mexico, induced abortion is legal when there is: danger to the pregnant woman's life; the possibility of congenital defects; or pregnancy resulting from rape. Seven states allow abortion when pregnancy would jeopardize a woman's health, and one state allows abortion in cases of economic hardship. Despite the country's family planning policy, abortion rates are high and increasing. This study attempts to identify factors that contribute to the decision by women, particularly poor women, to undergo abortion under unsafe, dangerous conditions. The study also explores the perceptions, attitudes, and knowledge of health care providers, particularly hospital staff, of the motivations of abortion seekers. Structured interviews were carried out with 300 women admitted in the Hospital de la Mujer for abortion complications between August 15, 1990, and January 15, 1991, and with 142 hospital staff. For all the women interviewed, economic circumstances were a factor in the Decision making process. Male attitudes; unstable relationships; youthful age; and inaccessibility and unavailability of contraceptive methods all contributed to the decision to abort. Regarding the quality of health care for abortion complications, the women could have received better care if the health providers were more compassionate and well-trained and the facilities had appropriate equipment. Many of the hospital staff were fully aware of the need for safe abortion services, however, none of these providers agreed to perform an abortion. To prevent induced abortion and its consequences, it requires not only a modification of the many aspects of the maternal health care system but also an understanding of the complex cultural values that support its existence.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : Reporte sobre la visión sobre los programas y las políticas de salud reproductiva implementadas en los países de Asia y América Latina. Evaluación exhaustiva sobre la calidad en la atención de los servicios de salud reproductiva de acuerdo las normas adoptadas por los organismos internacionales de salud en Bolivia, Brasil, Africa del Sur, Vietnam y Zambia
Web site : http://www.who.int/reproductive-health/pages_resources/listing_programme_reports.htmAbstract : South to South Cooperation in Reproductive Health, founded in 1987, promotes cooperative research projects and extends mutual assistance among developing country researchers. Its research program consists of a series of international, multicenter clinical research projects in both male and female contraceptive development and in products that can help women protect themselves from sexually transmitted diseases, including HIV/AIDS. During 1993-1995, its activities revolved around products in the advanced stage of development: contraceptive implants, the vaginal contraceptive pill, male contraception, vaginal microbicides/spermicides and anti-HIV products, induced abortion, emergency contraception, and contraceptive vaccines. This cooperative program has pioneered research activities designed to find a way (e.g., use of a daily pill) to reduce or eliminate HIV from the semen of infected men. Broader women's health issues the program is examining include chemical treatment of fibroids and of endometriosis and hormone replacement therapy during menopause. It is evaluating a new method of screening for cervical cancer that would make it more accessible to women in developing countries. Annual scientific meetings of South to South act as a training function and as a means to conduct a critical appraisal of ongoing clinical or probing studies. South to South collaborates with cooperating agencies through participation and co-sponsorship of workshops and international conferences. It collaborates with industry to develop products relevant to reproductive health needs.
Notes : Inglés/anglais/EnglishAbstract : The National Congress in Brazil is currently considering 9 abortion bills, 2 of which were introduced by women. In this interview, the women senators ; Jandira Feghall of the Communist Party and Eva Blay of the Social Democrat Party ; discuss the likely outcome of the abortion debate. Although the Roman Catholic Church has announced its intentions to oppose any liberalization of the abortion law, there are divisions within the Church as evidenced by the existence of groups such as Catholics for a Free Choice. Both senators agree that decriminalization of abortion will depend upon the societal response and an effort must be made to reach the many people who are confused and undecided about the issue. Although the present debate fits within the broader current debate on population policies, it has been the insistence of the feminist movement that put abortion reform on the agenda. Blay's bill calls for the legalization of abortion on demand until the 12th week of pregnancy and in cases of rape or risk to the woman's life after that point. A controversial aspect of Feghall's bill is the inclusion of maternal human immunodeficiency virus (HIV) infection as a condition for abortion. Feghall notes that this is an option rather than a requirement, but she will eliminate this condition if it engenders discrimination against HIV-infected women.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 096763Abstract : I. Autonomy and the right to make decisions : 1. Autonomy and culture: the case of Latin America ; 2. Abortion and contraception in Mexico: the attitudes and the Arguments of the Catholic church ; 3. Women´s reproductive rights and public policy in Argentina ; II. Justice and the right to health care : 5. Some philosophical consideration on Mexico´s education, health, and food program ; 6. Moral person and the right to health care ; III. Experimentation on human subjects : 7. Research in developing countries: the ethical issues ; 8. Bioethics and research in Brazil : IV. Ethical issues in the procurement and allocation of organs ; 9. What is (exactly) wrong with selling your body parts? ; 10. Interdisciplinaryethics committees for determining criteria of organ distribution
Notes : Inglés/anglais/EnglishAbstract : A number of bioethical issues have been the subjects of recent discussion and concern in Latin America. Access to assisted reproduction, assisted fertilization with spouse's sperm or with donor sperm, consent from recipients and donors, the confidentiality of and access to records, status of the human embryo, fertilization of eggs and the transfer of embryos, the disposition of gametes and embryos, surrogate motherhood, and cryopreservation of sperm, eggs, and embryos are considered for Argentina. General issues with regard to new reproductive technologies and practices are discussed for Brazil, Mexico, and Venezuela. Abortion in Argentina is considered, followed by sections on maternal-fetal conflicts in Honduras, Mexico, and Brazil; the care of severely disabled newborns in Argentina, Colombia, Paraguay, the Dominican Republic, and Ecuador; consent to treatment and experimentation in Honduras, Uruguay, Argentina, Brazil, and Costa Rica; confidentiality in Argentina and Colombia; equitable access to health care in Argentina, Brazil, Colombia, Cuba, and Peru; ethical concerns raised by cost containment measures in Chile, Guatemala, Mexico, Argentina, Costa Rica, Cuba, and Panama; active Euthanasia in Brazil; the definition of death in Cuba and Honduras; organ donation and transplantation in Argentina, Brazil, Honduras, Mexico, and Paraguay; AIDS and sexually transmitted diseases; and ethics committees and commissions.
Notes : Inglés/anglais/English, nbsp;114302Abstract : Contendio del libro: Introducción ; Lineamientos didácticos para el docente ; Anticoncepción : La relación entre esposos ; Mentiras sobre el crecimiento demográfico ; Verdades sobre la contracepción, la esterilización y el aborto ; Mechanism of action of intrauterine contraceptive devices and its relation to informed consent ; Aborto : Evidencias genéticas del embrión ; Yo realicé el aborto de mi hijo ; Major pshycological sequelea of abortion ; La protección de la vida humana ; Procreación artificial : La inseminación artificial ; ¿Qué es el embrión humano? ; Planificación familiar ; SIDA : el sexo seguro y el preservativo ante el desafío del SIDA
Web site : http://www.gire.org.mx/Abstract : Although abortion has been the most debated of all issues analyzed in bioethics, no moral consensus has been achieved. The problem of abortion exemplifies the difficulty of establishing social dialogue in the face of distinct moral positions, and of creating an independent academic discussion based on writings that are passionately argumentative. The greatest difficulty posed by the abortion literature is to identify consistent philosophical and scientific arguments amid the rhetorical manipulation. A few illustrative texts were selected to characterize the contemporary debate. The terms used to describe abortion are full of moral meaning and must be analyzed for their underlying assumptions. Of the four main types of abortion, only 'eugenic abortion', as exemplified by the Nazis, does not consider the wishes of the woman or couple ; a fundamental difference for most bioethicists. The terms 'selective abortion' and 'therapeutic abortion' are often confused, and selective abortion is often called eugenic abortion by opponents. The terms used to describe abortion practitioners, abortion opponents, and the 'product' are also of interest in determining the style of the article. The video entitled "The Silent Scream" was a classic example of violent and seductive rhetoric. Its type of discourse, freely mixing scientific arguments and moral beliefs, hinders analysis. Within writings about abortion three extreme positions may be identified: heteronomy (the belief that life is a gift that does not belong to one) versus reproductive autonomy; sanctity of life versus tangibility of life; and abortion as a crime versus abortion as morally neutral. Most individuals show an inconsistent array of beliefs, and few groups or individuals identify with the extreme positions. The principal argument of proponents of legalization is respect for the reproductive autonomy of the woman or couple based on the principle of individual liberty, while heteronomy is the main principle of opponents. Opponents have taken an active approach in decomposing their beliefs into different strands to be argued. Their assertions that the fetus is a person from conception or a person in potential have forced proponents of legalized abortion to argue in a largely reactive mode.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 135474Abstract : La Regional Río de Janeiro de la Rede Nacional Feminista de Saúde e Direitos Reprodutivos de Brasil, realizó el 9 de junio de 2000 el seminario "Bioética: Vida e Morte Femininas". Este libro reúne las temáticas abordadas en dicho seminario, como por ejemplo, mortalidad materna, aborto, modelos y prácticas de atención de salud, reproducción asistida, clonación y biotecnologías.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : After forced sterilizations under Fujimori, Peruvian women now face coercive Toledo programs to increase the birth rate. Such extremes are dangerous for women, who deserve control over their health and reproductive destiny. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 182391Abstract : In October 1990, the state of Chiapas, Mexico, enacted legislation allowing abortions to be performed in the first three months of pregnancy under the following circumstances: a) when couples agree on abortion as a family planning measure; and b) when a woman is unmarried. The abortion law of Chiapas already allowed abortions to be performed in cases of rape, genetic defect, and risk to the pregnant woman's life. On 31 December 1991, the legislature suspended this legislation and referred the issue to Mexico's newly established Human Rights Commission.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 086782Abstract : The bleeding patterns following early mifepristone-misoprostol abortion were compared with those following early surgical abortions (56 or fewer days gestation). Researchers analyzed women's reports of their bleeding and clinical measures of blood loss, and modeled the relationships between different bleeding measures and indicators of success and satisfaction. Using data from a multicenter trial held in China, Cuba, and India, bivariate and multivariate models were fit to analyze bleeding patterns, controlling for a range of demographic, experiential, and medical factors. Results showed that medical abortion patients perceived their bleeding to be heavier than surgical patients; however, there were few statistically significant differences in clinical measures of blood loss between the two groups, and blood loss rarely represented a medical problem. Nationality influenced women's impressions about blood loss. Although medical abortion patients saw their bleeding as heavier than surgical patients, their perceptions of heavier bleeding did not prevent them from having higher satisfaction levels. Pain and cramps were independently significant factors in predicting satisfaction with the method. This study concludes that women must be informed beforehand about the normal level of bleeding that generally accompanies the procedure as opposed to excessive bleeding that would signal a clinical problem.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : Este informe constituye un resumen del libro publicado en idioma original español por: Cabal, Luisa; Lemaitre, Julieta y Roa, Mónica (eds.) (2001) Cuerpo y Derecho: legislación y jurisprudencia en América Latina, Bogotá, Ed. Temis
Web site : http://www.crlp.org/pdf/bo_bodiesontrial_part1.pdfAbstract : Grupo de Información en Reproducción Elegida, GIRE (Mexico)"El debate ya estaba en el aire" (Debate Was Already Open, no. 18, September 1998) is dedicated entirely to the decriminalization of abortion, reporting on abortion's legal situation in the world to date and the legal reforms which have taken place between 1985 and 1997. Specifically, this publication discusses the recent debate on abortion in Mexico, where close to one million clandestine abortions are performed each year resulting in roughly 1,000 maternal deaths.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : This chapter on Bolivia is part of a comprehensive examination of the laws and policies that affect the reproductive lives of women in nine Latin American and Caribbean countries. Each report begins with a page of statistical information on population, the economy, status of women, and reproductive health and a brief summary of the nation's recent history. The first main section describes the country's legal and political framework, including the structure of national and local governments and national and international sources of laws. The second section examines laws and policies regarding health and population. The objectives of national health policy and the financing, infrastructure, and regulation of health services and patients' rights are analyzed. Population policy, legislation affecting reproductive health, and government- provided family planning services are then examined. Discussions of contraception, abortion, and HIV/AIDS and sexually transmitted diseases examine relevant legislation and prevalence. The third major section assesses the social and juridical status of women as an influence on the exercise of their reproductive rights, including civil rights within marriage, socioeconomic rights, and the right to physical integrity. The characteristics of marital and family relations and their educational level, access to economic resources and legal protection determine women's possibilities of satisfying their reproductive health needs and rights to services. The final major section examines the rights of adolescents in the areas of reproductive health, marriage, sexual crimes against girls and young women, and sex education. Efforts to improve observation of the reproductive and other rights of adolescents are important for self-determination and health of women in general.
Web site : http://www.crlp.org/Abstract : A program officer from The Johns Hopkins University Population Communication Services, Center for Communication Programs visited Bolivia in January 1994 to provide technical assistance to the pretesting of the National Reproductive Health Program mass media campaign. The campaign will include health messages on family planning, breast feeding, prenatal care, delivery, and abortion which will be disseminated on radio and television. Because Bolivia's Secretary of Health categorized unsafe abortion as the main cause of maternal mortality and a major factor in the creation of orphans, special discussions took place on the content of the abortion information. The pretest involved 4 television animatics, 5 radio spots, and 1 poster which were sampled by 147 men and women. The pretest revealed a high level of comprehension, approval, and recall; however, some modifications were indicated. The success of the pretest points to the effectiveness of an accurate research-based approach in the development of communication materials for public broadcasting.
Notes : Inglés/anglais/English, nbsp;094470Abstract : This chapter on Brazil is part of a comprehensive examination of the laws and policies that affect the reproductive lives of women in nine Latin American and Caribbean countries. Each report begins with a page of statistical information on population, the economy, status of women, and reproductive health and a brief summary of the nation's recent history. The first main section describes the country's legal and political framework, including the structure of national and local governments and national and international sources of laws. The second section examines laws and policies regarding health and population. The objectives of national health policy and the financing, infrastructure, and regulation of health services and patients' rights are analyzed. Population policy, legislation affecting reproductive health, and government- provided family planning services are then examined. Discussions of contraception, abortion, and HIV/AIDS and sexually transmitted diseases examine relevant legislation and prevalence. The third major section assesses the social and juridical status of women as an influence on the exercise of their reproductive rights, including civil rights within marriage, socioeconomic rights, and the right to physical integrity. The characteristics of marital and family relations and women's educational level, access to economic resources and legal protection determine their possibilities of satisfying their reproductive health needs and rights to services. The final major section examines the rights of adolescents in the areas of reproductive health, marriage, sexual crimes against girls and young women, and sex education. Efforts to improve observation of the reproductive and other rights of adolescents are important for self-determination and health of women in general.
Web site : http://www.crlp.org/Abstract : This article presents some reflections about the feminist alternative press that appeared in the state of Sao Paulo, Brazil, in the second half of the 70's. The press was a space for expression of a special breed of politics that was closely linked to the awakening of women to feminist ideas in the period after the armed struggle against the Brazilian dictatorship. The journals Brasil Mulher and Nos Mulheres portray, in their articles and editorials, the fight for amnesty, for day nurseries, for democratic freedoms - all symbols of opposition against the regime in the era of military dictatorship. In addition they report on specific matters, such as, domestic violence, women's working-conditions, reproductive rights, abortion and sexuality. From the point of view of the popular movement and the women's organizations, the alternative press of women is without any doubt an important source, and still under-explored, for understanding the period considered.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0104-026X2003000100014 lng=en nrm=isoAbstract : Brazil's federal constitution is its supreme law, and there is official separation of Church and state. However, because 88% of the citizens are Roman Catholics, the Brazilian government extends certain privileges in the areas of education, social services, and health care to the Church. The constitution guarantees the right to health and establishes a unified health system to ensure the delivery of health care. The Ministry of Health (MOH) regulates the provision of basic services and provides grants to individual states. Medical care and other social benefits are largely financed through a mandatory social security system established in 1934. Brazil has no explicit population policy and, although the constitution guarantees the provision of family planning (FP) resources, such services are limited and nongovernmental organizations have been important providers of FP services. Sterilization and abortion are generally prohibited, but contraception is legal, although a large unmet need for contraception exists. The lack of a national FP policy has favored the specific delivery of oral contraceptives, which are sold without prescription, and of sterilizations performed during Cesarean sections. Abortion is permitted only to save a mother's life or in cases of rape, but the law appears to be in the process of reform because the constitution does not protect a fetus from conception. While sterilization is considered a form of aggravated assault, it is permitted on restricted grounds, and efforts are underway to liberalize this law. HIV/AIDS is a major cause of death among women (22% of the 45,000 AIDS patients are women) even though it is illegal to expose a person to a sexually transmitted disease (STD) (including HIV). National AIDS prevention strategies center around strengthening STD diagnosis and care and coordinating IEC (information, education, and communication) campaigns targeted to health professionals, the public, high-risk groups, and adolescents. The constitution protects mothers and children and guarantees maternity leave, and the MOH provides safe motherhood services. Family allowances are paid for children up to age 14 years. Rape and other sexual offenses are crimes if perpetrated against "honest" women. Sentences vary according to the age of the victim. Brazil is in the process of developing sex education programs. The few legal rights patients have in Brazil are embodied in the 1988 Medical Code, but enforcement remains to be assessed.
Web site : http://www.crlp.org/Abstract : In Brazil, many women are using the synthetic prostaglandin misoprostol to induce abortion. Since abortion is illegal in Brazil, they take misoprostol without any medical supervision. It was introduced in Brazil in 1986 as a treatment for gastric ulcers. Its brand name is Cytotec. The prescription drug is widely available on the black market, where the price for 4 200-mg tablets begins at US$100. Use of the drug with failure to abort may be linked to birth defects. A geneticist and a neuropediatrician at the Children's Institute of the Sao Paulo Hospital das Clinicas are studying 9 children with congenital or neurological abnormalities. Physicians in other parts of Brazil are following another 30 children with the same circumstances. A physician in Porto Alegre is following 40 women who took misoprostol but did not abort. As of mid 1994, she had found 3 cases of congenital abnormalities. The Brazilian Society for Clinical Genetics is overseeing an epidemiologic study in 10 major maternity hospitals where researchers will examine all neonates and ask all mothers about the possible use of misoprostol. Staff at the genetics outpatient clinics of 6 leading hospitals are about to conduct a related study among mothers. Both of these studies run the risk of low reporting, since mothers may be disinclined to admit to criminal use of misoprostol. Almost 50% of all women who want pregnancy termination in Brazil use misoprostol. The abortion fails in about 33% of these cases. The evidence suggests an 8-10% risk of abnormalities among women who use misoprostol and experience abortion failure. Ministry of Health sources unofficially appreciate that misoprostol use is reducing the number of women hospitalized with infections caused by abortion attempts with sharp instruments, which in turn has reduced maternal mortality.
Web site : http://bmj.comAbstract : It is concluded that, during Brazil's rapid government-induced modernization, fertility declined. The reasons were increased motivation to control fertility and the indirect effects of institutional changes in health and social security. Social changes in institutions were introduced by the military regime in the mid-1960s. Mass media also influenced social behavior. There were high abortion and sterilization rates. These methods were used because of the interplay of attitudes, policies, and changing agendas of key power brokers that limited availability of other effective contraception. Fertility decline is also attributed to rapid urbanization, which catalyzed other factors. The Brazilian government never had fertility control policies or population targets. The population control establishment had an important indirect influence by spreading awareness of the advantages of small family size and by establishing a climate conducive to fertility control. It is posited that Brazilian fertility decline illustrates that "indirect impacts and unintended consequences" in the context of rapid social change can bring about fertility decline. One caveat is that serious negative health consequences are possible when access to a wide variety of contraceptive methods is limited. Less researched areas which affected motivation for birth control are identified as changes in gender relations, marital patterns, intergenerational transfers of resources, labor force participation, household composition, and urbanization. This article reviews the literature on fertility decline as it is related to 1) proximate determinants, 2) key social actors (the government, the Catholic Church, women's groups, the international population lobby and local representatives, and health professionals), 3) modernization and socioeconomic factors, 4) economic pressure, inequalities, and poverty, 5) "proximate structural determinants of fertility," and 6) the urban transition.
Web site : http://www.blackwellpublishing.com/journal.asp?ref=0098-7921Abstract : The Brazilian National Institute for Quality Control in Drugs (INCQS) reported in a study by GPUIM, a working group on misuse of drugs, at the University of Ceara and the University Hospital at Fortaleza, Ceara State, that the drug misoprostol (Cytotec) is being abused as an abortifacient. The drug is a "prescription only" drug, but is available over the counter, as is usual in Brazil. Since abortion if illegal, pregnant women ask pharmacists for advice on inducing abortion or uterine bleeding that may qualify them for hospital admission for emergency curettage. In a survey of 102 pharmacists in Fortaleza, 67% gave advice and 83% recommended misoprostol, usually 800 mcg, 2 tablets orally and 2 vaginally. Some suggest up to 46 tablets. At the maternity unit at the University Hospital in Fortaleza in 1988, there were 20 cases, and in 1990 there were 525 cases, 73% of admissions, of misoprostol used as the inducing agent. Complications such as infection were only 15% of these cases, lower than any other drug used locally to induce abortion. German studies on use of misoprostol as a 1st- trimester abortifacient, however, found that less than 50% of women experienced uterine bleeding and <10% complete abortion. There has been incidence of serious fetal abnormalities reported in women who took misoprostol but did not achieve abortion, among them bone lesions, hydrocephalus, cranial suture abnormalities, and abnormal digits. This situation of illegal abortion and uncontrolled drug marketing is unacceptable for women's and children's health.
Web site : http://www.thelancet.com/Abstract : This essay, the 12th chapter in a book that applies a global perspective to women's movements by considering the challenges faced by local "feminisms," describes the development of the feminist movement in Brazil since the 1970s. The introduction explains the chapter's focus on women's political action as expressions of feminism and provides a list of some general, demographic, and women's status indicators for the country. The chapter then outlines the political and economic context and traces the history of feminist struggles and organizing as well as the relationship between the feminist movement and the women's movement. The next section explores the gains and compromises reached during feminist dealings with the state, including efforts to create an institutional place for women within the state structure, to develop women's health policies, to combat sexual violence against women, and to institute legal reform. The chapter ends by identifying the following challenges faced by Brazilian feminists: articulating theory and practice, feminist action, and academic production in gender studies; ensuring the reproduction of feminist production by institutionalizing women's issues within the academic mainstream; reconciling the multiple arenas of feminist activism; understanding the relationship with the state; affording appropriate primary status to political dialogue within the national movement; determining the influence of international agencies; achieving decriminalization of abortion; and incorporating feminist ideas and values into politics.
Notes : Inglés/anglais/EnglishAbstract : In 1977, after a paper mill in Telemaco Borba, Brazil started a family planning (FP) program for its employees, mean family size fell from 5 to 2.2. The program has since expanded into the community supported by the mill and the city government. In the beginning, the Catholic Church vehemently opposed the program, but now local priests and nuns are allies. Even though Church officials oppose FP methods, some admit that most Catholics make their own reproductive decisions. Local priests and parishioners see daily the effects of rapid urbanization and overpopulation in Brazil and in Latin America. Local priests tend to disagree with the strict mandate of Rome, but they do not publicly support FP. FP programs in Latin America have been able to avoid confrontation with the Church by stressing birth spacing which protects mothers and children. They also have been able to convince local priests of the need for FP by noting that it reduces the number of unwanted pregnancies and thus the need for abortions. The main factors that led to a large fall in the birth rate over the last 30 years in Brazil were economic factors including urbanization. Reduced resistance of local church officials was not a major factor. In Brazil, the FP revolution started at the grass roots level and in the 1970s the government admitted that contraception was a personal right and allowed FP services to become active such as health maintenance organizations. Still it did not have an FP policy until 1984. The new constitution even confirms a woman's rights to FP. The Church still holds some power, however, since the Vatican insisted that the UN Conference on the Environment and Development in Rio de Janeiro not included population issues in its agenda.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 074397Abstract : Desplegado organizado por la ANCIFEM y lo firman diversas personas de asociaciones cercanas a ANCIFEM
Web site : http://www.gire.org.mx/Abstract : Introducción ; El proceso ; El foro de La Haya ; Reuniones del Comité Preparatorio y la Sesión especial de la Asamblea General ; Evaluación del documento de medidas clave ; Preámbulo ; Derechos reproductivos y salud reproductiva ; Prevención y tratamiento de las ETS, incluido el VIH/SIDA ; Anticoncepción de mergencia y métodos anticonceptivos controlados por la mujer ; Aborto ; Derechos reproductivos de la adolescencia ; Igualdad de género, equidad y empoderamiento ; Conclusiones
Web site : http://www.crlp.org/Abstract : HOJAS: 1. The facts ensuring the reproductive rights of adolescents, 2. the facts the world's abortion laws, 3. the facts the world's abortion laws, 4. the facts emergency contraception an important component of women's rights, 5. At home and abroad, 6. the facts female circumcision/female genital mutilation. FOLLETOS 1. Adolescent reproductive rights, 2.abortion laws in the post-Cairo world, 3. emergency contraception, 4. Cairo+5
Web site : http://www.crlp.org/Abstract : Analiza si las instituciones de salud han incluido o podrían incluir el tema de los derechos reproductivos. Para ello se revisan algunas referencias a elementos del marco jurídico e institucional que orientan guían y dictan los criterios de los programas de salud ligados a la reproducción
Notes : Español/espagnol/SpanishAbstract : Abortion is increasingly recognized as a serious public health problem worldwide. Of the 53 million women undergoing abortion each year, an estimated 150,000 die. In Latin America, some four million abortions each year are followed by hospitalization of 800,000 women for treatment of complications. The World Health Organization has estimated that 85% of abortions in Latin America are high risk, and an estimated 24% of maternal deaths in the region are abortion related. Because abortion is illegal, less is known of morbidity, chronic conditions, fertility problems, or other longterm consequences. The strategy of postabortal care is designed to combat mortality and morbidity, especially in countries with strong legal restrictions on abortion. Governments and nongovernmental organizations should assign highest priority to prevention of unwanted pregnancies, provide women with access to quality postabortal care, and offer immediate postabortal family planning information and services. Postabortion care includes emergency treatment of complications, family planning counseling and services, and linkage of emergency treatment and integrated reproductive health care. Current obstacles to provision of high quality postabortion care include the lack of appropriate technology and equipment and trained personnel in most health facilities, geographic inaccessibility for many women, failure to attend women promptly when they finally arrive at emergency services, lack of sensitivity to their emotional distress, and failure to provide family planning services. Seven elements of high quality postabortion services have been identified: 1) respectful and supportive treatment of patients 2) technical capability 3) appropriate technology 4) adequate equipment, supplies, and drugs 5) immediate postabortal family planning and reproductive health services 6) information and counseling on the woman's condition and future obstetric prospects and 7) accessibility of services.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 116882Abstract : The annual Campaign for the Prevention of Maternal Mortality and Morbidity to be held on May 28 will focus upon abortion-related maternal mortality with the goal of mobilizing women to discuss abortion and turn it into an issue of public debate. First, however, people must stop blaming women for abortion. People say women are responsible for abortion because they failed to use contraception, they had sexual intercourse outside of marriage, they were behaving immorally, and/or they violated religious precepts. However, blaming women for abortion simply denies reality. This paper explains what is known and not known about abortion and its related maternal morbidity and mortality, and counters some myths about the criminalization and legalization of abortion, religious prohibition of abortion, who has abortions, whether women will always be traumatized by an abortion, the health risks of induced abortion, and the need for abortion services. The history of the campaign is also described.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Contenido: Incluye la "Carta de Guanabara" a la cual se puede dar seguimiento en el sitio web de la Campaña:
Abstract : presenta un resumen de las actividades que realizó la coordinación regional de la campaña 28 de septiembre en sus actividades de diciembre de 2001 bajo la dirección de Rede Nacional Feminista de Saude E Direitos Reprodutivos (Brasil). Se señalá que la próxima coordinación pasará al Centro de la Mujer Peruana "Flora Tristán" de 2003 a 2005.
Web site : http://www.gire.org.mx/Abstract : Salud reproductiva y mortalidad materna ; Consideraciones ; Nuestra ; salud reproductiva y nuestros derechos ; Mortalidad materna y prevención ; Embarazo nodeseado y planificación familiar ; Sexualidad y educación sexual ; Aborto ; Propuestas ; Mujer y salud ocupacional ; Elementos del trabajo de la mujer que consideramos factores favorecedores del desarrollo de enfermedad ; Enfermedades que hemos tenido y que tienen relación con nuestro trabajo ; Propuestas para mejorar las condiciones de salud de la mujer trabajadora ; Trabajo doméstico ; Derechos reproductivos de la mujer trabajadora.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Medical abortion offers a new option to women seeking to terminate their pregnancies. In particular, the mifepristone-misoprostol regimen consists of simple pills, and is potentially suitable for self-administration. Yet access to and administration of this method of abortion remains tightly controlled. Is this strict control medically necessary? This paper identifies the seven steps women would need to accomplish in order to use mifepristone-misoprostol for abortion without medical supervision: 1) recognise they are pregnant 2) estimate the duration of pregnancy to be sufficiently short 3) select mifepristone-misoprostol as the appropriate regimen; 4) adhere to the correct protocol; 5) manage adverse reactions and seek care for those that warrant medical attention; 6) possibly notice and cope with expulsion of the embryo; and 7) recognise a complete abortion. Data from a large clinical trial of mifepristone-misoprostol medical abortion offer indirect evidence that women maybe able to complete these steps successfully. If so, it is possible that women could use the method safely and effectively with less medical supervision than is currently required in the standard protocols.
Web site : http://www.rhmjournal.org.ukAbstract : The study found that participation in the Epidemiological Research Center in Sexual and Reproductive Health/National Reproductive Health Program (CIESAR/NRHP) training increased the provision of family planning and counseling services among the cases compared with those in Comparison Group 2. These providers also performed more post-abortion care procedures using Manual Vacuum Aspiration (MVA) and trained more of their fellow physicians in MVA. CIESAR training also is associated with a greater use of PIP reference materials and, furthermore, with reported changes in individual and hospital practice for reproductive health services as a result of using PIP publications. One of the most cited changes in practice was better counseling techniques that enabled providers to better assist patients in making an informed choice about family planning. Among those that reported changes in practice, cases were also significantly more likely (p<.01) to recommend PIP reference materials to their colleagues than were those in the comparison groups. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 172801Abstract : Induced abortion is an issue that is debated all over the world, particularly in countries such as Brazil, where it is considered a crime. The decision about abortion frequently involves economic and social factors and the relationship to the partner. For instance, in a survey of 369 employees and students of a university, 72% of those who considered having an abortion did in fact have one. For the purpose of analyzing the association between selected current sociodemographic characteristics and the history of induced abortion, 138 students of a Brazilian university, who had been pregnant at least once and 82 of whom had undergone at least one abortion, were studied in 1990. These students were identified from among the 937 (42% of the total) who returned, by mail, a self-administered, anonymous questionnaire distributed to all the female undergraduates. The subjects were divided into two groups, those who had and those who did not have a history of induced abortion. The regression model utilized dependent variables (induced abortion ; yes, no) and independent variables (age, marital status, religion, number of pregnancies, and number of children). 56.2% of the subjects were in the 18-24 age group; 47.1% were singles and 36.2% were married; 48.6% were Catholics; 64.5% had been pregnant; and 55.8% had no children, while 26.8% had one child. There were significant differences between the two groups. 73% of women who had had an induced abortion were under 24 years of age (p < 0.001); 82% were not living in marital union (p < 0.0001); 78% had no religious affiliation (p < 0.01); and 91% had no children. Analysis by logistic regression showed that not having children was the only factor significantly associated with having had at least one induced abortion.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89101994000100010 lng=en nrm=isoAbstract : The 832 women who accepted Norplant implants at three hospitals in Peru between December 1988 and February 1991 participated in a study of Norplant method acceptability and user characteristics. The women were seen 1, 3, and 6 months after insertion and every 6 months thereafter. They ranged in age from 18 to 40 years and averaged 28. Nearly 78% had completed secondary school or had higher education. The average number of children was 2.1, and 87% had 3 or fewer children. 30.1% of the women had had 1 abortion, 13.0% had had 2, 2.2% had had 3, and 1.1% had had 4 or more. 47.3% of the women had previously used oral contraceptives or IUDs, 13.1% had used rhythm, 11.2% had used condoms or vaginal methods, 4.9% had used injectables, 1.6% had used other methods, and 21.9% had used no method. 47.9% stated they wanted no future pregnancies, 37.4% wanted to wait at least 3 years, and 6.3% were uncertain. Menstrual problems were the major side effect reported. 22 of the 71 removals were motivated by headaches, 18 by menstrual problems and 13 by medical problems. The continuation rate at 12 months was 88.75%. No pregnancies occurred.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 111741Abstract : Preliminary findings are presented of the 1987 Survey of Reproductive Behavior of Adolescents and Youth in the Mexico City Metropolitan Area. 1010 respondents aged 10-25 years were interviewed. 51.7% were male and 48.3% female. The average age was 17.0 years. 14.6% of respondents were married or in consensual union, and 1% had previously been married. 87.2% of the males and 81.4% of the females were single. In the 20-24 age group, 63.4% of males and 57.5% of females were single. The average age at menarche was 12.4 years, and the average age at first ejaculation was 14 years. 41.9% of males, 22.9% of females, and 32.7% overall had had sexual relations. The average age at first intercourse was 16 years for males and 17 for females. 33.8% of sexually active respondents reported having used some contraceptive method at the first intercourse. 7%, including 4% whose partners were prostitutes, stated they did not know if the partner used contraception. 36.5% reported using rhythm, 23.6% withdrawal, and 14.2% oral contraceptives, injectables, or IUDs. The average age at first union was 19.2 years for men and 17.8 years for women. 18.4% of the women and 20.4% of the men's partners had ever been pregnant. 66.1% of the men and 57.3% of the women stated that their first pregnancy was unplanned. The first pregnancy was related to the first marriage for 48.1% of the women and 82.4% of the men. 89.1% of the women's first pregnancies terminated in a live birth and 9.5% in abortion.
Web site : http://www.scielosp.org/scielo.php?script=sci_serial pid=0036-3634 lng=en nrm=isoAbstract : INTRODUCTION: The availability of socioeconomic, demographic and reproductive health data about women at national, regional and municipal levels allows comparisons between regions and may offer background information for planning actions of the Program of Integrated Assistance for Women's Health. METHODS: A population-based cross-sectional study was carried out in Southern Brazil. Three thousand and two women aged 15 to 49 years living in an urban area in Pelotas, were selected for inclusion in the study. A structured questionnaire was used to collect the socioeconomic, demographic and reproductive characteristics. The analysis included comparison of means and proportions. In the sterilization analysis the data were controlled for age. RESULTS: Nearly 56% of the women were married/in union and 35% were single. A third of them were housewives and 50% were wage workers. The mean of schooling was 8.5 years. Almost, half of the adolescents (15 to 19 years old) have an active sexual life, and of those 33% had already been pregnant. A high percentage of unwanted pregnancy was reported, mainly among younger women. Near the end of their reproductive life (women aged 45 to 49 years) the mean of children per woman was 2.4. The most prevalent methods were pill and sterilization. Among married women or those living in consensual union, 15% had been sterilized. The sterilization rate increased with age and attained nearly 25% of women aged over 35 years; 29.6% of sterilized women had had a stillborn child and 18.3% a pre-term baby; 20% of husbands/partners did not accept the use of any contraceptive method. CONCLUSIONS: The study results confirm the need for additional attention to and development of special programs for adolescents, improvements in the access to services, increase in the use of the contraceptive options already available and research and programatic actions related to the theme "men/reproductive health (author's).
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89101999000100009 lng=en nrm=isoAbstract : Sociodemographic, reproductive, and medical characteristics of 620 women admitted to an obstetric hospital in Florianopolis between July 1993 and June 1994 for complications of abortion were studied. Interviews with the women and hospital records were the main sources of data. 141 of the abortions were classified as definitely induced, 313 as probably induced, and 166 as spontaneous. Women with definitely induced abortions tended to be young and unmarried. 54% did not use contraception at the time of conception, 21% used pills, and 6% used condoms. About half of the 141 women reported using misoprostol, alone or in combination with other methods. 6% reported inducing the abortion by inserting foreign objects or by instilling chemical substances. 71 women using misoprostol reported dosages ranging from 400 to 5600 mcg. The clinical characteristics of the women hospitalized for induced abortion suggest that the frequency of severe complications is lower than previously reported. 33 had signs of infection and 18 had serious hemorrhage at admission. 76 were treated with antibiotics. 138 of the 141 women underwent dilatation and curettage. The results refer only to women seeking treatment in a public hospital and cannot be generalized to the total population. It is also probable that some induced abortions were misclassified.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0102-311X1998000200012 lng=en nrm=iso.Abstract : This letter to the Bulletin of the Medical Association of Puerto Rico takes issue with a previously published letter which argued that defining the moment when human life begins is a religious problem that should be debated by theologians and not physicians. The 41 signatories support the contrary view that physicians are the most competent to determine when life begins, and their findings will help theologians, moralists, jurists, and others to make better decisions in their areas of competency. The letter states that from the zygote stage to old age the living being continuously develops. In its earliest stages the human being obtains everything it needs from the mother. The new being is clearly not an organ or appendix of the mother, but the womb is its home for nine months. The writers believe that the position of the Medical Association of Puerto Rico must be that life begins at fertilization. The ethical and legal ramifications should be handled by experts in those fields. The head of the ad hoc committee to study the problem of abortion, replying to the letter, states his satisfaction at having prompted serious debate on the topic. It would be preferable for each person to know the religious, ethical, legal, and medical theory concerning abortion and to arrive at his own conclusions according to his own convictions, beliefs, and philosophy of life
Notes : Español/espagnol/Spanish, nbsp;7857485Abstract : Aspectos específicos sobre la condición de los adolescentes en relación a su sexualidad. Presenta datos sobre la actividad sexual de los jóvenes, sus conceptos y formas de pensar al respecto. Considera que el ámbito familiar es un elemento fundamental para el desarrollo en la identidad de los jóvenes con su sexualidad
Notes : Español/espagnol/SpanishAbstract : This report presents two case studies of program activities to improve women's reproductive health in Bolivia. The two programs are La Casa de la Mujer and the Centro de Información y Desarrollo de la Mujer (CIDEM). Both programs offer integrated approaches to service delivery. La Casa focused on women in reproductive health services and education, while CIDEM developed a new approach to health care practices that used a gender perspective. Women in Bolivia suffer from poor health and from a high maternal mortality rate, of which about 27-35% is due to illegal abortion. The root causes of women's poor health status are a lack of health information, education, and services and limited access to contraceptives. La Casa is unique in provision of multiple and diverse programs, an ability to build solidarity among a variety of women from Santa Cruz, and an emphasis on communication as a means of empowering women. Reproductive health is understood to be a shared experience among all women but unique to each woman, depending upon her culture, class, ethnic position, and life experience. Reproductive health services are integrated with legal and psychological services and other social services. CIDEM's approach emphasizes continued education and growth through the life cycle, respect for differences, an integration of education and health care, and interpersonal relationships. The approach allows women to share in the knowledge, responsibility, and decision making about their own reproductive health. CIDEM is unique in linking medical service to education, human rights, and personal empowerment, and in relying on more equal patient-client relationships. Both programs view women as participants in the design and delivery of health services and view health care as integral to social services and women's empowerment. Both programs use non-hierarchical and non-didactic ways of educating and communicating with women.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 127864Abstract : Catholic's opinions about contraception, abortion, divorce, and a married priesthood are reported. The countries are selected because of their sizeable Catholic population and include the following: Brazil (90%), Chile (80%), Colombia (95%), Czech Republic (70%), France (80%), Hungary (65.5%), Ireland (94%), Italy (90%), Lithuania (80%), Mexico (93%), Philippines (90%), Poland (95%), and Spain (95%). Respondents do not always designate their religious affiliation. An estimated 14% of Africa's total population will be Catholic by the turn of the century, with sizeable proportions in Equatorial Guinea (98%), Cape Verde (92.9%), Burundi (59.9%), Angola (55.6%), Gabon (52.7%), Zaire (50.6%), Rwanda (44%), Uganda (41%), and Congo (29.3%). However, African data are excluded from this study. The results show that modern contraception is used by 45% of reproductive age women in Mexico, 57% in Brazil, and 55% in Colombia. The Catholic position of birth control is to forbid use of modern contraception and voluntary sterilization, and use of condoms even for protection against AIDS. In Brazil 72% of Catholics believe that it is acceptable to use any form of birth control. In Colombia 47% stated use of condoms. In the Czech Republic only 2.3% of Catholic women of reproductive age use periodic abstinence, the only acceptable Catholic form of birth control. 63.6% of Catholics use other contraception. In the Philippines 80% approved of condom use, and 83% approved of condom use for protection against AIDS. 75% approved of voluntary sterilization. Abortion is illegal in many countries in Latin America, but an estimated 4 million abortions occur annually. In Brazil 30.8% of pregnancies end in abortion; abortion terminates 35.3% of pregnancies in Chile, 26.0% in Colombia, 27.9% in the Dominican Republic, 17.1% in Mexico, 30.0% in Peru, and 28.9% in the United States. 40% of Brazilian Catholics believe that couples should decide for themselves about abortion. 52.6% of Chileans believe in no abortion under any circumstances. 71% in Colombia are opposed to abortion, but 49% of women and 45% of men believe it is a woman's decision. In Ireland, 37% of Catholics believe that premarital sex is always wrong and 69% believe that priests should marry.
Web site : http://www.catholicsforchoice.orgAbstract : This account traces the history of Roman Catholicism in America, its adherents, their role in public affairs, debates over topics such as abortion. Annotation. Catholicism has grown from a suppressed and persecuted outsiders' religion in the American colonies to become the nation's single largest denomination. James Fisher surveys more than four centuries of Catholics' involvement in American history, starting his narrative with one of the first Spanish expeditions to Florida, in 1528. He follows the transformation of Catholicism into one of America's most culturally and ethnically diverse religions, including the English Catholics' early settlement in Maryland, the Spanish missions to the Native Americans, the Irish and German poor who came in search of work and farmland, the proliferation of Polish and Italian communities, and the growing influx of Catholics from Latin America. The book discusses Catholic involvement in politics and conflict, from New York's Tammany Hall to the Vietnam War and abortion. Fisher highlights the critical role of women in American Catholicism ; from St. Elizabeth Seton and Dorothy Day to Mother Cabrini, the first American citizen to be canonized a saint ; and describes the influence of prominent American Catholics such as Cardinal John J. O'Connor, 1930s radio personality Father Charles Coughlin, President John F. Kennedy, pacifists Daniel and Philip Berrigan, activist Cesar Chavez, and author Flannery O'Connor.Religion in American Life explores the evolution, character, and dynamics of religion in America from 1500 to the present day. Written by distinguished religious historians, these books weave together the varying stories that compose the religious fabric of the United States, from Puritanism to alternative religious practices. Primary source material coupled with handsome illustrations and lucid text make these books essential in any exploration of Americas diverse nature. Each book includes a chronology, suggestions for further reading, and index.
Notes : Inglés/anglais/EnglishAbstract : What Catholics believe is an important as what Church officials teach. Catholics around the world disagree among themselves and with Church officials on many matters, especially upon issues related to reproduction. Findings are presented from a comprehensive review of collected data which indicate that Catholics and non-Catholics in both northern and southern countries do not agree with the Catholic Church's prohibitions upon contraceptive use and abortion. Catholics were surveyed in Brazil, Colombia, Chile, Mexico, France, Italy, Ireland, Spain, the Czech Republic, Hungary, Lithuania, Poland, and the Philippines. Survey data are unavailable from Africa. With regard to the use of contraception, 72% of Brazilian Catholics believe it is permissible to use some form of birth control, 63.6% of sexually active youths aged 15-19 years in Chile use some form of contraception, 47% of Colombian men report using condoms, 63.6% of Catholics in the Czech Republic use some form of contraception other than periodic abstinence, 52% of all Irish Catholics reject the Church's opposition to contraception, and 80% of people in the Philippines approve of condom use. Considerable support exists among Catholics for a woman's right to abortion.
Notes : Inglés/anglais/EnglishAbstract : Millions of abortions are performed in unhygienic and unsafe conditions each year in Latin America despite the illegal status of the procedure. Catholics for the Right to Choose was founded in 1987 by a group of Catholics and feminists from different Latin American countries who were concerned about the high rate of abortion mortality among adolescents and young women. The organization suggests that alternatives to the norms and doctrines of the Catholic Church regarding procreation and sexuality could be based on principles of justice. Those who provide illegal abortions are not required to meet even minimal sanitary standards and can charge whatever they wish. Catholics for the Right to Choose reaffirms the moral capacity of women and men to make serious and responsible decisions about their own lives. The organization encourages education, research, and dialogue. Abortion is a political as well as a personal problem which relates to population policies and, in poor countries, to population growth, the spread of poverty, and the compromised ability to survive of large population sectors. The private act of abortion embodies a political dimension because the woman choosing abortion assumes responsibility for her own decision and her own body. Abortion is an issue of social justice in Latin America. Pregnancy termination should be viewed as morally valid when the material conditions for support of a child are absent. Religious authorities and the church frequently stress domination and manipulation of behavior rather than spirituality and religiosity, personal growth, and liberation.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 151392Abstract : Presenta los planteamientos que tiene el grupo de Católicas por el Derecho a Decidir en relación con la sexualidad y especialmente al aborto. Plantean que la sexualidad y el placer deben ser tomados como un "don de Dios" y separados del proceso reproductivo y que se debe crear una nueva teología que parta desde la realidad misma, desde la mujer. En relación con el aborto consideran que responde a una necesidad socioeconómica y que la decisión debe estar en manos de la mujer con base en su propia capacidad moral y con una conciencia bien informada
Notes : Español/espagnol/SpanishAbstract : Mujeres que participan en comunidades eclesiales de base, comparten la información con otras mujeres que se integran a los grupos, principalmente en los temas de los que no han recibido apoyo por parte de la iglesia y se viven con un gran sentimiento de culpa, como la sexualidad y el aborto
Web site : http://www.catholicsforchoice.orgAbstract : Contexto: Si bien análisis de datos de dos variables han demostrado que la proporción de embarazos no planeados está en aumento en el Ecuador, los determinantes de los embarazos no deseados y a destiempo aún quedan por ser identificados. Métodos: Se realizó un análisis de regresión logística con variables predictivas de embarazos no planeados (a destiempo y no deseados) mediante el uso de una submuestra de mujeres que fueron entrevistadas en la Encuesta Demográfica y de Salud Materna e Infantil del Ecuador de 1994. La muestra del estudio consistió en 4.534 mujeres cuyo embarazo más reciente había ocurrido entre enero de 1992 y agosto de 1994. Resultados: El análisis con múltiples variables indicó que varias variables explicativas influenciaron significativamente en la probabilidad de que una mujer clasificaría su más reciente embarazo como no deseado u ocurrido a destiempo. Entre las variables que incrementaron independientemente la probabilidad de un embarazo no planeado, se encontraron los factores de residencia en la región de la sierra, residencia en un área metropolitana, el número de nacimientos anteriores y el uso de un método anticonceptivo antes del último embarazo. En forma contraria, las variables que disminuyeron significativamente dicha probabilidad fueron las de vivir en zonas rurales, de vivir en un hogar de ingresos elevados y de dar a luz a una edad relativamente mayor (30-49 años). Conclusiones: Los servicios deben concentrarse en asistir a las mujeres identificadas mediante este análisis como los grupos de mayor riesgo de tener un embarazo no planeado ; las mujeres que presentan una elevada paridad, las residentes en la región de la sierra, y aquellas de las zonas metropolitanas de Quito y Guayaquil.
Web site : http://www.guttmacher.org/pubs/journals/25spa00299.htmlAbstract : The legality of induced abortion varies greatly throughout the world. In Latin America, where most countries except Cuba have highly restrictive policies, it is difficult to judge how many abortions are performed because of the criminal nature of the procedure. For instance, in Brazil in 1987 it was estimated that 1.5 million abortions were performed, although many specialists might give figures substantially higher or lower. In interviews with 1,004 women in Sao Paulo, only 8 admitted to having had an abortion in the past year. However, when the same sample responded to an anonymous questionnaire, 40 reported having had an abortion. A profile is developed of women most likely to have had an abortion. 21 References. Adapted from the source document.
Web site : http://www.cfh.ufsc.br/~refAbstract : Each year, 40,000-50,000 abortions occur in Bolivia, according to a study by the Nongovernmental Workshop on History and Popular Participation. Nearly 150 pregnancies are interrupted each day illegally in hospitals and clinics or in places with precarious sanitary and hygienic conditions. Although the exact role of abortion in maternal mortality and morbidity is unknown, abortion is one of the causes of the estimated 1000 maternal deaths each year. 62% of maternal deaths occur during pregnancy and the rest during or after delivery. The mothers tend to be very young, with an average of 4.8 children and barely 15 months between births. 54% of fertile aged women in Bolivia are at risk of conceiving in conditions posing health risks. Nearly 50% of pregnant women have no prenatal care. Reaffirmation of the right to reproductive health and responsible family planning is urgently needed, as called for in the action platforms of the international forums agreed to by Bolivia.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 151391Abstract : In the vanguard of progressive policies that reflect a women- centered approach have been programs in Brazil and Colombia. In Brazil, the Comprehensive Program for Women's Health Care had, since 1983, provided women's services beyond maternal care, regardless of age and inclusive of occupational and mental health services. The approach centered on provision of knowledge through all stages of the life cycle and on prevention. The alliance was between the Ministry of Health and the women's movement at the national, state, and local level. This program was facilitated by health care reform which moved toward decentralization of health care, the position of feminists within government, and the pressure from women's groups for comprehensive services and a wider choice of contraception. In Asia, women's activism has taken many forms depending on the country of origin and the circumstances. For example, in the Philippines, women's groups have lobbied for access to safe abortion and contraceptive choice and formed an alliance of over 50 networks. About 40% of women's groups in Asia emerged during the 1980s. In Africa, the women's health movement has emerged slowly and focused on specific issues such as genital mutilation. Latin American groups have been highly organized. Women in southern countries have been influenced by northern thinking but have generated their own analyses, organizations, and movements.
Notes : Inglés/anglais/EnglishAbstract : This article presents the results of a participatory exploration of male attitudes towards sexual and reproductive health issues in Nicaragua. Nicaraguan culture views men in a machismo concept. The study examined the knowledge, attitudes and behavior of men in relation to the social construction of masculinity: sexuality, reproduction, and fatherhood. Employing 90 men from both rural and urban communities, attitudes towards sexuality, reproduction, abortion and fatherhood were discussed. Several insights were gathered from the research, which explains men's behavior. Thus, it was deemed imperative that in empowering women by promoting sexual and reproductive health among men would require challenging male hegemony and persuading men to participate in health promotion. However, the setting and application of a men's agenda for sexual health promotion should not result in the curtailment of services for women because funds are being reallocated to men, nor should it give men the opportunity to more subtle forms of domination and exploitation.
Web site : http://www.oxfam.org.uk/what_we_do/issues/gender/gad/Abstract : La population de l'Amérique latine dans la population mondiale ; Un continent peu peuplé ; La transition démographique ; D'une fécondité naturelle a la limitation des naissances ; Politiques de population ; Concentration urbaine et transition demographique ; Conclusion ; Bibliographie ; Glossaire.
Notes : Francés/français/French, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This paper reports developments regarding abortion laws in Ireland, Philippines, and Paraguay. In Ireland, the government published a discussion document on the subject of abortion. In response, many sectors in religion, medicine and the law have expressed their own views on abortion. The Philippine government drafted a bill which proposes a partial decriminalization of abortion. It is hoped that the law can be changed to allow abortion in cases of rape, incest, fetal abnormality, or to save the life of the woman. In Paraguay, on the other hand, a bill on sexual and reproductive health was presented for public discussion. The bill was designed to regulate the exercise of reproductive rights, and to protect and promote responsible parents.
Web site : http://www.rhmjournal.org.ukAbstract : Context: Abortion levels may differ between subgroups of women because of variations in the level of unintended pregnancy and in the likelihood that women will choose abortion if they become pregnant unintentionally. Understanding differentials in levels of abortion according to women's characteristics can shed light on the circumstances surrounding the reasons leading to abortion.Methods: Data from government statistics, nationally representative sample surveys and subnational sources are used to estimate percentage distributions of abortions and abortion rates and ratios by selected characteristics of women, particularly age at abortion, marital status and parity. Comparisons are made within and across countries.Results: Women aged 40 and older generally obtain the lowest proportion of abortions (10% or fewer in most countries). Although adolescents account for a high proportion of abortions in some countries (for example, 33% in Cuba and 22% in Scotland), they do not obtain a disproportionate share of procedures. In general, abortion rates by women's age show an inverted U-shaped pattern. Abortion ratios by age, however, show two patterns: a U shape and a monotonic increase with age. In more than half of the countries studied, married women obtain a larger proportion of abortions than unmarried women. However, once pregnant, unmarried women are more likely than married women to choose abortion. More than half of abortions are obtained by women with at least one child. Some variations exist in these patterns by region.Conclusions: Women's characteristics influence their likelihood of terminating unintended pregnancies. However, within all demographic and socioeconomic subgroups, some women will obtain an abortion when faced with an unintended pregnancy.
Web site : http://www.agi-usa.org/pubs/journals/2506899.htmlAbstract : Serious human rights violations were committed in Chile under General Augustus Pinochet's rule. In 1988, Chile began a transition to democracy. The state now guarantees free and equal access to the protection, promotion, and recuperation of health, as well as the rehabilitation of the individual. It is a state priority to ensure that this guarantee is implemented through either public or private institutions. The authors describe government family planning policy since the 1960s, the current government program, the availability of contraceptives and sterilization, health impacts, the impact of fertility, and program weaknesses regarding the provision of family planning information to women. Public sector primary care clinics provide IUDs, oral contraception, diaphragms, and condoms free of charge. Tubal ligation, even when necessary for medical reasons, is highly regulated, while most doctors refuse to perform vasectomy. Abortion was legalized in the 1930s to save the life of the pregnant woman or to preserve her health. However, the Catholic Church pressured the government to amend the constitution of 1980 to protect the life of the unborn, effectively outlawing abortion except to save the pregnant woman's life. Adolescents, education, and lack of information; abortion law, information, and health impacts; HIV/AIDS and sexually transmitted diseases; the role of the church; and the role of nongovernmental organizations are discussed, followed by recommendations on family planning information, sex education, abortion, sterilization, and HIV/AIDS.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 121876Abstract : In Chile, it is illegal to obtain, provide, or be associated with an abortion under any circumstance. Findings are presented of an analysis of court cases during 1983-84 and 1990-91 against women who had abortions, people who provided an abortion, and people prosecuted as accomplices to abortion in Santiago, Valparaiso, Arica, and Temuco. Overall, 90% of all people prosecuted were female. 159 of the 221 people involved in the cases studied were women who had had an abortion, of whom only 38% had legal representation and 57% spent time in jail before their trial. 8% were younger than age 18 years, 61% were 18-29 years old, and 26% were 30-41. 43% of the women were married or cohabiting, 44% were single, and 5% were either widowed or separated. 61% already had 1 or more children. 80% of all cases were reported to the police or courts by someone affiliated with a public hospital, typically when a woman presented for medical care due to the complications of an unsafe abortion. No case was reported to the police or courts by a private hospital or clinic. 70% of cases against women accused of having an abortion, 62% of those against providers and participants, and 66% of those against accomplices resulted in a suspension decree, usually because the abortion could not be medically confirmed. 16% of women prosecuted for abortion were convicted, of whom 80% and 20% were sentenced to 541 days and 3 years imprisonment, respectively. Most were eligible for alternative punishments and spent no time in jail after their trial. The 40% of providers, participants, and accomplices convicted were usually imprisoned after receiving sentences of 541-1082 days.
Web site : http://www.guttmacher.org/Abstract : Although Colombia is one of the few countries that have not legalized abortion under any circumstances, abortion is very common. No totally reliable statistics are available because of its illegality. It is estimated however that some 300,000 abortions occur each year. 20% of women aged 13-45 are believed to have undergone at least one abortion, and 30% of those have had more than one. Hospital statistics show abortion to be the third most frequent cause of maternal mortality and morbidity. 75% of maternal deaths from infection were due to abortions. 200,000 women are estimated to die each year worldwide from complications of illegal abortion, and 15 women suffer serious medical complications for each one who dies. The deaths, complications, and suffering from illegal abortion are preventable. A recent Profamilia study showed that two-thirds of Colombian women of fertile age wanted no more children. Of the 900,000 births each year, 540,000 are desired at the time, 135,000 occur before the parents would have wished, and 171,000 are frankly unwanted. It is easy to imagine the atmosphere of emotional and affective disadvantage that surround unwanted children, as well as the possible social consequences. The one undeniable fact about abortion is that, despite the sermons of the church and the terrorizing tactics of antiabortion groups, women will continue to seek abortions. Legal and safe abortion must be defended if women are to be able to opt freely for motherhood.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 097335Abstract : The legal status and occurrence of abortion in Puerto Rico are examined for the years from 1937 (when abortion under some conditions was legalized) through 1970. A series of legislative initiatives in 1937 repealed laws prohibiting interstate transportation of contraceptive materials and information, legalized contraceptive sterilization, and permitted abortion to conserve the health or life of the woman. The effective legalization of abortion in 1937 was not publicly recognized at the time or in later decades, and the legal changes apparently did not lead immediately to a significant increase in the number of abortions, unlike sterilizations, which did increase significantly. The requirement that indications for therapeutic abortion be identified by physicians excluded the nurses and midwives who had traditionally been responsible for most births and abortions. Foreign organizations such as the Clergy Consultation Service promoted the legal practice of abortion in Puerto Rico. Efforts in 1964 to amend the penal code to curtail abortion were less successful than the passage by New York in 1970 of the most liberal abortion law in the US, which greatly reduced the number of abortions in Puerto Rico. Puerto Rican women able to pay obtained abortions from trained professionals, despite the perception of abortion as illegal, but poor women had recourse to poorly trained midwives and nurses at best. A training program for midwives during the 1930s provided instruction and equipment necessary for safe deliveries, but the knowledge gained was reflected in safer abortions and declining maternal mortality.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 139259Abstract : The study's aim was to examine contraceptive use and use of induced abortion for preventing unwanted births in Brazil, Colombia, Chile, Peru, Mexico, and the Dominican Republic. Trends in contraceptive use were described and problems identified. The context of abortion use was described in terms of the role within a reproductive life cycle, the primary users, the methods used, and the risks associated with different techniques and different practitioners. Data were obtained from analyses of fertility surveys, an Alan Guttmacher Institute survey of about 200 professionals in the six study countries who were knowledgeable about abortion practices, and official government statistics on abortion complications reported by hospitals. Presently in Latin America, couples desire a small family: 2.7 in Peru, 2.8 in Colombia and Chile, 3,0 in Brazil, and 3.3 in Mexico and the Dominican Republic. In Latin America, family size has declined by 45% from about 6 children per woman in the 1960s. Based on surveys, about 30% of women of reproductive age have never had sexual intercourse or been in a union. Of the remaining 70% who could become pregnant, 34% in Mexico, 44% in Brazil, 36-40% in Colombia, Peru, and the Dominican Republic, and 56% in Chile use family planning. Preferred method varied by country, but was predominately a female method. It was estimated that 19-34% of all women aged 15-44 years in the six countries were inadequately protected: 8 million in Brazil, 6.7 million in Mexico, and 1.9 million in Peru. Incorrect use and distrust of modern methods account for a proportion of unplanned pregnancy. A listing of some of the folk methods generally available and manufactured was given. The medical survey found that women used a broad range of methods for terminating unwanted pregnancies. The vaginal or oral application of a drug called misoprostol or Cytotec was popular in Colombia and the Dominican Republic. In Brazil, this drug is available only by prescription. Many desperate measures are used, and in rural areas most women self-abort or use untrained practitioners, which was considered by medical personnel to be the most responsible for complications. A medically approved abortion cost the lowest in Colombia. Estimated abortions were 2.8 million annually for all six countries, which means an estimated 4 million for Latin America.
Web site : http://www.guttmacher.org/Abstract : Most research on abortion in Latin America has focused on women who are hospitalized with abortion complications, but little is known about the characteristics of women who are able to obtain clandestine procedures performed by trained personnel working in sanitary conditions. Analysis of medical records for 808 clients of an urban clandestine abortion service in South America was supplemented with observation of clinic operations for 6 weeks in 1995. Nearly 9 in 10 clients had at least a secondary education, about three-quarters were younger than 30 and a similar proportion were unmarried. 54% had never given birth, and 13% had had at least 1 prior abortion. Three-fifths of women had not been using a contraceptive method when they conceived; among users, three-fifths had been using a traditional method. 3% experienced mild complications related to the procedure (e.g., heavy bleeding or pelvic pain), and another 2% reported serious complications (e.g., pelvic infection, hemorrhage or suspected uterine perforation). To reduce the need for abortion, it is important for family planning programs to include women who are young, unmarried and highly educated in their outreach efforts. (author's)
Web site : http://www.agi-usa.org/pubs/journals/2703401.pdfAbstract : This report details in-depth interviews with 10 clandestine abortion providers in Latin American cities. The introduction notes that unsafe abortion is thought to cause 24% of maternal deaths in Latin America and is known to strain public health resources. Because most of the abortions occur in women with children, the high mortality rate causes adverse effects in surviving children. Efforts to redress this situation have focused on reducing the number of unwanted pregnancies by providing high quality contraceptive services, improving postabortion health care, and changing the legal prohibition on abortion. The article continues by discussing the factors that led the abortion providers to begin their clandestine work, such as experiencing a sense that they were called to help women in this way, a personal experience with abortion, and a commitment to social change. Next, the article considers the major difficulties this work causes in the personal and professional lives of providers as they deal with a lack of medical support; the need for secrecy; and threats of violence, extortion, and prosecution. Finally, the article reviews what gives the providers satisfaction in their work, such as the feeling that they are saving women's lives and empowering women while meeting a challenge.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 142247Abstract : This paper reports on research carried out in Mexico City in 1995-1996 on the meaning of motherhood, contraception, an unwanted pregnancy or child, and the experience of illegal, clandestine abortion, as described by 12 women of different ages, class, education and marital status who had one or more clandestine abortions. A priest, two doctors from the public health system, a group of gynaecologists and nurses and a health social worker were also interviewed. The data show that it is the illegal and clandestine nature of abortion that has a negative effect on women in Mexico. Although terminating a pregnancy can also be a difficult experience in itself, it became traumatic for most (though not all) of the women interviewed due to the dominant Catholic church doctrine that abortion is a sin, and because of the criminal law punishing those who have abortions, which forces women to have the procedure in high risk conditions, all of which adversely affected their mental and physical health. In spite of this, all the women considered abortion a personal decision that they had to make. Even those who believed that termination of pregnancy was the transgression of a divine commandment also believed that it was a rightful and necessary decision, given their circumstances.
Web site : http://www.rhmjournal.org.ukAbstract : The study's aim was to examine contraceptive use and use of induced abortion for preventing unwanted births in Brazil, Colombia, Chile, Peru, Mexico, and the Dominican Republic. Trends in contraceptive use were described and problems identified. The context of abortion use was described in terms of the role within a reproductive life cycle, the primary users, the methods used, and the risks associated with different techniques and different practitioners. Data were obtained from analyses of fertility surveys, an Alan Guttmacher Institute survey of about 200 professionals in the six study countries who were knowledgeable about abortion practices, and official government statistics on abortion complications reported by hospitals. Presently in Latin America, couples desire a small family: 2.7 in Peru, 2.8 in Colombia and Chile, 3,0 in Brazil, and 3.3 in Mexico and the Dominican Republic. In Latin America, family size has declined by 45% from about 6 children per woman in the 1960s. Based on surveys, about 30% of women of reproductive age have never had sexual intercourse or been in a union. Of the remaining 70% who could become pregnant, 34% in Mexico, 44% in Brazil, 36-40% in Colombia, Peru, and the Dominican Republic, and 56% in Chile use family planning. Preferred method varied by country, but was predominately a female method. It was estimated that 19-34% of all women aged 15-44 years in the six countries were inadequately protected: 8 million in Brazil, 6.7 million in Mexico, and 1.9 million in Peru. Incorrect use and distrust of modern methods account for a proportion of unplanned pregnancy. A listing of some of the folk methods generally available and manufactured was given. The medical survey found that women used a broad range of methods for terminating unwanted pregnancies. The vaginal or oral application of a drug called misoprostol or Cytotec was popular in Colombia and the Dominican Republic. In Brazil, this drug is available only by prescription. Many desperate measures are used, and in rural areas most women self-abort or use untrained practitioners, which was considered by medical personnel to be the most responsible for complications. A medically approved abortion cost the lowest in Colombia. Estimated abortions were 2.8 million annually for all six countries, which means an estimated 4 million for Latin America.
Web site : http://www.guttmacher.org/Abstract : Although twice as many restrictive abortion bills as abortion rights bills have been introduced in state legislatures this year, there are indications that anti-abortion violence has produced a backlash of concern with protecting services, property, and lives at abortion facilities. By the end of the first quarter of 1995, 213 abortion-related bills had been introduced in 43 states. Over half these bills seek to restrict access through mandatory parental consent or notification for minors, longer waiting periods, and public funding prohibitions. Most successful appear to be those concerning parental notification. A quarter seek to preserve access to abortion or impose stiff criminal penalties for anti-abortion protesters who threaten abortion services. The remaining quarter are nonspecific. To date, nonbinding resolutions condemning clinic violence have been adopted in Michigan, New Mexico, and Pennsylvania. The only bill passed prohibits physicians' assistants from performing abortions in Montana.
Notes : Inglés/anglais/English, nbsp;12289004Abstract : Los Estatutos y Reglamentos del Colegio Médico de Bolivia incluyen un Código de Etica Médica. El Artículo 15 del Capítulo II del Código (Deberes del Médico para con los Enfermos) trata de la interrupción del embarazo y establece condiciones de indicación terapéutica, acuerdo de una junta médica, y autorización de la paciente o sus familiares inmediatos.
Notes : Español/espagnol/SpanishAbstract : Several chapters of Peru's revised penal code relating to abortion, family relationships, and sex crimes are presented in this document. Chapter 2 of book 2 regarding abortion establishes sentences for women causing or obtaining abortion, health professionals or others practicing abortion, and individuals who cause unintended abortions through violent actions. Abortions practiced by physicians with the woman's consent to save the life of the mother or avoid grave harm are not punishable. Shorter sentences are specified for abortions in cases of rape outside of marriage reported to the police, or of medically diagnosed probability of grave physical or mental deformity. Chapter 1, title 3, on crimes against the family, establishes sanctions for persons knowingly entering into bigamous marriages or officiating at them. Chapter 2 of title 3, on crimes against civil status, establishes sanctions for persons altering vital records, pretending pregnancy or substituting one child for another to give false filiation or alter or hide filiation. Chapter 3 specifies sanctions for removing a child or inducing a child to leave the parents or other responsible parties. Chapter 4 establishes sanctions for persons not fulfilling their responsibilities of providing food and for men who abandon women they have impregnated. Chapter 9 establishes sentences for rape under different conditions, including rape of a minor. Article 179 of chapter 10 specifies sanctions for persons promoting the prostitution of another person under different conditions or profiting from the exercise of prostitution. Sanctions are also specified for participation in international transport of prostitutes. Article 442 of title 2 in book 3 establishes sanctions of community service or fines for abuse of a spouse in which no lesions occur.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 085265Abstract : This report presents the findings of a project designed to generate experience in the use of Norplant in order to facilitate its introduction in Peru. Carried out by the Cayetano Heredia University with support from the Population Council, the study had the following objectives: 1) assess the clinical performance of Norplant in 3 clinics; 2) compare the acceptability of Norplant to that of other methods; and 3) study the characteristics of Norplant acceptors. clinical activities got underway on November 30, 1988 in 2 public hospitals and a private clinic. During the project's duration, 457 women received the contraceptive implants. Because of labor problems at the public hospitals, the project has not completed follow-ups on clients. Nonetheless, an assessment of the project reveals a remarkable performance on the part of Norplant: at the time of this publication, no pregnancies had occurred and only 32 removals had taken place (headache and bleeding irregularities were the most commonly cited reasons for removal). As previously reported in other studies, Norplant acceptors were predominantly young women (under 30 years of age) and highly educated. Most of these acceptors had 1 or 2 children (few had more than 3) and had previously used other modern contraceptive methods. Furthermore, the majority (54%) of the acceptors did not plan to have any additional pregnancies, and 1/2 of the acceptors had undergone at least 1 abortion. encouraged by the results of the project, the Cayetano Heredia University has developed plans to disseminate its findings and provide training on the insertion and removal of Norplant.
Notes : Inglés/anglais/English, nbsp;071198Abstract : This chapter on Colombia is part of a comprehensive examination of the laws and policies that affect the reproductive lives of women in nine Latin American and Caribbean countries. Each report begins with a page of statistical information on population, the economy, status of women, and reproductive health and a brief summary of the nation's recent history. The first main section describes the country's legal and political framework, including the structure of national and local governments and national and international sources of laws. The second section examines laws and policies regarding health and population. The objectives of national health policy and the financing, infrastructure, and regulation of health services and patients' rights are analyzed. Population policy, legislation affecting reproductive health, and government- provided family planning services are then examined. Discussions of contraception, abortion, and HIV/AIDS and sexually transmitted diseases examine relevant legislation and prevalence. The third major section assesses the social and juridical status of women as an influence on the exercise of their reproductive rights, including civil rights within marriage, socioeconomic rights, and the right to physical integrity. The characteristics of marital and family relations and women's educational level, access to economic resources and legal protection determine their possibilities of satisfying their reproductive health needs and rights to services. The final major section examines the rights of adolescents in the areas of reproductive health, marriage, sexual crimes against girls and young women, and sex education. Efforts to improve observation of the reproductive and other rights of adolescents are important for self-determination and health of women in general.
Web site : http://www.crlp.org/Abstract : The Grupo por la Despenalizacion del Aborto en Colombia (Group for the Decriminalization of Abortion in Colombia) and the Cali branch of the Red Colombiana de Mujeres por los Derechos Sexuales y Reproductivos (Colombian Network of Women for Sexual and Reproductive and Sexual Rights) are leading other women's organizations in a national and international campaign to reform the current Penal Code. Their goal is the decriminalization of abortion in cases of rape, risk to the mother's life, fetal malformation and unfavorable psychological or socioeconomic factors. This campaign for free choice emphasizes that Colombia is one of four countries in the world where abortion is totally prohibited, despite the government's international commitments to protect women's health and rights.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : In a 6-3 decision issued on January 23, the Constitutional Court of Colombia upheld a ban on all abortions. A challenge had been brought seeking to make abortion in cases of rape or unwanted artificial insemination punishable as homicide. Ruling that life begins at conception, the tribunal held that a fetus has rights that preclude abortion but decided against classifying abortion as homicide. A dissenting opinion found that abortion should be legal under the circumstances considered in the case ; forcing a woman to raise a child conceived against her will, the judges held, violated her right to a dignified life. It has been estimated that despite the ban, 300,000 to 450,000 abortions take place in Colombia each year.
Web site : http://www.crlp.org/rfn_1997.htmlAbstract : The family planning programs of the 1950s and 1960s were vertical and stressed contraception, while in the 1970s a natural association was created with maternal-child health care. The accords of the Cairo conference on population incorporated socioeconomic development, the right of health, and reproductive and sexual health rights. Actions in the health sector deal with family planning (with a focus on men and adolescents); maternal health (from menarche to menopause, with a focus on adolescence); abortion (the high rate of induced abortion makes imperative prevention efforts in education, counseling, and increasing contraceptive use rates); reproductive tract infections (of concern are the increasing numbers of sexually transmitted disease and HIV cases, as well as the culture of silence among the poorest that permits pelvic pain, leukorrhea, and dyspareunia to be considered the normal and untreated afflictions of womanhood); and infertility (with its relationship to sexually transmitted diseases and tuberculosis).
Notes : Español/espagnol/Spanish, nbsp;115700Abstract : This discussion of the special police stations serving women in Rio de Janeiro begins by providing background on women's rights as human rights, the international feminist movement, and the definition and prevalence of gender violence. The women's police stations, which investigate and judge crimes against women, are then placed in the historical context of Brazil's overthrow of dictatorship and renewed attention to the rights of citizens, including women. Several influential court cases involving murders of women by their husbands or fiancés are then discussed. Duties of the special police stations serving women are listed and their definitions and sanctions in the penal code are examined and commented upon. The women's police stations are responsible for investigating the crime of abortion by a third party, bodily injury, abandonment of a disabled person, mistreatment, crimes against individual liberty, threats, kidnapping, crimes against decency, corruption of minors, and rape. The state of Rio de Janeiro opened 6 women's police stations between 1986 and 1997. Data from the police statistical services are presented to provide an idea of the magnitude and type of crimes against women that occur in the state of Rio de Janeiro. In 1996, for example, 6264 cases of grave bodily injury, 228 of rape, 2211 of threats, and 418 of other crimes were reported to the women's police services. A series of appendices provide further detail on the aggressors and victims involved in cases handled by the women's police stations.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 158726Abstract : Women in Brazil induce abortion despite legislation in the country forbidding such practice except to save the mother's life and in cases of rape. Misoprostol, a synthetic analogue of prostaglandin E1, was introduced in Brazil in 1986, under license for treatment of gastric and duodenal ulcers. Misoprostol, however, stimulates uterine activity and when used either alone or together with mifepristone (RU-486) or methotrexate, the drug has shown a variable effectiveness in inducing complete abortion. Bought over the counter in pharmacies, misoprostol has become a popular abortifacient agent among Brazilian women. By 1990, about 70% of women hospitalized with abortion-related diagnoses reported use of the drug. In 1991, the Ministry of Health restricted the sale of misoprostol, even banning its use in some states. The proportion of abortions induced with misoprostol has since decreased, but the drug is still sold on the black market at an inflated price. Research suggests that women have gained experience using the drug over time, and are using lower doses administered more effectively. Several studies show that the rate and severity of complications are significantly less among women who used misoprostol compared with women who underwent invasive abortion methods. Research also suggests that although about half of the women have complete abortion with misoprostol, they seek medical care as soon as they experience vaginal bleeding.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : This article offers research support for the operational policy principle that preventing pregnancies leads to fewer abortions. Findings pertain to a study by the Office of Population of the USAID, a large-scale study in four Latin American countries, a comparative study between Colombia and Mexico, a study in Tanzania, and pilot projects in Turkey and Egypt. USAID reports that use of abortion was closely associated with unmet need for contraception and use of less effective methods of contraception. Abortion rates declined over a 15-20 year period as contraception became the norm. Countries with more effective modern methods of contraception had lower abortion rates than countries with reliance on less effective methods. Family planning programs are becoming effective in countries with historically high rates of abortion, such as Russia and eastern Europe. It is estimated that about 32 million abortions occur yearly in developing countries, and most are unsafe. In Turkey, about 34% of married women who chose abortion had not used contraception, and 45% had relied on withdrawal. 73% of women in Bolivia, Colombia, Peru, and Venezuela who were hospitalized for unsafe abortions had not used contraception. The decline in abortion rates does not occur until contraception is both widely available and consistently used. For short periods there may be increases in both abortion rates and contraceptive use rates as the population strives for a smaller family size. For example, in South Korea, contraceptive use increased from 24% to 77% during 1971-88, while lifetime abortion rates increased to 2.9 in 1978 and declined to 1.9 in 1991. Colombia, Mexico, Chile, and Hungary all experienced declining abortion after widespread availability and increased use of contraception occurred. The reduction in abortions results in greater availability of beds in hospitals and lower maternal mortality.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 12293001Abstract : In Mexico, Mexicanos contra el SIDA, a confederation of 15 nongovernmental organizations (NGOs), was formed in July 1989 in order to present a stronger political presence, strengthen activities, and increase access to international funding. The group works with homosexuals, women, persons who are seropositive for human immunodeficiency virus (HIV), laborers, students, and professionals. From July 27 to December 15, 1989, in collaboration with the Mexican Radio Institution (IMER), 90 radio spots, which were primarily aimed at youngsters, were broadcast. 16 full-length programs were also produced. The result was a huge demand for condoms and information, especially in Mexico City, among young people who attended rock concerts organized in collaboration with IMER. The national acquired immunodeficiency syndrome (AIDS) program, CONASIDA, began public education campaigns again in response to the radio programs, in spite of the anti-abortionists, Provida, who had put a stop to public education on condoms and AIDS prevention in 1988. Mexicanos contra el SIDA threatened legal action when Provida and the National Union of Parents in Families tried to take legal action against the director of CONASIDA, Dr. Jaime Sepulveda Amor. The confederation has now signed a working agreement with CONASIDA, although there is concern regarding CONASIDA's political control of funds and fear the bureaucracy will slow down work. The confederation is seeking more direct contact with international funding agencies.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 106747Abstract : Informe detallado que analiza los problemas de salud en países en desarrollo y las intervenciones que se pueden utilizar para tratar estos problemas. El informe da una idea general de los pasos que se necesitan tomar para poner en práctica los objetivos establecidos en la Conferencia Internacional sobre Población
Web site : http://www.prb.org/Abstract : Cómo convertir una tragedia real en un drama imaginario ; Nacer o no nacer: esa es la cuestión ; La paradoja del tercer incluido ; La ambigüedad esencial del embarazo ; Parto y nacimiento: dos nombres para el mismo suceso ; Doble de cuerpo ; Mortajas y sotanas ; El corsé de la lógica en la política del siglo XX ; La iglesia de hoy repudia sus tradiciones ; Sin alma no hay crimen ; El embrión invasor ; El aborto y la propiedad del semen ; Alma y método ; El asesinato no debe ser directo ; El sexo detrás de la condena ; De la prohibición sexual al derecho individual ; La moral del cadáver de la madre ; Aborto y bautismo ; Mujeres, derechos y estrategias ; Vientres esclavos ; ¿Vida = sobrevivencia? ; Dos344 modos de disolver el aborto terapeútico ; Los riesgos de una estrategia jurídica ; El sexo borradode la reproducción.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Cuestiona la moral conservadora que persiste actualmente en la sociedad mexicana con respecto a la sexualidad humana, se refiere en especial a la jerarquía católica y grupos de derecha política, como es, Acción Nacional y sectores empresariales. Quienes impiden el avance en la prevención de las enfermedades de transmisión sexual al estar en contra del uso del condón, la masturbación y el sexo seguro. Propone una estrategia de la tolerancia como solución posible
Notes : Español/espagnol/SpanishAbstract : CONTEXT: Each year, an estimated 120,000 women in Mexico seek treatment in public hospitals for abortion-related complications ; the country's fourth leading cause of maternal mortality. Models of postabortion care emphasizing counseling and provision of contraceptives have the potential to improve the quality of care these women receive. METHODS: Between April 1997 and August 1998, women treated for abortion complications in six Mexican Institute of Social Security (IMSS) hospitals in the Mexico City metropolitan area were surveyed. Data related to patient-provider interaction, information provision and counseling were analyzed for three models of care: sharp curettage standard care, sharp curettage postabortion care and manual vacuum aspiration postabortion care. RESULTS: Women in the two postabortion care groups rated the quality of services they received more highly than did those receiving sharp curettage standard care. A significantly greater proportion of women treated under the postabortion care models than of those treated under the sharp curettage standard model received information about their health status before treatment, the uterine evacuation procedure, signs of postabortion complications and care at home. In addition, a greater proportion of women treated under the postabortion care models accepted a contraceptive method before leaving the facility (64-78% vs. 40%). CONCLUSIONS: Implementation of a postabortion care model contributes to the delivery of high-quality services to women experiencing abortion complications. The standard IMSS model of postabortion treatment should be modified to emulate those in hospitals that systematically link general counseling and family planning services to the clinical services provided to women with abortion complications.
Web site : http://www.agi-usa.org/pubs/journals/2900603.html.Abstract : Illegal induced abortion exposes women to risks and complications. These decrease when the abortion is carried out safely. Complications resulting from unsafe abortions can cause death or may effect future pregnancies, increasing ectopic pregnancy and spontaneous abortion, for example. The purpose of this paper is to present Brazilian data on the association between complications caused by illegal induced abortions and the conditions in which they are performed. The study was done in 1990 in a Brazilian university. Data was obtained through a questionnaire distributed to all the female employees and graduate students. Forty-two percent of the students and 27% of the employees responded; 82 students and 264 employees had had at least one illegal abortion; 15 and 50, respectively, had suffered health problems (complications) after the last one. The women whose abortions had been done by physicians, in a clinic or hospital, and using modern techniques presented fewer complications. Younger women were not significantly different from the others when frequency of complications was studied. However, this group was composed mainly of students with a higher level of education and more economic resources.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X1992000400010 lng=en nrm=isoAbstract : Sets out guidelines that can help reduce the high levels of maternal morbidity and mortality associated with abortion, whether spontaneous or induced. Recommendations are backed by extensive practical experience and rooted in the principle that emergency care for the complications of abortion should be available 24 hours a day in every health care system. In view of the need to prevent life-threatening complications, the book also established standards of safe abortion practice for use in those countries where abortion is permitted by law. Prevention of abortion through education and family planning is likewise discussed.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/complications.htmlAbstract : Se realizó un estudio descriptivo transversal con adolescentes de la enseñanza politécnica y profesional de Ciudad Habana, durante el curso escolar 1995-1996, con el objetivo de explorar comportamiento sexual y antecedentes de embarazo, aborto, y regulación menstrual. La información se obtuvo a través de una entrevista estructurada y elaborada para tales fines, aplicada previo adiestramiento. Se trabajó con una muestra equiprobabilística de 1 185 estudiantes de tecnológicos (15-19 años) de ellos, 466 eran femeninas y 719 masculinos. Se constató que el 83,9 % de los adolescentes estudiados mantenían vida sexual activa con predominio del sexo masculino, observándose que los mayores porcentajes estaban en las edades de 12 a 15 años. Fue referido el antecedente de abortos en mayores proporciones, seguido de regulaciones menstruales y embarazos (88,1; 83,7 y 72,1 %, respectivamente). Existió una frecuencia de 2 o más abortos en el 29,5 % de la muestra, similar a la frecuencia de los embarazos. Más de la mitad de los entrevistados consideraron que la calidad de la información recibida en temática sexual era regular y deficiente en sus centros educacionales.
Web site : http://scielo.sld.cu/scielo.php?script=sci_serial pid=0138-600X lng=es nrm=isobvs.sld.cu/revistas/gin/vol25_1_99/gin07199.htmAbstract : An 11-page information packet examines maternal mortality in Ecuador and the plan for reducing maternal deaths. Despite Ecuador s ratification of international accords on actions to reduce maternal mortality, its health plans have not made maternal mortality a priority, and the maternal death rate has not varied in the past decade. The rate of 150/100,000 live births is the fourth highest in Latin America. Success of the National Plan for Reducing Maternal Mortality will require commitment of public and private, national and international agencies, the communications media, and society as a whole. Women with few resources who lack access to basic health services are at especially high risk. 38% of maternal deaths in 1994 were due to direct obstetrical causes. 28% were due to toxemia, 20% to hemorrhage during pregnancy or delivery, 7% to postpartum complications, and 5% to abortion. Only 28% of deliveries occur in health services. Lack of prenatal care and information about sexuality and reproductive health are other factors. A high proportion of maternal deaths is from preventable causes and could be avoided with adequate IEC strategies. Maternal mortality is a problem of the entire society, not just of the women who die. Improvement of the living conditions of girls and women is a necessary step in prevention. The Plan for IEC and Social Mobilization aims to promote integral attention to women s health and encourage political and government leaders to make prevention of maternal mortality a national priority. Communication programs should be reinforced by other strategies aimed at improving quality of health care.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 146466Abstract : Guía diseñada como herramienta para la reflexión, para que cada mujer y cada pareja tome la que considere la mejor decisión, cuando enfrentan un embarazo no deseado
Web site : http://www.gire.org.mx/Abstract : First person accounts are presented of the abortion experiences of five Peruvian women of varying circumstances. The accounts detail the type of relationship the woman had with the father, the motives behind the decision to seek abortion, and the woman's emotional and psychological reactions to the abortion. Few technical details are given. Several of the procedures appeared to have occurred several years previously. Most of the five women obtained their abortions from health professionals with at least some training. A brief introduction identified common threads in the experiences of the women, but few of their circumstances or reactions appear to have been universal. Some felt guilty, some were afraid, some were angry at the father, some were in stable unions, some underwent more than one abortion. Several had additional children after the abortion. The women had varying attitudes toward abortion in general and varying opinions of the desirability of legalizing abortion. Most had some experience with contraception but one or two had very limited knowledge and no experience.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 094098Abstract : Muestra la experiencia de la madre y el bebé desde la fertilización hasta las primeras semanas de vida
Notes : Español/espagnol/SpanishAbstract : Septic abortion is an infectious process whose most common origin is illegal abortion under suboptimal hygienic conditions. The true number of illegal abortions is unknown in Mexico, and can only be estimated on the basis of the number of women treated for serious complications. A study by the National Polytechnic Institute and unofficially published stated that approximately 60,000 women die each year from unsafe abortions, and approximately 10% of women hospitalized for abortion complications die. The most common etiologic agents in septic abortion are those present in the normal flora of the female genital tract. The majority of septic abortions are polymicrobial infections, with participation of both aerobic and anaerobic bacteria. The ample irrigation of the placenta and endometrium with blood and lymph during pregnancy facilitates entry of microorganisms to the general circulation during the abortion, with development of bacteremia and dissemination of infection. Factors predisposing to septic abortion include some abortion techniques, incomplete evacuation of the uterine cavity, advanced gestational age, and lack of care in decontaminating the equipment used. Bacteremia, peritonitis, or septic emboli, alone or in combination, can lead to development of septic shock, failure of organs or systems, and death. Most patients present at the end of the first trimester or later. Many deny having been pregnant or undergoing abortion. Treatment is based on antibiotic therapy and surgical evacuation of the uterus, which often necessitates hysterectomy. Broad spectrum drugs should be used because of the polymicrobial nature of most cases. The implementation of measures such as better education and sex education of the population, increased accessibility of health and family planning services, and improved socioeconomic conditions will definitely reduce the number of cases of septic abortion and the associated mortality.
Web site : http://scielo-mx.bvs.br/scielo.php?pid=0300-9041 script=sci_serialAbstract : The first meeting of researchers of abortion in Latin America and the Caribbean took place in Santafe de Bogota, Colombia, during November 15-18, 1994. The meeting drew 135 attendees, including researchers, members of parliament, and representatives of institutions from 22 countries. A total of 60 papers were presented at seven working group sessions on the following themes: incidence of abortion; determinants of abortion and associated factors; practice of abortion and related services; hospital care and abortion costs; effects of abortion; social representations and social movements; and research methodology. Towards the end of the meeting, participants divided themselves into five working groups to draw conclusions and make recommendations in the following areas: incidence and legislation; adolescence and unwanted pregnancy, hospital care and abortion costs, contraception and abortion, and maternal mortality and abortion. The recommendations and conclusions are contained in the report.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 137432Abstract : The conclusions and recommendations of the Multidisciplinary Workshops on Abortion held in La Paz in 1991 reiterate points made in the various individual articles concerning the juridical, demographic, ethical, social, medical, and psychosocial aspects of abortion. The discussion of the juridical aspects summarizes the sanctions in the penal code referring to different types of abortion. The section concludes that the Bolivian Constitution protects maternity from the moment of conception and that family planning is a basic human right. Conclusions and recommendations concerning demographic aspects stress that development and educational policies taking into account the links between population, development, and protection of the environment should be strengthened. The discussion of ethical aspects concludes that the right to life is the principal right and is recognized in religious, moral, and juridical norms, and that international assistance to Bolivia should be directed toward improving living conditions of children rather than promoting contraceptive methods. The discussion of social aspects concludes that abortion is the principal cause of maternal mortality in Bolivia and is much more dangerous than any contraceptive method. A specific program should be developed to prevent abortion. The population should have access to information and education on sexuality, population, and reproductive health. The penal code should be revised to facilitate prevention of abortion and treatment of complications. The recommendation of the discussion of medical and psychosocial aspects was that sex and reproductive health education should be more widespread, with accessible family planning services provided.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 104432Abstract : In Peru a major problem of reproductive health is the persistence of high rates of maternal mortality caused by pregnancy and labor complications and induced abortion. The majority of women who turn to health facilities with incomplete abortion are inappropriately treated by health staff. Providers do not assure good quality of services because of the lack of political will. In reproductive health programs the curative aspects are given priority instead of prevention. There is also lack of sex education programs, partly because the Catholic Church obstructs the organization of sex education and reproductive health programs. Men do not participate actively in family planning programs, in child rearing, or in home chores. To alleviate this situation and find solution to these problems it is recommended to: enlist the power of the state in the execution of reproductive health programs; improve the training of human resources in the health field; institutionalize sex education for all young people stressing the equality of sexes; improve the quality of reproductive health services; improve health care in delivery; improve the management of abortion and the treatment of its complications; motivate men to participate in family planning programs; foster research in reproductive health, especially its social aspects; strengthen local governments for reproductive health prevention; and disseminate the Program of Action of the Cairo International Conference on Population and Development.
Notes : Español/espagnol/Spanish, nbsp;115704Abstract : The Latin American literature on adolescent sexual and reproductive behavior is reviewed to provide professionals in the area with more relevant findings. The data demonstrates that sexually active adolescents of both gender are increasing and starting sexual activity at an earlier age. For example in Panama one out of every 5 births is from an adolescent 15-19 with 25% of these out of wedlock; in Chile, 44% of live births are illegitimate. Factors that are affecting these changes are the media, peer groups and other sources of information competing with parental discipline (TV, movies, music). In spite of the high incidence of out-of-wedlock pregnancies, the majority of pregnancies among adolescents in Latin America and the Caribbean take place in marriage with the average age of marriage at 20, with variation between the rural and urban areas. In 1978 the total fertility rate of El Salvador's urban areas was 3.3 as against 8.4 in the rural. Young girls in developing countries have few options for education, retaining their virginity and marriage, so when presented with the change early on, they marry and get pregnant. Cuba remains the only Latin American Country where abortion is offered (up to 10 weeks) within the context of health services; while illegal abortion in the majority of Latin American countries continues to increase. The proportion of complications due to abortion for those under 20 ranges from 11-20% in the region. Illegal abortions has become a major cause of maternal mortality constituting from 12-53% of deaths among the majority of women 15-24. Significant data is given for pregnancy, factors that influence knowledge and use of contraception, and available sex education programs, an extensive bibliography in these areas is included.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - CPFH 27687cr990Abstract : The Conference of Bolivian Youth for Development was held in Cochabamba in mid-1994 to analyze the problems and needs of Bolivian young people, strengthen youth organizations, and increase awareness of demographic phenomena and their effects on people and the environment. The final declaration of the conference contained three statements on population, development, and the environment; gender equality and equity; and sexual and reproductive health. Bolivia's poverty was said to be related to economic policies that do not respond to the true needs of the country and that are harmful to the environment. Peasants do not receive technical assistance in the management of their lands and in the absence of any progress they join the migratory flow to the cities. It is proposed that young people be given a voice in the decision making process in regard to programs affecting development, population, and the environment. Participation of youth should be promoted through creation of microenterprises that would contribute to reducing unemployment and dependency. A vigorous program should be undertaken to inform youth about population, the environment, and development. The unequal distribution of opportunities for men and women in Bolivia is expressed in machismo and male dominance, systematic discrimination against women, and limited participation of women in societal spheres outside the home. Youth should question the patterns of socialization within the family and should seek to develop new norms of gender relations. Information and training programs should be developed to help all family members find adequate employment. A national policy of sex education is needed that will incorporate young people. It should be oriented toward self-esteem, interpersonal communication, and responsibility so that unwanted pregnancy, abortion, and sexually transmitted diseases will be avoided. The conference opposed any policy that would promote abortion. It urged that maternal mortality be prevented through reproductive health and family planning services for the general population and for young people.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 099436Abstract : Resumen y contenido: Desarrollo sostenible y población -- La población, sujeto y actor principal del desarrollo sostenible -- El ordenamiento territorial como proceso organizador de uso y ocupación del territorio El enfoque sistémico de la población -- Opciones y responsabilidades -- La salud reproductiva.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Over 150 countries sent official delegations to the 1994 International Conference on Population and Development, which was held to study the problems caused by unprecedented population growth and to propose a plan of action to achieve stabilized population growth in a framework of equity and justice. The few countries refusing to attend were all Islamic. The most significant and controversial discussions were undoubtedly those concerning health of women and reproductive risks. It is estimated that half a million maternal deaths occur annually, 99% of them in the developing countries. The World Health Organization estimates that the risk of dying from maternal causes is 1 in 20 in developing countries but 1 in 10,000 in developed countries. At present nearly 90% of countries permit abortion to save the mother's life. But a large proportion of maternal deaths result from unsafe abortions. The Conference urged countries to approach abortion in unsafe conditions as a serious public health problem. The demand for abortion should be reduced through expansion and improvement of family planning services. Maximum priority should be given to prevention of unwanted births. The Conference urged countries to take measures to reduce maternal mortality by introducing means of preventing pregnancy at the extremes of reproductive age. Nutrition programs should be implemented for fertile-aged women. Adolescents should receive information to help them postpone starting a family. The first week of the Conference was spent discussing the controversy generated by the opposition of the Vatican and some Islamic countries to the Preparatory Document. The problems of maternal health, undesired pregnancy, and abortion received much greater attention than in any previous World Population Conference. The 114-page Conference document urged the developed countries to contribute generously to the population plan of action, which cannot be successful without adequate financing. In Chile, existing legislation does not satisfy the recommendations of the Cairo conference. All forms of abortion are currently illegal, but 150,000 to 200,000 abortions are believed to take place annually. The restrictive laws have not stopped abortions but have caused them to occur in unsafe conditions.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103377Abstract : With the exception of women in Cuba, women in the countries of Latin America do not have broad, legal access to induced abortion services. Nonetheless, women engage in sexual intercourse without using contraception, become pregnant, and subsequently abort unwanted and unplanned pregnancies. An estimated four million abortions are conducted annually in Latin America. There is therefore an enormous practice of clandestine abortion in the region. Clandestine abortions are not necessarily unsafe, but the high levels of abortion-related morbidity and mortality in the region stem from the dangerous conditions which surround a high proportion of such procedures. Given the large number of illegal abortions and the substantial volume of research already conducted by individuals, universities, and organizations on the issue, a meeting was organized and convened to exchange knowledge on the incidence, determinants, consequences, and social and economic costs of clandestine abortion in the region. The November 15-18, 1994, Research Conference on Induced Abortion in Latin America and the Caribbean in Bogota, Colombia, was organized by the Universidad Externado de Colombia with the collaboration of the Special Program of Research, Development, and Research Training in Human Reproduction of the World Health Organization, the Alan Guttmacher Institute, and the Ford Foundation. The first of its kind in Latin America, the conference was attended by 130 researchers, health professionals, policy makers, and legislators from twenty countries. That the conference took place marks a turning point in the way the region's reproductive health and population field address abortion. During the final day of the conference, working groups developed recommendations relating to induced abortion in terms of incidence, legislation, adolescents, hospitalization, and costs for treatment of complications, contraception, and maternal mortality.
Web site : http://www.guttmacher.org/Abstract : With the exception of women in Cuba, women in the countries of Latin America do not have broad, legal access to induced abortion services. Nonetheless, women engage in sexual intercourse without using contraception, become pregnant, and subsequently abort unwanted and unplanned pregnancies. An estimated four million abortions are conducted annually in Latin America. There is therefore an enormous practice of clandestine abortion in the region. Clandestine abortions are not necessarily unsafe, but the high levels of abortion-related morbidity and mortality in the region stem from the dangerous conditions which surround a high proportion of such procedures. Given the large number of illegal abortions and the substantial volume of research already conducted by individuals, universities, and organizations on the issue, a meeting was organized and convened to exchange knowledge on the incidence, determinants, consequences, and social and economic costs of clandestine abortion in the region. The November 15-18, 1994, Research Conference on Induced Abortion in Latin America and the Caribbean in Bogota, Colombia, was organized by the Universidad Externado de Colombia with the collaboration of the Special Program of Research, Development, and Research Training in Human Reproduction of the World Health Organization, the Alan Guttmacher Institute, and the Ford Foundation. The first of its kind in Latin America, the conference was attended by 130 researchers, health professionals, policy makers, and legislators from twenty countries. That the conference took place marks a turning point in the way the region's reproductive health and population field address abortion. During the final day of the conference, working groups developed recommendations relating to induced abortion in terms of incidence, legislation, adolescents, hospitalization, and costs for treatment of complications, contraception, and maternal mortality.
Web site : http://www.guttmacher.org/Abstract : The present US abortion law, Roe vs. Wade, is based on the trimester/viability concept. However, both concepts seem to be biologically ill-founded and are likely to contribute to confusion regarding abortion laws. a survey of the abortion laws in individual states revealed a lack of uniformity. The time limit for abortion upon request varies from 13 to 28 weeks; 9 states have no specific abortion law. This confusion also exists in other countries. Standards are lacking regarding requests from the dates of the last menstrual period, fertilization, and implantation. Some states do not allow termination of pregnancy for maternal indications after 24 weeks, and the definition of maternal endangerment has rarely been addressed and remains vague. Only a few states have provisions for fetal malformation. Such terms as trimester and viability are not biologically founded and are likely to contribute to the confusion. The terminology should be clarified so abortion, contraception, birth control, and other such terms are uniform. (author's)
Web site : http://www.reproductivemedicine.com/index1.htmlAbstract : In Brazil and other South and Central American countries where abortion is illegal, misoprostol is widely available and commonly used to induce abortion. However, misoprostol is not very effective as an abortifacient agent and can cause fetal abnormalities. The present study reviewed the cases of 42 infants from Sao Paulo, Brazil, who were exposed to misoprostol during the first trimester of pregnancy and then born with a congenital abnormality. 17 children had equinovarus with cranial nerve deficiencies and 10 had equinovarus as part of a more extensive arthrogryposis. The most distinctive phenotypes were arthrogryposis confined to the legs (5 cases) and terminal transverse limb defects (9 cases). Congenital hydrocephalus was present in 8 children. The most commonly taken dose of misoprostol was 800 mcg (range, 200-16,000 mcg). Greater awareness of the widespread use of misoprostol to induce abortion should lead to public health interventions to prevent teratogenic effects.
Web site : http://www.thelancet.com/Abstract : Three cases of an unusual congenital malformation of the skull occurred in newborns in Fortaleza, Brazil, over a 5-month period. In each case, the only unusual feature of the pregnancy history was the fact that the mothers had taken misoprostol orally and/or vaginally in the first trimester to induce an abortion. In the first case, the mother took 800 mcg of misoprostol orally at the time of expected menses and experienced slight vaginal bleeding and intense abdominal pain. The baby was born at 36 weeks gestation with a localized fronto-temporal defect with an asymmetric, well-circumscribe deficiency of the cranium and overlying scalp and exposure of the cerebrum and dura mater. After surgery to cover the defect, the child developed convulsions which are controlled by phenobarbital. In the second case, the mother took 600 mcg misoprostol at the time of expected menses and experienced spotting and pain. One month later, she repeated the dosage and experienced only spotting. The full-term baby had a localized frontal defect with an asymmetric, well-circumscribed absence of the cranium and overlying scalp, exposing the cerebrum and dura mater. A week after surgery to cover the defect, this child also developed convulsions. In the third case, the mother took 600 mcg misoprostol orally and 200 mcg vaginally at the time of expected menses. 4 weeks later she took 1200 mcg misoprostol orally and 400 mcg vaginally. After an otherwise normal pregnancy and delivery, the child was delivered with a complete deficit in the cranium and scalp in a localized region of the frontal-temporal area. This child died postoperatively. Controlled studies have not been performed to determine the effect of misoprostol during the first trimester of pregnancy, but no teratogenic effects were found in animals. The cases reported here suggest the need for further investigation of a possible association.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - 095505Abstract : The purpose of the study was to verify the knowledge of male university students regarding induced abortion. The sample was comprised of 71 male students that corresponded to 70% of the population made up of students from different health related programs at a federal university. Data was collected in August and October of 1998, by means of a questionnaire that was based on two previous exploratory studies. The respondents were 17 to 22 years old, catholic, single and financially dependent. The results demonstrated that a large percentage of male students had knowledge of what an induced abortion was and of its consequences, as well as of the methods used to induce the fetal loss. The respondents expressed a negative opinion about abortion and placed the responsibility for such a decision on the couple. They also indicated that besides the woman, other individuals, such as friends and family members bared some responsibility for the decision to end or not a pregnancy.
Notes : Portugués/portugais/PortugueseAbstract : PURPOSE: to evaluate knowledge, opinion and practice of gynecologists/obstetricians regarding induction of abortion. Method: a pretested, structured questionnaire was sent to gynecologists/obstetricians affiliated to FEBRASGO. They were asked to answer and return the questionnaire in a self-addressed, prepaid envelope, without identification of the respondent so as to preserve anonymity. Knowledge about the legal situation of abortion in Brazil, opinion about it and practice if confronted with abortion requests were questioned. RESULTS: approximately 90% of the respondents believed that abortion is legal for pregnancy resulting from rape or in case of risk to a woman's life and for 31.8% in case of severe fetal malformation. In their opinion abortion should be permitted in the case that pregnancy is a risk for a woman's life (79.3%), fetal malformation (77.0%) and after rape (76.6%), added to 9.9% who expressed that abortion should be permitted in all circumstances. Two thirds wrongly thought that a judicial order is required to practice a legal abortion and only 27.4% knew that a written request by the woman is required. Confronted with unwanted pregnancy, 77.6% of female gynecologists/obstetricians and 79.9% of partners of male respondents had an abortion, 40% would help a client and 48.5% a relative in the same situation. CONCLUSION: gynecologists/obstetricians lack knowledge on the legal situation of abortion although their opinion and practice are favorable.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0100-72032004000200002 lng=en nrm=isoAbstract : En 2002 se llevo a cabo la primera encuesta entre médicos mexicanos para conocer sus opiniones, practicas y conocimientos en relación al tema del aborto. Participaron 1,206 médicos seleccionados aleatoriamente de un censo nacional de instituciones publicas de salud en México quienes respondieron un cuestionario auto administrado. De los participantes el 70 por ciento eran hombres y el 53 por ciento médicos generales; el 86 por ciento se identifico como católicos. El 84 por ciento identifico correctamente las leyes que en ocasiones permiten el aborto, mientras que 16por ciento considero que el aborto era siempre ilegal. Se considero que el aborto debía ser legal cuando el embarazo era resultado de una violación (86 por ciento), cuando pone en peligro la vida de la mujer (93 por ciento) o su salud esta en riesgo (87 por ciento) o cuando el producto presenta defectos congénitos serios (82 por ciento). Mientras que el 84 por ciento considero que todas las instituciones publicas de salud deberían ofrecer abortos legales, solo el 11 por ciento había llevado a cabo un aborto. El 81 por ciento de los participantes manifestaron el deseo de contar con mayor información sobre aspectos legales, el 65 por ciento sobre aspectos éticos y el 56 por ciento sobre regímenes aprobados de aborto. Nuestros hallazgos aportan información valida sobre las opiniones de estos médicos y pueden contribuir a informar sobre el debate en torno al aborto en México.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : El Comité de América latina y el Caribe para la Defensa de los Derechos de la Mujer (CLADEM) presenta este documento como una contribución para identificar consensos y disensos o puntos pendientes del debate del movimiento de mujeres en torno a los derechos sexuales y reproductivos. Se recopilaron y analizaron trece documentos de la década de los noventa, con agendas sobre el tema producto de encuentros de mujeres y de organizaciones sociales, organismos no gubernamentales y feministas de América Latina y el Caribe. El resultado de este análisis muestra que existe consenso respecto a que los derechos reproductivos suponen: "El derecho de todas las parejas e individuos a decidir libre y responsablemente el número de hijos, el espaciamiento de los nacimientos, y a disponer de la información y los medios para ello. El derecho de alcanzar el nivel más elevado de salud sexual y reproductiva. El derecho a adoptar decisiones relativas a la reproducción sin sufrir discriminación, coerción ni violencia. La autonomía, la autodeterminación y la libre elección". Respecto a los derechos sexuales se mencionan como elementos de consenso los siguientes: conocer nuestro cuerpo, vivir en condiciones materiales adecuadas que garanticen una sexualidad plena, acceso al placer dentro del ejercicio de opciones sexuales diferentes, poder decidir sobre tener o no tener hijos, acceso a la información y uso de métodos anticonceptivos variados sin distinción de edad, estado civil o situación económica y tomar la decisión de practicarse o no un aborto sin que éste sea considerado un delito. Los disensos o debates pendientes se ubican en torno a la relación entre los derechos sexuales y los derechos reproductivos; la universalidad ...etc
Web site : http://www.gire.org.mx/Abstract : La mayor parte de las mujeres en edad reproductiva, antes o durante la gestación, experimentan temor y ansiedad ante la posibilidad de generar un ser con anomalías genéticas. La posibilidad del diagnóstico prenatal de los defectos congénitos en etapas más tempranas del embarazo, ha conducido a un aumento inexorable de las peticiones para su interrupción voluntaria. Muchas circunstancias se han invocado para explicar o justificar la práctica del aborto por indicaciones médicas. Con base en los avances científicos y tecnológicos de la medicina actual, en la práctica diaria esas indicaciones son excepcionales, pero el hecho de que exista una sola, obliga a que perdure la denominación "aborto terapéutico", el cual -como el aborto en general- es un tema controvertido. Mientras nuestras instituciones y nuestras sociedades no sigan buscando un terreno medio y neutral que permita llegar a un acuerdo y sólo muestren tesis morales totalmente antagónicas, el problema seguirá cobrando vidas humanas. Las nuevas técnicas de reproducción asistida han aparecido en el mundo contemporáneo en forma explosiva. El hecho de que puedan existir abusos y prácticas irregulares no significa que haya que combatir el progreso en este campo. Por ello, es importante evitar que el tener un hijo se convierta en una cuestión de laboratirio o que la mujer sea definida cada vez más en términos de su capacidad reproductiva y cada vez menos como ser humano.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : Se realizó una revisión histórica sobre el desarrollo de cada uno de los métodos anticonceptivos que pueden ser usados como medios para evitar los embarazos no deseados y poder tener una adecuada planificación familiar. Se hace referencia a los efectos que los diferentes métodos anticoncepcionales pueden tener en la sexualidad humana.
Web site : http://bvs.sld.cu/revistas/mgi/vol17_4_01/mgi10401.htmAbstract : This document contains major provisions of Paraguay's 1992 Constitution. Highlighted portions include article 4, which protects the right to life from the time of conception; article 6, which notes that the state will promote research on population factors and their links with socioeconomic development, preservation of the environment, and quality of life; article 7, which expresses the right to a healthy environment; article 33, which makes personal and family privacy inviolable and exempts individual behavior "that does not affect public order" from public authority; articles 46-48, which hold that all persons are equal, set guarantees for equality, and specify that the state will create conditions to make equal rights for men and women "true and effective"; article 50, which codifies the right to constitute a family; article 53, which provides that parents must care for children; and article 61, which recognizes the right of people to decide on family size and birth spacing and calls for implementation of special plans to ensure reproductive health and maternal-child health care for low-income people. Additional articles describe rights to education, to the protection of health, and employment rights, including the prohibition of discrimination against workers because of race, sex, age, religion, social status, or political or union preference and a provision that affords women maternity leave of at least 12 weeks. Other articles outline the objectives of agrarian reform and rural development.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 087067Abstract : For the last three decades, government and health institutions have recognised that unsafe abortion is an important social and public health problem in Mexico. Although the Penal Code in every state defines at least one situation in which abortion is legal, access to legal abortion services is restricted for women throughout Mexico. In August 2000, the Mexico City Legislative Assembly reformed the Penal Code to include a wider range of grounds on which abortion is legal and added regulations to ensure access to legal abortion services in cases of rape and forced artificial insemination. The Mexican Supreme Court upheld the constitutionality of the reforms in January 2002. This paper describes a collaborative project between Ipas Mexico and the Mexico City Department of Health to provide legal abortions in cases of rape and to ensure that comprehensive health services for survivors of sexual violence are available and accessible. It describes a model of care being introduced into 15 public general and maternal-child health hospitals in Mexico City through a programme of multi-disciplinary consciousness-raising workshops and training courses on sexual violence and legal abortion. Few health care providers have had prior training in service provision for survivors of sexual violence or abortion service delivery. Workshop participants showed a high level of willingness to participate in legal abortion services for survivors of sexual violence when and if they are receive solid institutional support. .
Web site : http://www.rhmjournal.org.ukAbstract : The data of the 1991 census indicated that the population count of Brazil fell short of a former estimate by 3 million people. The population reached 150 million people with an annual increase of 2%, while projections in the previous decade expected an increase of 2.48% to 153 million people. This reduction indicates more widespread use of family planning (FP) and control of fertility among families of lower social status as more information is being provided to them. However, the Ministry of Health ordered an investigation of foreign family planning organizations because it was suspected that women were forced to undergo tubal ligation during vaccination campaigns. A strange alliance of left wing politicians and the Roman Catholic Church alleges a conspiracy of international FP organizations receiving foreign funds. The FP strategies of Bemfam and Pro-Pater offer women who have little alternative the opportunity to undergo tubal ligation or to receive oral contraceptives to control fertility. The ongoing government program of distributing booklets on FP is feeble and is not backed up by an education campaign. Charges of foreign interference are leveled while the government hypocritically ignores the grave problem of 4 million abortions a year. The population is expected to continue to grow until the year 2040 and then to stabilize at a low growth rate of .4%. In 1980, the number of children per woman was 4.4 whereas the 1991 census figures indicate this has dropped to <3.5. The excess population is associated with poverty and a forsaken caste in the interior. The population actually has decreased in the interior and in cities with <15,000 people. The phenomenon of the drop of fertility associated with rural exodus is contrasted with cities and villages where the population is 20% less than expected.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 069423Abstract : This is a collection of six papers given at a symposium on contraception and abortion sponsored by the demographic department of the University of Rome, held in Rome in November 1994. Each paper summarizes the role of contraception and abortion in a particular area of the world: Sub-Saharan Africa, the Muslim countries, Asia, Latin America, the developed countries, and Italy. There is also a statistical appendix containing, for countries around the world, data on general demographic indicators, fertility, maternal and infant mortality, abortion, and contraception by type.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND RH6C052Abstract : Currently, more than 50% of married women of childbearing age are using a form of contraception. Between 1960-65 and 1985-90, the number of contraceptive users in all developing countries increased from 31 to 381 million, in East Asia from 18 to 217 million, in Latin America from 4 to 44 million, in South Asia from 8 to 94 million, and in Africa from 2 to 18 million. WHO has recently estimated that over 500,000 women die each year from causes related to pregnancy and childbirth. With a worldwide estimate of 36-53 million induced abortions performed each year, between 125,000 and 170,000 women die each year because of unsafe abortions. According to data from the World Fertility Survey, short spacing between births raises the average chances of offspring dying in infancy by 60-70% and the chances of dying before the age of 5 years by about 50%. WHO's minimal estimate for yearly incidence of bacterial and viral STDs (excluding HIV infection) is 130 million. Most STDs have more serious sequelae in women than in men and lead to pelvic inflammatory disease (PID), permanent infertility, and the risk of ectopic pregnancy. African countries with high incidence of STDs have the lowest prevalences of contraceptive use. A recent examination of the WHO international data base of 22,908 IUD insertions and 51,399 woman-years of follow-up indicates that the occurrence of PID in IUD users is most strongly related to the insertion process and to background STD risk and suggests that PID is an infrequent occurrence after the insertion period. A WHO Scientific Working Group review confirmed the beneficial effects of oral contraceptives in reducing the risk of ovarian cancer, endometrial cancer, and biopsy-proven benign breast diseases. A WHO collaborative study in 5 centers in Kenya, Mexico, and Thailand provided assurance that women who used DMPA for a long time and who initiated use many years previously are not at increased risk of breast cancer.
Web site : http://bmb.oupjournals.org/Abstract : The mean fertility rate in developing countries has fallen from 6.1 to 3.9 between the early 1970s and 1992. Increases in contraceptive use contributed to this decline. In 1965-1970, just 9% of married couples used contraception, but by 1985-1990, 50% did. During the same period, the number of contraceptive users increased from 18 to 217 million. Yet, vast regional differences in the decline in fertility exist. The greatest decline occurred in East Asia, while the smallest took place in sub-saharan Africa. Availability of family planning services contributes to this disparity (95% in East Asia and 9% in sub-Saharan Africa). Contraceptive availability in southeastern Asia and Latin America is 57%, and 54% in southern Asia. Just 60% of the population in developing countries can easily obtain at least one safe, effective, and acceptable family planning method. Couples in East Asian countries, especially China, are more likely to use contraception than couples in developed countries. Further, 71% of people who use contraceptives in China use modern contraceptive methods compared to just 47% in developed countries. Just 1% of Chinese contraceptive users depend on traditional methods, while 24% of developed world contraceptive users depend on them. Nevertheless, about 300 million couples worldwide who want to stop having children do not use any contraception. Almost 50% of the 910,000 daily conceptions are not planned and 25% are unwanted. 150,000 induced abortions occur daily, 33% of which are done in an unsafe manner resulting in 500 deaths. Further, many people do not realize that most women who have an abortion are either married or part of a stable union and are mothers to several children.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 079131Abstract : The aim was to study the contraceptive patterns among men and women in León, Nicaragua. The predominance of female sterilization and the occasional condom use - mainly reported by men - reflects a situation of relative male control over contraceptive and reproduction. This probably originates from "machista" values where men having many children with different women are considered strong. There was also a significantlyhigher use of contraceptives among the better-off women and men compared with the extremely poor. The situation of many poor women, in a country with limited contraceptive services, is worrying considering that abortion is illegal and the threat of HIV epidemic is growing. The situation for adolescents is particularly problematic with low experience in contraceptive use (AU).
Notes : Inglés/anglais/EnglishAbstract : Despite increases in the use of modern methods of contraception, contraceptive prevalence remains low in Haiti, according to the 1989 National Haitian Contraceptive Prevalence Survey. The survey involved 1996 women aged 15-49 and 1842 men aged 15-59 and examined such factors as marital status, sexual behavior, fertility, contraceptive knowledge and use, and maternal and child health. The survey collected additional information regarding the sexual attitudes and behavior and contraceptive use of 15-24-ear-old respondents. As the survey revealed, the mean age at first union was 22.5 years. 7% of sexually active males and less than 1% of females reported having more than one sexual partner in the 30 days prior to the survey. Among 15-24 year-olds, 41% of women and 44% of men had had sexual intercourse. For the 12 months preceding the survey, the total fertility rate (TFR) was 6.0 live births/woman. TFR was 4.5 among urban women and 6.9 among rural women. 6% of the women ever pregnant reported having had an abortion (1/3 of these women had aborted their own pregnancies). Nearly 1/2 of all live births in the last 5 years had resulted from unplanned pregnancies. 81% of the women and 84% of the men reported knowledge of at least one method of contraception, the most commonly known methods being the condom and the pill. Contraceptive prevalence among women in union was 10%, up from 7% in 1983. Moreover, in 1989 modern methods accounted for nearly all use among women in a union, compared to just over 1/2 the use in 1983. 55% of fecund women in union wanted no more children, and 47% of men whose were fecund wanted no more children. Concerning maternal and child health, 68% of women who had given birth in the past 5 years had received prenatal care.
Web site : http://www.guttmacher.org/Abstract : Context: The year after a woman gives birth presents a rising risk of an unwanted conception and an often frustrated desire for contraceptive protection. At present, contraceptive use levels during this period fall short, resulting in unplanned pregnancies and unwanted childbearing. Methods: Data from 27 surveys conducted as part of the Demographic and Health Surveys series between 1993 and 1996 are analyzed to assess intentions to practice contraception and unmet need for it, both in the first year after birth. Unmet need is partly redefined here to focus on future wishes rather than on past pregnancies and births. Results: Across the 27 countries, there is much unsatisfied interest in, and unmet need for, contraception. Unweighted country averages indicate that two-thirds of women who are within one year of their last birth have an unmet need for contraception, and nearly 40% say they plan to use a method in the next 12 months but are not currently doing so. Moreover, of all unmet need, on average nearly two-fifths falls among women who have given birth within the past year. Similarly, nearly two in five women intending to use a method are within a year of their last birth. The two groups-those with an unmet need and those intending to use a method-overlap; their common members include nearly all of those intending to use a method and about two-thirds of those with an unmet need (which is the larger group of the two). Only trivial proportions of both of these groups want another birth within two years. Between 50% and 60% of pregnant women make prenatal visits or have contact with health care providers at or soon after delivery, and additional contacts occur for infant care and other health services. Conclusions: Women who have recently given birth need augmented attention from family planning and reproductive health programs if they are to reduce their numbers of unwanted births and abortions and to lengthen subsequent birth intervals. Prenatal visits, delivery services and subsequent health system contacts are promising avenues for reaching postpartum women with an unmet need for and a desire to use family planning services.
Web site : http://www.guttmacher.org/pubs/journals/2702001.htmlAbstract : Conducted by the Empowerment of Women Research Program in Arlington, Virginia, this paper examines the control and resistance factors in the sexual and reproductive empowerment of women in La Paz Market, Bolivia. The introductory chapter presents the 30 interview subjects aged 31 years and outlines their sociocultural background and identity. It then gives a broad overview of their reproductive lives, tracing the chain of events from first menstruation, sexual initiation, pregnancy, birth, miscarriage, and abortion. Chapter 2 identifies the main factors through which family pressures, established gender roles, and social norms combine to control women's sexual and reproductive lives. Chapter 3 identifies the points at which women attempt to break the repetitive cycle of pregnancy, birth and child rearing, through active resistance to family pressures and marital violence; the decision to use a contraceptive method; or through evasive tactics such as avoiding sex and provoking miscarriage. The last chapter gives suggestions on institutional strategies, which can support women in their own process of sexual and reproductive empowerment. It stresses the need for culturally sensitive intervention in the spheres of education, communication and reproductive health services in discussing and orienting adolescents and adults concerning sexuality and fertility.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 149275Abstract : La ilegalidad con la que se práctica el aborto en México y en otros países de América Latina favorece la injusticia y la desigualdad. El índice de muertes maternas y de esterilidad por ésta causa plantea un grave problema de salud pública. La presentación de éstos ensayos sobre diferentes cuestiones morales en relación con el aborto surgen para proponer leyes justas
Notes : Español/espagnol/SpanishAbstract : Developed by Ipas Mexico and the Secretariat of Health in Mexico City, this bulletin, currently available only in Spanish, summarizes a strategy for equipping facilities in general and maternal-child health hospitals to provide abortion for legal indications and key experiences to date implementing this strategy in Mexico City. The article includes results of a questionnaire surveying various hospital-based health care providers' knowledge and opinions about legal abortion and violence, as well as inquiring about their training and experiences related to these subjects. Finally, the bulletin describes a comprehensive health care model for women who are victims of violence. (February 2002)
Web site : http://www.ipas.orgAbstract : Developed by Ipas-Mexico and the Secretariat of Health in Mexico City, the six-page bulletin Building Women's Access to Abortion Services in Cases of Rape summarizes a strategy for equipping facilities in general and Maternal/Child Health hospitals to provide legal abortions and key experiences to date implementing this strategy in Mexico City. The article includes results of a questionnaire surveying various hospital-based health care providers' knowledge and opinions about legal abortion and violence, as well as inquiring about their training and experiences related to these subjects. Finally, the bulletin describes a comprehensive health care model for women who are victims of violence.Full text on-line at www.ipas.org; hard copies available free of charge
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Despite the existence of less costly and less invasive techniques to evaluate abnormal uterine bleeding, sharp curettage continues to be the most common form of endometrial sampling in the less developed world. Because manual vacuum aspiration (MVA) equipment is often associated with abortion care in countries where abortion is illegal, many practitioners have been slow to incorporate its use for other gynecological conditions. In this study, MVA was introduced in a large teaching hospital in El Salvador as an alternative for patients with abnormal uterine bleeding. Hospital cost, length of stay and complication rates were compared in a prospective, nonrandomized controlled study of 163 patients assigned to either traditional sharp curettage or MVA services. Patients were assigned to each group depending on the availability of trained providers. Methodologies for cost-savings analysis were modified to obtain more precise cost estimates. Use of MVA was associated with a significant cost savings of 11% and a hospital stay that was 27% shorter as compared to sharp curettage. Cost savings could be much higher if MVA was institutionalized as an ambulatory procedure with minimal or no preoperative evaluation and postoperative stay. (author's)
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?iss=5 vol=68 viewtype=issueAbstract : 440 women treated for abortion complications at two Lima hospitals were interviewed using structured questionnaires between November 1992 and February 1993 for an analysis of the economic and social costs of abortion. 30 of the women were interviewed in depth and the clinical and financial records of the women were analyzed. The Maternal Perinatal Institute, a public hospital belonging to the Ministry of Health, serves low and very low income families. The Edgardo Rebagliati Hospital belongs to the Peruvian Institute of Social Security. Most of the women hospitalized were aged 20-39. 12% in the Institute and 1% in the Rebagliati were under 20. Over half the women in both hospitals had secondary or higher education. 17% of the patients in the Institute and 9% in the Rebagliati were not in union. 80% in the Rebagliati and 52% in the Institute were economically active. 22% in the Institute and 25% in the Rebagliati had no live-born children, while 33% in the Institute and 25% in the Rebagliati had three or more. 38% of patients in the Institute and 47% in the Rebagliati reported having a previous abortion, spontaneous or induced. The great majority knew of modern contraceptive methods, but only 35% in the Institute and 25% in the Rebagliati used a modern method before the abortion. 39% at the Institute and 36% at the Rebagliati used no method. The average cost of an abortion and duration of hospital stay were US$137 and 3.8 days in the Institute and US$226 and 3.1 days at the Rebagliati. Patients in the Institute receive subsidized medical services and in some cases are excused from paying. The public health problem of abortion should prompt extension of coverage of family planning programs, and especially provision of immediate postabortal counseling.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 094099Abstract : In much of the developing world, sharp curettage (SC) is the most commonly used technique for treating incomplete abortion. The procedure is usually performed in a hospital setting where physicians and operating theatres are available; it often involves light to heavy sedation for pain control and an overnight hospital stay for patient recuperation and monitoring. This study examined the hypothesis that use of manual vacuum aspiration (MVA) ; a variation of vacuum aspiration (VA) ; would be less costly than SC and thus be advantageous to healthcare systems with limited resources. The purpose of the study was to identify and, where possible, to explain the factors that contributed to cost differences between MVA and SC for treatment of incomplete abortion. To achieve this objective, researchers observed patient management and documented resource use at hospital sites in Kenya and Mexico. The results of the study support the researchers' hypothesis that, in most cases, treatment with MVA required a shorter patient stay and fewer hospital resources than SC, as the two techniques were practiced at the various study sites. The policy decision to adopt MVA, supported by procurement of instruments and incorporation of training in its use, is the basic prerequisite to achieving reduced levels of resource use. The study results also suggest that the full advantages of MVA can be realized only if it is introduced in conjunction with certain changes in patient management, such as offering outpatient treatment for incomplete abortion.
Web site : http://www.sciencedirect.com/science/journal/02779536Abstract : A demonstration project was implemented at hospitals in Kenya, Mexico, and Ecuador between January and August 1991 to identify and explain the factors that contribute to cost differences between the use of dilation and curettage (D C) and manual vacuum aspiration (MVA) to treat incomplete first-trimester abortion. After an introduction and a brief discussion of methodology, the results are presented for duration of hospital stay associated with each procedure, for the cost of treating patients for incomplete abortion, and for trends in duration of stay and resource utilization. It was found that MVA offers significant potential benefits for women, service providers, and health care systems and that it requires fewer resources for most of the cost elements studied (staff, drugs, and hospitalization). The results indicate that realization of the full benefits of MVA depends upon the adoption of changes in patient-management protocols. The discussion continues with a consideration of the policy and protocol decisions required for a change from D C to MVA, including the purchase of MVA instruments, training and procedural adaptations (including the adoption of new sterilization procedures and the implementation of appropriate pain control practices), patient-management issues (location of the evacuation procedure in a treatment room rather than an operating room, level of priority given to incomplete abortion patients, and modifying hospital discharge protocols to eliminate needless waiting time), and decentralization of abortion care to lower levels of the health care system (which is not required, but which enhances resource savings and women's health). The outcomes of policy changes related to the treatment of incomplete abortion will be reduced waiting times, resource reallocation, and improved accessibility of services. These findings have already contributed to policy changes in Kenya, Mexico, and Ecuador and to discussions with Ministry of Health representatives from Zambia and Zimbabwe. Appendices provide additional information about the study sites, explain variations in data collection, and describe cost determinants.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103423Abstract : In the Dominican Republic a study was conducted to identify the main factors associated with the occurrence of induced abortion. The study involved interviews with 350 women admitted in two hospitals with abortion complications, review of their clinical records, and in-depth interviews with 30 of these patients. The results indicated that the majority of these women had a low socioeconomic status and a low level of education. Many were born in rural areas but had migrated to Santo Domingo, the capital, in search of employment. Their average age was about 26 years. Adolescents represented 16% of the total study sample. Most of these women were in some sort of union, but only 13% were formally married. Contrary to popular belief that it is only unmarried adolescents who resort to induced abortions, the study showed that the majority were in permanent or semi-permanent unions. In fact, most of them had been in the union for three or more years. The use of contraception was low and unsystematic, with high discontinuation rates. Although 75% of the total study population declared to have used at least one contraceptive method during their lifetime, only 42% had tried a second method. This project has had a significant policy impact. In 1993, a revised Health Code was presented to the Dominican Congress for discussion and approval. The Senator who introduced this legislation, using results from the study, proposed to modify the law with respect to therapeutic abortions to include a clause that would make abortion legal under certain conditions and make corresponding services available as part of maternal and child health care programs. Also, with a view to lowering the incidence of abortion, PROFAMILIA, an agency affiliated to the international Planned Parenthood Federation, has adopted improved measures, reinforcing counselling and communication efforts to improve understanding of the correct way of using modern methods. (full text)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 099574Abstract : Introducción ; Salud sexual y reproductiva ; El alcance de los derechos sexuales y reproductivos ; Ser adolescente, hoy ; Juventud paraguaya, derechos a conquistar ; Niñas-madres ; Aborto, invisibilidad mortal ; ITS y VIH/SIDA ; Educar para el bienestar ; Información, Educación y Comunicación (IEC) - Información veraz ; Legislación paraguaya ; La Responsabilidad Social Empresarial (RSE) ; La inversión social: Un reto para las empresas ; Compromiso con la niñez y la juventud ; "Alamo crece contigo": Un desafío ; "Crecemos contigo": Se suman nuevos actores ; Cámara de Anunciantes del Paraguay (CAP).
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Se analiza la opción por el aborto a partir de una pespectiva crítica sobre las relaciones de subordinación de género. Se cuestionan las reglas sociales y concepciones ideológicas existentes sobre la maternidad, la sexualidad y la moral sexual femenina.
Notes : Español/espagnol/SpanishAbstract : Presenta los pasos que se realizaron en relación al tema por parte de diversos grupos. (Movimiento feminista, gobierno, iglesia, etc.) de 1990 1991. Plantea que el movimiento feminista trabaja muchas veces como reacción a las situaciones externas que se presentan y debe elaborarestrategias de movilización antes de que los acontecimientos lo rebasen.
Notes : Español/espagnol/SpanishAbstract : En 1999, Paulina quedo embarazada a los treces años, como consecuencia de un violación. Paulina decidió abortar... pero funcionarios públicos lograron, con base en engaños de, que se desistiera. Axial le impusieron que nunca decidió: ser une madre adolescente a consecuencia de la violación que sufrió. En el ano 2000, el Grupo de Información en Reproducción Elegida (GIRE) publico la primera parte de esta historia: Paulina en el nombre de la ley. En el 2004, aun quedan muchas cuentas pendientes, por eso hubo que escribir Paulina cinco anos después. Este numero incluye información de los hechos mas relevantes los últimos años en torno a la vida de Paulina y a " su caso ", que se ha convertido en emblemático porque evidencia las limitaciones en materia políticas publicas que garanticen el acceso al aborte a las victimas de violación.
Web site : http://www.gire.org.mx/Abstract : The coordinator of the International Reproductive Rights Research Action Group [IRRRAG], which conducted a seven-country research project on women's views of reproductive rights, presents some conclusions and policy recommendations in this chapter. Some common patterns were found among the low-income women that were interviewed in Brazil, Egypt, Malaysia, Mexico, Nigeria, the Philippines, and the United States. Women in all the countries wished to control their own fertility, childbearing, and contraceptive use, although many barriers prevented this. Religion influenced, but did not govern women's behavior with regard to fertility control. Women's earnings significantly increased their sense of reproductive entitlement, as did participation in community groups. Women consistently complained about the poor quality of reproductive health care available to them. The policy recommendations made include targeting older women as influential factors, improving the quality of health care, providing safe abortions, and improving the general conditions of women, which are inextricably intertwined with their reproductive rights and health.
Notes : Inglés/anglais/EnglishAbstract : Éste es un análisis descriptivo del aborto voluntario entre diferentes grupos de mujeres de origen mexicano en la región fronteriza Tijuana, Mexico-San Diego, Estados Unidos. El primer objetivo es contribuir al conocimiento del aborto voluntario entre las mexicanas, mediante su práctica en el país vecino del norte. Un segundo objetivo es examinar el comportamiento diferencial del aborto entre subgrupos étnico-lingüísticos de mujeres que coexisten en el contexto transfronterizo. La información proviene de 1 190 expedientes clínicos de Womancare, Planned Parenthood, de San Diego y Riverside, correspondientes a 1993. Los resultados indican la existencia de distintos patrones de aborto entre las mujeres, los cuales se expresan en variaciones en la edad al abortar, la edad al primer embarazo, las opiniones acerca del aborto, los motivos para abortar y las estrategias de recuperación emocional en la fase posaborto.
Notes : Español/espagnol/SpanishAbstract : contenido: Cuando digo aborto... ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : En los medios gráficos ; En los talk shows televisivos ; Propuestas ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Una transición demográfica temprana y completa ; De la disparidad a la homogeneidad ; Los determinantes del cambio en la fecundidad ; Inequidad reproductiva y grupos vulnerables ; Referencias bibliográficas generales ; Anexo estadístico y documental.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : In a response to an article by Benjamin and Haendel on the Cuban medical system (Links, Fall 1991), A.F. Brown criticizes the 2 authors for failing to call the Cuban medical system by its rightful name: superior to that of the US. According to Brown, Benjamin and Haendel's own data bear out the fact that Cuba has a better medical system than the US. Life expectancy is 76 years in Cuba compared with 75 in the US. Doctor/patient ratio is double that of the US. In 1990, there were no measles cases in Cuba compared with 25,000 cases in the US. In Cuba, there is 100% prenatal care coverage and hospital delivery; abortion is free and available on demand; and immunization rates are nearly 100%. As Brown explains, the 2 authors omit an important feature of comparison between the 2 systems: in Cuba there is free and universally available medical care, while some 35 million US citizens lack any health insurance. In their article, Benjamin and Haendel describe Cuba's response to the AIDS epidemic ; mass testing for HIV and confining all seropositive cases ; as draconian. But according to Brown, the fact that Cuba's rate of infection is 0.19/100,000 compared with a rate of 13.88/100,000 in the US validates the policy. Brown also dismisses criticism that there are too many doctors in Cuba, that nurses have a low status, and that such physician-heavy system is not cost-effective. Failure to acknowledge the superiority of the Cuban health care system, Brown maintains, reflects an attitude that such a system is too good for them ; and better than ours.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 072737Abstract : Cuerpo y Derecho" es el primer proyecto latinoamericano de estudios comparados de la jurisprudencia de las altas cortes de la última década del siglo XX relacionada con los derechos del cuerpo en la sexualidad y la reproducción. El libro incluye una descripción del sistema político y jurídico, la estructura judicial y las leyes vigentes y decisiones judiciales de las altas cortes de cinco países (Argentina, Chile, Colombia, México y Perú). Este trabajo surge como respuesta a la necesidad de estudiar el discurso judicial de las altas cortes con relación a los Derechos de la mujer y, en particular, a los derechos del cuerpo en la sexualidad y la reproducción, en razón a las continuas denuncias de que no existe una protección real de los derechos de quienes acuden a la administración de justicia.
Notes : Español/espagnol/SpanishAbstract : Este publicación es la primera investigación latinoamericana en hacer un estudio comparado de la jurisprudencia de las Altas Cortes de la última década del siglo XX relacionada con los derechos del cuerpo en la sexualidad y la reproducción. La versión completa incluye una descripción del sistema político y jurídico, la estructura judicial y las leyes vigentes y decisiones judiciales de las Altas Cortes en temas relacionados con los derechos sexuales y reproductivos.
Web site : http://www.reproductiverights.org/pdf/bo_jurisp_sp.pdfAbstract : Introducción ; Aspectos metodológicos ; Aspectos conceptuales ; Adolescencia y sexualidad ; Género y sexualidad en la adolescencia ; Anticoncepción y embarazo adolescente ; El embarazo adolescente en el contexto nacional ; VIH y SIDA en las adolescentes ; Obstáculos y limitaciones para el diseño de políticas públicas de salud para los/las adolescentes ; Algunos resultados de la investigación ; Las adolescentes ; El inicio de las Relación sexual en la adolescencia ; Los Servicios de adolescencia y los/las profesionales ; Caracterización de la oferta según los profesionales entrevistados ; Motivos de consulta ; Conocimiento del cuerpo, ciclo reproductivo y anticoncepción ; Enfermedades de transmisión sexual y VIH ; El aborto ; Conclusiones preliminares
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : La ciudadanía de las mujeres comienza, se desarrolla y culmina en sus cuerpos, territorio personal y privado sobre el cual deben estar capacitadas para adoptar decisiones soberanas, es decir, libres de coacción o violencia. La autonomía es, por lo tanto, fundamental para dicho ejercicio, al igual que el acceso a información adecuada y suficiente, y a servicios de salud sexual y reproductiva donde se asegure una atención de la más alta calidad. Por lo tanto, la defensa de la libertad sexual y reproductiva y del control del propio cuerpo constituye un elemento central de la agenda feminista, y debe ser considerada un principio ético político no negociable.El acceso al aborto legal, seguro y gratuito forma parte intrínseca de la autonomía sexual y reproductiva, y se sustenta no solo en consideraciones sanitarias, sino más bien en la perspectiva de las mujeres como sujetas de derechos, con plena capacidad moral para tomar las decisiones más favorables de acuerdo a sus realidades de vida. En ese sentido, numerosas reflexiones acerca de la penalización del aborto que aún persiste en numerosos países, enfatizan que este castigo atenta directamente contra el goce de una serie de derechos humanos y ciudadanos de las mujeres, entre otros: -El derecho a la vida, -El derecho a la libertad y seguridad personales, -El derecho a gozar del más alto nivel de salud, -El derecho a la igualdad y a la no discriminación, -El derecho a la autodeterminación, -El derecho a no ser sometida a torturas, -El derecho a no ser objeto de injerencias arbitrarias, -El derecho a la libertad de pensamiento, conciencia y religión, -El derecho a controlar su propia fecundidad, -El derecho a la privacidad -El derecho a contar con servicios de salud reproductiva y acceso al aborto seguro para responder a las necesidades de salud, -El derecho a los beneficios del progreso científico, -Y, por cierto, los derechos sexuales y reproductivos. La Red de Salud de las Mujeres Latinoamericanas y del Caribe, RSMLAC, uno de cuyos principios de acción prioritarios es, precisamente, la defensa irrestricta de la libertad sexual y reproductiva y del derecho al aborto como derecho humano, ofrece esta edición de Cuadernos Mujer Salud como un aporte a las discusiones relativas al tema que se desarrollan en nuestra región.
Notes : Español/espagnol/SpanishAbstract : Movements for reproductive rights in Latin America contend with the strong influence of the Catholic Church. In Argentina and Chile, two predominately Catholic countries where abortion is illegal yet commonly practiced, reproductive rights activists consider the Church to be their focal opponent. Political opportunity theory would suggest that weaker links between political and religious elites in Chile would provide more political opportunity for activists seeking reproductive rights, but the opposite is true. In Chile, the strong links between Church and society make Chilean activists more cautious in their criticism. Religious and political elites are more allied in Argentina than in Chile, yet the Argentine movement is stronger and more critical. In this paper, I analyze social movement materials and information from personal interviews with activists to argue that societal or 'cultural opportunity' may be more important in the strategic use of religion. Synthesizing political and cultural variables is important for movements that make claims on both State and society, especially movements that challenge powerful social actors like the Catholic Church.
Notes : Inglés/anglais/EnglishAbstract : Neste relatório, elaborado por Ipas, busca-se avaliar a evolução ocorrida em paises da América Latina, no cumprimento das definições do novo marco conceitual, estabelecido pela Conferência Internacional sobre a População e Desenvolvimento(CIPD) celebrada no Cairo, no Egito em 1994; centrado no direito das pessoas com um enfoque integral em torno da saúde reprodutiva e na participação das mulheres na tomada de decisões que afetam sua saúde e direitos. Para avaliar as mudanças ocorridas relacionadas com os serviços de aborto seguro, nesse período, desde a CIPD de 1994 e da revisão de cinco anos depois, Ipas estudou a situação da saúde reprodutiva na região, centrando-se no tema do aborto e conduziu entrevistas com pessoas-chave, intimamente relacionadas com esse tema no grupo selecionado de paises. O relatório aponta que; embora tenham ocorrido avanços na saúde reprodutiva das mulheres a partir do próprio engajamento desses paises, com movimentos visando fortalecer a luta pela ampliação e normatização de programas de saúde reprodutiva e no direcionamento aos compromissos estabelecidos na CIPD; vários fatores tem impedido essa evolução, entre eles: a falta de compromisso político, as pressões dos movimentos contrários e a redução de interesse e recursos dos apoiadores para a região. " Depois de 10 anos desde que se celebrou a conferência do Cairo, é essencial manter o ímpeto e multiplicar esforços para dar seguimento aos governos e assegurar que se responsabilizem pelos compromissos que adquiriram em 1994".
Web site : http://www.ipas.org.br/arquivos/ipas%20internat/ICPD_LAC_book_es.pdfAbstract : Neste relatório, elaborado por Ipas, busca-se avaliar a evolução ocorrida em paises da América Latina, no cumprimento das definições do novo marco conceitual, estabelecido pela Conferência Internacional sobre a População e Desenvolvimento(CIPD) celebrada no Cairo, no Egito em 1994; centrado no direito das pessoas com um enfoque integral em torno da saúde reprodutiva e na participação das mulheres na tomada de decisões que afetam sua saúde e direitos. Para avaliar as mudanças ocorridas relacionadas com os serviços de aborto seguro, nesse período, desde a CIPD de 1994 e da revisão de cinco anos depois, Ipas estudou a situação da saúde reprodutiva na região, centrando-se no tema do aborto e conduziu entrevistas com pessoas-chave, intimamente relacionadas com esse tema no grupo selecionado de paises. O relatório aponta que; embora tenham ocorrido avanços na saúde reprodutiva das mulheres a partir do próprio engajamento desses paises, com movimentos visando fortalecer a luta pela ampliação e normatização de programas de saúde reprodutiva e no direcionamento aos compromissos estabelecidos na CIPD; vários fatores tem impedido essa evolução, entre eles: a falta de compromisso político, as pressões dos movimentos contrários e a redução de interesse e recursos dos apoiadores para a região. " Depois de 10 anos desde que se celebrou a conferência do Cairo, é essencial manter o ímpeto e multiplicar esforços para dar seguimento aos governos e assegurar que se responsabilizem pelos compromissos que adquiriram em 1994".
Web site : http://www.ipas.org./english/publications/international_health_policies.aspAbstract : Cytotec is a brand name for misoprostol, a synthetic analogue of prostaglandin E1. Cytotec was developed in the 1970s for the treatment of certain gastric and duodenal ulcers. Like all prostaglandins, Cytotec makes smooth muscles, including the uterus, contract. In Brazil, Cytotec was widely used by women to self-induce abortion. When this became known, the government took action to keep the drug out of the hands of women. Cytotec was introduced in Brazil in 1986, and information about its abortifacient qualities quickly spread through a large "underground" network. In 1988, the drug was approved in the US for use against ulcers, and anti-abortion groups publicly opposed the granting of this license because of Cytotec's abortifacient effect. This led anti-abortion activists in Brazil to begin a campaign to restrict sales of the drug, and restrictions were duly in place by 1992; however, the drug is still available on the black market. It is difficult to estimate the extent of Cytotec use during this period, but interviews with gynecologists and with women who used the drug indicate that its use was becoming more and more common, that it reduced the health risk associated with illegal abortions, and it influenced the attitudes of women and physicians towards abortions. Many of the women who used the drug felt that its use should be limited to certain conditions, such as the first month of pregnancy. Most would not recommend it or use it again themselves. Women in the women's health movement are beginning to organize politically around the issue of abortion in Latin America. Until women in this region are presented with opportunities to achieve safe abortion, they will continue to bear unwanted children or to attempt to terminate unwanted pregnancies despite the danger this action entails.
Web site : http://www.rhmjournal.org.ukAbstract : Aborda el tema del embarazo, la reproducción, la anticoncepción y la sexualidad, realizando una revisión histórico religiosa de las tradiciones y conceptos que han marcado el desarrollo social de nuestro país. Puntualiza la importancia de diferenciar entre sexualidad y sumar como una parte importante que debe ser tomada dentro de la educación sexual, por la que aboga. Describe las diferentes medidas de anticoncepción presentando mitos e informaciones sobre sus usos y conveniencias. Plantea el aborto como el último recurso resaltando sus diversas implicaciones y que debe ser una decisión de la mujer basada en su contexto específico
Notes : Español/espagnol/SpanishAbstract : Diálogos de jóvenes que expresan sus dudas e inquietudes en torno a las emociones, al amor, a su desarrollo físico, su conocimiento de la vida, sus vivencias como experiencias en su relación con otros jóvenes y con la familia; invitan a reflexionar sobre el hecho de prevenir infecciones de transmisión sexual y embarazo
Notes : Español/espagnol/SpanishAbstract : Reproductive health care and especially abortion are examined from the perspective of nurses and social workers. The work begins by discussing the role of women as the principal providers of reproductive and other health care to their families throughout most of history, and their current relegation to lower status employment as nurses and social workers. Sexual and reproductive rights and health care are then explored, with safe and legal abortion defended as a reproductive right. The next chapters correct a variety of myths and unfounded beliefs about abortion, and present information on the legal status of abortion throughout the world and in Mexico. Estimates of the number of abortions in Mexico, the cost of treating complications, the extent of abortion-related morbidity and mortality, the ethics of abortion, and the characteristics of women seeking abortion occupy the next chapter. The often deficient treatment of women hospitalized with complications of illegal abortion and international accords concerning postabortal care are then discussed. The Second International Abortion Matters Conference held in Amsterdam in 1996 and its declaration are described. The final chapters analyze the causes of the low status and compensation of female employment from a gender perspective and call for improvements.
Web site : http://www.gire.org.mx/Abstract : Experiencia sistematizada que promueve y apoya la recuperación práctica teórica de las experiencias de capacitación en salud reproductiva con una perspectiva de género desde las ONGs de mujeres y mixtas en Ecuador. Experiencia de un servicio de salud alternativo dentro de un modelo que se llevó a cabo con la colaboración de una ONG e instituciones gubernamentales
Notes : Español/espagnol/SpanishAbstract : This study measured the contribution of abortion-related deaths to overall maternal mortality and calculated the underestimation of maternal mortality using verbal autopsy and clinical record review where available. We reviewed 807 death certificates of women aged 12-50 who died in 2001 in two sites of about 1.5 million inhabitants each in the state of Morelos (primarily rural) and the municipality of Nezahualcóyotl (primarily urban) in the state of Mexico. Deaths were classified as definite, possible or non-maternal deaths. Finally, we identified abortion-related deaths and calculated the underestimation of maternal mortality. Among 326 possible maternal deaths, we encountered five misclassified cases: one spontaneous abortion and four non-abortion maternal deaths. Among 32 registered maternal deaths, we found four misclassified cases that were actually second trimester, abortion-related deaths. There were no officially registered abortion-related deaths in either Morelos or Nezahualcóyotl, making the overall underestimation of abortion mortality 100%. Abortion contributed 13.5% of all maternal deaths. The overall underestimation of maternal mortality was 13.5%, higher in Morelos (21.7%). There were no unregistered maternal deaths in Nezahualcóyotl. Unsafe abortion continues to be an important cause of maternal mortality, though first trimester deaths appear to be decreasing. We identified domestic violence as an important cause of death among pregnant and post-partum women, and two abortion-related suicides, and believe these should be reconsidered as indirect maternal deaths. The misclassification of second trimester abortion deaths as maternal deaths from other causes is an obstacle to preventing them.
Web site : http://www.rhmjournal.org.ukAbstract : Colombia and Uruguay are the sites of active movements aimed at decriminalizing abortion. The Colombian Network for Women's Sexual and Reproductive Rights supported a decriminalization bill that was based on operationalization of rights guaranteed in the country's Constitution as well as United Nations resolutions adopted by the Republic; however, the bill lacked sufficient public and legislative support to be presented. Although Colombia's Constitution acknowledges the right of couples to determine their family size, there is no sex education and effective methods of contraception are not available. In Uruguay, representatives of the four political parties have introduced a bill that permits abortion in the first trimester, although the reason for pregnancy termination must be stipulated and the father must agree. Second-trimester abortions would be legal only if necessary to save the life of the mother or in cases of fetal deformities. Specific regulations are outlined for adolescents and the disabled. Finally, physicians with moral objections to abortion are excused from performing the procedure. The observance of a Day of Action to Decriminalize Abortion in Latin America and the Caribbean (September 28, 1994) is indicative of the growing strength of the pro-choice movement.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 096815Abstract : En torno al artículo 86 del Código Penal sobre el aborto. Su significación actual Resumen y contenido: Deber del Estado y derechos reproductivos -- Derecho Internacional de los Derechos Reproductivos -- Límite de los Estados, legislación interna -- Derechos reproductivos y aborto -- Derechos interno y aborto -- ¿Qué se penaliza? -- A modo de conclusión
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Este sitio fue construido por las y los integrantes de DECIDIR, un grupo de jóvenes activistas que trabajamos por los derechos sexuales y reproductivos de las y los jóvenes, convencidos de la importancia de la creación y consolidación de espacios de libertad y de respeto a la diversidad. Quienes integramos DECIDIR no tenemos filiación política alguna, ni profesamos como grupo religión o creencia dogmática, y de ninguna manera promovemos que alguien lo haga. Sin embargo respetamos a las personas que así decidan hacerlo.
Web site : http://decidir.org.mx/index.htmAbstract : A mulher argentina encontra restrições arbitrárias e discriminatórias em relação a sua decisão reprodutiva, ao acesso a meios contraceptivos, e ao aborto. Portanto, muitas mulheres são obrigadas a escolher entre uma gravidez e o nascimento indesejado ou de alto risco, ou ainda, o aborto ilegal e inseguro. O aborto inseguro pode provocar seqüelas permanentes ou até a morte. O Ministério da Saúde afirma que hoje na Argentina são feitos aproximadamente meio milhão de abortos ilegais por ano, o que reperesenta 40 porcento do total de gestações. Esta alta taxa de gravidezes interrompidas atráves do aborto é uma prova concreta da ausência de acesso a informações e a serviços de planejamento familiar que as mulheres encontram. O aborto inseguro tem sido a causa principal da mortalidade materna na Argentina por várias décadas. "Decisão Negada" e um relatório do Human Rights Watch que documenta as conseqüências trágicas e pessoais decorrente das restrições que a Argentina impõe aos direitos reprodutivos das mulheres.
Web site : http://hrw.org/portuguese/docs/2005/06/15/argent11123.htmAbstract : Este informe se basa en una investigación de campo realizada en Argentina entre septiembre y octubre de 2004, así como en investigaciones anteriores y posteriores. Una integrante del equipo de Human Rights Watch entrevistó a profundidad a más de cuarenta mujeres y una niña que experimentaron problemas en el acceso a anticonceptivos o que se habían sometido a abortos ilegales y poco seguros. Estas entrevistas se llevaron a cabo en las provincias de Buenos Aires, Tucumán y Santa Fe. Todos los nombres e información que puedan servir para identificarlas han sido cambiados para proteger su privacidad. Contenido : I. Resumen ; II. Recomendaciones ; Al gobierno de Argentina ; A los donantes ; A la Federación Argentina de Sociedades de Ginecología y Obstetricia ; III. Marco general y antecedentes ; La condición política, económica y social de la mujer ; Nacionalismo y el rol procreador de la mujer ; La oposición de la Iglesia Católica a los derechos reproductivos ; IV. Obstáculos generalizados en el acceso a los anticonceptivos ; Violencia doméstica y sexual ; Información tendenciosa, incorrecta, o incompleta ; Restricciones económicas ; V. Ligadura tubaria voluntaria: Un estudio de casos sobre la denegación de acceso a anticoncepción ; La ligadura tubaria y la ley ; Decisiones de la mujer sujetas a la autoridad masculina ; Decisiones de la mujer sujetas a veto médico arbitrario ; El dinero supera la necesidad médica: Acceso disponible en clínicas privadas ; El requisito de la autorización judicial ; VI. Obstáculos al derecho a decidir en asuntos relacionados con el aborto ; Incumplimiento de la ley ; Abortos ilegales y poco seguros ; Métodos comunes para inducir el aborto en Argentina ; Consecuencias para la salud ; Ausencia de responsabilidad médica ; Atención post aborto inadecuada o inhumana ; Obligación de denunciar a las mujeres a las autoridades ; Condenadas a prisión por aborto ; VII. Derecho internacional de derechos humanos y aborto ;Derecho a la no discriminación y a la igualdad ; Derechos a la salud y a la atención médica ; El derecho a la vida ; El derecho a la libertad ; El derecho a la privacidad y el derecho a decidir el número de hijos e intervalo entre los nacimientos ; El derecho a la libertad de conciencia y religión ; VIII. Conclusión ; Agradecimientos
Web site : http://hrw.org/spanish/informes/2005/argentina0605/index.htmAbstract : En Argentina, las mujeres enfrentan restricciones arbitrarias y discriminatorias a sus decisiones reproductivas y al acceso a anticonceptivos y al aborto. Como resultado, muchas mujeres se ven obligadas a elegir entre un embarazo y parto no deseados o peligrosos, o un aborto ilegal e inseguro que podría seriamente dañarlas o hasta incluso matarlas. Ocurren aproximadamente medio millón de abortos ilegales en Argentina al año, lo que representa un estimado 40 por ciento de los embarazos. Esta proporción muy alta de embarazos que terminan en abortos es una ilustración siniestra de la falta de acceso a información y servicios efectivos de planificación familiar. Los abortos inseguros han sido durante décadas la principal causa de mortalidad materna. "Decisión prohibida: Acceso de las mujeres a los anticonceptivos y al aborto en Argentina", un informe de Human Rights Watch, documenta las consecuencias trágicas y personales de las restricciones a los derechos reproductivos de las mujeres argentinas.
Web site : http://hrw.org/spanish/docs/2005/06/15/argent11122.htmAbstract : Women in Argentina face arbitrary and discriminatory restrictions on their reproductive decisions and access to contraceptives and abortion. As a result, many women must choose between an unwanted or dangerous pregnancy and birth or an illegal and unsafe abortion that might seriously injure or even kill them. Approximately half a million illegal abortions occur every year in Argentina, according to the health ministry, representing 40 percent of all pregnancies. This extraordinarily high proportion of pregnancies ending in abortions is a graphic testament to women's lack of access to effective family planning information and services. Unsafe abortions have constituted the leading cause of maternal mortality in the country for decades. The tragic personal consequences of Argentina's restrictions on women's reproductive rights are documented in Human Rights Watch's report, "Decisions Denied: Women's Access to Contraceptives and Abortion in Argentina," which this fact-sheet summarizes.
Web site : http://hrw.org/women/argentina/Abstract : The Andean Declaration for Motherhood Without Risks was adopted in April 1993 by the Andean Conference on Motherhood Without Risks, which was attended by delegates of the 5 Andean countries and representatives of donor agencies and international organizations. The Andean Conference was part of the World Initiative on Motherhood Without Risks launched in 1987. Each year, 5000 women in the Andean countries die of causes related to childbearing, leaving behind over 10,000 motherless children under 5 years old. An estimated 175,000 years of potential productive life are lost. Most maternal deaths are preventable. Additional resources must be assigned to health services, especially in the less favored geographic and social strata. Women in the Andean countries continue to suffer violence and discrimination, because cultural norms are stronger than juridical measures. Government protective mechanisms are evidently inoperative. Health services are generally not based on local social and cultural realities, but on the academic training of health personnel. They are often insensitive to local realities, resulting in reduced coverage. Health services are often inadequately organized to provide the truly integrated care that is needed. Improved family planning education and services would help reduce the incidence and complications of illegal abortion. Management of abortion complications requires improvement. Rates of adolescent pregnancy have been increasing in rural areas and marginal urban communities of the Andean countries. The Conference recommendations are intended to help bring about the needed changes in health and family planning policy and service delivery, and to contribute to improvement in the status and quality of life of women.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 116705Abstract : Análisis y recomendaciones respecto a la atención de la salud de la mujer. Aunque en los países se ha ratificado la Convención para la Eliminación de todas las Formas de Discriminación contra la Mujer, aún existen barreras legislativas que limitan la posibilidad de la mujer de participar en forma plena en la toma de decisiones que afectan su vida y de acceder a los recursos que necesita para mejorar su salud
Notes : Español/espagnol/SpanishAbstract : Desarrollo sostenible y población ; La población, sujeto y actorprincipal del desarrollo sostenible ; El ordenamiento territorial como proceso organizador de uso y ocupación del territorio El enfoque sistémico de la población ; Opciones y responsabilidades ; La salud reproductiva.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Presentación e intercambio de puntos de vista. Se elaboró una declaración conjunta, con un diagnóstico y recomendaciones en torno a esta problemática. Una de las recomendaciones fue la formación de un comité promotor que dé seguimiento a la declaración y realización de comités y conferencias en distintos estados del país
Notes : Español/espagnol/SpanishAbstract : Este documento recoge la política oficial del gobierno de Bolivia en materia de población. Fue presentada por la delegación boliviana a la Conferencia Internacional sobre Población y Desarrollo en El Cairo, en septiembre de 1994. Termina con un acápite sobre salud reproductiva que hace alusión a la política estatal sobre planificación familiar, el derecho reproductivo a decidir libremente el número y espaciamiento de los hijos, la libertad de opciones, el aborto como problema de salud pública, el aborto inseguro, y el deber de las políticas y programas sociales y de salud de ayudar a las parejas, especialmente a las mujeres, a evitar el aborto proporcionñandoles acceso a información, asesoramiento y servicios de planificación de la familia. Establece que las mujeres que hubieran recurrido al aborto deben ser tratadas humanamente y con la debida orientación; y termina mencionando las causales del aborto impune.
Notes : Español/espagnol/SpanishAbstract : Voluntary abortion is the most controversial act in the entire field of medical practice, although today it is a practice that, under different conditions, has been legalized in more than 100 countries, mostly in the developed world. The UN has agreed that in no case should abortion be promoted as a method of family planning and, therefore, it should be utilized only when contraception has failed. Overall, 61% of humanity lives in countries where abortion is legal and widely available; 14% in countries where termination is allowed to protect a woman's health ; physical, mental, or both; 21% in countries where it can be performed only to save the mother's life; and 4% in countries where abortion is not permitted at all. Restrictive legislation, per se, does not represent a valid deterrent to prevent abortion, while it may contribute to an increase in morbidity and mortality associated with pregnancy. In addition, because abortion is outlawed, nothing is done to actively reduce the reasons leading to it. Indeed, the countries with the lowest abortion rates are those where, on the one hand, pregnancy termination is legal and, on the other, sex education and contraceptive knowledge are widely spread. (author's)
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : This decree sets forth a new version of the Brazilian Social Welfare Benefits Regulations. Among the benefits to be provided are family allowances and maternity benefits. The rate of family allowances is Cr$1.360,00 per child under the age of fourteen if the worker earns less than Cr$51.000,00 per month; and Cr$170,00 per child under the age of fourteen if a worker earns more than Cr$51.000,00 per month. Maternity benefits are to paid, regardless of worker income, for twenty-eight days before and ninety-two days after delivery, under conditions set forth in the Labor Code. This period may be extended by two weeks for reasons of health, certified by the state health system. Women who have undergone a legal abortion are entitled to two weeks of paid maternity leave. Payment for maternity leave is to be equal to the worker's salary. Workers must furnish employers with a statement that they have received maternity benefits, and employers are required to keep, for ten years, records of maternity benefits paid. Further provisions of the decree describe other benefits covered by the regulations and set forth rules on eligibility, among other things. The benefits provided by this decree are in accord with those provided by Law No. 8213 of 24 July 1991, which approved social welfare benefits plans (Colecao das Leis, Vol. 183, No. 4, 1991, pp. 1587-1638.)
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 087221Abstract : Although Mexico passed the Population Law in 1973, which gave everyone the right to freely and responsibly choose the number of children, abortion in practice is still a crime. Mexican women have sought legal abortion since 1937. The movement to legalize abortion has not been strong enough to convince the state to make legislative reforms. The Catholic Church and conservative groups are active in defeating reforms. Political campaigns prior to 1988 focused on Mexican women's right to vote. The abortion debate was still considered too taboo for political discussion. Illegal abortions are performed in clean hospitals and unsanitary doctor's offices but are never prosecuted. The cost varies. The Pro-Life group in Mexico in 1989 used the same methods used in the US, such as widespread raids on abortion clinics and detentions of patients. Strong public protest forced a decline in persecution, but conservative politics were stronger and better financed than supporters of abortion legalization. Reform of the Mexico City Criminal Code is scheduled for debate in November 1989. The abortion provision includes a variety of reasons for abortion, but it does not include economic reasons. Mexico supports the UN Population Activities for reducing population growth. The government set up eight family planning programs in the poorest, most populated rural areas. The Health Ministry found that the cost of illegal abortion was greater than provision of abortion services in government clinics. These actions give hope for reform. The feminist movement in Mexico is marginal and declining. There is hope in political action from the top level of government administration.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 110763Abstract : This news article summarizes the meeting on "Abortion in Latin America and the Caribbean. Women's Rights in the Global Context," held in Rio de Janeiro on December 2-4, 2001. The meeting is part of the effort in September 28 Campaign for the Decriminalization of Abortion in Latin America and the Caribbean managed by Brazil's National Feminist Network for Reproductive Health and Rights. Participants analyzed and discussed the existing global context of abortion and its impact on women's rights.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : The experiences of Augustinian nun and theologian Ivone Gebara with poor women in Brazil, where maternal mortality from illegal abortion is 10%, prompted her to advocate the decriminalization and legalization of abortion. Gebara argues that the Catholic view of abortion as murder of an innocent fetus must be modified in a situation where abortion is already being practiced on a wide scale and represents a form of institutionalized violence against Brazilian women and society in general. Gebara refused to follow the instructions of the National Conference of Catholic Bishops of Brazil and Jose Cardozo Sobrinho, the archbishop in Recife, to publicly retract her position. In this statement, issued after her refusal, Gebara notes, "Legalizing abortion is merely one of the important aspects of a broader struggle within a society that condones the social abortion of its sons and daughters. A society that does not provide the conditions of adequate employment, health, housing, and schools is an abortive society. A society that obliges women to choose between keeping their jobs and terminating pregnancy is an abortive society. A society that continues to permit pregnancy testing as a requirement for hiring women is abortive. A society that remains silent about the responsibility of men and blames only women, disrespects their bodies and their history, that is exclusive and sexist, is an abortive society." to Gebara, legalization of abortion represents a historically imperative defense of life, not the affirmation of the goodness of the act itself.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 095140Abstract : Proporciona información sobre la violencia relacionada a la sexualidad. Abre la discusión en relación a lo que significa darle sentido a lo que entendemos por vida, respeto, dignidad, libertad y placer. Propone también darle importancia a la contraparte, es decir, a la transgresión, lo prohibido y lo sancionable, de acuerdo a lo establecido en la Declaración de Naciones Unidas para la Eliminación de la Violencia contra la mujer. El objetivo central del estudio es producir conciencia social pasando del reconocimiento de la violencia sexual como un problema social a la justicia de la misma
Notes : Español/espagnol/SpanishAbstract : Introducción ; Las políticas de población durante el gobierno del Dr. Alfonsín ; Nupcialidad, Fecundidad, Anticoncepción ; Proyectos de Ley presentados en la Cámara de Senadores ; Proyectos de Ley presentados en la Cámara de Diputados ; Las políticas de población durante el gobierno del Dr. Menem ; Nupcialidad, Fecundidad, Anticoncepción ; Proyectos de Ley presentados en la Cámara de Senadores ; Proyectos de Ley presentados en la Cámara de Diputados Particulares ; Debates Parlamentarios ; La posición del Poder Ejecutivo ; Las políticas de población durante el gobierno del Dr. de la Rua ; En la Cámara de Senadores ; En la Cámara de Diputados ; Debates Parlamentarios ; Conclusiones ; Reflexión final
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Statistics are presented on the sex ratio, fertility, mortality, educational status, nuptiality, and migration of Cuban women during the 1980s. In 1990, 49.7% of the Cuban population of 10,792,923 was female. The sex ratio in 1981 was 97.7 overall, 102.6 in urban areas and 88.6 in rural areas. It was 94 for ages 0-4 and over 100 for ages over 30. The Cuban population is aging; between 1981 and 1990 the mean age increased from 29.5 to 32.7 years. Cuba's total fertility rate declined from 4.7 during 1960-65 to 1.82 during 1981-90. The highest age specific rates were in the 20-24 cohort. The 1987 National Fertility Survey indicated that 92.6% of women surveyed had used a contraceptive method at some time and 60.5% currently used a method. 9.8% used oral contraceptives, 29.2% IUDs, 18.0% sterilization, and 1.5% condoms. Abortion continues to be widely used. There were 147,530 reported abortions in 1990. The rate was 45.6/1000 women 12-49 years old, and there were 43.9 abortions per 100 pregnancies. The crude death rate in 1990 was 6.0/1000 for women and 7.5 for men. Life expectancy at birth was 76.8 years for women and 72.9 for men during 1988-89. The maternal mortality rate declined from 52.6 in 1980 to 31.6 in 1990. 93% of Cuban women were literate in 1990. Women attained educational levels similar to those of men. According to the 1987 National Fertility Survey, 19.3% of reproductive-age Cuban women were single, 34.7% were married, 28.4% were in union, 6.6% were divorced, 10.3% were separated, and 0.7% were widows. 38.9% of women were economically active in 1990.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 111172Abstract : El presente documento incluye (1) una breve revisión del estado de la legislación en materia de aborto en América Latina y (2) un análisis en profundidad del derecho internacional de los derechos humanos en este campo. Además de citar el contenido de diferentes tratados internacionales en la materia, este documento se basa fuertemente enel trabajo realizado por los órganos de supervisión de la ONU. Human Rights Watch espera que este compendio de derecho internacional sirva para apoyar los esfuerzos de las activistas por los derechos de las mujeres de América Latina en su trabajo por superar los desafíos al derecho de las mujeres a decidir de manera independiente sobre temas relacionados al aborto.
Web site : http://abortolegal.org/DDHHaborto_legalfinal.pdfAbstract : Conceptos y estudio de los Derechos humanos de las mujeres.
Web site : http://www.unifem.org.mxAbstract : En esta página se responden una serie de preguntas, consideradas esenciales para entender la relación entre los derechos humanos y el aborto ¿Por qué el aborto es un tema de derechos humanos? , Derecho a la vida, Derechos a la salud y a la atención médica , Derechos a la no discriminación y a la igualdad, Derecho a la seguridad personal, Derecho a la libertad, Derecho a la privacidad, Derecho a la información, Derecho a no ser sometido al trato cruel, inhumano y degradante , Derecho a decidir el número de hijos e intervalo entre los nacimientos, Derecho a gozar de los beneficios del progreso científico, Derecho a la libertad religiosa y de conciencia , ¿Cuáles son las consecuencias en la salud del aborto ilegal e inseguro? , ¿Por qué el aborto ilegal suele ser inseguro? , ¿El derecho a la vida aplica al feto? , ¿Cuál es la posición de Human Rights Watch con respecto al aborto?
Web site : http://hrw.org/backgrounder/americas/argentina0605/qna0605sp.htm#cAbstract : Demuestra que el incumplimiento de los derechos reproductivos por parte de los países es una violación a los derechos humanos. Por lo tanto el respeto a la autodeterminación reproductiva comprende la prohibición de todas las formas de discriminación así como la eliminación de leyes y prácticas que permiten tal discriminación. Los derechos reproductivos tienen escaso valor si el gobierno, organizaciones e individuos no se comprometen a cumplirlos
Notes : Español/espagnol/SpanishAbstract : Presenta los materiales legales internacionales básicos para la defensa de los derechos reproductivos de las mujeres. Define derechos reproductivos y plantea el marco legal boliviano que permite su defensa. Desarrolla igualdad de derechos, políticas de población, salud reproductiva, aborto y familia como capítulos individuales
Notes : Español/espagnol/SpanishAbstract : La intención de este documento es la de presentar un "reporte sombra" del informe del Estado argentino al Comité de Derechos Humanos. Este informe ha sido recopilado y escrito por el Instituto de Género, Derecho y Desarrollo (IGDD), de Rosario, Argentina, y editado por el Center for Reproductive Law and Policy (CRLP). Este informe enfoca particularmente los derechos sexuales y reproductivos reconocidos en conferencias recientes tales como la Conferencia Internacional de Población y Desarrollo, de El Cairo, en 1994, y la Cuarta Conferencia Mundial sobre la Mujer, de Beijing, en 1995. El informe discute las leyes y políticas públicas relacionadas con dichos derechos, y las realidades que afectan los derechos de la mujer en Argentina. Incluye: Introducción ; Puntos principales de preocupación ; Los derechos de las mujeres en Argentina según las disposiciones pertinentes del Pacto de Derechos Civiles y Políticos ; Derecho a la salud reproductiva de las mujeres: acceso a servicios de salud reproductiva y planificación familiar, incluido el aborto seguro y legal (Artículos 3, 6, 23 y 26 del PDCP) ; Violencia contra las mujeres, incluido los menores (artúculos 3, 6, y 7 del PDCP) ; Relaciones familiares, incluida la igualdad entre los cónyuges, matrimonio y uniones de hecho (artículos 23, 24 y 25 del PDCP) ; Derecho a la educación (artículos 2, 3, 19, 24 y 26 del PDCP) ; Derechos económicos y sociales de la mujer (artículos 3 y 26 del PDCP)
Web site : http://www.crlp.org/Abstract : La intención de este documento es la de presentar un "reporte sombra" del informe del Estado boliviano al Comité de Derechos Económicos, Sociales y Culturales (CDESC). Este informe ha sido recopilado y escrito por la Oficina Jurídica para la Mujer de Cochabamba, Bolivia, y editado por el Center for Reproductive Law and Policy (CRLP) , con sede en la ciudad de Nueva York. Este informe se centra particularmente en los derechos sexuales y reproductivos reconocidas en conferencias recientes tales como la Conferencia Internacional de Población y Desarrollo, de El Cairo, en 1994, y la Cuarta Conferencia Mundial sobre la Mujer, de Beijing, en 1995. El informe discute las leyes y políticas públicas relacionadas con dichos derechos, y las realidades que afectan los derechos de la mujer en Bolivia. Incluye: Introducción ; Puntos principales de preocupación ; Los derechos de las mujeres en Bolivia según las disposiciones pertinentes del Pacto Internacional de Derechos Económicos, Sociales y Culturales ; Derecho a la salud reproductiva de las mujeres: acceso a servicios de salud reproductiva y planificación familiar, incluido el aborto seguro y legal (artículos 10,12 y 15(1)(b) del PIDESC) ; Acceso a servicios de salud, incluida la salud reproductiva ; Anticoncepción ; Aborto ; Esterilización ; VIH/SIDA ; Relaciones familiares, incluyendo la igualdad entre los cónyuges, matrimonio y uniones de hecho (artículo 10 del PIDESC) ; Igualdad entre los cónyuges, matrimonio y uniones de hecho ; Divorcio y custodia ; Matrimonio de menores ; Violencia sexual 76 contra las mujeres, incluyendo menores (artículos 10(3) y 12 del PIDESC) ; Violación y otros delitos sexuales ; Acoso sexual ; Violencia domestica ; Violencia en los servicios de salud ; Derecho a la educación (artículos 12,13,14 y 15 del PIDESC) ; Derecho a condiciones de trabajo equitativas y satisfactorias (artículos 6, 7 y 10 del PIDESC)
Web site : http://www.crlp.org/Abstract : Este informe tiene como objetivo proveer a los miembros del Comité de Derechos Humanos información recogida por sectores no gubernamentales sobre leyes, políticas y prácticas del estado peruano con relación a los derechos que son de especial importancia para las mujeres y que están consagrados por el Pacto de los Derechos Civiles y Políticos (PDCP). La intención de este documento es dar elementos al Comité que le permitan revisar y evaluar el informe oficial presentado por el Estado peruano sobre este tema. El informe cubre cinco aspectos: 1) el acceso a servicios de salud reproductiva y planificación familiar, incluyendo el aborto seguro y legal; 2) la violencia contra las mujeres; 3) las relaciones familiares, incluyendo la igualdad entre los cónyuges; 4) el derecho a la educación; y 5) los derechos económicos y sociales. Incluye: Leyes y políticas publicas que afectan los derechos reproductivos ; La aplicación de leyes y la realidad de las vidas reproductivas de las mujeres ; Introducción ; Puntos principales de preocupación ; Observaciones al informe periodico del gobierno del Perú ; Acceso a servicios de salud reproductiva y planificación familiar, incluso el aborto seguro y legal (Artículos 3, 6, 23 y 26 del PDCP) ; Acceso a servicios de salud reproducctiva y planificación familiar ; Aborto ; Esterilización ; VIH-SIDA y otras infecciones transmisibles sexualmente (ITS) ; Violencia contra mujeres (Artóculos 3, 6 y 7 del PDCP) ; Violencia sexual ; Violencia domestica ; Acoso sexual ; Relaciones familiares, incluyendo la igualdad entre los cónyuges (Artículos 23, 24 y 25 del PDCP) ; El derecho a la educación (Artículos 2, 3,19, 24 y 26 del PDCP) ; Derechos económicos y sociales de la mujer (Artículos 3 y 26 del PDCP) ; Derecho a la propiedad y la sucesión ; Derechos en el ámbito laboral
Web site : http://www.crlp.org/Abstract : A brief compendium of articles by physicians and other experts on reproductive rights, the law, and abortion is presented. The work begins by identifying the basic principles of reproductive health and their legal implications for women. The international legal framework entails viewing reproductive rights as human rights. The next chapter examines aspects of reproductive health, including health research and ethics in daily practice, bioethics as a reflection of social processes and value changes, reproductive behavior and health from the perspective of service delivery, and professional responsibility in regard to abortion. A chapter on abortion law examines the legal situation in the world and in Mexico and the practical consequences of legal status. The final section, on abortion, provides statistics on illegal abortions in Mexico, estimates of the economic impact of abortion complications, and abortion mortality. A profile of women in Mexico who seek abortion, a questioning from an ethical standpoint of the government s right to prohibit abortion, and results of national opinion surveys on who should make the abortion decision, complete the work.
Web site : http://www.gire.org.mx/Abstract : Las implicaciones conceptuales y prácticas de los derechos reproductivos y sexuales ; El progreso en la protección de los derechos reproductivos y en la promoción de la salud reproductiva: cinco años después de El Cairo ; Derechos y necesidades: repensando las conexiones en los debates sobre salud reproductiva y sexual ; Derechos reproductivos ¿Cómo avanzar? ; El derecho a la salud sexual y reproductiva: la CIPD y la Convención sobre la Eliminación de todas las formas de discriminación contra la mujer ; Sexual no reproductivo: explorando la conjunción y disyunción de los derechos sexuales y reproductivos ; El doble discurso sobre los derechos sexuales y reproductivos en América Latina: el absimo entre las políticas públicas y los actos privados ; El VIH/Sida y los derechos sexuales en el África del Sur ; El aborto en los Estados Unidos: obstáculos para el acceso ; Los derechos reproductivos en la legislación húngara: ¿un nuevo derecho para la procreación asistida?.
Web site : http://www.gire.org.mx/Abstract : El Grupo de Trabajo sobre embarazo no deseado y aborto fue fundado en 1994 como un foro interinstitucional de debate, coordinación y diseminación de investigaciones e información. Este documento fue elaborado por el Grupo en sucesivas reuniones de discusión, como base de principios y propuestas para guiar sus acciones en las áreas de salud, género y derechos de las personas
Notes : Español/espagnol/SpanishAbstract : Female sexuality is conditioned by biological factors as well as the social, political, and economic environment. The female body has nearly always been relegated to a reproductive role. Women marginalize themselves by not communicating about their sexuality with other women. Female sexuality is constrained by a system of morality imposed by the church, family and state, and by myths and taboos imposed by society. Induced abortion under unsanitary conditions is a primary cause of Bolivia's maternal mortality rate of 138/100,000 live births, the highest in Latin America. A Bolivian hospital study of 4000 women with diagnoses of abortion indicated that 62% had not used any contraceptive method due to lack of information. 77% indicated desire to use a family planning method following the abortion. An estimated 40,000-50,000 abortions are performed annually in Bolivia, and 60% of Bolivian women are believed to have had at least one abortion. Inadequate sex education, lack of family planning information and services, and ignorance of women about their own bodies and sexual and reproductive rights are factors contributing to the prevalence of induced abortion. Bolivia's government has initiated a national plan for accelerated reduction of maternal, infant, and child mortality. Family planning has been recognized as a component of reproductive health and abortion as a public health problem that should be confronted by combating its socioeconomic causes and providing couples access to family planning information and services. Family planning services should strive to make men aware of their responsibility for contraception.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 151393Abstract : Aborda los aspectos biológicos y psicosociales de la sexualidad humana,los presenta desde una visión sexológica, jurídico penal
Notes : Español/espagnol/SpanishAbstract : Neste caderno são oferecidos a parlamentares, sensibilizados com as causas e os direitos das mulheres, subsídios com bases éticas que poderão auxiliá-los na elaboração de leis referentes ao aborto e aos direitos reprodutivos. Esses assuntos tão controvertidos são objeto de fortes pressões por parte de setores religiosos fundamentalistas, que colocam dificuldades para que os pontos de vista e os interessas das partes afetadas sejam contemplados, obstruindo o caminho da reflexão, do diálogo maduro e, consequentemente, da elaboração de leis justas. Deseja-se também, com este caderno, oferecer subsídios teóricos para que mulheres católicas de diferentes setores sociais tenham argumentos para reafirmar sua capacidade ética para tomar decisões no que diz respeito à vivência da sexualidade e de sua capacidade reprodutiva.
Notes : Portugués/portugais/PortugueseAbstract : Presentación ; Agradecimientos ; Introducción ; Metodología y narrativas ; Percepciones de la sexualidad femenina y de las relaciones afectivas ; El comportamiento reproductivo: debate público y conflictos privados ; Abortar en la clandestinidad ; Reflexiones finales ; Bibliografía ; Anexos ; Guía de entrevista ; Circunstancias en torno al aborto ; Características de las entrevistadas ; Relación de mujeres entrevistadas. A través de entrevistas reseña vidas de mujeres que han experimentado abortos voluntarios, con el fin de entender el sentido que tiene para ellas y plantean posibles soluciones a sus necesidades y problemas psico sociales. Presenta las contradicciones entre el discurso público y el privado, el debate nacional sobre el aborto y una reflexión desde la psicología feminista
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : In the conviction that abortion is a fundamental right of women and that its illegal practice constitutes a serious threat to life, several Latin American women's groups have united to work for decriminalization. The groups have been attempting to increase public awareness of the consequences of illegal abortion. Official silence on the topic appears to deny the existence of a problem. Proposals in the different Latin American countries are adapted to their political and legal circumstances. In Argentina, a campaign has been underway for nearly two years to collect signatures for a petition for a law concerning contraception and abortion. The National Network for Women's Health and other groups have held regional and national workshops on the issue. In Bolivia, radio and television programs have been broadcast in Spanish and indigenous languages on the right to choose, reproductive health, and sex education. Abortion was debated in Brazil during the process of constitutional reform, but it remains illegal. Illegal abortion continues to be a reality and women's groups are lobbying for decriminalization. Abortion is considered a crime in Colombia's penal code. Attempts to legalize abortion have been rejected by the legislature without debate. The practice of abortion under the circumstances has become a lucrative business whose lack of regulation has resulted in a growing number of maternal deaths. Attempts are underway in Costa Rica to legalize abortion in cases of rape or incest. Studies show that illegal abortion is the third most important cause of maternal death. A bill to legalize abortion is under study in Chile's Parliament but has not been approved. Abortion is illegal but common in Ecuador. Efforts are underway in Mexico and Nicaragua to encourage debate on abortion. Peru's Health Commission was recently prevented from classifying abortion for any reason other than grave congenital anomaly as homicide. Abortion has been legal in Puerto Rico since 1974, but amendments and laws to limit this right are under study. A bill to legalize abortion is under study in Venezuela and is being promoted by feminist groups.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 095359Abstract : The World Health Organization (WHO) classification scheme for pregnancy terminations was modified to evaluate the accuracy of pregnancy terminations as spontaneous or induced abortion in Demographic and Health Survey (DHS) calendar data. The decision algorithm considered length of gestation at time of termination, whether contraception was used during the period before termination and, if so, reason for discontinuation, whether the pregnancy was wanted or unwanted, and age, parity, and marital status at the time of the pregnancy termination. 1993 DHS calendar data on 1539 pregnancy terminations from Turkey were applied to the classification method. The algorithm classified 1413 (92%) of the terminations. It classified 71.8% (1015) as probably induced compared to 63% as reported by survey respondents. The algorithm classified 28.2% (398) as probably spontaneous compared to 37% as reported by survey respondents. The ratio of test positive to true positive (i.e., sensitivity of the method) was 92.5%, showing that the algorithm does a good job at identifying true cases of induced abortions. On the other hand, the ratio of test negatives to true negatives (i.e., specificity of the method) was only 65%, suggesting that the algorithm yields a relatively large number of false positives. When the investigators considered the effects of errors caused by misreporting of classification on the efficacy of the proposed scheme, both sensitivity and specificity increased (assuming 10% error, 92.7% and 67.3%; 25% error, 92.9% and 71.4%; and 50% error, 93.3% and 79.1%, respectively).
Web site : http://www.popcouncil.org/publications/sfp/default.htmAbstract : El aborto en condiciones de riesgo constituye uno de los factores que más incide en los altos índices de morbilidad y mortalidad materna en Bolivia. Según datos estadísticos del Ministerio de Salud y Previsión Social, del 27 al 35% de la mortalidad materna en Bolivia es causada por complicaciones del aborto realizado en condiciones de riesgo. Una de las estrategias gubernamentales más importantes para la reducción de la mortalidad materna fue la implementación del Seguro Básico de Salud, actualmente el Seguro Universal Materno-Infantil (SUMI), en cuyo paquete básico de prestación de servicios incluyó la Atención a las Hemorragias de la Primera Mitad del Embarazo, mediante la técnica de Aspiración Manual Endouterina (AMEU). En el marco de su colaboración con el Ministerio de Salud y Previsión Social, Ipas Bolivia realizó una investigación para determinar el nivel socioeconómico y grado de pobreza de las usuarias que acuden a los servicios de atención postaborto con AMEU, así como su percepción de calidad de los servicios ofertados.
Notes : Español/espagnol/SpanishAbstract : Despite the scarcity of data on illegal abortion in Latin America, it is known that abortion occurs at all stages of fertile life and is substantially influenced by sociodemographic characteristics. But studies of pregnant adolescents have focused on determinants of pregnancy rather than of abortion. The identification and evaluation of sociodemographic determinants and of family and social influences is an indispensable step in understanding resort to abortion by adolescents. A case-control study was conducted between August 1992 and January 1993 in two Mexico City hospitals to study the influence of family composition on abortion. 110 adolescents admitted to the obstetric and gynecologic service with bleeding who subsequently aborted and 339 adolescents of the same age with term deliveries participated in the study. At the time of the pregnancy, there were no significant differences between cases and controls in age, place of birth, duration of residence in Mexico City, marital status, or occupational status. There was no difference in educational status between the two groups. Over 70% had already left school, but those still in school had a greater tendency to seek abortion. Absence of the adolescent's mother from the household doubled the probability of abortion, while absence of the father had no effect. The reproductive history of the adolescent's mother and sisters was not significantly associated with interruption of the pregnancy. The probability of abortion was 3.5 times greater for adolescents who had lived together for less than six months. Adolescents who underwent abortion had greater knowledge of the existence of methods of abortion and made more attempts to end their pregnancies. The presence of the mother-in-law as a source of support during the pregnancy increased by three times the probability of an abortion, compared to the presence of the mother as a source of support.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100716Abstract : Determinantes socio-culturales del aborto inducido en países en desarrollo : caso peruano / Magdalena Chú y A. Vásquez ; Aborto en el cono urbano de Buenos Aires : opiniones, evidencias e interrogantes / Elsa López y Alicia Masautis ; Algunos hallazgos en torno a los condicionantes sociales del aborto inducido en la República Dominicana / Denise Paiewonsky ; El aborto : qué papel juegan los hombres, esposos y compañeros? / Kathryn Tolbert ; Aborto inseguro : el caso de Nicaragua / Flor de María Marín ; Determinants of induced abortion among poor women admitted to hospitals in Fortaleza, north eastern Brazil / Chizura Misago ... [et al.] ; Determinantes del aborto en adolescentes mexicanas / Mariana Romero, Lizabeth López Carrillo, Ana Langer ; El aborto adolescente en Colombia : factores asociados derivados del contexto familiar y de la relación de pareja / Lucy Wartenberg ; La realid del aborto en Puerto Rico : investigar para educar / Yamila Azize Vargas.
Notes : Español/espagnol/SpanishAbstract : This study was conducted among pregnant women admitted to two major public hospitals of Fortaleza, Ceara, Brazil, with the diagnosis of loss of pregnancy during October 1, 1992, and September 20, 1993, using questionnaires and medical records while maintaining the anonymity of the patients. 2084 abortion cases were classified as induced abortion during this period. 2074 patients of these admitted having attempted to terminate their pregnancy themselves. Only 10 cases were classified as induced abortion based on clinical signs (cervical laceration and/or foreign objects in the vagina or the uterus). 59.7% of the women were 20-29 years old and 22.6% were under 20 years old. 4.3% were illiterate, and 73.2% had up to 8 grades of elementary education. 61.5% were either singles or did not have a stable relationship. 34% of the patients were homemakers and 10% were students. 26% of the sample had had a previous live birth, and 33.1% had had 2 or more previous births. Only 7.7% of the respondents were multiparas with five or more births. 22.2% had a history of previous induced abortion, while 11.8% had experienced a previous spontaneous abortion. 61.1% did not use any method of contraception; 12.3% used oral contraceptives, 5.3% used condoms, 11.2% used the rhythm method, 6.4% relied on coitus interruptus, and only 1.7% used injectables. 66% recounted having used misoprostol for the induction of abortion, either alone or in combination with another abortifacient. 34% of the patients reported inducing abortion by other means, including herbal medicines, injections, and insertion of foreign objects into the vagina. Among the 1369 women who admitted having used misoprostol, 89.8% mentioned the ingestion of the drug and simultaneously introducing it into the vagina. Approximately 4.0% and 6.4%, respectively, admitted having used misoprostol exclusively vaginally or orally.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89101996000100003 lng=en nrm=isoAbstract : En el estudio de la fecundidad, diferentes factores han sido ensayados para explicar su nivel y las diferencias entre poblaciones. Se habla de determinantes contextuales o indirectos (tales como la mortalidad infantil, la urbanización y el nivel educativo) y de determinantes próximos o intermedios (por ejemplo la nupcialidad y el uso de anticonceptivos) a través de los cuales cualquier factor social influye en el nivel de la fecundidad. Desde hace poco una nueva categoría de determinantes, los "no convencionales" (como la globalización, las cuestiones de género, el empoderamiento de la mujer, etc.) ha emergido. La denominación obedece a su reciente surgimiento en la discusión sobre los factores de descenso de la fecundidad y por el momento su comprensión es un desafío para los investigadores en el sentido que no hay un modelo matemático que permita conocer su peso relativo y que ayude a explicar la lógica de su influencia en la fecundidad. El presente trabajo tiene como objetivo describir las tendencias recientes de los principales determinantes próximos de la fecundidad; evaluar la vigencia del modelo propuesto por Bongaarts para estimar el efecto de estos determinantes en la reducción de la fecundidad a partir de información actualizada; así como aplicar las modificaciones sugeridas por Stover al modelo original.
Web site : http://www.eclac.cl/publicaciones/Poblacion/7/LCL2097P/LCL2097.pdfAbstract : Reconocimientos ; Presentación ; Encuesta hospitalaria ; Introducción ; Aspectos metodológicos ; Características generales de la muestra hospitalaria ; Anticoncepción y planificación familiar ; Experiencia del aborto ; Actitudes de las mujeres hacia el aborto ; Conclusión de la encuesta hospitalaria ; Hallazgos de las entrevistas en profundidad ; Las entrevistas a testigos calificados ; Las entrevistas a mujeres ; Análisis de las entrevistas a mujeres ; Actitudes de las mujeres ante la entrevista ; Los métodos empíricos y la "Teoría de laformación" ; Aspectos reproductivos ; El aborto.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : As part of a larger study of sociocultural determinants of abortion in developing countries, a case-control study was conducted in Lima between August 1992 and November 1993. 225 women treated for abortion complications at two Lima hospitals were the cases, while 254 women with no history of abortion treated in the Obstetrics and Gynecology services of the two hospitals were hospital controls and 252 women living in communities similar to those of cases were community controls. 21% of both cases and controls were adolescents. The majority of abortion seekers were aged 20-29. Educational and occupational status of cases and their partners were not strongly associated with the decision to abort, but the proportion of partners without employment was 7.8% for women in the abortion group, 5.3% for hospital controls,and 0.8% for community controls. Only 43% of respondents in the three groups stated they attended church at least once a month. Degree of declared religiosity was not associated with abortion. Women in the abortion group had a significantly greater tendency to believe that the roles of men and women are strictly defined. Abortion is prevalent in Peru despite its illegality, and abortion complications are a principal cause of maternal mortality. But only 38% of women in the abortion group were in favor of legalizing abortion, while 41% declared themselves opposed. Abortion tended to be viewed as justified only when the pregnancy resulted from rape or threatened the health of the mother, or when the infant would be seriously malformed. Most women disapproved of abortion, but those in the case group resorted to it under pressure of a precarious economic situation or unstable relationship with the partner. The decision to seek abortion appeared to be independent of whether or not the youngest child was wanted. 73% in the abortion group, 75% of hospital controls, and 92% of community controls stated that it was difficult or very difficult to obtain a safe abortion in their community.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100710Abstract : This work correlates a series of variables influencing fertility, maternal-child health, and infant mortality from Colombia's 1990 Contraceptive Prevalence, Demography, and Health Survey for 13 regions of Colombia. Causes of death among women aged 15-49 years for 1989 are then examined, and an integrated health program developed by the Association for Family Welfare (PROFAMILIA) for lower income rural and semirural women is described as an example of a successful primary health care program. Colombia's total fertility rate declined from 7.0 in 1965 to 2.9 in 1990. The marital total fertility rate among some subgroups, however, still exceeds 5.0. Fertility is often higher in rural zones, among less educated women, and among those not employed outside the home. The major fertility determinants are family planning, nuptiality, and socioeconomic status, as well as infertility due to lactation and abortion. Family size ideals also play a role. The highest fertility in Colombia today is in the departments of the Atlantic region, in Choco and the Pacific Coast, and in the subregion of the departments of Tolima-Huila and Caqueta. According to the 1990 survey, 66% of women currently in union used a contraceptive method. 62.3% of women in Cali and 61.8% in Bogota used modern methods, compared to only 41% in Tolima-Huila-Caqueta and 43% in Guajira-Magdalena. About 52% of fertile-aged women in Colombia are currently in union. The region of highest fertility have the lowest ages at 1st sexual relations, 1st union, and birth of 1st child. The 1st birth occurred at an average age of 24 years in Antioquia compared to 20 years in the Atlantic Coast. The regions of highest fertility are also those with the greatest proportion of women in union: 60% in the Atlantic region and in Tolima-Huila-Caqueta but only 46% in Antioquia. Socioeconomic status is a major fertility determinant, working through education and accessibility of family planning services. The correlation between illiteracy and fertility in positive and significant. The 1990 survey indicated that there has been progress since 1986 in the proportion of women obtaining prenatal care and professionally attended at delivery, and that the prevalence of acute respiratory infections and diarrheal diseases among children under 5 has declined. Infant mortality rates have declined as well, but are higher among the youngest and oldest mothers and for higher birth order children and those born in rapid succession. Infant mortality was also highly correlated with accessibility of health care and with socioeconomic status. Abortion and obstetrical causes were the 6th major cause of death among fertile-aged women, accounting for 5.4% of deaths overall. Mortality rates from these causes were much higher in less developed departments, accounting for 9.3% of deaths to the age group in Tolima-Huila-Caqueta, 8.6% in Choco-Cauca-Narino, and 7.1% in Boyaca-Cundinamarca-Meta, compared to 3.3% in the Valle region and 2.8% in Antigua Caldas.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 067539Abstract : In Brazil, induced abortion is illegal except in cases of rape or when pregnancy would seriously endanger the life of the pregnant woman. This paper describes a study of the determinants and medical characteristics of induced abortion in Fortaleza, northeast Brazil, from a 1-year prospective study of women admitted to hospitals with complications associated with pregnancy loss. Data were collected from hospital record excerpts and by interviewing cases. Overall, findings indicate that self-administration of medicines (mainly misoprostol) plays an important role in pregnancy termination. Most women seeking hospital care for complications of induced abortion tend to be young, single or living without a stable partner, of low parity, with limited formal education, and not using an effective contraceptive method at the time of conception. Their medical characteristics indicate fewer complications, since these women seek hospital care after self-administration of misoprostol. The findings suggest the need for improved access to family planning and health care, including surgical abortion by vacuum aspiration as well as a more efficient oral abortifacient in reducing morbidity and mortality associated with induced abortion.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : In to two public maternity hospitals in Fortaleza, Brazil, in 1992-93, a total of 4359 women admitted to the hospitals during the 12-month study period with a diagnosis of pregnancy loss were interviewed. 48% of abortions were classified as certainly induced, 40% as possibly induced, and 12% as spontaneous. 1369 (66%) of the 2074 women with certainly induced abortion reported use of misoprostol (mean dose, 400 mcg; range, 200-2400 mcg). Although sales of this abortifacient were suspended in 1991 due to concerns about congenital malformations in unsuccessful procedures, the drug remains widely available on the black market. Compared with women with an unlikely induced abortion, women with a certainly induced abortion were significantly younger, more often unmarried, had fewer living children, and were more likely to have experienced one or more previous induced abortions. The risk of infection was increased by 40% in women with certain induced abortion above that of women with unlikely induced abortion. There were no significant differences between groups in terms of the complication rate or duration of hospital stay. The use of misoprostol in this series may have contributed to the relatively low rate of severe abortion-related complications. Wider availability of emergency contraception could reduce the need for unsafe abortion in Brazil. BACKGROUND: Maternal mortality from complications of unsafe abortion constitutes a serious problem in several developing countries. There is, however, a paucity of well-designed and implemented studies in this area, especially in Latin America. The aim of this paper is to present the findings on the determinants and medical characteristics of abortions among women admitted to hospitals. METHODS: A descriptive cross-sectional hospital-based study was carried out between October 1992 and September 1993 in Fortaleza, Brazil. A Cox's proportional hazard model was used to estimate prevalence rate ratios after adjustment for confounding. RESULTS: Among 2074 (48%) women who admitted to terminating the pregnancy, 66% reported using misoprostol to induce abortion. Women with an induced abortion as compared with those with an unlikely induced abortion are younger, more often not married, have fewer children alive and experienced one or more previous induced abortions. We have not found any important differences with regard to complication or duration of stay in hospital. CONCLUSIONS: This finding, at odds with most previous studies, could reflect the special situation in Brazil where misoprostol is used for illegally-induced abortion. The use of misoprostol by this population may have contributed to the reduction of severe complications related to induced abortion which were most prevalent with more invasive methods. Recommendations are made as to the need for confirmatory studies as well as on information regarding cultural perceptions and concepts of abortion, and reasons why poor women fail to adopt available family planning methods.
Web site : http://ije.oupjournals.org/Abstract : In Brazil, legal abortions were restricted to saving a woman's life and pregnancy following a rape. Illegal abortions have been estimated at 300,000 to 3 million annually. In this study, 2048 cases appearing at two Forteleza maternity hospitals during October 1992 and September 1993 were analyzed. Findings were that 59.7% of women were aged 20-29 years and 22.6% were under 20 years of age. 4.3% were illiterate and 73.2% had primary schooling. 91.6% were Catholic. 61.5% lived alone or were in an unstable union. 34.0% were housewives. 10% were students. 34% of women had no prior live births. 33.1% had had 2-4 live births, and 7.7% had had 5 or more births. 22.2% had had a prior abortion, and 11.8% had had a previous spontaneous abortion. 61.1% used no contraception. 12.3% used the pill and 1.7% used injections. 5.3% used condoms. 11.2% used rhythm and 6.4% used withdrawal. 2.1% reported use of the diaphragm, spermicide, or breast feeding. 66% of the women had used misoprostol, a frequent abortifacient available from pharmacies and a treatment for gastric and duodenal ulcers. 34% had tried to induce abortion with herbal medications, intramuscular injections, or insertion of foreign objects. 17 women were more than 28 weeks pregnant. The proportion of induced abortions appearing in these two hospitals (48%) was similar to a study in Rio de Janeiro (50%). A study in 1991 in Fortaleza found only 31% of hospital cases due to induced abortion. Brazil appeared to be the only country where misoprostol was used for illegal abortion. The reasons for not using contraception included carelessness or lack of consideration of risk (32.1%), unexpected intercourse (18.3%), fear of side effects (22.2%), and unavailability of contraception (8%).
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100715Abstract : This paper reviews two types of determinants of induced abortion: proximate and systemic determinants. Proximate determinants are those individual-level factors that lead to unintended pregnancy and termination of an unwanted pregnancy. These relate directly to a woman's use of contraception and the immediate circumstances that lead to the decision to terminate an unwanted pregnancy. Systemic determinants more generally influence the Decision making process leading to a safe or unsafe pregnancy termination. They include access to health services as well as social, economic, religious, and policy factors. In many developing countries determinants work against a woman's intention to terminate an unwanted pregnancy safely and serious health complications may result. Findings from case studies conducted under a . World Health Organization research initiative on induced abortion in the developing world are used to examine the varying conditions under which women undergo abortions. The role of service factors in Indonesia and Chile, the use of traditional herbal preparations in Mexico, and the increased use of misoprostol in Brazil are explored. The influence of social factors in a variety of national contexts, including China, Tanzania, the Dominican Republic and Turkey. The impact of adverse economic circumstances on the abortion Decision making process is underscored in case studies from Mexico and the Republic of Korea. The way in which religious beliefs influence reproductive attitudes is discussed in several Latin American contexts. The paper ends with recommendations for further research on this much neglected topic
Notes : Inglés/anglais/EnglishAbstract : Comparative survey results were provided on response rates, marriages, sexual experience, contraceptive usage, current sexual activity, and fertility in selected Latin American countries and cities. Data were obtained from health surveys conducted since 1985 in Jamaica, the Dominican Republic, Costa Rica, and 10 Latin American cities and from demographic surveys in Panama, Brazil, Paraguay, Honduras, El Salvador, and Haiti. The health surveys pertained to a sample of men and women aged 15-24 years, while the demographic surveys only included women aged 15-24 years. Response rates varied between 72% and 97%. Reinterviews were conducted, and responses varied with educational level, marital status, premarital sexual experiences, births, and contraceptive use. The results showed that marital unions usually began for males after 19 years of age. 69-84% of males aged 20-24 years were not in a union. About 22-42% of Central American and Mexico City, ever-married women, aged 15-24 years with at least one infant, had premarital conceptions. In South America, premarital conceptions ranged from 25% in Guayaquil, Ecuador, to 63% in Santiago, Chile, and 59% in Haiti. 50-66% of pregnancies were unintended among unmarried women with at least one pregnancy in Haiti, Mexico City, Costa Rica, and Brazil. 75% were unintended in Jamaica and in Quito and Guayaquil, Ecuador. There were similar patterns of premarital intercourse in 11 of the 12 countries. The range was 12-27% among those aged 15-19 years of age. Jamaica was the exception, and, by the age of 20-24 years, almost all had had sexual experience. Male premarital sexual experience was higher, with experience reported by over 85% of males in 12 countries or cities among 20-24 year olds and 30-78% among 15-19 year olds. 91% of males were sexually experienced by the age of 19 years. Contraceptive usage increased with age at intercourse. Among those with first intercourse at the age of 18-24 years, less than 45% had used contraception. Females preferred the rhythm method, but knowledge about rhythm was under 31% for females and under 26% for males. 32-60% of males reported a partner's having had an abortion. Desired family size was 2-3 children. This inconsistent use of contraception corresponds to the low frequency and sporadic nature of the sexual behavior of these young people.
Notes : Inglés/anglais/EnglishAbstract : The main objective of this project was to develop and test a supervision instrument and corresponding guidelines to collect information about postabortion care (PAC) services andto provide constructive feedback to service providers and program managers. The instrument and guidelines were designed to be used by technical supervisors to monitorperformance and engage providers in continuous quality improvement of PAC services.Specific project objectives were: 1) to review, analyze and compare existing supervision practices and models of postabortion care, 2) to adapt the best practices of existingmaterials into one single instrument and set of guidelines that can be used by external and internal supervisors without extensive investment of staff time or changes in the datacollection forms, 3) to test the improved supervision instrument, 4) to conduct a qualitative evaluation of the effectiveness of the supervision instrument in improving and maintaining quality of PAC services provided at selected hospitals, and 5) to make recommendations and suggest best practices to supervise PAC services. As part of the project activities, existing postabortion care supervision practices were reviewed and analyzed, and, during a one-week workshop in December 2002, an international technical committee produced a first version of the instrument and guidelines. These materials were tested during a four-month period, and several limitations wereidentified at that time. Problems encountered in the use of the instrument were similar to those observed for other existing materials: the instrument was too long to be used duringshort-term supervision visits; it did not differentiate well between problems related to the overall quality of health services in general and the problems related to postabortion careservices in particular; and several items did not allow unique answers or were too subjective to provide valid responses.A group of technical advisors met in Mexico City in May 2003 to develop a second version that focused on the essential information needed to monitor quality of PAC services and useinstructions for a supportive supervision process. The supervision procedure is described in Appendix 2 of this report: "Guidelines for Supervising Postabortion Care (PAC) Services:A Constructive Approach.
Web site : http://www.popcouncil.org/pdfs/frontiers/FR_FinalReports/LAC_Regional_PAC_Supervision.pdfAbstract : Reivindicaciones y demandas de la campaña internacional con motivo del día internacional por la Salud de la Mujer. Se enfatiza que la primera causa de mortalidad materna es la irresponsabilidad y negligencia en la atención de los servicios. Contiene datos estadísticos a nivel mundial
Notes : Español/espagnol/SpanishAbstract : El objetivo del presente estudio es conocer cuál es la situación de los derechos sexuales y los derechos reproductivos en Honduras. Este estudio forma parte de uno más amplio realizado en trece países de América Latina y el Caribe, bajo la responsabilidad de cada uno de los CLADEM nacionales y/o enlaces en cada país. Recoge información relevante en torno a los derechos sexuales y los derechos reproductivos, así como los procesos políticos, sociales y económicosrelacionados con su evolución durante el período 1995 - 2000.
Web site : http://www.cladem.orgderechosdelamujer.org/html/PUBLICACIONES/Dise%F1o%20CLADEM.pdfAbstract : La investigacion muestra como el embarazo en adolescentes no se ve como un problema sino que es parte de la cultura de América Latina y el CaribeEste libro ofrece una amplia mirada sobre la salud sexual y reproductiva de adolescentes en América Latina y el Caribe, a partir del análisis de la información disponible actualmente. Su contenido está dividido en los siguientes capítulos: 1. La adolescencia y la salud reproductiva; 2. La situación actual del embarazo adolescente y del aborto; 3. Preferencias reproductivas en adolescentes; 4. La sexualidad y la formación de uniones; 5. El conocimiento en salud sexual y reproductiva y la educación sexual; 6. Uso de anticonceptivos en adolescentes; 7. Consecuencias del embarazo adolescente; 8. ITS y VIH/SIDA en adolescentes; 9. Violencia doméstica y sexual; 10. Conclusiones finales. Incluye numerosos cuadros y gráficos complementarios.
Notes : Español/espagnol/SpanishAbstract : Differentials and determinants of fertility in Bolivia were examined at the individual and aggregate level for the highlands, valleys, and lowlands and in urban and rural areas. The Bongaarts and Easterlin models were used to explain fertility. The interrelationships between proximate determinants and microeconomic variables such as cost, motivation, culture, and modernization are also examined. Data were obtained from the 1989 Demographic and Health Survey, which for the first time provided detailed data on biological, behavioral, economic, social, environmental, and cultural variables affecting fertility. The total fertility rate declined during 1985-89 to 5.06 children per woman. Considerable differences occurred between urban and rural fertility. In the lowlands, currently married fertility rates among women aged older than 30 years showed a sharp decline associated with use of modern contraceptives, higher education, and urbanization. Aggregate analysis revealed that the proportion married, contraceptive usage, and postpartum infecundability accounted for most of the variation in fertility levels. 95% of the variance was explained by proportion married, contraceptive usage, induced abortion, and postpartum infecundability. Early marriage age explained the higher fertility in the lowlands and rural areas. Breast feeding for 18.31 months in the highlands and 17.92 months in rural areas inhibited natural fertility. The lowlands had higher natural fertility and lower total marital fertility. Observed fertility was 4.9. Total fertility in the highlands and valleys was inhibited by extended breast feeding and later age at marriage. In the individual analysis, duration of marriage, second birth interval, and first birth interval were the main proximate determinants of fertility. Duration of marriage had the strongest impact, with a birth every 2.5 years over a 30-year period. Contraceptive use for total population was explained by cost of regulation. Modernization and cultural factors are interrelated in their impact on fertility. Increased education contributes to marriage postponement, lower fertility, and limited breast feeding, which contributes to increased natural fertility.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 097341Abstract : Any attempt to study the practice of illegal abortion faces the problem of asking women about a delicate, sensitive issue that has many implications. This may make it difficult to obtain truthful information on the subject. Results related to methodological aspects are emphasized, and their possible association with variables included in a cross-sectional study carried out among 1955 women aged 15-49 years is analyzed. The frequency and conditions under which induced abortion was performed in a region of S. Paulo State are investigated. The women were interviewed at home using a pre-tested, structural questionnaire. Most of the women interviewed declared they had never had an abortion, nor had they thought of having one, and 4% admitted to having had an induced abortion. However, another 16.7% said that they had taken tea or medicine at least once to bring on their menses. In this group, most of the women who thought they were pregnant at that time said they never had an abortion, in spite of having bled after drinking tea or medicine. The results lead to the conclusion that women tend to omit information on the practice of abortion when questioned directly. This is especially true of those who use oral means to bring on their menses and who seem not to consider this a way of inducing an abortion. (author's modified) (summaries in ENG, POR)
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0034-89101996000500007 lng=en nrm=isoAbstract : Esta investigación fue premiada por un programa latinoamericano de investigación sobre derechos sexuales y reproductivos. El informe reconstruye diferentes historias de casos emblemáticos de aplicación exitosa o fallida del Artículo 266 sobre Aborto Impune del Código Penal boliviano. Categoriza tanto los casos de apelación al Aborto por Violación, como las estrategias de advocacy implementadas por organizaciones feministas y campañas por el derecho a decidir. Concluye con una serie de aprendizajes para guiar futuras acciones a favor de la aplicación de la Ley, hasta ahora sin reglamentación.
Notes : Español/espagnol/SpanishAbstract : El perfil diferencial de los varones en cuanto a las conductas sexuales ; Las razones aducidas por los varones para cuidarse o no cuidarse en la relación sexual ; Los jovenes varones y las "lógicas del amor" ; La comunicación en la pareja con respecto a las prácticas sexuales ; La postura frente al aborto ; Los significados de la masculinidad ; Conclusiones ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This publication consists of a selection of studies presented at the Twentieth Congress of the Latin American Association of Sociology. The studies focused on population dynamics and social change in Latin America. The 26 papers included are organized under five main topics: demographic aging, increases in life expectancy, and survival conditions; reproductive health, including abortion; the family, life cycle, and the demographic transition; mortality and morbidity; and population and development. A primary concern of the contributions is to increase public awareness of the demographic impact of the current economic and social policies that are being implemented in the region.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND RH85032Abstract : contenido: Discurso ; Quadro comparativo ; Projeto de Lei do Senado no 78/93: descriminaliza o aborto ; Projeto de Lei do Senado n° 181/92: estabelece normas para o exercicio do planejamento familiar ; Projeto de Lei do Senado no 28/93: regulamenta o paragrafo 70 do artigo 226 da Constituiçao Federal e da outras providencias ; Agradecimento.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : El alcance del debate sobre salud reproductiva, género y derechos de las mujeres ha sido considerablemente ampliado por la constitución de un acervo crítico de literatura sobre la temática. Como contribución a ese debate, esta publicación reúne artículos producidos en el ámbito del segundo Programa de Treinamento em Pesquisa sobre Direitos Reprodutivos na América Latina e Caribe - PRODIR II- organizado por la Fundación Carlos Chagas: 1. Sexualidade em tempo de guerra: Mulheres de El Salvador. Norma Vázquez, Cristina Ibañez, Clara Murguialday. 2. Maternidad sob o signo da AIDS: Um estudo sobre mulheres infectadas. Daniela Knauth. 3. Assédio sexual no trabalho. Ana Lía Kornblit, Mónica Petracci. 4. Trabalhadoras: Direitos reprodutivos nos acordos coletivos. Vera Soares. 5. Significados da reprodução na construção da identidade masculina em setores populares urbanos. Alejandro Marcelo Villa. 6. Opções masculinas: jóvenes diante da gravidez. Irma Palma, Cecilia Quilodrán. 7. Identidade religiosa e moralidade sexual entre católicos e evangélicos. María das Campos Machado. 8. Medicina, sociedade e corpo feminino: Lima, 1900-1930. María Emma Mannarelli. 9. 126 Aborto e anticoncepção na interação da consulta médica: um estudo de caso. Mixaela Parras, Susanna Rance. 10. Tentativas de deslegitimação do direito ao aborto em Porto Rico. Alice Colón, Ana Luisa Dávila, María Dolores Fernós, Esther Vicente. 11. Entre o desejo e a norma: A depenalização do aborto no Uruguai, 1934-1938. Graciela Sapriza.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Presentación ; Argentina: el conflicto entre el hecho y el derecho; Cómo abordar el tema ; Hablan ellas; Aborto: a favor y en contra ; El discurso de laambiguedad ;Abor... ¿qué?; Epílogo.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Discussions with several groups of low-income, middle-aged women in various countries of Latin America showed that most disapproved of abortion. In the course of group discussions about the motives of women who seek abortions and the psychological and sanitary conditions under which abortion occurs, however, their disapproval became less categorical. They began to accept the need to decriminalize abortion in order to protect women. The majority, strongly influenced by the Catholic Church, believed that human life begins at conception. Others disapproved of abortion because they feared it would be used as a birth control method and would encourage promiscuity. Most disapproved of abortion for single women attempting to escape family or social censure of unmarried motherhood. Fear of health effects or death from abortion and fear of divine punishment were also mentioned. Recognition of the anguish and pain suffered by women deciding to seek abortion and the difficulty of providing for the material and other needs of many children were factors that led to reconsideration of the wholesale condemnation of abortion. The women realized that such condemnations never take the woman's circumstances into account. Some of the women felt that aborting an unwanted pregnancy would be preferable to abandoning or neglecting an unwanted child. Many of the women came to feel that abortion should be legalized at least under some circumstances.
Web site : http://www.geocities.com/catolicas/conciencia/www.catolicasporelderechoadecidir.orgAbstract : This paper analyzes the attitudes of low-income women towards abortion and contraception. A survey was conducted in 1992 with a total of 3,149 childbearing-age women living on the outskirts of the Greater Metropolitan São Paulo Area. The study focuses on a sub-sample of 583 women. Attitudes of sterilized and non-sterilized women are compared. Women, especially those sterilized, found the most important attribute of a contraceptive method to be its effectiveness. Women currently taking the pill were less likely than those sterilized to agree that sterilization was the best method because of its effectiveness. Sterilized women were less likely than non-sterilized women to trust the pill. Sterilized women were more likely than non-sterilized to have reported adverse effects from the pill. Most women found abortion unacceptable except in the case of risk to the woman's life. Women using more effective methods showed stronger negative attitudes towards abortion. The tendency to be sterilized while still young was associated with more negative attitudes towards abortion. Family planning activities in basic health care services should include individual counseling for contraceptive use.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X1999000400008 lng=en nrm=isoAbstract : Bolivian women in diverse cultural contexts continue to rely primarily on traditional methods of fertility regulation. Modern contraception has only recently been introduced within State reproductive health services. Unwanted pregnancies occur frequently, and public concern is growing with regard to high rates of morbidity and mortality from abortion practised unsafely in conditions of povert and illegality. A Dutch-funded project and a women's organization commissiones research to guide prevention of unwanted pregnancy and abortion in their peri-urban health district. Following an ethnographic study through in-depth interviews with health service users and providers, in 19995 the authors observed interactions between staff and women consulting in reproductive health and general medicine clinics. The study found contrasts between providers' frequent suppositions regarding their patients, and women's expressions of their realities. Women's accounts of their relationships with partners, and their concern about the circumstances of past abortions, were often treated as irrelevant to medical agendas. The study recommends that health workers be trained to ask, listen, acknowledge and attend to each woman's needs within her personal and socio-cultural frame of reference.
Notes : Inglés/anglais/EnglishAbstract : Dr. Halfdan Mahler is Secretary General of the International Planned Parenthood Federation (IPPF). While in Santo Domingo at the invitation of Profamilia, he was able to visit with the President of the Dominican Republic and the presidents of the Senate and the House of Representatives. Dr. Mahler praised Profamilia's efforts to reduce socioeconomic inequality and establish a new order for development by the year 2000. He spoke to whether a conflict exists between population and development, and argued that nongovernmental organizations must bridge the gap between the people and government policies. Dr. Mahler also spoke in Puerto Rico on the merits of adopting the pro-choice position regarding women's right to choose whether or not to carry a pregnancy to term. He argued against the anti-abortion stance of fundamentalists as being a position which ignores women's sexual health and rights. Pro-life groups simply want to deny women their rights to reproductive and sexual health options, and to discredit the organizations working in support of those rights. Finally, Dr. Mahler also visited Brazil where he made an extended visit to the family planning clinics of BEMFAM.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 093145Abstract : This article reports on the plan of Rebecca Gromperts, a Dutch physician, to provide a women's health clinic aboard an offshore ship, in which women are offered an alternative to illegal and unsafe abortions. The "floating health clinic", named Sea Change, will also offer counseling and contraceptive advice, as well as training to local health care professionals in post-abortion care. The ship will accommodate two doctors and a nurse and will concentrate on South America, most of Africa, and a large number of Asian countries. In addition, European countries such as Malta, Poland, and Ireland will also be targeted. According to Gromperts, no law would be breached since the procedure would be done in international waters under the Dutch flag and in a Dutch-registered vessel. However, anti-abortion groups and religious leaders, including those in Malta and Ireland have condemned the idea.
Web site : http://www.thelancet.com/Abstract : The objective of this study was to confirm the effectiveness and safety of self-administration of misoprostol every 24 h, for abortion up to 9 weeks of gestation. A group of 720 volunteer subjects with gestations from 35 to 63 days received 800 µg of vaginal misoprostol every 24 h up to a maximum of three main doses for abortion. Outcome measures assessed included successful abortion (complete abortion without requiring surgery), side effects, decrease in hemoglobin, mean time of vaginal bleeding, and mean time of return of menses. Complete abortion occurred in 644 of 720 (89.4%, 95% CI 87, 92) subjects. The mean decrease in hemoglobin was statistically significant (p = 0.0001). There were 14 subjects with clinically significant decreases in hemoglobin, but only two required transfusions. Vaginal bleeding lasted 6.7 ± 3.9 days, spotting 8.1 ± 4 days, and total bleeding 14 ± 5.3 days. Mean expulsion time was 8.0 ± 3.4 h. Although mifepristone remains unavailable, given the low price and availability of misoprostol in >72 countries of the world, this latter drug constitutes an abortion alternative, provided that a minimum clinical network is nearby or accessible.
Notes : Inglés/anglais/EnglishAbstract : Results on adolescent's knowledge, attitude, and practice in sexuality and reproductive health are presented from 2 surveys of 1199 middle-class youths aged 13-18 years in main cities of Colombia. Survey populations were selected from high schools and users of Family Compensation Fund. While traditional values and customs prevail among these youths, they nonetheless tend to begin sex between ages 15-18, and have little concern over the consequences of their sexual behavior. They are, moreover, quite ignorant about reproductive health. Sexuality is not thought of as part of marriage, women are expected to be virgins at marriage, and a resounding 87% of the study population rejected abortion legislation. 90% of the young men had their 1st sexual encounter with either a prostitute or domestic servant, while 90% of the young women had their 1st encounters with friends from within their social groups. Sexual relations from adolescence on were supported by 35% of the girls and 60% of the boys, 72% of the girls and 38% of the boys supported virginity, yet less than 10% were in favor of the notion of open relationships. 20% of the girls and 25% of the boys had active sex lives, with homosexuality representing 1.6% and 3.1% of the two sex groupings, respectively. Sex education is practically non-existent. Most young women know little of contraception, and fail to use it out of misconceptions regarding method safety, and fear of one's parents finding out. The young men, on the other hand, cite forgetfulness and inability to obtain contraception as reasons for use failure. Accordingly, 5% of the girls fell pregnant between ages 15-17, with 66% ending in abortion, and 18.6% of the girls and 12.3% of the boys admitted to having had a sexually transmitted disease. 55% indicated that they would not use contraceptives.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 069325Abstract : This paper investigates the consequences of using different economic status proxies on the estimated impact of economic status other determinants of fertility. Using micro survey data from Ghana Peru, we find that the proxies for income that best predict fertility are a principal components score of the ownership of consumer durable goods a simple sum of ownership of these durable goods. Furthermore, the choice of the proxy generally has a minor influence on the predicted effects of the control variables. We compare the results from using a restricted set of proxies, such as those available in the Demographic Health Surveys, with the results obtained using a lengthier set of proxies. Our results suggest implications beyond fertility analyses by providing researchers with an awareness of the sensitivity of microanalyses to the treatment of economic status. Our results also suggest practical recommendations for the collection of survey data. 6 Tables, 36 References. Adapted from the source document.
Notes : Español/espagnol/SpanishAbstract : El objetivo es dar a los jóvenes y adolescentes la información adecuada sobre la sexualidad, vida familiar y profesional
Notes : Español/espagnol/SpanishAbstract : This article analyzes the effect of globalization towards the efforts ensuring access to safe abortion and implementing laws on illegal abortion in Mexico. Globalization of information and communication benefited action programs through increased technology and advanced communication facilities. However, the threat of economic globalization and potentials in information and communication affected abortion and the effort to decriminalize and legalize it in Mexico. Despite official recognition of abortion as the third or fourth leading cause of maternal death, minimal attention was given which resulted to scarcity of funds and slow progress in the reduction of maternal deaths secondary to abortion. The International Conference on Population Development impelled the government to integrate reproductive health, and reproductive and sexual rights into the public policy. On the other hand, the nongovernmental organizations and the government have made headway in ensuring access to safe abortion and review of laws that contain punitive measures against illegal abortions. The 1999 Mexico City Penal Code review advocates changes related to artificial insemination without consent and increased punishment for abortion practitioners. To ensure proper access to legal abortion, awareness of the law through public information campaigns must be initiated initially. The government, on the other hand, must continue to provide policy change and service provider training for the benefit of the female population.
Web site : http://www.ingentaconnect.com/content/pal/dev/2001/00000044/00000003Abstract : L'article présente les résultats d'une recherche sur l'interruption volontaire de la grossesse en Colombie. Afin d'étudier l'ampleur de ce phénomène dans un pays où cet acte est puni par la loi, une méthodologie spécifique d'enquête a été mise au point. Cette pratique de l'interruption volontaire de grossesse est importante puisque près d'un tiers des femmes ont tenniné au moins une grossesse par un avortement. Les auteurs souli- gnent l'importance de ce phénomène dans le processus de tran- sition démographique, puisque l'avortement, en Colombie, contribue à une réduction significative de la fécondité.
Notes : Francés/français/FrenchAbstract : Respuesta a los diversos cuestionamientos sobre el aborto. Analiza los diferentes aspectos que encierra la prohibición del aborto, lo cual lleva a problemas de salud pública, justicia social y al desarrollo de la democracia
Web site : http://www.gire.org.mx/Abstract : Estudio explicativo sobre el aborto, combina fundamentos científicos, psicológicos y filosóficos en términos de reafirmar conocimientos y significados sobre este fenómeno. Su información ayuda a aclarar dudas y responder cuestionamientos sobre los cambios del cuerpo antes y después del aborto. Reflexión sobre la conducta y el pensamiento del individuo frente a lo que es la vida y dar vida a otro ser humano. Define al aborto como un problema social, económico, jurídico y moral
Notes : Español/espagnol/SpanishAbstract : Este artículo presenta un análisis de los argumentos liberales y conservadores, expuestos en la prensa mexicana, respecto al aborto. El estudio se hizo con base a diez textos periodísticos (cinco de corte liberal y cinco de tipo conservador) provenientes de la discusión del " caso Paulina " que tan extensivamente se ventiló en los medios de comunicación durante el año 2000. El análisis de los argumentos indica que los puntos de vista liberal y conservador difieren fundamentalmente en la forma de concebir el aborto y la legalidad, pues mientras los primeros consideran necesario que el aborto siga siendo legal en algunas circunstancias (como cuando el embarazo es resultado de una violación), los conservadores niegan toda posibilidad de que sea legal. Otra diferencia importante es el objeto central de cada discurso, ya que los conservadores enfocan su atención en el feto, mientras que el núcleo del discurso liberal lo hace en las mujeres. Sobresale el hecho de que los argumentos de conservadores y liberales no coinciden con los de la población, por lo que queda pendiente investigar cómo es que el público logra conciliar o ajustar los argumentos provenientes de ambos bandos al aceptar o rechazar la práctica del aborto en determinadas circunstancias.El texto es un resumen de un capítulo de la tesis de maestría en antropología social Análisis del discurso sobre el aborto en la prensa mexicana: El caso de Paulina, CIESAS, México, 2004
Web site : http://www.ciesas.edu.mxAbstract : Two recent studies, "Abortion in Colombia: Demographic and Sociocultural Characteristics" and "Risk Factors Associated with Early Pregnancy and Adolescent Abortion", provided quantitative and qualitative data for this work. Interviews in Bogota, Cali, and five smaller cities with 76 adolescents representing a wide variety of socioeconomic and family circumstances demonstrated the great importance of socioeconomic level in the abortion decisions of adolescents. For young women of the lowest social strata, abortion is often used to control their growing number of children, while in the middle and upper classes it is a means of avoiding early motherhood. School attendance and educational attainment contribute to reducing the risks of abortion at very early ages. The lack of goals in life and of alternatives to motherhood increase the risk of pregnancy and abortion in marginal population sectors. Adolescent pregnancy is associated with family dysfunction and lack of affection. Inappropriate methods of controlling adolescents contribute to the problem. The psychological and social immaturity of adolescents makes them vulnerable to pregnancy. The partners of the interviewed adolescents were significantly older than they were, and the youngest adolescents had the greatest age differences. Gender inequalities, age differences, and sometimes differences in social status restricted the capacity for self-determination of the adolescents and reduced their ability to control their relationships. Adolescents experienced the economic, family, affective, and personal pressures of their pregnancies differently depending on their social strata. Lack of assistance from the partner prompted abortion among those of scarce resources, while adolescents of middle or higher status sought abortion so as not to disappoint the expectations of their families.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100717Abstract : Contexto: La mayoría de los trabajos de investigación sobre el aborto inducido en América Latina se han centrado en los casos de mujeres hospitalizadas debido a complicaciones causadas por el aborto. Sin embargo, se conocen poco sobre las características de las mujeres que pueden obtener este procedimiento realizado por personal capacitado que trabaja en condiciones sanitarias adecuadas. Métodos: Los análisis de los registros médicos de 808 pacientes de un servicio urbano de aborto clandestino en América del Sur fueron complementados con observaciones clínicas realizadas durante seis semanas en 1995. Resultados: Casi nueve de 10 pacientes habían cursado por lo menos enseñanza secundaria, cerca del 75% tenían menos de 30 años y un porcentaje similar no estaban casadas. El 54% nunca había dado a luz y el 13% había tenido anteriormente por lo menos un aborto inducido. Tres quintos de las mujeres no se encontraban usando anticonceptivos en el momento de quedar embarazadas; entre las usuarias de un método, tres quintos habían estado usando un método tradicional. El 3% tuvo complicaciones leves causadas por el procedimiento (por ejemplo, sangrado profuso o dolor pélvico), y otro 2% presentó complicaciones severas (por ejemplo, infección pélvica, hemorragias o sospecha de perforación uterina). Conclusiones: Para reducir la necesidad de tener que recurrir a un aborto, es importante que los programas de planificación familiar incluyan en sus esfuerzos de extensión las mujeres jóvenes, las no casadas y las de un alto nivel de educación.
Web site : http://www.guttmacher.org/pubs/journals/2702401sp.pdfAbstract : Este estudio explora la práctica del aborto inducido en Perú, desde un enfoque de salud pública y desde una perspectiva de derechos, actualizando la investigación "El aborto clandestino, una realidad peruana", desarrollada en 1994 por el Instituto Alan Guttmacher. Se analiza el contexto social y demográfico del país, incluye los resultados de una encuesta de opinión a profesionales y no profesionales sobre el aborto, y ofrece una estimación del número de abortos inducidos clandestinamente por año en Perú, además de datos adicionales, como complicaciones frecuentes y razones por las cuales las mujeres abortan. Incluye: Introducción ; El contexto social y demográfico ; Nivel y tendencias de la fecundidad. El promedio de hijos por mujer. El deseo de más hijos y la fecundidad deseada ; Nivel y tendencias de la fecundidad por regiones ; Uso de anticonceptivos y problemas asociados ; Mujeres expuestas al riesgo de embarazo insuficientemente protegidas ; Encuesta de opinión a profesionales sobre el aborto ; Métodos para inducir abortos ; Dónde acuden las mujeres para solicitar un aborto ; Estimación del riesgo de complicación ; Estimación de la probabilidad de hospitalización ; Estimación del número de abortos inducidos clandestinamente por año ; Embarazos no planificados ; Datos adicionales sobre el aborto inducido en el perú ; eprfil de las mujeres atendidas en establecimientos públicos de salud por complicaciones de aborto ; Complicaciones más frecuentes del aborto inducido ; Razones por los que las mujeres recurren al aborto ; Sugerencias para reducir el número de abortos practicados en condiciones inseguras y los abortos en general ; Conclusiones
Web site : http://www.abortolegal.org/aborInducPeru.docAbstract : Abortion is a traumatic experience which is often worsened by poor medical care. Abortion is significant on the personal, family, and community level because it engenders a condition of grief in the woman and it may also be the cause of grave complications or death. Of the estimated 4,200,000 pregnancies each year in Mexico, 60% terminate in live births and the rest, some 1,700,000 pregnancies, in abortion. Half are estimated to be spontaneous and the rest induced. One-third of women experiencing abortion are estimated to require hospitalization. A recent study of abortion determinants in Mexico indicated that economic problems were a factor in 76%, large family size in 70%, and low educational level in 68%. Physicians performed the procedure in one-third of cases, midwives in 20%, and the woman herself in 19%. Among serious consequences of abortion are genital bleeding, infection, disseminated intravascular coagulation, and physical lesions of the genital organs. Abortion is the third principal cause of maternal mortality in Mexico. Estimates of the monetary cost of abortion reveal the true dimensions of the problem. The average hospital stay for all clinical forms of abortion is 1.8 days. Nearly 1500 hospital beds per day are required for treatment of abortion complications. The average duration of incapacity at work is ten days. Work days lost each year because of abortion amount to approximately 5.5 million. It is believed that the abortion rate and its associated morbidity and mortality would decrease with greater availability of family planning methods and education in their use.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103316Abstract : Induced abortion is one of the most serious public health problems in Latin America. Abortions performed in unsafe conditions have high rates of complications, and can lead to infertility or death. Precise statistics for abortion morbidity are available only for women seeking treatment in health facilities. The exact number of maternal deaths and abortion deaths in Latin America is unknown. An estimated 28,000 maternal deaths occurred in 1990, with 10,000 due to abortion complications. 83-250 deaths are estimated for each 100,000 abortions, compared to 0.6% where abortion is legal. Abortion mortality is lower where contraceptive usage is high and quality treatment for complications is available. The costs of reducing unwanted pregnancy by improving coverage and quality of family planning services and offering services to adolescents would be lower than the direct cost of care for abortion complications. Some 400,000 abortions occur each year in Latin America, where 19-34% of fertile aged women do not use effective contraception. Wealthier women are able to obtain relatively safe abortions from trained personnel, but poor women resort to desperate and unsafe measures. They often receive poor treatment for complications from insensitive workers, and few are given family planning counseling. Official programs, world opinion, and the media promote small families, but do not acknowledge the role of abortion in achieving small families. Society should openly and honestly debate the status of abortion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 143868Abstract : En América Latina, como consecuencia de las restricciones existentes en la legislación, se presenta con frecuencia el uso de procedimientos de aborto inducido no seguros que causan serías complicaciones de salud en las mujeres, constituyendo esta realidad un considerable problema de salud pública en la región. Esta problemática ha sido reconocida y visibilizada por parte de varias organizaciones empeñadas en el mejoramiento de las condiciones de salud de la mujer y en el fortalecimiento de políticas con perspectiva de género y de derechos en el campo de la salud sexual y reproductiva. El método de interrupción del embarazo mediante el uso de medicamentos, parece incidir en la reducción de las tasas de mortalidad y de morbilidad maternas que han sido asociadas por la investigación a los métodos no seguros mediante los cuales abortan en muchas ocasiones las mujeres en los países de América Latina donde el procedimiento está restringido legalmente (Barbosa y Arilla, 1993; Ferrando, 2002,Sherris y cols., 2005). En la región, se dispone de muy pocos estudios acerca de la utilización de este método por parte de las mujeres, habiendo evidencia de un creciente uso del mismo por parte de ellas en los diferentes países. Se estableció, con fundamento en esta realidad, la importancia de abordar, desde la experiencia de las mujeres, la interrupción del embarazo con medicamentos en países latinoamericanos con un contexto legal restrictivo frente al aborto. Atendiendo a esta necesidad, se llevó a cabo un estudio de tipo cualitativo, con perspectiva de género y de derechos, haciendo uso de entrevistas a profundidad, mediante el cual fue posible hacer una aproximación hacia la vivencia propia de 49 mujeres que han experimentado el aborto con medicamentos en cuatro países de América Latina en que el aborto está restringido legalmente (México, Colombia, Ecuador y Perú). El proceso permitió recoger y analizar las construcciones y las valoraciones de las mujeres acerca de su experiencia con la interrupción del embarazo con medicamentos, teniendo en consideración sus características sociodemográficas y los contextos culturales en que se desenvuelven.Este documento da cuenta del trayecto del estudio, desarrollado durante dos años, cuyos hallazgos reportan aspectos de interés primordial para la salud pública, para el desarrollo de políticas y para el fortalecimiento de la educación y prevención en el campo de la salud sexual y reproductiva de las mujeres en la región de América Latina.
Web site : http://www.ipas.org/publications/es/LACMEDAB_S05_es.pdfwww.ipas.org/spanish/womens_health/abortion_methods/medication_abortion.aspAbstract : A medico-legal definition of abortion is "the intentional interruption of pregnancy resulting in death of the fetus". According to the Bolivian penal code, unsuccessful attempts to abort are not punishable for the woman but punishable for practitioners. The penal code, in articles 263 through 269 of chapter 2, defines abortions and makes several distinctions concerning degrees of culpability. Abortions are either consented to by the woman or not. Abortion "honoris causa" carries a lighter sanction, and abortions of pregnancies resulting from rape, abduction not followed by marriage, or incest are not punishable. Therapeutic abortions are those necessary to avoid a threat to the mother's life. Abortions immediately resulting from violence are also recognized. The habitual practice of abortion by health professionals and others is included. The penal code makes no mention of eugenic abortion, a controversial topic likely to assume greater urgency as the AIDS epidemic progresses. Statistics on the frequency of abortion in Bolivia are unreliable because of the illegal and clandestine nature of the practice. Few abortions are prosecuted in Bolivia, partly because of the difficulty of proving that an abortion occurred. Reporting a possible abortion may violate professional secrecy, but not reporting may suggest criminal participation or complicity.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 104435Abstract : Leído ante la Legislatura de la provincia de Córdoba, Argentina, en ocasión de la presentación de una nueva ley de salud reproductiva, septiembre 2001.
Web site : http://www.despenalizaciondelaborto.org.co/data/documentos/200509161436590.aborto_america_latina.pdfAbstract : Although abortion legislation is restrictive in Latin America, the limited available data confirm the region s high volume of abortion. The average number of abortions per woman in Latin America is around 1.5, according to estimates of various authors. Abortion contributes an estimated one-fourth of deliberate fertility control in the region. Abortion rates depend on the degree of motivation for limiting births and the availability and use of contraception. The motivation for smaller families preceded widespread introduction of modern contraception into Latin America. Fertility began to decline before 1960 in a few countries and declined more rapidly thereafter, due principally to induced abortion. The decline continued as contraceptive usage increased rapidly and substantially in the 1970s and 1980s. Abortion rates remained high, basically because the desire for smaller families was widely diffused, while barriers of different kinds hampered access to modern contraception. Inadequate contraceptive supplies, restricted choice of methods, lack of access for women who are poor or single or adolescent, misguided fears about health effects, and poor understanding of the operation of health services may all constitute obstacles to contraceptive use. Contraceptive failure is not infrequent and is another factor in the persistence of abortion. Even within the framework of restrictive legislation, steps could be taken to reduce the problem of abortion: improving the supply and availability of contraceptives, improving the quality of services, promoting sex education, and improving the status of women.
Web site : http://www.ejournal.unam.mx/demos/demos_index.htmlAbstract : En la sociedad colombiana, la discusión sobre el aborto ha pasado de ser un tema del mundo privado y de los públicos especializados para convertirse en un asunto debatido en un amplio espectro de espacios y públicos. En este sentido, la prensa puede ser considerada un campo de observación privilegiado para analizar la creciente politización de este tema. El aborto es el pretexto para expresar distintas formas de articular lo biológico, lo político y lo social. Los artículos publicados en la prensa colombiana recogen los valores, patrones culturales y actitudes vigentes en cada momento ante el aborto y reflejan fielmente el peso de estas consideraciones en el intenso debate a su alrededor. Se consideró pertinente estudiar la problemática del aborto desde un ángulo bien particular: su debate en la prensa nacional. En este marco, se llevó a cabo un proyecto cuyos objetivos eran: estudiar el debate que se ha dado en la prensa colombiana en relación con el aborto entre 1975 y 1994; identificar los principales sectores sociales involucrados en este debate; caracterizar los argumentos utilizados por ellos para justificar sus posturas y los significados sociales subyacentes en dichos argumentos; determinar la participación del movimiento social de mujeres colombiano en este debate.Los documentos analizados fueron las unidades redaccionales (noticias, editoriales, artículos,cartas de lectores, etc.) publicadas sobre el tema entre el 1º de enero de 1975 y el 30 de noviembre de 1994, en cinco diarios colombianos. A partir de la cronología del debate se identificaron cinco coyunturas en las cuales la polémica en la prensa cobró particular intensidad. Además de la parte documental, se acopió material de otros eventos relacionados con el temapara recuperar el entorno socio-político e informativo global de cada coyuntura. Finalmente, se realizaron quince entrevistas en profundidad a mujeres y hombres líderes de opinión con el objeto de recoger los múltiples argumentos y significados sociales elaborados en torno al aborto. Se intentó reconstruir el discurso de los distintos sectores sociales que se han manifestado públicamente sobre el asunto: partidos políticos, líderes de organizaciones feministas o profesionales, sacerdotes o teólogos, columnistas de prensa, investigadores y educadores. En esta ponencia se presenta el balance de la participación de los distintos sectores sociales participantes en el debate, los argumentos para justificar u oponerse a la despenalización del aborto y las dimensiones socio-culturales presentes en este debate.
Web site : http://www.abortolegal.org/abortoColombia.pdfAbstract : Se identifican los principales sectores sociales involucrados en el debate sobre el aborto en la prensa colombiana durante el período 1975-1994, y los argumentos que justifican sus posturas.
Notes : Español/espagnol/SpanishAbstract : Abortion practiced under conditions of risk is a phrase used to refer to illegal abortion. The phrase does not highlight the disappearance of risk when legislation changes. Rather, it calls attention to the fact that legal restrictions significantly increase dangers while failing to discourage women determined to terminate pregnancies. The International Planned Parenthood Federation defines abortion under conditions of risk as the use of nonoptimal technology, lack of counseling and services to orient the woman's decision and provide postabortion counseling, and the limitation of freedom to make the decision. The phrase encompasses concealment, illegality, corruption, and negligence. It is designed to impose a reproductive health perspective in response to an unresolved social conflict. Steps have been developed to improve the situation of women undergoing abortion even without a change in its legal status. Such steps include training and purchase of equipment for treatment of incomplete abortions and development of counseling and family planning services. The central difficulty of abortion induced in conditions of risk derives from the laws imposing the need for secrecy. In Mexico, the abortion decision belongs to the government and the society, while individual absorb the consequences of the practice of abortion. Public decision making about abortion is dominated by the concept that the female has an obligation to carry any pregnancy to term. Women who interfere with male descendency and practice a sexuality distinct from reproduction are made to pay a price in health and emotional balance. Resolution of the problem of abortion will require new concepts in terms of legal status, public health issues, and the rights of women. The problem becomes more pressing as abortion becomes more common in a country anxious to advance in the demographic transition. Only a commitment to the reproductive health of women and the full development of their rights as citizens will permit a favorable outcome to the problem.
Web site : http://www.ejournal.unam.mx/demos/demos_index.htmlAbstract : Situación del aborto ; Situación de la salud reproductiva ; El aborto inseguro en conferencias y reuniones internacionales y nacionales ; Voces disidentes dentro de la Iglesia católica ; Voces de otra iglesias ; Mitos y verdades sobre el aborto ; Investigación sobre los efectos psicológicos de un aborto ; Razones y opiniones ; De aquí y de allá en breve.
Notes : Español/espagnol/SpanishAbstract : Thorough, well-written monograph examines Cuba's high abortion rate, its practice and causes, and the relationship between abortion and contraception. Discusses impact of abortion on Cuba's population and presents a chart on maternal mortality from 1970-93.
Notes : Español/espagnol/SpanishAbstract : 20 Peruvian opinion leaders selected to represent varying views and both sexes were interviewed in early 1993 concerning their feelings about abortion and possible liberalization of abortion laws. A major purpose of the work was to contribute to the public debate about abortion and its treatment in the new Constitution and Criminal Code. Among the opinion leaders interviewed were lawyers, politicians, elected officials, physicians, two Jesuit priests and a Maryknoll sister, heads of women's service organizations, feminists, and journalists. The interviews were presented in the form of questions and answers, with questions reflecting the profession or particular interests of the subject. Many of the questions examined the 1990 proposals to decriminalize abortion in the new criminal code under certain circumstances, and interpretations of events and arguments in that debate.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 094096Abstract : Au niveau national, le taux des avortements par rapport aux naissances augmente de 1964 a 1973, se stabilise jusqu'en 1980 et diminue a partir de 1981. La comparaison entre deux provinces (Pichincha et Cotopaxi), l'une urbaine et l'autre rurale, indique des évolutions différentes : la zone urbaine connait une évolution conforme à l'évolution nationale tandis que la zone rurale connait un accroissement très irrégulier
Web site : http://www.ifeanet.org/publicaciones/publicaciones.phpAbstract : La interrupción de embarazos no planificados es un recurso al que anualmente apelan muchas decenas de miles de mujeres en Uruguay. La desinformación acerca del número, condiciones y consecuencias de estas intervenciones quirúrgicas es uno de los resultados de la clandestinidad en que se practican. Desde 1938, en los artículos 325 a 328 del Código Penal se tipifica el aborto como delito. Las atenuantes y eximentes que allí se establecen no mitigan, prácticamente en ningún caso ni para ninguna circunstancia, las consecuencias ni peligros que la clandestinidad impone a la interrupción de la gravidez. En todo caso, disponer de más de 400 dólares para pagar una buena clínica, constituye una relativa garantía en cuanto a las condiciones médicas en las que el aborto se realiza.
Web site : http://www.bitacora.com.uyAbstract : Expone las diferentes posturas con relación al aborto que han sostenido en los postulados del catolicismo a través de la historia. Se presenta la posición de la iglesia católica que no condenó el aborto sino hasta 1869. Se analizan las dos teorías en las que se sustentan el debate del aborto en los medios eclesiásticos: la infalibilidad y el probabilismo
Web site : http://serpiente.dgsca.unam.mx/ceiich/publicaciones.php?vId=210 vId_h=9 vTitulox=Feminismo%20y%20Alternativas%20SocialesAbstract : The Bolivian Constitution declares that the state will protect motherhood, implying the inclusion of pregnancy. Human life in any form is respected as the maximum value requiring moral, judicial, economic, social, cultural, and political consideration. The penal code of 1834, which was in effect until 1973, included abortion with homicide. Attempts at abortion without the woman's consent were sanctioned by 2-4 years of prison. Medical personnel received terms of 2-6 years of public work if the abortion failed and 4-8 years if it succeeded, and they permanently lost authorization to practice their profession. Women knowingly securing abortions were sentenced to 1-2 years in prison. Widows or single women of previously good name securing abortions to protect their reputations were sentenced to 1-2 years of arrest. A preliminary draft of a revised penal code in 1943 made several additional distinctions which were incorporated into Decree Law 10428 of April 2, 1973. The 1973 code for the first time defined abortion, and it distinguished between abortion with or without the woman's consent and in minors under 16 or in older women. An unsuccessful abortion attempt is punishable for the practitioner but not for the woman. In the case of accidental injury or death of the woman, the sanction varies according to whether or not the woman consented to the abortion. The term is 1-6 years in case of injury and 2-9 years for death of a nonconsenting woman. A sentence of 3 months to 3 years is specified for abortion occurring unintentionally as a result of violence. Abortions performed to save the honor of the woman are considered to have mitigating circumstances. Abortion of a pregnancy following rape, abduction not followed by marriage, or incest, and abortions to save the life of the mother are not punishable as long as they are performed by a physician, consented to by the woman, and authorized by a judge.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 108176Abstract : aborto; Latin America
Notes : Español/espagnol/SpanishAbstract : Published estimates of the annual incidence of abortion in Mexico have ranged from 50,000 to 6 million. Induced abortion is difficult to measure because it is a sensitive topic and an illegal act. Hospital records indicate that slightly fewer than 110,000 women were admitted in 1985 for abortion complications, but induced and spontaneous abortions were not distinguished, and no information was available on the proportion of induced abortions requiring hospitalization. Data from the 1987 Survey of Fertility and Health indicate that 14.3% of women aged 15-49 had had at least one spontaneous or induced abortion. Only 13% admitted having an induced abortion. The data suggest a rate of 12.2 abortions per 1000 fertile aged women in 1986, or 250,000 in Mexico. Among women ever pregnant, 22.7% had had at least one abortion, with the proportion rising to 34% at 45-49. Men aged 15-59 and women aged 15-49 were interviewed in Mexico City for the Survey of Reproductive Health, a project to develop a methodology for obtaining reliable data on induced abortion. The women reported that 9.3% of first pregnancies terminated in abortions, of which 58.4% were considered spontaneous, 28.8% were declared spontaneous but may have been induced, and 20.8% were reported as induced. The men reported that 10.6% of pregnancies ended in abortion, with 45.5% reported induced and only 4.5% considered probably induced. Despite limited available data, it is clear that induced abortion is a social and public health problem in Mexico.
Web site : http://www.ejournal.unam.mx/demos/demos_index.htmlAbstract : En 1995, CLADEM, (Cómite de América Latina y el Caribe para la defensa de los derechos de la Mujer), una organización que aglutina diferentes grupos de mujeres, se propuso realizar este estudio con el objetivo de iniciar el debate respecto al tema de la salud sexual y reproductiva de las mujeres, debido a que este aspecto no había sido abordado por ningún espacio dedicado a promocionar los derechos de la mujer en el país. Se realizó un análisis sobre la regulación de la figura del aborto en el ordenamiento jurídico: el aborto se define como la interrupción provocada del embarazo, con muerte del feto, fuera de las excepciones legales, desde el punto de vista de medicina legal. También se enumeran las diferentes formas de practicarse un aborto: aborto terapéutico, eugénico, accidental o provocado. Los presupuestos para que se produzca el aborto deben ser: que exista un embarazo; que interrupción sea intencional y que haya voluntad para interrumpir el embarazo. La investigación señala los procedimientos abortivos que se utilizan para provocar un aborto: sustancias tóxicas, medicamentos e inclusive medicinas tradicionales a base de plantas; en cuanto a maniobras mecánicas como la sonda, inserción de objetos cortopunzantes e inclusive lavados vaginales con preparados. Al abordar los aspectos sociales del aborto, los datos indicaron que solamente en la región de América Latina se ha comprobado que las complicaciones del aborto inducido son la principal causa de muerte en mujeres entre los 15 a 19 años. Las mujeres que recurren a un aborto son aquellas que están casadas, con varios hijos que viven en condiciones de pobreza y que no han tenido acceso a medios para evitar embarazos adicionales; del mismo modo también están en mayor riesgo de embarazo no deseados las solteras, de bajos ingresos y adolescentes. Un aspecto interesante que arrojó el estudio fue que un alto porcentaje de estas mujeres eran católicas, lo que llama la atención ya que se sabe que la iglesia católica mantiene un postura rígida con respecto a la cuestión del aborto e igual al uso de medios anticonceptivos.
Notes : Español/espagnol/SpanishAbstract : Se desarrolló una encuesta de opinión, en torno a lo que pensaban las mujeres activistas y teóricas respecto a la promoción de sus derechos en cuanto a la problemática del estudio. Fueron aplicadas un total de 30 encuestas de opinión, lográndose captar información en 26 de ellos. Los resultados señalaron que más de la mitad de las entrevistadas se encontraban entre los 38 a 49 años, lo que coincide con lo encontrado en diversos estudios que indican que las mujeres cobran conciencia de sus derechos a edades maduras. El 90% de este grupo eran mujeres profesionales, con educación media y superior. La mayor parte de estas estaban unidas o casadas y todas ellas tenían hijos. El 100% de las participantes coincidían en que el aborto es un tema que no ha sido debatido , ni abordado responsablemente en nuestro país; un 42% opina que es una temática que debe ser analizada debido a que es una realidad que afecta a las mujeres en su vida y en sus derechos y sirve para sensibilizar a la población sobre una problemática tan alarmante. El 28% de las encuestadas opinan que el aborto es un derecho que tiene la mujer y 16% considera que es un medio para evitar embarazos no deseados. El total de la muestra (100%) aprueba el aborto por violencia sexual y terapéutico. Un 70% señaló que el aborto es una practica muy frecuente en nuestro país para regular la fecundidad. En cuanto la participación del hombre en la temática de aborto, las mujeres señalaron que esta es necesaria e interesante (31%), que el varón juega un papel decisivo en la toma del aborto (27%) y que no representa ningún tipo de apoyo para la mujer (19%). Las entrevistadas opinan que la atención médica ante el aborto es indiferente; 23% la catalogan de deficiente y 20% lo ven como un acto comercial. A fin de eliminar el aborto provocado , que fue la categoría que contó con menor aceptación (22%), se propone brindar orientación y educación, sensibilizar a la opinión pública, promocionar la adopción como alternativa, acelerar trámites burocráticos para la adopción de niños y permitir el aborto en salud pública.
Notes : Español/espagnol/SpanishAbstract : This is a review of the current induced abortion situation in Puerto Rico. It includes a selection of bibliographic references to 67 relevant studies in English or Spanish, all of which have Spanish abstracts. (ANNOTATION)
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND 8031422Abstract : El Population Council y el Instituto Alan Guttmacher promovieron la conferencia con el propósito de aprender y compartir información sobre el tema, el informe muestra un panorama global de los temas tratados
Web site : http://www.gire.org.mx/Abstract : Sección: Prostitución
Web site : http://www.gire.org.mx/Abstract : Due to the restrictive abortion legislation which operates in almost all Latin American countries, knowledge about the incidence of induced abortions, their associated complications and related mortality is unreliable and approximate. There is little doubt, however, that the incidence of induced abortion in Latin America is among the highest in the world. The number of deaths due to complications from unsafe abortions is severely underestimated throughout the region. Based on Royston's method called the "maternal mortality route", the authors estimate that the actual number of abortion-related deaths in Latin America is between 5000 and 10,000 per year. Thus, compared to the estimated 4-6 million annual induced abortions, the abortion-related mortality rate would range from 83 to 250 deaths per 100,000 abortions. It is clear from the calculations presented that induced abortion in Latin America is a serious public health problem associated with deaths and health complications which could largely be avoided through the provision of accessible and appropriate family planning methods and the availability of high-quality abortion services. (author's) (summaries in ENG, SPA)
Web site : http://www.eclac.cl/cgi-bin/getProd.asp?xml=/celade/agrupadores_xml/aes51.xml xsl=/celade/agrupadores_xml/a18l.xslAbstract : Este es un estudio sociodemográfico comparativo del aborto inducido de las mujeres que viven en los dos lados de la frontera México-Estados Unidos. Se analiza el caso especifico de Tijuana y San Diego mediante la utilización de fuentes complementarias de datos: una encuesta posparto realizada en el IMSS de Tijuana en 1993 con información para un total de 2 709 mujeres y los expedientes de la clínica Womancare de Planned Parenthood, con información para 1 109 mujeres. Esta última fuente incluye información sobre las mexicanas que cruzaron la frontera entre la primavera y el verano de 1993 para practicarse un aborto en condiciones legales y seguras en San Diego. Los resultados indican que el aborto ocurre más frecuentemente en las etapas avanzadas del periodo reproductivo de las mujeres. Sin embargo, también utilizan el aborto para posponer el inicio de su trayectoria reproductiva. Existen distintos patrones de aborto entre las mujeres fronterizas definidos por variaciones en la edad al momento del aborto, el número de hijos al momento de abortar, la edad al primer embarazo, las opiniones acerca del aborto, los motivos para abortar y los planes para enfrentar los efectos emocionales en la etapa postaborto.
Web site : http://redalyc.uaemex.mx/redalyc/src/inicio/ArtPdfRed.jsp?iCve=11203807 iCveNum=0Abstract : In a 1992 study of induced abortion in Colombia, 30% of urban women ever pregnant reported having had at least one induced abortion. The proportion rose to 45% for women under age 20 and 39% for those with 4 or more pregnancies. 79% of women reporting abortions had one, 16% had two, 3% had three, and 1% had four or more. The incidence of repeat abortions was probably underestimated. The average number of children in Colombia is 1.9 in urban and 2.9 in rural areas, while the average number of induced abortions is 0.29. Women undergoing abortion have 3.3 children on average. The proportion of women who had abortions each year increased from 1.7% in 1952-56 to 12.3% in 1987-91. Age specific data confirm a rapid increase in abortion rates especially in women under age 25. Women under age 20 are at greatest risk of abortion, followed by those aged 20-25 and women of any age or marital status with more than 3 children and 4 pregnancies. 46% of abortions in lower socioeconomic status women occurred after the third pregnancy, while 54% in higher status women corresponded to the first pregnancy. 55% of women having abortions were married or in stable union and had children at the time of the abortion. 33% of the women were strongly pressured by their partner to have an abortion, while 22% of the women did not inform their partners of their pregnancies or abortions. 78% of the pregnancies ending in abortion were in women not using contraception, with little difference by social status. But the majority knew more than one contraceptive method and had ever used one. 34% of the abortions were reportedly carried out in medical centers.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159709Abstract : Este número recoge el resultado de tres de las investigaciones sobre aborto inducido, realizadas entre 1992 y 1995 como parte de un programa académico, que comenzó en 1992 con una investigación de cobertura nacional urbana orientada a indagar por el peso del aborto como variable interviniente en el proceso de transición demográfica. La complejidad sociocultural del tema llevó al equipo a ampliar el estudio mas allá de lo demográfico y así se completaron cuatro investigaciones: "El aborto inducido en Colombia: características demográficas y socioculturales" (Zamudio, Rubiano, Wartenberg), "El aborto en Colombia: veinte años de debate en la prensa colombiana 1975 -1994" (Viveros), "El aborto en Colombia: una exploración local de la experiencia masculina" (Salcedo) y "Factores de riesgo asociados al embarazo precoz y aborto adolescente" (Waternberg). La diversidad de los temas exigió metodologías procedimentales y técnicas distintas. Con la publicación de sus resultados esperamos contribuir al cumplimiento de las recomendaciones de la Conferencia de El Cairo y la ampliación de la mirada sobre un tema que tradicionalmente ha polarizado las opiniones aun antes de iniciar cualquier debate.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This retrospective study analyzes the sociodemographic and fertility characteristics of a sample of 5368 women undergoing abortion at a private clinic in San Juan, Puerto Rico, in 1985. Although induced abortion is a controversial phenomenon in Puerto Rico, there is as yet little knowledge of the characteristics of women who seek abortions. The 5358 study women ranged in age from 12-48 years and averaged 26. 63% were aged 20-29 years. 40% were single, 43% were currently married, 16% were divorced, and 1% were widows. Women who has never married were 23.7 years old on average and ever-married women were 27.8 years old on average. 46.7% were economically active, 28.1% were housewives, 22.7% were students, and 2.5% were unemployed. The women had had an average of 2.9 pregnancies each. 6 women had been pregnant 12-15 times including the current pregnancy. 50.7% of the women were in the 3rd or higher order pregnancy, 20.8% were in their 2nd pregnancy, and 28.5% were in their 1st pregnancy. Ever-married subjects had an average of 3.5 pregnancies vs. 2.0 for single subjects. The average numbers of pregnancies were 2.9 for both economically active and inactive women. 40.9% had abortions without ever having children, 45.1% had had 1 or 2 children, and 13.9% had had 3 children or more. 74.2% of the single women and 19.2% of the ever-married women had abortions before ever having children. The average numbers of living children were .46 for single women, 1.64 for ever-married women, 1.1 for economically active women, 1.24 for inactive women, and 1.17 for the entire sample. The average numbers of prior induced abortions were .45 for single women, .72 for ever-married women, .71 for economically active women, .53 for inactive women, and .61 for the entire sample. 63.1% were undergoing their 1st abortion, 22.6% had had 1 previous abortion, and 14.2% had had more than 1. 17 women had had 6 ore more previous abortions. 65.5% of the women had used contraception. 78.1% of the abortions were performed at 8 weeks gestation or earlier, and 90.7% were done in the 1st trimester. Complications occurred in 35 of the 5368 procedures (.7%). These findings, which are not necessarily representative of induced abortion in Puerto Rico, suggest that both single and ever-married women resort to abortion. Single women tend to terminate their 1st pregnancies while ever-married women terminate pregnancies exceeding their desired number of children.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 066404Abstract : El aborto inducido es un problema de interés para la salud pública mundial, tanto en los países donde las leyes lo permiten como en aquellos donde el procedimiento se practica en forma clandestina. El presente artículo es el resultado de una revisión bibliográfica de los métodos más comúnmente empleados en la inducción del aborto en los últimos 50 años, comparándolos con los métodos utilizados en la actualidad, analizando sus riesgos y complicaciones a corto y largo plazo y tratando de sistematizar y actualizar el conocimiento que se tiene al respecto.
Web site : http://redalyc.uaemex.mx/redalyc/src/inicio/ArtPdfRed.jsp?iCve=28333204 iCveNum=1027Abstract : Induced abortion is an urgent public health problem that can be controlled if it is approached in its true complexity and with a social and humanist perspective. Induced abortion has been discussed in Chile since the last century, but not always openly. Abortion is not just an individual and collective medical problem, it is also an ethical, religious, legal, demographic, political, and psychological problem. Above all it is a problem of human rights. In the past 60 years, more than 50 countries representing 76% of the world population have liberalized their abortion legislation. Around 980 million women have some degrees of access of legal abortion. The magnitude of illegal abortion is difficult to determine because of the desire of women to hide their experiences. Estimates of the incidence of abortion in Chile made some 25 years ago are no longer valid because of the numerous social changes in the intervening years. The number of abortions in Chile in 1987 was estimated using an indirect residual method at 195,441, of which 90%, or 175,897, were induced. By this estimate, 38.8% of pregnancies in Chile end in abortion. Data on hospitalizations for complications of induced abortion show an increase from 13.9/1000 fertile aged women in 1940 to 29.1 in 1965. By 1987, with increased contraceptive usage, the rate declined to 10.5 abortions per 1000 fertile aged women. The cost of hospitalization for abortion complications in 1987, despite the decline, was still estimated at US $4.3 million, a large sum in an era of declining health resources. The problem of induced abortion can be analyzed by placing it in the context of elements affecting the desire to control fertility. 4 complexes of variables are involved: those affecting the supply of contraceptive, the demand for contraceptives, the various costs of fertility control measure, and alternatives to fertility control for satisfying various needs. The analysis is further complicated when efforts are made to understand the dynamics of the process. Awareness of fertility control is a social process that matures slowly. Contraception and abortion have different significance for fertility control, with contraception preventing pregnancy and abortion is a sense curing it. Chile has progressed far in its fertility control awareness. 2/3 of sexually active women use some form of contraception. At the same time, induced abortion is also used. It is estimated that 58% of abortions occur after a contraceptive failure. It appears that recourse to abortion would be minimized if strategies centered on supply of contraceptives were complemented by stronger efforts to develop awareness of fertility control. Delivery of contraceptives should be accompanied by complete information on their effective use. Efforts should be targeted especially at groups at high risk abortion, including adolescents and women hospitalized for complications.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 067784Abstract : Información especializada sobre el aborto en condiciones de riesgo. Contiene datos estadísticos a nivel mundial proporcionados por la Organización Mundial de la Salud
Web site : http://www.ipas.orgAbstract : Estamos conscientes de que el aborto voluntario es la cancelación de un proceso de vida. No lo deseamos. Así mismo creemos que la gran mayoría de las mujeres que han pasado por este trance no lo han anhelado; no se lo han practicado con alegría en sus corazones; no disfrutan ni encuentran gozo en esta dolorosa decisión. El aborto ha sido para ellas un último recurso porque quieren evitar un mal mayor: no humanizar una vida. Visto así, el aborto representa de manera dramática un rechazo a la deshumanización.Nos preguntamos si podemos condenar absolutamente al aborto cuando se practica con la intención de no crear un daño mayor; cuando la madre está en peligro de muerte; cuando se trata de impedir una mayor injusticia a la mujer, embarazada brutalmente en una violación; cuando no hay posibilidad de humanizar esa vida en ciernes; cuando se trata de evitar el empeoramiento de la ya de por sí mínima calidad de vida de los hijos e hijas que ya se tienen. Hacemos nuestras las palabras de Ivone Gebara, 6 teóloga feminista católica, quien afirma que la "legalización es, apenas, un aspecto coyunturalmente importante de un proceso más amplio de lucha contra una sociedad organizada sobre la base del aborto social de sus hijos y de sus hijas. Una sociedad que no tiene condiciones objetivas para dar empleo, salud, vivienda y escuelas, es una sociedad abortiva. Una sociedad que obliga a las mujeres a escoger entre permanecer en el trabajo o interrumpir un embarazo, es una sociedad abortiva. Una sociedad que continúa permitiendo que se hagan pruebas de embarazo antes de admitir a la mujer a un empleo, es abortiva. Una sociedad que silencia la responsabilidad de los varones y sólo culpabiliza a las mujeres, que no respeta sus cuerpos y su historia, es una sociedad excluyente, sexista y abortiva".
Web site : http://www.catolicasporelderechoadecidir.org/publicacionesAbstract : Analysis of abortion in Mexico from a juridical perspective requires recognition that Mexico as a national community participates in a double system of values. Politically it is defined as a liberal, democratic, and secular state, but culturally the Judeo-Christian ideology is dominant in all social strata. This duality complicates all juridical-penal decisions regarding abortion. Public opinion on abortion is influenced on the 1 hand by extremely conservative groups who condemn abortion as homicide, and on the other hand by groups who demand legislative reform in congruence with characteristics that define the state: an attitude of tolerance toward the different ideological-moral positions that coexist in the country. The discussion concerns the rights of women to voluntary maternity, protection of health, and to making their own decisions regarding their bodies vs. the rights of the fetus to life. The type of analysis is not objective, and conclusions depend on the ideology of the analyst. Other elements must be examined for an objective consideration of the social problem of abortion. For example, aspects related to maternal morbidity and mortality and the demographic, economic, and physical and mental health of the population would all seem to support the democratic juridical doctrine that sees the clandestine nature of abortion as the principal problem. It is also observed that the illegality of abortion does not guarantee its elimination. Desperate women will seek abortion under any circumstances. The illegality of abortion also impedes health and educational policies that would lower abortion mortality. There are various problems from a strictly juridical perspective. A correct definition of the term abortion is needed that would coincide with the medical definition. The discussion must be clearly centered on the protected juridical right and the definition of reproductive and health rights and rights to their own bodies of women. The experiences of other countries with decriminalization of abortion should also be assessed. Factors considered should include the true impunity of abortion, public health problems and socioeconomic problems generated by the state through criminalization of abortion, and the psychological and economic implications for women of the criminal status of abortion. Systems of decriminalization should be examined to decide which would be appropriate for Mexico. These systems include authorizing complete freedom of choice for the 1st trimester and permitting abortion only for specific indications. All penal codes in Mexico now use the system of abortion for specific indications. Few cases are accepted for legal pregnancy termination.
Web site : http://www.ejournal.unam.mx/demos/demos_index.htmlAbstract : The acute economic crisis in Peru has deepened poverty and increased the unsatisfied demand for housing, health, and other services. 25% of Peru's 1993 population of 22,639,433 were women of reproductive age. Reproductive health problems of Peruvian women include a maternal mortality rate officially estimated at 303/100,000 live births, and widespread illegal abortion, which accounts for 30% of admissions to obstetrics and gynecology wards. 85% of maternal deaths are from direct causes. 23% result from hemorrhage, 22% from abortion, 18% from infection, and 17% from gestational hypertension. 15% of reported maternal deaths are in adolescents. The 1992 version of the National Plan to Reduce Maternal Mortality has not yet been approved. The Alan Guttmacher Institute estimates that 270,000 induced abortions occur each year, or 4 per 10 live births. Rural and poor urban women usually resort to untrained practitioners for abortion or try to induce abortion themselves, and their complication rates are high. Wealthier urban women seek abortion from physicians in 79% of cases and run a much lower risk of complications. It is estimated that half of women with complications are hospitalized. There were 54,000 hospitalizations for complications of induced abortion in 1989. 60% of Peruvian pregnancies are believed to be undesired, and half of undesired pregnancies end in induced abortion. The maternal-perinatal health program has set specific goals of reducing the maternal mortality rate from 303/100,000 to 220 in 1995 and less than 150 by the year 2000. The perinatal mortality rate is to be reduced from 30/1000 live births to 25 in 1995 and 15 in 2000. Service goals include increasing coverage of prenatal care to 75% in 1995 and 85% in 2000.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 110519Abstract : El aborto es un problema de salud pública con un elevado índice de mortalidad y complicaciones. La mayoría de los países cuentan hoy con una legislación que lo permite en ciertas circunstancias y las pacientes que tienen que acudir a esta opción para conservar su salud y su vida, puedenacceder a los centros de salud y ser tratadas por personal idóneo. En nuestro país, por el contrario, el aborto se califica como un hecho pecaminoso y se aplican medidas punitivas con base en el Código Penal, obligando a las mujeres a buscar recursos clandestinos con grave peligro para sus vidas y su integridad física. El resultado es un elevado índice de muertes y complicaciones cuya responsabilidad recae íntegramente en el Estado. No hay una organización sanitaria en ninguna parte del mundo que haya sido capaz de establecer programas racionales para el manejo del aborto, que armonicen con las creencias de las múltiples tendencias religiosas que existen y las interpretaciones que moralistas, eticistas, filósofos y sociólogos le dan a los hechos y circunstancias que lo rodean. El doloroso episodio que se vivió recientemente en la Universidad de Pamplona demuestra con caracteres alarmantes la manera absurda como se está manejando este problema en Colombia, situación que debe ser corregida.
Web site : http://www.catolicasporelderechoadecidir.org/publicacionesAbstract : Marco de referencia ; Otro punto a caracterizar es qué denominamos como derechos sexuales y reproductivos ; Cortes y sectores ; El feminismo: su relación con otros actores sociales ; Un poco de historia ; Argumentos en pro de la legalización del aborto ; Puntos para discutir y algunas propuestas ; Hacia dónde ir.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Four out of every 10 pregnancies among university students in Sucre, Bolivia, end in abortion. The women are 20 years old on average at the time of the first abortion, and 28% have a second or third abortion. 1071 male and female students at the St. Francis Xavier University in Sucre answered anonymous, self-administered questionnaires about abortion. 21 students were interviewed in depth, and a case study of one couple was conducted. Family planning services are clearly needed but unavailable in Sucre, and young people run the risk of sexually transmitted diseases and unwanted pregnancy. 88% of the survey respondents reported having access to information on family planning, but only 23% of those sexually active and not desiring pregnancy actually used a method. 82% of respondents reporting abortions were Catholic, 94% were single, 35% lived alone and 25% with their parents. 66% did not use contraception at the time of conception. Half of the users employed rhythm, often incorrectly, and 23% used condoms. 75% of the abortions were performed by physicians. 28% occurred in doctors' offices, 25% in clinics, and 47% in various other places. 57% of the women received no postabortal advice on contraception. 43% of the women reported physical complications, most frequently hemorrhage, pain, and infection and fever. 15% of the women required hospitalization.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 134285Abstract : This article discusses abortion legislation in Mexico based on the premise that the relevant protected juridical good is human life. The criteria for the punishment or permission of abortion from a strictly juridical perspective may be classed in two large categories, those based on indications and those based on time factors. Indications in turn may be ethical, therapeutic, or economic. Articles 329-334 of chapter 6, title 19, book 2 of the Mexican code regulate abortion. Certain ethical and therapeutic indications are accepted. The Civil Code for the Federal District establishes in its article 22 that an individual is entitled to legal protection beginning at conception. Article 333 of the penal code establishes that abortion is not punishable if the pregnancy resulted from rape. Article 334 of the Federal District code permits abortion if, in the opinion of two physicians, the woman's life is endangered by the pregnancy. Both the ethical and therapeutic indications are contrary to Catholic Church teachings. The legal status of abortion is unavoidably affected by the cultural context of the country. The problem of abortion does not arise from uncertainty about the nature of human life at conception but about the value of that life. It is a normative rather than a biological problem. Human life is a value over which only another human life can prevail. Abortion cannot be said to be a right; it can only be said to be an everyday occurrence. Belief in the preference for human life over any other juridical good must be reflected in abortion law.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : Results are presented of an opinion survey conducted in the Mexican state of Guanajuato on the occasion of an initiative to prohibit abortion in pregnancies resulting from rape and subject women seeking such abortions to jail terms. Guanajuato is one of the two Mexican states with the highest proportions of Catholics, 96%. Only 32% of survey respondents knew that abortion is currently legal in Guanajuato under some conditions. 51% of respondents stated that it is not legal under any conditions and 8% that it is legal under all conditions. 9% did not know. Among those knowing that abortion is sometimes legal, 73% recognized danger to the mother's life, 69% risk to health, 56% accidental abortion, and 49% pregnancy resulting from rape as motives for legal abortion. 46% erroneously believed that birth defects, 22% that being an underage mother, 16% that grave economic problems, and 9% that an extramarital pregnancy were legal motives for abortion. 45% of respondents approved of abortion under specific circumstances and 17% approved of abortion on request, while 36% believed it should be prohibited under all circumstances. Among those approving of abortion under specific circumstances, 69% approved of it to save the mother's life, 67% for health reasons, 44% to avoid birth defects, 43% in cases of rape, 19% in underage women, 14% for lack of economic resources, 10% for contraceptive failure, and 10% in extramarital pregnancies. 63% of respondents who disapproved of abortion after rape did not approve of imprisoning women seeking them. No significant differences in attitude were observed by sex, but more educated and younger respondents were more likely to approve of abortion under some conditions and rural residents were less likely. 84% felt that legislators should not vote on abortion legislation based on their personal religious beliefs.
Web site : http://www.ejournal.unam.mx/demos/demos_index.htmlAbstract : El aborto provocado es, sin duda, uno de los problemas bioéticos más arduos que pueden plantearse a la conciencia del médico, del jurista o del legislador. José Manuel Septién... reúne en este volumen, además de sus propias contribuciones, una amplia recopilación de ensayos de prominentes médicos, abogados, sacerdotes y filósofos que estudian el aborto desde el punto de vista ético, legal y social, con la competencia y rigor científico que a todos ellos los caracterizan. 'Los médicos no son instrumentos de muerte', afirma el Dr. Septién, al profundizar en la función primordial que debe desempeñar el médico como defensor de la vida: 'La misión del obstetra consciente de sus obligaciones éticas radica en defender los derechos de la madre y los derechos del hijo por igual'
Web site : http://www.gire.org.mx/Abstract : La ciudadanía de las mujeres comienza, se desarrolla y culmina en sus cuerpos, territorio personal y privado sobre el cual deben estar capacitadas para adoptar decisiones soberanas, es decir, libres de coacción o violencia. La autonomía es, por lo tanto, fundamental para dicho ejercicio, al igual que el acceso a información adecuada y suficiente, y a servicios de salud sexual y reproductiva donde se asegure una atención de la más alta calidad. Por lo tanto, la defensa de la libertad sexual y reproductiva y del control del propio cuerpo constituye un elemento central de la agenda feminista, y debe ser considerada un principio ético político no negociable. El acceso al aborto legal, seguro y gratuito forma parte intrínseca de la autonomía sexual y reproductiva, y se sustenta no solo en consideraciones sanitarias, sino más bien en la perspectiva de las mujeres como sujetas de derechos, con plena capacidad moral para tomar las decisiones más favorables de acuerdo a sus realidades de vida. En ese sentido, numerosas reflexiones acerca de la penalización del aborto que aún persiste en numerosos países, enfatizan que este castigo atenta directamente contra el goce de una serie de derechos humanos y ciudadanos de las mujeres, entre otros: -El derecho a la vida, -El derecho a la libertad y seguridad personales, -El derecho a gozar del más alto nivel de salud, -El derecho a la igualdad y a la no discriminación, -El derecho a la autodeterminación, -El derecho a no ser sometida a torturas, -El derecho a no ser objeto de injerencias arbitrarias, -El derecho a la libertad de pensamiento, conciencia y religión, -El derecho a controlar su propia fecundidad, -El derecho a la privacidad, -El derecho a contar con servicios de salud reproductiva y acceso al aborto seguro para responder a las necesidades de salud, -El derecho a los beneficios del progreso científico, -Y, por cierto, los derechos sexuales y reproductivos. La Red de Salud de las Mujeres Latinoamericanas y del Caribe, RSMLAC, uno de cuyos principios de acción prioritarios es, precisamente, la defensa irrestricta de la libertad sexual y reproductiva y del derecho al aborto como derecho humano, ofrece esta edición de Cuadernos Mujer Salud como un aporte a las discusiones relativas al tema que se desarrollan en nuestra región. La intención es compartir valiosos pensamientos, estrategias y voces de mujeres y hombres con un profundo compromiso político en torno a los derechos de las mujeres. También deseamos hacer un aporte para avanzar hacia los cambios culturales y legales que permitan sustentar el ejercicio de la libertad sexual y reproductiva. Ejercicio que se ve impedido por leyes punitivas, por un discurso moral religioso, y por un manto de silencio social. Y, por último, queremos contribuir a la erradicación del indigno aborto clandestino y de la sanción y encarcelamiento que hoy recaen mayormente en mujeres pobres y jóvenes, muchas de las cuales pasan a formar parte de la vergonzosa cifra anual de muertes maternas, lo que además transforma al aborto inseguro en un problema de justicia social.
Notes : Español/espagnol/SpanishAbstract : Selected results are presented of a national opinion survey on abortion conducted in Mexico in 1991 by the Gallup Organization. 2579 subjects were asked, among other things, who should have the right to make decisions regarding abortion. The respondents were 15-46 years old and were evenly divided by sex. 19.8% were of upper, 40.2% of middle, and 39.9% of lower socioeconomic status. Among men, women, and the total sample, respectively, 38.8%, 46.3%, and 42.5% claimed the decision should be made exclusively by the woman; 38.7%, 32.1%, and 35.5% that it should be made by the couple; 18.0%, 15.3%, and 16.6% that it should be made by the woman with advise of a physician, priest, or the government, and 4.8%, 7.0%, and 5.8% that no one had a right to make such a decision. 50.9% of women but only 39.3% of men said that the opinion of the Catholic Church should be considered. The proportions believing that the decision should be made exclusively by the woman ranged from 42.1% for respondents 15-20 years old to 44.9% for those 26-35. 48.2% of upper, 42.3% of middle, and 42.0% of lower socioeconomic status felt the decision should be made by the woman. 47.0% of upper, 39.7% of middle, and 48.5% of lower socioeconomic status felt the opinion of the Church should be considered. Only 32.9% of respondents in the city of Guadalajara compared to 44.0% in Mexico City and 48.9% in Monterrey felt the decision should be made exclusively by the woman.
Web site : http://www.ejournal.unam.mx/demos/demos_index.htmlAbstract : El aborto se define como la terminación del embarazo antes de que alcance la viabilidad del producto de la gestación , ya sea que termine espontáneamente o sea inducido o provocado, esto es la pérdida antes de las 20 semanas de gestación a antes de alcanzar un peso de 500 grs. Debido al "status" legal del aborto en el país, no se cuenta con cifras reales sobre le número de ellos que ocurren cada año, más bien, se conoce mejor el número de mujeres que demandan atención institucional. La norma de salud señala que se atenderá a toda paciente que acuda al hospital con complicaciones del aborto, independientemente del lugar donde se realiza el procedimiento. Los abortos contribuyeron con el 25% de la morbilidad hospitalaria. Estudios realizados sobre esta temática indican que existe aproximadamente un 30% de subregistro en cifras oficiales relacionadas con la razón de mortalidad fetal, la cual según la Contraloría General de la República aumentó de un 94.5 por cada 1,000 nacimientos vivos en 1990 a 130.4 en 1995; el aumento de las defunciones fetales se relacionan directamente con el aumento en la incidencia de abortos. Mientras que el número de defunciones fetales ha aumentado considerablemente (5.441 en 1990 a 7,038 en 1996), el número de nacimientos lo ha hecho levemente en algunas provincias y ha disminuido en otras , lo que sugiere, que el aborto es utilizado como método de regulación de la fecundidad y que su práctica ha aumentado en algunas provincias en los últimos años. Las tasas de aborto más se localizaron en los extremos de los grupos etáreos: entre las más jóvenes (10 - 14 años) y en las mayores de 30 años. El problema del aborto se ha agudizado en los últimos años. A pesar de los esfuerzos del sector salud los programas de planificación presentan coberturas no satisfactorias. Aunado a esto, los cambios en el comportamiento sexual de la población (inicio de vida sexual temprana, falta de orientación sexual sistemática, actitudes con respecto a la responsabilidad sexual personal y aspiraciones y proyectos de vida no compatibles con la maternidad y paternidad temprana, entre otros) están contribuyendo con el aumento de este fenómeno.
Notes : Español/espagnol/SpanishAbstract : Aborda desde un punto de vista médico social la problemática del aborto, y la atención y tratamiento del aborto incompleto en Perú. Por medio de gráficas informa los porcentajes de mortalidad materna, y las diferentes características de las mujeres que se practican un aborto inducido. Además de analizar a fondo las condiciones y problemas del aborto también propone alternativas y atención más humana para mejorar estas condiciones
Web site : http://www.flora.org.pe/Abstract : Mortalidad materna, el aborto y sus implicancias médico-sociales ; Éticay atención humanista del aborto ; Modelos y técnicas atención del aborto incompleto en losservicios de salud ; Aspiración manual endouterina ; Costos hospitalarios para la atención delaborto incompleto ; Consejería y anticoncepción postaborto.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Research on the psychological, economic, religious, and cultural aspects of abortion usually assumes the perspective of the woman's needs. Data from Latin America and elsewhere indicate that the role of the man has been studied only slightly, but has proven important when it has been studied. A review of the Latin American literature suggests that the man's feelings play an important role in the woman's decision whether he agrees with her decision or not. An analysis of power relations between men and women in the society and in the couple may offer a model for predicting the woman's decision. The "economic" reasons given by women in surveys about motivations for abortion may include instability or conflicts between the partners. The rational/feminist model of how women come to obtain abortions may neglect elements important in Latin America, including direct or indirect coercion by individuals emotionally or economically important to the woman. A comprehensive examination of the role of men in abortion decisions should therefore be undertaken.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100713Abstract : Only countries that have legalized abortion have relatively reliable abortion statistics. International Planned Parenthood Federation data suggest that about 5 million illegal abortions occur in Latin America each year, giving a rate of at least 65/1000 women 15-44 years old and a ratio of nearly 30% of known pregnancies. An estimated 39,000 abortions occurred in 1986 in Bolivia, where abortion appears to be increasing. A 1983-84 study in 5 Bolivian hospitals indicated that the mortality rate from abortion was 60/10,000 procedures. Bolivia's maternal mortality rate is estimated at 50/10,000 live births. An estimated 235 women die annually in Bolivia from complications of illegal abortion, although the true number may be higher because of the reluctance of women to admit to abortion. The majority of deaths are in impoverished urban women and to a lesser extent in poor rural women. Women of the wealthier classes may be able to secure relatively safe abortions from medical personnel, but lower class women are more likely to experience pain, fear, and complications from unsafe and unhygienic practices. Illegal abortion is 10-250 times more dangerous than any contraceptive method. Abortion is not exclusively a question of health. Economic problems, especially in households dependent on the woman's income; the stigmatization of single mothers; the lack of sex education in an environment of pervasive sexual stimulation; the desire of men to affirm their virility through pregnancy despite the unwillingness of the partners; and misunderstanding of the fertile period among users of natural family planning methods are factors in the persistence of abortion. Lack of access to family planning and contraceptive failure are other factors. Approximately 60% of the budgets of hospital obstetrics and gynecology services in Bolivia are expended on treating complications of abortion. Measures to prevent abortion should include improving the social and economic status of poor women and making sex education and family planning services available.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 104434Abstract : The juridical treatment of abortion has undergone profound transformation in much of the world. The idea that in some cases the mother's rights merit protection even at the cost of an embryonic existence has taken root in many countries, but not Peru. Peru's 1991 penal code, like its 1924 predecessor, regulates abortion among crimes against life, the body, and health. The only exception to the condemnation is therapeutic abortion performed by a physician with the woman's consent to save her life or avoid grave and permanent damage to her health. Peru's General Health Law and 1984 National Population Policy Law recognize the right of individuals and couples to decide freely and responsibly the number of their children, but both exclude abortion as a method for terminating unwanted pregnancy. Circumstances that cause thousands of women to resort to abortion as a last resort, such as rape, incest, poverty, and fetal malformation, are not accepted in Peruvian legislation. Peru resorts to penal repression to control the problem of abortion, but the failure to address root causes obliges women to seek illegal and often dangerous clandestine abortions. The 1997 General Health Law requires physicians to report evidence of illegal abortion. The various human rights conventions have inspired some legislatures to decriminalize early abortion. A recent decision of Colombia's Constitutional Court provides an important precedent for decriminalization of abortion in Latin America. The real consequences of existing legislation for the status of abortion in Peru should be analyzed from a human rights perspective.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 165843Abstract : Objetivo: Describir el procedimiento para obtener un aborto legal por violación en la ciudad de México, las características de las mujeres que se embarazan a consecuencia de la violación y su acceso a servicios de aborto legal. Metodología: Se realizaron seis entrevistas a personal de instituciones que atienden a víctimas de violación y una revisión de 231 expedientes clínicos de mujeres que se embarazaron a consecuencia de una violación atendidas en un hospital de la ciudad de México de 1991 al 2001. Resultados: El mecanismo para obtener la autorización de un aborto legal es burocrático. En la muestra estudiada, 188 la tasa de embarazo a consecuencia de la violación fue de 13.9 por ciento. El 66 por ciento de estas mujeres tenia menos de 20 anos. A 22.3 por ciento de las mujeres embarazadas se les practico un aborto legal. La variable que influyo mas en el acceso al aborto legal fue la duración del embarazo a la primera cita en el hospital (p<0.01). Conclusiones: El acceso al aborto legal por violación es limitado. Cuando las mujeres logran obtener la autorización para practicarse un aborto legal, muchas veces el embarazo sobrepasa el primer trimestre y la mayoría de los médicos se niegan a realizar el procedimiento.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : La primera parte del programa de acción muestra los puntos donde hay concidencia con los valores católicos y la segunda parte explica las posiciones adoptadas por el Vaticano en el Cairo sobre temas esenciales de salud sexual y reproductiva
Notes : Español/espagnol/SpanishAbstract : Con el fin de ayudar a aclarar la confusión o la información errónea sobre el derechocanónico y el aborto, este panfleto presenta algunos conceptos fundamentales delderecho canónico, de la ley sobre el aborto en particular, sobre cómo aplica la iglesiasanciones a sus miembros, sobre cómo y cuándo finalizan dichas sanciones y aquiénes aplican esas leyes.
Web site : http://www.despenalizaciondelaborto.org.co/data/documentos/200509161640430.codigo_derecho_canonico.pdfAbstract : In the past few years a greater openness to examination of the characteristics and consequences of abortion as a public health issue and as a social phenomenon has been evident in Peru. To study the attitudes and experiences regarding abortion of low income women living in squatter settlements, focus groups were organized in the Andean city of Cuzco and the Amazon city of Iquitos. The participating women were aged 15 to 49, married or in union, and had at least three living children. The women in each city were divided into three groups of modern contraceptive users, traditional contraceptive users, and nonusers of contraception. They were further divided into two age groups over and under 30 years old. Two focus groups were held for each age and contraception group in each city for a total of twelve sessions in each. A total of 173 women participated. The focus groups met in Iquitos in December 1986 and in Cuzco in March 1987. Younger users of modern contraception did not express approval of abortion but rather stressed its health risks and especially the belief that repeat abortions would lead to cancer. Contraceptive users over 30 and women in the other two groups cited health risks and moral condemnation, speaking in terms of crime, sin, and punishment. Some saw a distinction nevertheless between very early abortion and later abortions, which were disapproved. Some women expressed resentment at wealthier women who were suspected of using abortion to limit their family size. Women in both cities identified abortion seekers as predominantly young, unmarried, older, or multiparous. Private physicians and nurses were said to be the most frequent practitioners, although health workers of all kinds were mentioned. A wide variety of herbal preparations and abortifacients were mentioned, but doubt was expressed as to efficacy in some cases. Curettage was said to be performed by physicians but no details were given. Opinion was divided concerning the desirability of possible legalization of abortion. There was evident feeling that abortion should be used for special cases or emergencies, but that family planning should be the usual practice for fertility limitation.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103043Abstract : En muchos países en desarrollo, la alta frecuencia de embarazos no deseados coloca a las mujeres en mayor riesgo de morbi-mortalidad en el embarazo y compromete en ocasiones su salud sexual y reproductiva. La mayoría de las muertes por aborto no seguro ocurren en estas naciones, lo que confirma el amplio descuido de las necesidades de salud reproductiva de la mujer. Este estudio estimó el costo del aborto correspondiente inducido, en la Maternidad María Cantera de Remón, de enero a junio de 1990. Se reclutaron 639 mujeres con aborto en curso, de las cuales, 53% admitieron que eran inducidos o tenían signos o síntomas de infección u otros que surgieron que fueron inducidos. Un 37% de las pacientes tenían entre 21 y 25 años; su escolaridad (48%) era de secundaria incompleta; la mayoría manifestó estar unida y 34% tenían un ingreso familiar mensual menor a B/ 100.00. El 33% de éstasno tenía hijos y sólo 7% tenía 5 hijos. De las mujeres que admitieron haberse provocado el aborto, 85% utilizó la sonda vaginal . El costo estimado del aborto espontáneo resultó en B/ 8.58/aborto y del provocado o dudoso fue de B/ 168.38/aborto. Concluimos que el 53% de la partida destinada a la Maternidad Cantera de Remón durante el estudio se gastó en tratamiento del aborto. Se considera que con un plan acción de prevención , que permita a las pacientes recibir información sobre planificación familiar antes de ser dada de alta , se gastaría mucho menos que en el tratamiento de aborto provocados.
Web site : http://www.guate.net/revcog/esp/index.htmAbstract : Introduce el concepto de bioética, su objeto de estudio y las polémicas y contradicciones que han surgido en torno a temas tales como el aborto y la eutanasia principalmente. Plantea la necesidad de una nueva ética capaz de resolver problemas actuales ausentes en los códigos tradicionales; presenta y explica los distintos tipos de códigos éticos y su relación con los sistemas religiosos.
Notes : Español/espagnol/SpanishAbstract : Introducción ; Metodología ; La mortalidad del aborto y sudespenalización: actitudes generales ; Actitud general hacia el aborto inducido: tipología ; Posturas frente al aborto: perfil social y cultural ; Condiciones para la despenalización del abortoinducido ; El perfil social o cultural según el tipo de causa o situación de despenalización delaborto ; Conclusiones generales ; Bibliografía ; Notas.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Presentación ; Avances del programa de planificación familiar enMéxico ; De la planificación familiar a la salud reproductiva ; Fundamento normativo: la normaoficial Mexicana de los servicios de planificación familiar ; La planificación familiar y los derechossexuales y reproductivos ; Métodos y estrategias anticonceptivas ; La planificación familiar: unarespuesta a la problematica del aborto ; Poblaciones prioritarias ; Vinculación de la planificaciónfamiliar con los otros componentes de salud reproductiva ; Prevención y manejo de la infertilidad ; Investigación ; Ampliando la cobertura y la calidad de los servicios.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This work argues that abortion, like family planning, is intended to reduce the numbers of births especially in developing countries, where antinatalist propaganda is concentrated. Abortion is not referred to as the intentional death of a new being, but rather in terms of the rights of women. The right to life is the most basic of all rights, uniformly recognized in religious, moral, and juridical codes throughout the world, and expressly recognized in the Bolivian Constitution. The right to life is so sacred that it must be respected even in persons suffering grave illnesses or abnormalities. The moral and social dangers of abortion affect the entire society. The material damages of underpopulation can be witnessed in Bolivia, where the lack of a sizable internal market has limited industrial development and where past territorial losses have occurred in nearly unpopulated regions. Bolivia requires foreign aid and assistance, but to provide educational and health services to children, not to eliminate them. Abortion must continue to be regarded as illegal and punishable, because it constitutes an attack on the moral and social interests of society. The fact that few abortions are prosecuted does not justify decriminalization; Bolivian jails are not full of prisoners convicted of bribery, but nobody would argue that bribery should be decriminalized. Abortion must retain its criminal character as a matter of principle. The line must be firmly drawn: if abortion is recognized as licit, there will be no reason not to authorize infanticide in some cases, and other types of legalized killing may follow.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 104437Abstract : The right to life has traditionally been defined as the right to existence, and within the traditional conception it is recognized as a first order right, a support and prerequisite for other rights. From this formalist perspective, life begins at conception, but there is debate regarding the juridical protection merited by the fetus and the mother. Some believe they have equal weight, but others argue that birth marks a fundamental difference; the law recognizes the juridical personhood, obligations and rights of the person, but attributes the quality of "subject of rights" to the fetus. Like any other human right, the right to life is not absolute and may be restricted when it conflicts with other rights. Abortion implies interruption of a pregnancy whose continuation would injure the life or health of the mother, whose rights thus prevail. A number of juridical systems throughout the world also recognize as prevailing the mother's right to physical and mental integrity, to free development of personality, and to self-determination, which are based on the principle of human dignity. The principal of human dignity adds to the right to life a substantial and integrating dimension that goes beyond mere protection of existence. Peruvian legislation reflects the traditional conception of the right to life in its formal or existential dimension. But the constitutional norm transcends this formalist view. The first article of the Peruvian Constitution asserts that the defense of the human being and respect for human dignity are the supreme goals of the society and state. Public policy and legislation should be guided by the constitution.Por tradición, el derecho a la vida se ha definido como el derecho a la existencia, y dentro de la concepción tradicional se reconoce como un derecho de primer orden, un apoyo y requisito previo para otros derechos. Desde esta perspectiva formalista, la vida comienza en el momento de la concepción, pero hay debate respecto a la protección jurídica que merece el feto y la madre. Algunos consideran que tienen el mismo peso, pero otros argumentan que el nacimiento señala una diferencia fundamental; la ley reconoce la personería jurídica, las obligaciones y los derechos de la persona, pero atribuye al feto la calidad de "sujeto con derechos". Como cualquier otro derecho humano, el derecho a la vida no es absoluto y se puede restringir cuando está en conflicto con otros derechos. El aborto implica la interrupción de un embarazo cuya continuación pondría en peligro la vida o la salud de la madre, cuyos derechos deben prevalecer. Varios sistemas jurídicos en todo el mundo también reconocen que prevalece el derecho de la madre a la integridad física y mental, al libre desarrollo de la personalidad y a la autodeterminación, que se basan en el principio de la dignidad humana. El principio de la dignidad humana añade al derecho a la vida una dimensión considerable e integrante que va más allá de la simple protección de la existencia. La legislación peruana refleja la concepción tradicional del derecho a la vida en su dimensión formal o existencial. Pero la norma constitucional trasciende esta opinión formalista. El primer artículo de la constitución peruana afirma que la defensa del ser humano y el respeto de la dignidad humana son los objetivos supremos de la sociedad y del estado. La legislación y la política pública deberían ser guiadas por la constitución.
Notes : Español/espagnol/Spanish, nbsp;165822Abstract : Consideramos que el acceso a la información, además de un derecho en sí, es un primer paso para el ejercicio de los derechos en materia de aborto legal. Por ello, GIRE presenta esta compilación de los textos vigentes de todos los códigos penales del país, donde se señalan las condiciones bajo las cuales el aborto es legal en cada una de las entidades federativas. Esperamos que esto sea un aporte en la construcción colectiva de un ejercicio pleno de la libertad reproductiva de cada persona.
Web site : http://www.gire.org.mx/Abstract : En América Latina, el sistema del "doble discurso" afecta la capacidad de las personas para ejercer sus derechos sexuales y reproductivos. Este sistema, vigente en diferentes sociedades y países, defiende por un lado las políticas públicas represivas o negligentes y, por otro lado, tolera los mecanismos no oficiales (y a menudo ilegales) que permiten que las personas accedan en privado a más opciones en lo que toca a su sexualidad y reproducción. Bonnie Shepard analiza dos casos específicos: el divorcio en Chile y el aborto en Colombia y Chile. En todo el mundo, el clima político que rodea los derechos sexuales y reproductivos se caracteriza por un aumento notable del fundamentalismo religioso y, a la vez, por una globalización cultural. En América Latina, la mayoría de las personas se consideran católicas, sin embargo, los y las católicas de estos países no se ciñen a las enseñanzas oficiales de su Iglesia sobre la fecundidad y el aborto. Al mismo tiempo, un progresivo aumento en la fuerza de sectores conservadores en los últimos veinte años ha generado una creciente rigidez en las posiciones de la iglesia al respecto. Por otro lado, dentro de la mayoría de las agencias y partidos políticos, aparentar que hay un consenso público sobre estos temas es un recurso valioso. Como resultado, apunta Shepard, el discurso "legítimo" que se difunde en los medios de comunicación sigue siendo el que emana del discurso de la jerarquía católica y de las figuras públicas que la respaldan. Las voces disidentes que defienden los derechos sexuales y reproductivos rara vez llegan a la opinión pública, excepto cuando son atacadas por la Iglesia.This article examines how political controversies affect citizens' ability to exercise sexual and reproductive rights in Latin America. The article argues that societies accommodate conflicting views on sexuality and reproduction with a "double discourse system," which defends repressive or negligent public policies while privately tolerating unofficial and often illegal mechanisms that expand private sexual and reproductive choices. The examples of divorce policy in Chile and abortion policy in Colombia and Chile are highlighted to illustrate how this breach between public discourse and private actions operates in practice, and who is harmed by it. The article concludes by discussing the implications of this system for rights advocacy.
Web site : http://www.gire.org.mx/Abstract : 99% of the half-million maternal deaths in the world each year occur in developing countries, and many are the result of inopportune or undesired pregnancies. Each month over a million infants an small children also die. In Latin America and the caribbean, women have a risk 50-100 times greater of dying as a result of pregnancy or delivery than women in the US, and their children have a 5 times greater risk of dying before heir 1st birthday. The majority of infant and maternal deaths are preventable. Education and family planning services, which are neither costly nor complicated, could significantly reduce these high mortality rates. A woman's lifetime risk of maternal death is related in great part to her economic and social environment, how many pregnancies she has had, and the availability of maternal health services, It is often difficult for women in developing countries to maintain good health especially if they are poor. They are frequently poorly nourished, and may be required to perform hard physical labor. Pregnancy places greater physical demands on them and may worsen existing health problems. Maternal health risks are substantially increased as well by age under 18 or over 40 years, parity over 4, previous delivery during the last 2 years, and preexisting health problems that could affect pregnancy. Some 75% of maternal deaths are believed to result from obstetrical complications. Hemorrhage, 1 of the most frequent,is more common among older women who have already had 4 or more deliveries. Hemorrhages can be fatal in areas lacking the capability to provide immediate transfusions. Toxemia can lead to convulsions and death if not treated early. Sepsis usually results from complications of an obstructed delivery in very young mothers. Illegal abortion is another major cause of maternal death. In some Latin American ad Caribbean countries, 1/2 of maternal deaths are due to illegal abortions under unhygienic conditions. The same obstetrical risks exist throughout the world but the probability of death is greater in the developing world where access to obstetrical care is deficient. If family planning were easily accessible, women could plan their pregnancies to reduce these risks. Various factors affect the wellbeing of the children. Infants born too soon after another delivery or into families that already have 3 or more children, those born to mothers under 20 or over 40 years old, and those whose mothers die are at significantly increased risk of early death. Compared with other health interventions, family planning is an economical means of improving both maternal and child health, but it is not widely accessible in many developing countries.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 066173Abstract : El aborto es un problema que afecta a casi todos, directa o indirectamente, por lo menos una vez en la vida. Nadie está al favor del aborto. Es una solución desesperada que tampoco agrada a nadie y que deja siempre cicatrices emocionales y físicas. La gente tiende a tener fuertes opiniones sobre el aborto, sin haber dedicado a la debida atención y la profunda y amplia reflexión sobre el problema que nos ofrece el libro de Faúndes y Barzelatto.
Notes : Español/espagnol/SpanishAbstract : Uno de cada seis nacimientos en el país, ocurre en mujeres menores de 19 años. El embarazo en la adolescencia se considera desde el punto de vista médico y social como una situación de riesgo para la salud y el desarrollo personal de la madre, su hijo o hija y su pareja. Aunque no se tienen cifras fidedignas, se estima que un gran porcentaje de los nacimientos que ocurren en menores de edad son embarazos no planeados y probablemente no deseados. Aún cuando los adolescentes tienen información sobre los métodos anticonceptivos y su forma de uso, solo la mitad de los jóvenes sexualmente activos usa algún tipo de anticonceptivo. Por otra parte la demanda insatisfecha de anticoncepción es mucho mayor en la población adolescente que en cualquier otro grupo etáreo. Para poder aprovechar el momento histórico que vive el país, donde un gran porcentaje de su población es gente joven con potencial de desarrollo social y económico, es indispensable que se aumente la edad al primer embarazo, que aumente el intervalo entre los embarazos, que se incremente la oferta de métodos anticonceptivos a la población adolescente y que se promuevan de manera decidida los derechos sexuales y reproductivos de toda la población y de los adolescentes en particular.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : Se hace una revisión de los argumentos comúnmente utilizados para definir al embarazo adolescente como un problema público: su supuesto incremento, su contribución al crecimiento acelerado de la población, sus efectos adversos sobre la salud de la madre y del niño y su contribución a la persistencia de la pobreza; y se proponen algunos elementos para una posible explicación alternativa, con la intención de contribuir a definir con mayor rigor y pertinencia los problemas reales vinculados con el embarazo en adolescentes y poder diseñar políticas y programas más adecuados para enfrentarlos.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0036-36341997000200008 lng=en nrm=isoAbstract : El informe está organizado en una introducción y 5 capítulos. El capítulo 1 presenta la revisión de la literatura biomédica y socioantropológica. En el capítulo 2 se analizan las perspectivas de funcionarios de diversos sectores (salud, educación, desarrollo social) y de los profesionales que trabajan en los servicios de salud acerca de la temática del estudio. El capítulo 3 describe y analiza los resultados de la encuesta a las adolescentes puérperas realizada en las principales maternidades de las jurisdicciones en las que se desarrolló el proyecto. El capítulo 4 presenta un análisis comparado de los datos de la encuesta a puérperas y los de la Encuesta de Condiciones de Vida (Siempro, 2001). Finalmente, en el capítulo 5 se desarrollan las conclusiones del estudio y se ofrecen recomendaciones para la reorientación de programas y políticas de salud. El informe concluye con un apartado con Anexos, en los que se adjunta el cuestionario y el consentimiento informado aplicado en la encuesta a puérperas, tablas adicionales de la encuesta einformación acerca de la legislación nacional referida a la población adolescente y joven.
Web site : http://www.msal.gov.arwww.cedes.orgAbstract : Introducción ; El embarazo forzado ; Invisibilidad de las mujeres en el concepto de madres ; La desvalorización de la salud y la vida de las mujeres gestantes ; Salud y salud reproductiva ; La negativa de realizar el aborto terapeútico como violación a los derechos humanos de las mujeres ; El derecho a la integridad personal, a no ser sometida a trato cruel, inhumano o degradante ; La responsabilidad del Estado Argentino ; El peligro para la vida y la salud de la mujer en la jurisprudencia nacional ; Posibilidad de utilizar la acción de amparo para proteger la integridad personal y logar la aplicación del Art. 86 Inc. 1 cp ; Regulación de la acción de amparo ; Utilización del amparo para obtener la tutela del derechos a la salud y la integridad personal ; Utilización de la vía judicial para la realización de esterilizaciones quirúrgicas ; Posibilidad de utilizar la garantía del amparo en un caso de aborto terapeútico ; Conclusiones ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Los permanentes obstáculos para el ejercicio pleno de los derechos humanos en el campo de los derechos sexuales y reproductivos y la permanente e invisible violación de esos derechos demuestra a las autoras la necesidad de profundizar en la realidad del embarazo forzado. En primer lugar, se intenta definir el embarazo forzado, sus causas y consecuencias psicológicas y sociales. En segundo lugar, se trata de ver las respuestas que se han dado desde el campo jurídico a esta problemática. Finalmente, las autoras intentan esbozar algunas propuestas para solucionar las contradicciones que aparecen en el campo de los derechos humanos. Incluye: Introducción ; Definiendo "embarazo forzado" ; Algunas causas ; Algunas consecuencias ; El embarazo forzado desde la óptica jurídica, su inserción dentro de los derechos humanos sexuales y reproductivos ; Derecho humanitario internacional ; La Corte Penal Internacional y el Estatuto de Roma ; El derecho nacional ; El embarazo forzado y la penalización del aborto ; El aborto terapéutico en el Código Penal ; El embarazo forzado y la penalización de la violación sexual ; El embarazo forzado como delito autónomo ; Consideraciones finales ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Introduction / Introducción ; Summary of Plenary Sessions / Resumen de las Sesiones Plenarias ; Summary of Presentations / Resumen de Presentaciones ; Disseminating Research Results / Diseminación de Resultados de Investigación ; Overall Conclusions / Conclusiones GeneralesEl Population Council y el Instituto Alan Guttmacher promovieron la conferencia con el propósito de aprender y compartir información sobre el tema, el informe muestra un panorama global de los temas tratados
Web site : http://www.guttmacher.org/pubs/lac.pdfAbstract : Engaging in sexuality and reproduction should always be something that is wanted and planned. Unfortunately, when that is not the case, one result can be unwanted pregnancy. Unwanted pregnancies have consequences for women, their families, and their countries. This document reviews the causes and results of unwanted pregnancy, emphasizing the impact that this problem has on Latin America and the Caribbean (LAC). Four reasons why unwanted pregnancy is a continuing problem in LAC are: 1) people's growing desire to have smaller families, 2) the unmet need for family planning, 3) the fact that contraceptive methods are not 100% effective, and 4) unwanted sexual relations. Unwanted pregnancies especially affect adolescent women, single women, and women over 40 years of age. Given their desperate situation with an unwanted pregnancy, some women opt for an unsafe abortion, which can lead to their death. Other women can go so far as to commit suicide, or be murdered by a family member or other person who is unhappy that the pregnancy has occurred. It has been found that women who decide to continue with the pregnancy have higher risks of suffering an illness, and the same is true for the child. Reducing unwanted pregnancies and treating post-abortion complications are key to lowering maternal mortality and morbidity. This necessitates developing mass communication programs that address gender issues, education programs for girls, and sex education programs. It is also vital to make available to all persons reproductive health services that include family planning methods. In the countries of LAC with laws that specify grounds for legally ending a pregnancy, it is necessary that health care be organized to actually provide this service, and that health care programs obtain the safest, most effective technologies now available for ending a pregnancy. [Journal Article; In Spanish; United States]
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S1020-49892002000300013 lng=en nrm=isoAbstract : This work argues that a risk focus in maternal-child health programs would be an effective strategy to combat the high maternal mortality rates of Latin America and the Caribbean. The risk focus recognizes that not all persons have the same probability of becoming ill or dying, and it establishes a continuum of health services ranging from minimal attention for individuals at low risk to maximal services for those at high risk of future health problems. The risk focus is based on a concept of equity in which the limited available resources are allocated to those most needing them. Risk factors, the prediction of disease, and possible interventions to avoid disease are the tools of the risk concept that facilitate identification of future health needs. Although almost all maternal deaths are preventable, maternal mortality continues to be a serious social and health problem in Latin America. Some 28,000 women die each year in Latin America from causes related to abortion, pregnancy, delivery, or the postpartum. Significant differentials are observed in maternal mortality rates within countries according to income, education, and degree of urbanization. Factors determining the high maternal mortality rates are multiple and include social inequalities aggravated by rapid population growth, rapid urbanization, poverty, underemployment, deficient education, and insufficient and inadequate health and family planning services. Family planning services should offer the greatest possible choice of contraceptive methods, and clients should be fully informed of the possibility of side effects. Complete information has been found to increase rates of continuation and acceptability. Voluntary male and female sterilization should be available as the most effective method for couples desiring a permanent method. Over 90% of women aged 15-44 in Latin America know at least 1 contraceptive method. Prevalence rates fluctuate around 57% for Latin America and the Caribbean. Rates vary from 71% in Costa Rica, 66% in Brazil, and 65% in Colombia to 30% in Bolivia, 23% in Guatemala, and 7% in Haiti. Various surveys in Latin America have demonstrated high rates of unwanted pregnancy and considerable unsatisfied demand for family planning services, especially among log income urban and rural women. Access to family planning services has been recognized as a basic human right, and universal family planning coverage is an important element of programs to reduce maternal mortality. Sterilization has increasingly gained acceptance in Latin America and is at present the 1st or 2nd most common method in almost all countries.
Web site : http://cipa.snv.jussieu.fr/web_en/revues/references/rev39.htmlAbstract : Recopilación y análisis del material que se produjo en el estado de Nuevo León entre 1998 2000 sobre el derecho a la vida en este estado
Notes : Español/espagnol/SpanishAbstract : Reseña del movimiento feminista en México desde la perspectiva política. Revisa y analiza los acontecimientos históricos y políticos del país, como son, las alianzas que se han establecido entre los nuevos sujetos de la modernidad, la iglesia católica y el gobierno. Ante estos acontecimientos qué alternativas propone el movimiento feminista para las elecciones de 1994
Notes : Español/espagnol/SpanishAbstract : Until relatively recently, sheer survival has been a more pressing concern of most human populations than has control of population growth through contraception. Today family planning with its varied technologies has become an accepted behavior of the majority of fertile couples. Colombia has achieved a satisfactory contraceptive prevalence rate largely due to private institutions. The decline from 6.5 to 3.5 children per woman that required 58 years in the US (1842-1900) required just 15 years in Colombia, according to UN data. Other UN publications demonstrate that family planning prevalence is strongly correlated with quality of life as measured by income, life expectancy, and education, with family planning and quality of life tending to improve simultaneously and coherently. Reproductive health might more appropriately be considered sexual health, since most couples wish to continue sexual relations without fear of unwanted pregnancy. Reproductive health defined as referring to fertile-aged women and children under 15 concerns around 2/3 of the population in developing countries. Although the reproductive health of a country depends in large measure on the physical and mental well-being of its women, discrimination against women in education health, employment, and participation is a serious problem in many countries. Accessibility of family planning is another indicator of women's status. The potential health benefits of avoiding births before age 20 and after 35, high parity births, and closely spaced births are well known. Avoiding all such births would reduce maternal mortality by 20-25% worldwide, saving 100,.000-125,000 maternal lives. Proper spacing would also combat infant mortality. Infant survival programs that omit family planning as a component are short sighted. Family planning has the important benefits of reducing recourse to abortion and of allowing savings in public services including health care, education, and nutrition. In the area of family planning, Colombia's PROFAMILIA continues to prefer a cafeteria approach in which numerous contraceptive options are available. It has been demonstrated that each new method increases the number of acceptors by 6% on average. The especially for women who want to terminate childbearing. Morbidity and mortality rates of the different contraceptive methods, even in the worst conditions, are lower than they would be if contraception were not used. Oral contraceptives, for example, are 4-5 times less risky than nonuse of contraception. PROFAMILIA is currently seeking authorization to use a new combined monthly injectable contraceptive called Cyclofem. The subdermal implant NORPLANT has been well accepted in Colombia.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 080933Abstract : There is consensus among demographers that, in countries where abortion is illegal, its magnitude cannot be estimated directly and can be estimated indirectly only with great difficulty. Because of the difficulty of quantifying the practice of abortion in Mexico, its occurrence is neglected in discussions of the country's demographic problems. But apart from issues of women's rights or health consequences, it is necessary that the general population, politicians, and opinion leaders assess abortion in its relationship to fertility and population growth. Study in numerous countries with varying socioeconomic characteristics suggests that no country can achieve a population growth rate near 1% without recourse to induced abortion as a complement to effective contraceptive usage. Experience shows that no country has achieved a total fertility rate under 2.2 without abortion. Observation of the demographic transition suggests that there are three phases in the relative role of induced abortion. In the first, fertility levels are high in the absence of contraception, and abortion is practiced but is not responsible for most intrauterine mortality. At a second stage, abortion becomes very important as the population begins to control fertility but lacks access to effective contraception. In the third stage, use of effective contraception permits fertility to be controlled, and abortion is used when contraception fails or is not used. National surveys indicate that in the 1960s, most Mexican women had 7 children and fewer than 10% used contraception. At present, most Mexican women in union use effective contraception, but a significant proportion still do not. Women not using contraception but not desiring more children and women whose methods fail constitute a pool of potential abortion seekers. Computer simulation models employing data from national fertility surveys have been used to estimate the different combinations of contraception and abortion that result in observed or projected total fertility rates. Assuming that in Mexico at present, 60% of couples limit their fertility after two children, that the total fertility rate is 3, and that the level of effectiveness of contraception is 95%, the implied total induced abortion rate is approximately 0.7 abortions per women at the end of her reproductive life. This level represents around 20% of current fertility. The abortion rate will decrease with increases in contraceptive efficacy, but the sociocultural conditions of the population, qualitative characteristics of family planning programs, and current state of contraceptive technology will limit increases in contraceptive efficacy in the short term in Mexico.
Web site : http://www.ejournal.unam.mx/demos/demos_index.htmlAbstract : Interpretación de los diferentes papeles que desempeña la mujer en la familia. Existen diferentes formas de ser mujer en un solo espacio, como es la familia, en donde los roles asignados se han transformado a través de las diferentes etapas históricas en la evolución de la familia
Notes : Español/espagnol/SpanishAbstract : The data and estimates presented suggest that the incidence of induced abortion in Latin America is high. In individual countries the average total abortion rate, ie lifetime induced abortions, seems to be between one and two per woman of fertile age, if not higher. The incidence of induced abortion in Latin America appears to be among the highest in the world, comparable to several East Asian and East European countries. Apparently the practice of induced abortion was already quite extensive in urban Latin America in the 1960s at a time when the use of contraception was low. As of the 1980s, induced abortion accounts for about one quarter of deliberate fertility control, and contraception for the remaining three quarters. The high incidence of induced abortion is due to an imbalance between the strong motivation for smaller families and the imperfect availability and utilization of contraception. The motivation for smaller families is widespread and contraceptive prevalence has been increasing steadily since the 1960s, yet many barriers exist to its universal and effective application. Contraceptives are not always available when needed; frequently access is difficult, particularly for young, single, and poor women and men; knowledge about reproductive functions and contraceptives is deficient and erroneous among large proportions of women; and at times the use of contraception is at odds with deeply in grained cultural and social patterns, as well as with personal sentiments. For these and other reasons, contraceptive failure is not uncommon. Consequently, the incidence of unwanted pregnancy is high and many women/couples resort to induced abortion. [Journal Article; In Spanish; Mexico]
Web site : http://www.scielosp.org/scielo.php?script=sci_serial pid=0036-3634 lng=en nrm=isoAbstract : This report entails 6 primary areas of The Population Council in Latin America and the Carribean: family planning and fertility, reproductive health and child survival, women's role and status, contraceptive introduction, publications and public information, and development of human and institutional resources. Operations research in family planning and fertility focuses on upgrading the quality, coverage and cost-effectiveness of family planning services. By September 1989, 48 projects were completed. These projects concentrated on training and supervision; information, education, and communication; service delivery systems; management information systems; and AIDS prevention. SUB- projects had a median cost of US$68,000. the area of reproductive health and child survival includes programs in child health and adolescent fertility, the prevention of unsafe induced abortions, postpartum care, and demographic and health surveys. Objectives of child health and adolescent fertility programs are advancing the health of infants and children and decreasing adolescent pregnancies; socioeconomic, biomedical, and behavioral factors are studied. Specific areas concerning postpartum care include breastfeeding management training and contraception during breastfeeding. To advance women's roles and status, programs are studying women's health and hardships. Contraceptives introduced in this region are NORPLANT implants and the T-Cu 380A intrauterine device. Publications and public information have focused on nutrition, health, population, the prevention of unsafe induced abortion, and operations research. Workshops were conducted for further understanding of adolescent fertility and AIDS prevention. Human and institutional resources are available through fellowships for advance training in population studies and reproductive biomedicine.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - CPFH 27477cr990Abstract : The antecedents of intergovernmental conferences on population date back to the World Population Conference in Bucharest in 1974 and even before to Rome in 1955 and Belgrade in 1965. In Bucharest the pronatalist and the antinatalist positions confronted each other and women's role in development was discussed. In 1984 the World Population Conference was held in Mexico, by which time many countries had adopted population policies and family planning programs. In 1994 in Cairo it became the International Conference on Population and Development, for the first time reflecting in its very title an international consensus on a relationship between demographic variables and socioeconomic development. The relationship between population dynamics, economic development, natural resources, and sustainable production and consumption were analyzed. More than 10,000 people from 180 countries participated. 60% of official delegations had representatives of nongovernmental organizations among them. The Cairo conference adopted a Program of Action for the next 20 years reflecting an evolution in thought on the issues of population during the previous two decades. It was based on human rights: the equality of women, free elections, universal education, the eradication of poverty, and the right to development. In relation to sustainable development it examined poverty and development; population and development strategies; sustainable development for human welfare; and forces employed to reduce population growth. In relation to the empowerment of women it sketched the equal participation of women in development and education as a major element in their empowerment. The goals of the conference were centered on education, reduction of mortality, and access to reproductive health care including family planning. The implementation of the Program of Action in the next 20 years will place women in the mainstream of development, assure that all pregnancies are wanted, reduce the abortion rate, promote reproductive health, combat AIDS, and promote the integrity of the family.
Notes : Español/espagnol/SpanishAbstract : Este documento contiene: (1)Ser hombre, ser padre. Un estudio sobre las representaciones sociales de la paternidad y (2)El varón en las relaciones de género: reflexiones para la intervención en sexualidad y reproducción.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Después del debut ¿Qué?, una mirada a la sexualidad de los varones jóvenes de Buenos Aires/ Rosa Geldstein y Marta Shufer - Respuestas de los varones a preguntas sobre sexualidad: de las diferencias por sexo al enfoque de género/ Ana Lía Kornblit y Ana María Medes Diz - Una aproximación cualitativa a la salud sexual y reproductiva de los adultos jóvenes varones desde su propia perspectiva en Lima, Perú, 2000/ Jesús L. Chirinos, Carlos Cabezudo y Olga Bardales - Ser hombre en el Perú hoy: una mirada a la salud sexual desde la infidelidad, la violencia y la homofobia/ Carlos Caceres, Ximena Salazar, Ana María Rosasco y Percy Fernandez - El cáncer cervical: un problema también de varones? El caso de México a partir de las perspectivas de médicos y pacientes/ Diana Reartes - Opçao pela vasectomia: participaçao masculina na contracepçao ou falta de alternativas?/ Nadia Maria Marchi, Maria Jose Duarte Osis, Augusta Thereza de Alvarenga y Luis Bahamondes - Actitudes y conductas de los varones ante la mujer con cáncer, la mastectomia y reconstrucción mamaria/ María del Carmen Calderón Benavides, Ernesto Sánchez Forgach y Pilar Lavielle Sotomayor - Varones y derechos sexuales y reproductivos, en las ciudades de Lima y Ayacucho/ Miguel Angel Ramos Padilla - "Como un juego": la perspectiva del varón adolescente sobre la coerción sexual/ Hernán Manzelli - Masculinidade, juventude e vulnerabilidade a aids: uma experiencia de prevençao entre jogadores de futebol juniores em Campinas-SP, Brasil/ Wilson Aparecido Silva - Expectativas, logros y cambios en los asistentes a un programa de educación sexual/ Graciela Sikos - Efectos de un programa de capacitación dirigido a hombres en la demanda de servicios de anticoncepción/ Susana Sánchez V. Y Kenia T. Ricaldi A. - Realidad y creencias en el proceso de toma de decisiones, sexuales y reproductivas: hombres percepciones y conductas/ Franklin García Pimentel - Reflexiones sobre el uso de la doble protección en varones adolescentes/ Nina Zamberlin - Aproximación al comportamiento reproductivo de los varones: un estudio en dos sectores sociales y dos generaciones de la ciudad de México/Olga Lorena Rojas - La protección de las Relación sexual y reproductivas de los habaneros/ Luisa Alvarez Vázquez, Jorge Luis Calero y Esther M. León Díaz - El proceso de toma de decisiones anticonceptivas en la pareja desde la perspectiva de varones adultos/ Graciela Infesta Domínguez - Presencias masculinas en las decisiones reproductivas: relaciones de género, regulación de la fecundidad y recursos cognitivos entre mujeres y varones jóvenes de sectores urbanos medios y pobres/ Alejandro M. Villa - Construcciones culturales e imaginarios en los ejercicios de la virilidad en etnias andinas/ Rodrigo Tenorio Ambrossi - Algunas reflexiones sobre la sexualidad y la salud en el contexto de los varones que son parte de las fuerzas armadas/ Juan Guillermo Figueroa Perea - Jovens do sexo masculino, sexualidade e Saude reproductiva: um estudo de caso na comunidade de Capuava, Santo André, Sao Paulo/ Sylvia Cavasin, Sandra Unbehaum y Valeria Silva - Sexualidad y masculinidad en un contexto de transformación en las relaciones de género: Chile 2002/ Humberto Abarca Paniagua - Representaciones prácticas de los hombres de sectores pobres urbanos sobre los métodos anticonceptivos y el aborto/ Susana Rostagnol - Sexualidad, relaciones de género y masculinidad en la adolescencia: experiencias aprendidas de un programa de intervención/ Alejandro M. Villa - Prevención en salud reproductiva con jóvenes varones en un espacio asistemático/ Enrique Berner.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This chapter on El Salvador is part of a comprehensive examination of the laws and policies that affect the reproductive lives of women in nine Latin American and Caribbean countries. Each report begins with a page of statistical information on population, the economy, status of women, and reproductive health and a brief summary of the nation's recent history. The first main section describes the country's legal and political framework, including the structure of national and local governments and national and international sources of laws. The second section examines laws and policies regarding health and population. The objectives of national health policy and the financing, infrastructure, and regulation of health services and patients' rights are analyzed. Population policy, legislation affecting reproductive health, and government- provided family planning services are then examined. Discussions of contraception, abortion, and HIV/AIDS and sexually transmitted diseases examine relevant legislation and prevalence. The third major section assesses the social and juridical status of women as an influence on the exercise of their reproductive rights, including civil rights within marriage, socioeconomic rights, and the right to physical integrity. The characteristics of marital and family relations and their educational level, access to economic resources and legal protection determine women's possibilities of satisfying their reproductive health needs and rights to services. The final major section examines the rights of adolescents in the areas of reproductive health, marriage, sexual crimes against girls and young women, and sex education. Efforts to improve observation of the reproductive and other rights of adolescents are important for self-determination and health of women in general.
Web site : http://www.crlp.org/Abstract : Cápsulas informativas para la defensa de los derechos sexuales y reproductivos
Notes : Español/espagnol/SpanishAbstract : Percepciones sobre los hitos y cambios fundamentales que marcaron la historia de las mujeres en el siglo XX en diversos y variados ambitos. Volumen doble. ; Contenido: 1778 Filadelfia: siel hubiera nacido mujer.- Claves identitarias de las latinoamericanas en el umbral del milenio.- La tercera mujer.- Feminismo: de Cristine de Pisan a la posmodernidad.- El segundo sexo:cincuenta aos después.- Algunos hombres del segundo sexo.- Género: los conflictos y desafios del nuevo paradigma.- Hitos: trabajo, una presencia constante.- Mercados globales, género y el hombre de Davos.- Representacin politica: un análisis comparado del caso argentino.- Caribe anglofono: tranformar la politica, un reto para el proximo siglo.- Comunicaciones: la revolucion del conocimiento.- En la conquista por la educación.- Luces y sombras de la educación.- Sexualidad: resistencia, imaginacion y cambio.- Tras las huellas de un porvenir incierto: del aborto a los derechos sexuales.- Teologia feminista latinoamericana.- De complicidades y diferencias: lecturas feministas.- Creadoras latinoamericanas.- Los nuevos derroteros a fin de milenio: derechos y autonomia.- Conversacion con Matta: de las armas, la cultura y las mujeres.
Web site : http://www.unifem.org.mxAbstract : Although Mexico's local laws on abortion have been maintained without significant change for many years, the right has demonstrated great concern over abortion legislation. Conservatives appear to fear growing acceptance of arguments favoring Decision making by women themselves over whether or not to terminate pregnancies. Some statements made during the recent abortion debate in Nuevo Leon reflect their fears. According to one statement in a Nuevo Leon newspaper, if abortion is admitted to be justified in determined circumstances considered grave, it will be easy progressively to increase the number of motives regarded as serious, until the interruption of an undesired pregnancy is left in the hands of the mother. A similar statement held that once a crime as execrable as abortion becomes regulated, even for apparently "humanitarian" reasons, new motives and new excuses will be found to open the way for more and more abortion requests. But if the possibility of a more liberal abortion law frightens the right, some of their own proposals could frighten the entire population. A columnist opposed to the proposed constitutional modifications in Nuevo Leon received an e-mail arguing that divorce has been very harmful for society and that efforts are underway to give preference in employment to persons married in the church to guarantee better morality and regenerate the country to make it decent again.
Web site : http://www.gire.org.mx/Abstract : Con el presente trabajo se pretende incorporar al estudio del aborto en México la perspectiva generacional y la distinción según el tipo de unión, dos dimensiones que no han sido consideradas en los estudios publicados hasta la fecha. Los datos utilizados corresponden a los de la Encuesta Nacional de la Dinámica Demográfica levantada en 1997. Entre los resultados obtenidos destaca el relativo a la reducción que experimentó el aborto entre las jóvenes (menores de 30 años) de las generaciones nacidas a fines de los años cuarenta y aquellas que lo hicieron veinte años después, a fines de los sesenta. La distinción por tipo de unión nos permite atribuir esta disminución a las mujeres casadas, que casi exclusivamente eran quienes lo practicaban, y evaluar su impacto reductivo sobre la fecundidad en 1.2 nacimientos evitados en las generaciones mayores y 0.5 en las mas jóvenes. Las mujeres en uniones libres no superan los 0.6 nacimientos evitados en ninguna de las dos generaciones. Al aplicar el factor de separación propuesto, estas diferencias se traducen en relaciones de un aborto espontáneo por casi seis inducidos entre las casadas de más edad y solamente uno de cada dos entre las más jóvenes. Finalmente la distribución según el método anticonceptivo utilizado nos indica que las jóvenes en unión libre están más eficazmente protegidas que las casadas.
Web site : http://redalyc.uaemex.mx/redalyc/src/inicio/ArtPdfRed.jsp?iCve=31205604 iCveNum=1262Abstract : El presente análisis aborda la salud sexual y reproductiva, así como la participación del hombre en la crianza de los hijos
Notes : Español/espagnol/SpanishAbstract : The numbers of adolescent pregnancy are undoubtedly higher if we consider that not all pregnancies are carried to term, whether because they end in a spontaneous abortion or in an induced one. An international study found that a large proportion of births by young women from 15 to 19 years old in Latin America were unplanned. (excerpt)
Web site : http://www.gire.org.mx/Abstract : Cita los cambios físicos y emocionales que experimentan las y los adolescentes. Puntualiza en el arribo al conocimiento de la sexualidad y en las causas y consecuencias del embarazo en mujeres adolescentes
Notes : Español/espagnol/SpanishAbstract : According to the 1990 Demographic and Health Survey, 21% of fertile-aged women in Colombia are adolescents aged 15-19. Research throughout the world has revealed that young people are initiating their sexual lives at ever earlier ages, due to earlier sexual maturation, constant erotic stimuli, and a mistaken understanding of sexuality. A Colombian survey showed that 49% of males and 11% of females had sex by age 18. Earlier sexual activity is leading to increased incidence of unwanted pregnancy. 78 of each 1000 adolescents become mothers each year. Among adolescents aged 16-18 with positive pregnancy tests at the Profamilia Adolescent Clinic in Bogota, 80% did not use contraception and 85% did not with to be pregnant. Unwanted adolescent pregnancy is usually traumatic, with implications for all areas of life. None of the options open to an adolescent with an undesired pregnancy is desirable. Keeping the baby exposes the mother to ostracism and rejection by the family, expulsion from school, and societal rejection. Forced marriages almost always end in separation. Adoption leads to frustration and feelings of guilt in the future. Abortion in Colombia is illegal and exposes the women to emotional and physical trauma and to risk of death or injury. The unwanted child is at risk of mistreatment, abandonment, or rejection. A demographic survey by Profamilia showed that 25% of Colombian women are mothers by age 19. 62% of uneducated adolescents are mothers by this age. Low educational level is associated with early pregnancy and limited economic opportunity. Adolescents are at higher risk of pregnancy complications due to physiological immaturity, stress, poor adaptability to pregnancy, and inadequate prenatal care. Adolescent pregnancy should be prevented. The prevention should be achieved through integrated sex education beginning at the first contact of the child with the world outside the family. The child should learn basic concepts of self-esteem, values, and responsibility because it is important to be able to say no. Sexuality should be a positive and responsible experience in which the love, sharing, and understanding of the couple permit coitus to be postponed. Society incites adolescents to coital activity but criticizes and abandons them when problems arise. Only with adequate education, sufficient maturation, and knowledge and access to contraception can adolescent pregnancy be avoided.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 097334Abstract : Texto sobre los factores de riesgos que propician el embarazo en la adolescencia, las medidas para prevenir y el aborto legal e ilegal.
Web site : http://www.unifem.org.mxAbstract : The goal of this paper is to provide information about pregnancy in adolescents and to influence those people who have to do with the situation of pregnant adolescents and the family and social consequences. The research was carried out at the Dr. Carlos Diez del Ciervo Hospital from 1989 to 1990. It included 1,500 cases and the variables considered were mothers' age, marital status, number of gestations, number of childbirth, residence and initiation of sexual life. The main findings are stated in detail.
Web site : http://www.bvs.sld.cu/revistas/enf/indice.htmlAbstract : El problema y la situación actual ; Perspectivas sobre el problema a corto y mediano plazo ; Políticas existentes ; Programas de educación sexual ; Los medios de 130 comunicación de masas ; Anticoncepción posparto y posaborto ; Políticas de prevención de embarazos adolescentes ; Hacia una política de largo plazo ; Referencias bibliográficas.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : A larger portion of women were exposed to the risk of unwanted pregnancy in the 1980s than in any other decade during the history of humanity. Because of the global slowdown in family planning, the number of abortions soared, with grave implications for worldwide reproductive health. High-risk abortions occur as a result of legal restrictions leading to a lack of access to safe abortion. With respect to induced abortion, the views of no religious groups should be accepted, but rather the right of individuals to make a voluntary informed decision should be ensured, and legal regulations should be strictly followed. About 75% of the global population live in countries that permit abortion on medical and social grounds. Contraception is the primary line of defense against undesired pregnancy according to the IPPF. Therefore, the rate of abortion may be reduced by the increase in access to contraceptive services. The expansion of education about responsible parenthood and about family planning services for adolescents also helps reduce the number of abortions. In 1979, in Chile, the fertility rate was considered adequate (22/1000); therefore, contraceptive information and education activities were suspended, and at present there are no massive sex education plans. Consequently, Chilean youth is very ignorant about its own sexuality. Adolescent pregnancies made up 13.8% of all live births in 1989, 59.8% outside of marriage. The problems of adolescents also reflect other social problems, including unwanted pregnancy, closely related to extreme poverty: in 1987 more than 5 million people were in such condition in Chile. A recent survey indicated that 28.3% of pregnancies are terminated and are classified as unwanted. Family planning, quality of care, and observance of the rights of women would help reduce the number of women resorting to illegal abortion.
Web site : http://www.scielo.cl/scielo.php?pid=0717-7526 script=sci_serialAbstract : 602 women treated between October 1990 and January 1991 for incomplete abortion at a reproductive health center in Bogota were interviewed for a descriptive study of the reproductive behavior of women who seek abortion. The women ranged in age from 16 to 48 years (average age, 27 years). 91% were urban. The women were better educated and more were economically active than in the general population. 61% were sexually active before age 19. The average number of pregnancies for the group was 2.9, of which 1.8 were unwanted. Unwanted pregnancies were more common in women who became sexually active at an early age, older women, and in those with more children. The average number of abortions was higher among women who lived with their partners and among those in stable relationships over a period of time. The study women had an average of 1.4 children each and an ideal family size of 2.3. 43% wanted no more children. Only 26% had been in the relationship for less than one year at the time of the abortion. 14% considered their relationship poor and 27% deemed it average. Only 14% who wanted no more children used an effective contraceptive method. Lack of knowledge about human reproduction and fear of side effects impeded effective contraceptive usage. 87% had some prior use of contraception. But only 57.5% were using any method when they became pregnant and only 12% used modern methods. 43% of the women aborting did not use contraception, and 36% who used contraception did not know the correct use. 15% made the abortion decision without telling the partner about the pregnancy. 52% of the partners strongly opposed carrying the pregnancy to term.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 160406Abstract : OBJECTIVE: To describe the proportion of unwanted pregnancies among all pregnant adolescents, its association with sociodemographic characteristics, and the use of post-partum contraceptive methods. MATERIAL AND METHODS: A cross-sectional study was conducted among 220 women between 13 and 19 years of age, in two semi-urban municipalities of the State of Morelos, Mexico, interviewed between 1992 and 1994. Women were interviewed at home, six to twelve weeks after their delivery date. Women were asked whether they had wanted their last pregnancy, and about knowledge and use of contraceptive methods after delivery. RESULTS: Adolescent pregnancies accounted for 17% of all births registered in these two municipalities. Among all adolescent mother 22.73% reported that their pregnancy had not been wanted. A positive association was found between the lack of access to health services provided by public medical insurance systems (Instituto Mexicano del Seguro Social IMSS and Instituto de Seguridad y Servicios Sociales para los Trabajadores del Estado ISSSTE) and unwanted pregnancy (adjusted OR=3.03, 95% CI (1.31, 7.) An association was also found between living in an urban community (adjusted OR=2.16, 95% CI (1.08, 4.33) and an unwanted pregnancy. Among all adolescent mothers, 91.3% were familiar with "the pill" as a contraceptive method; 84.72% knew about the IUD, and 63.68% knew about the condom. However, only 35% of them were actually using an effective contraceptive method six weeks after delivery. No difference in frequency of contraceptive use was found among the adolescent mothers, according to whether they wanted their last pregnancy. Only 43.39% of mothers who delivered at hospitals or health centers were using an effective contraceptive method. CONCLUSIONS: These findings suggest that there is a great potential for family planning programs to target adolescents, and that the use of contraceptive methods after delivery should be promoted among adolescent mothers, especially those lacking access to public medical insurance and those living in semi-urban settings. It is also recommended to conduct studies on family planning education programs that can be introduced earlier in the school system in Mexico.
Notes : Español/espagnol/SpanishAbstract : El Grupo de Trabajo sobre Embarazo No Deseado y Aborto se fundó en mayo de 1994 como un foro para la discusión, coordinación y diseminación de investigación, información y experiencias de trabajo sobre el embarazo no deseado y el aborto en Bolivia. Esta Bibliografía contiene 502 fichas con la referencia de cada documento y un índice de títulos para facilitar su ubicación. En la segunda parte del libro se presenta un directorio de las instituciones que participan en el Grupo de Trabajo y/o poseen documentación sobre los temas que aborda la bibliografía
Notes : Español/espagnol/SpanishAbstract : Estudio basado en una muestra de 121 mujeres embaradas como consecuencia de violación, que buscaron ayuda en los Centros de Remisiones de Cali, entre 1998 y 1999. La investigación describe los lugares y las características de las violaciones, incluyendo datos sobre el agresor y los efectos psico-emocionales y somáticos en las víctimas. Luego, se centra en el problema del embarazo por violación, la anticoncepción de emergencia, la interrupción del embarazo a través del aborto o la decisión de continuar con la gestación. Finalmente, entrega un conjunto de recomendaciones derivadas de las conclusiones del estudio.
Notes : Español/espagnol/SpanishAbstract : Este trabajo está orientado a identificar los factores de riesgo que se asocian con el embarazo precoz y el aborto adolescente entre mujeres urbanas menores de 19 años. Su objetivo fue profundizar en el problema que enfrentan las adolescentes embarazadas y dotar a las personas que piensan y crean modelos de prevención y de educación sexual y a quienes proveen información y servicios a los adolescentes con un instrumento de trabajo que los aproxime a la realidad en Colombia. Se investigan las condiciones y circunstancias personales y ambientales que rodean a las jóvenes que viven esta experiencia, así como las representaciones que orientan el ejercicio de su sexualidad, la percepción de la reproducción, la maternidad y el control reproductivo. Por otra parte, se ahonda en los procesos de decisión, las redes de control y solidaridad, las rutas de búsqueda de los servicios de aborto entre la población seleccionada, y se analizan las condiciones sanitarias y relacionales en que se realizaron los abortos, con las consecuencias físicas y psicológicas de éstos.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Venezuela has no family planning or population policy, and does not provide services needed by adolescents. Article 33 of the law governing medical practice states that minors may not be attended in the absence of their representatives. The Penal Code requires imprisonment of adults having sex with individuals under 16, with or without the minor's consent. Lack of information and education leave minors ill prepared to prevent unwanted pregnancy. The code of medical practice permits abortion only to save the mother's life. The law also prohibits depriving an individual of his reproductive capacity. Legislation concerning family planning and reproduction should be modernized. 40% of Venezuela's population lives in critical poverty and 80% are considered poor. 20% of births are to women under 20, and 5000 Venezuelan girls aged 12 to 14 are mothers. In 1991, 109,000 children were born to adolescents, while the family planning program only covered 13% of fertile-aged women. 55% of the 600,000 births each year are extramarital. A national policy on prevention of early pregnancy is also needed.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103373Abstract : 1. Textos para pensar ; 2. El aborto de cara a la verdad ; 3. La sanción legal sólo se aplica a las mujeres ; 4. Del aborto... ¿Por qué abortan las mujeres? ; 5. Propósitos del Vaticano ; 6. Las adolescentes y el aborto ; 7. La experiencia masculina en torno al aborto ; 8. La perspectiva ética y religiosa del aborto ; 9. Nuevos valores sexuales ; 10. La iglesia, las mujeres y el estado laico ; 11. Curas y pastores en mis partes ; 12. Sexualidad y aborto ; 13. Datos para la vida ; 14. Las adolescentes: población de riesgo ; 15. No es penalizado en América Latina ; 16. Cada sesenta minutos muere una mujer en Bolivia : legislación y cifras (gráfica).
Notes : Español/espagnol/SpanishAbstract : Dr. Charlotte Gardiner, technical officer of the Reproductive Health Branch, Technical and Evaluation Division, United Nations Population Fund (UNFPA), was interviewed on June 6 concerning the focus of UNFPA on reproductive health following the International Conference on Population and Development (ICPD) and the role foreseen for JOICFP in implementing the Program of Action. Her remarks include the following information. UNFPA has high regard for the JOICFP program in family planning (FP) because of its community-based approach. The perceptions of the community dictate the way the project is fashioned; local needs are met; services are acceptable; and the quality of care is ensured. JOICFP's approach has always been integrated (controlling intestinal parasites; nutrition; family planning). It has operated one of the earliest reproductive health (RH) programs, an approach to FP that would better fit Africa's local needs and that has been successful in Asia and Latin America. Over the years UNFPA has increasingly supported the RH approach, one that integrates the vertical type of FP program in a maternal and child health (MCH) framework. The ICPD has moved further into a RH approach where FP becomes a changing concern over the lifespan of a woman and more attention is paid to the relationship between contraception and health. The ICPD has focused on the needs of adolescents for FP information and services. UNFPA will support programs that incorporate information and services for prevention, early detection, and management of sexually transmitted diseases, especially human immunodeficiency virus (HIV) infections. Another goal of the ICPD is to reduce the high maternal mortality rates that exist in most of the developing world, so UNFPA will continue to advocate the integration of FP in maternity care programs and to support integration of obstetric care interventions in the public health care system. UNFPA sees FP programs as an important means of preventing abortion and reducing the impact that abortion has on maternal health.
Web site : http://www.joicfp.or.jp/Abstract : Emergency contraception promises to reduce Mexico's high unwanted pregnancy and unsafe abortion rates. Because oral contraceptives are sold over-the-counter, several emergency contraceptive regimens are already potentially available to those women who know about the method. Soon, specially packaged emergency contraceptives may also arrive in Mexico. To initiate campaigns promoting emergency contraception, we interviewed health care providers and clients at health clinics in Mexico City, ascertaining knowledge, attitudes, and practices concerning the method. We found limited knowledge, but nevertheless cautious support for emergency contraception in Mexico. Health care providers and clients greatly overestimated the negative health effects of emergency contraception, although clients overwhelmingly reported that they would use or recommend it if needed. Although providers typically advocated medically controlled distribution, clients believed emergency contraception should be more widely available, including in schools and vending machines, with information prevalent in the mass media and elsewhere.
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?iss=4 vol=60 viewtype=issueAbstract : Hay una demanda penal presentada por dos ciudadanas que reclaman que se haya obstaculizado a la jovencita el ejercicio de un derecho legítimo, que se la hay sometido a tortura psicológica y se le haya violado su intimidad. El Procurador de Derechos Humanos de Baja California emitió una recomendación dirigida al gobernador del estado en la que pide que se deslinden responsabilidades a las autoridades de justicia y médicas involucradas en el caso y se cree un fideicomiso para reparar los daños y gastos realizados hasta ahora, así como la subvención de la educación y la atención médica de la madre y la criatura hasta la mayoría de edad. El gobernador, panista, no ha aceptado la recomendación. El clima político tampoco ayuda. El PAN aprovechó la ocasión para presentar de nuevo su iniciativa de reforma a las constituciones Federal y local para que se inscriba en ellas el derecho a la vida desde la concepción. Toda clase de aborto quedaría prohibido. (extracto)
Web site : http://www.gire.org.mx/Abstract : En Chile existe una prohibición absoluta contra el aborto, y ni siquiera se permite el aborto para salvar la vida de la mujer embarazada. Esta norma restrictiva viola los derechos reproductivos de las mujeres, incluyendo su derecho a la salud, a la libertad, a la seguridad y potencialmente su derecho a la vida. Además de los derechos violados por la legislación misma, la manera de denunciar a estas mujeres ante la policía, así como el proceso judicial que se sigue contra ellas, los proveedores de abortos y sus "cómplices," violan varios derechos humanos adicionales. Las mujeres de escasos recursos económicos y poca educación son las típicas víctimas de procedimientos insalubres. Cualesquiera que sean sus razones para tomar la difícil decisión de no tener un hijo, estas son las mujeres que típicamente se ven sometidas a procesos penales y a menudo, a la cárcel.
Web site : http://bookstore.crlp.org/wombehbarchi.htmlwww.reproductiverights.org/esp_pub_bo_encar.htmlAbstract : In order to improve the treatment of postabortion patients, it is essential to promote ideas of humane treatment within medical schools and teaching hospitals. Research in two urban teaching hospitals in La Paz found contradictions between the official health policy promoting humane treatment and physicians' use of depersonalizing language in treating women with incomplete abortion. An action research project tested two reflection exercises with first-year students, interns, residents and teachers to address these issues. The first involved group discussion of varying accounts of one woman's abortion experience; in the second exercise, participants wrote first-person narratives of a critical event in their medical education or practice. These narratives made it clear that participants' own lives provide elements required to defend and promote humane treatment. However, reflection is needed to transform experience into a tool for learning. The author suggests addressing the programmatic focus for promotion of humane treatment within its broader context, verifying the extent to which service protocols on humane treatment are explicitly transmitted in health science education, and addressing humanization issues through regular curricula and in specific courses. (full text)
Web site : http://www.rhmjournal.org.ukAbstract : La investigación sobre "Aborto realizado en condiciones de riesgo" que viene desarrollando el Centro Internacional de Investigación e Información de la Universidad para la Paz, nos llevó a entrevistar a un grupo de médicos directamente vinculados a una población de mujeres que sufre las consecuencias de esa práctica. Bitácora brinda hoy un resumen de algunos de los temas tratados durante la entrevista. Omitimos la indicación del titular de cada respuesta, por cuanto hemos seleccionado aspectos en los que, como se verá, más allá de matices, las opiniones recogen amplias coincidencias.
Web site : http://www.bitacora.com.uyAbstract : Contenido: Introduction ; Schedule of the event ; Presentations ; Abortion as a public health problem ; Medical aspects of induced abortion ; Abortion as a public health problem in Colombia ; Ethical perspectives for legislating on abortion ; Religious aspects of induced abortions ; Legal aspects of induced abortion ; Bogota Declaration ; Directory of participants ; Reference material.
Web site : http://www.gire.org.mx/Abstract : Contiene varios textos con el propósito de estimular una reflexión colectiva sobre la relación entre políticas públicas, marcos normativos y actores sociales en conexión con la sexualidad y salud reproductiva. Los temas variantes que se analizan en el libro son las políticas de salud y empleo, la educación formal de la práctica médica y de las instituciones religiosas, la influencia de los movimientos de derechos humanos, feministas y conservadoras
Notes : Español/espagnol/SpanishAbstract : Although abortion is recognized to contribute heavily to Mexico's high maternal mortality rate, information is lacking on the attitude of the public toward abortion. An opinion survey was conducted in late 1989 in Mexico City as part of a larger study of the prevalence of abortion in Mexico City. 387 women aged 15-49 and 338 men aged 15-59 in lower and middle class neighborhoods were asked if they agreed with a woman's decision to seek an abortion under seven different circumstances. A bivariate analysis of the respondents' sociodemographic characteristics was conducted, and affirmative responses were analyzed by these characteristics. A scale was then created to assess respondents' overall attitudes toward abortion. Among the women and men respectively, 50.9% and 52.8% were under 30 years old, 13.7% and 8.6% had fewer than six years of schooling, 60.4% and 57.9% were married or in union, 66.7% and 76.3% had had two or fewer pregnancies, 12.4% and 11.0% had lost a child under five years old, and 17.8% and 14.8% had experience of abortion. The bivariate analysis and scale produced different interpretations of public opinion and attitudes toward abortion. Among women and men respectively, 69.5% and 65.9% approved of abortion as the right of the woman, 68.5% and 61.4% approved for fetal defect, 63.3% and 70.6% approved if the mother's life was in danger, 55.6% and 60.4% approved in case of rape, 26.1% and 32.9% approved in case of lack of money, 11.4% and 18.6% approved if the mother was unmarried, and 9 and 11% approved if the mother had no regular partner. Few respondents took absolute positions. 5.7% of women were in favor of all and 5.2% were opposed to all reasons for abortion. 5.6% of men were in favor of all and 4.7% were opposed to all reasons for abortion. 94.8% of women and 95.3% of men approved of abortion in at least one situation. The groups most likely to approve of abortion in specific circumstances were men in union, women not in union, respondents over 30, respondents with secondary or higher education, respondents with fewer pregnancies, and respondents with experience of abortion.
Web site : http://www.scielosp.org/scielo.php?script=sci_serial pid=0036-3634 lng=en nrm=isoAbstract : The purpose of this study is to organize and testify the teaching of Sexual Education for Adolescents. Two groups of first level School adolescents were selected to be submitted to a diagnostic test; after being worked, they were submitted to a post-test about their knowledge of subject matter. It was concluded that the teenagers are very little informed about sexuality, although they are highly motivated and able to discuss and to receive information about the subject. The results of the research points to the necessity of a multidisciplinary approach, with the active participation of scholar nursing in its development. It is recommended that the Program of Sexual Education should also include some bio-psychosocial aspects and must be based on the diagnosis of students' needs.
Notes : Portugués/portugais/Portuguese, nbsp;2130384Abstract : Results are presented from the Mortality, Morbidity, and Service Use Survey (EMMUS-III) conducted in Haiti during February-July 2000. Third in the series including two other surveys in 1987 and 1994-95, EMMUS- III was commissioned by Haiti's Ministry of Public Health and Population (MSPP) and conducted by the Haitian Childhood Institute (IHE). Study results are presented in the following chapters: country characteristics and survey methodology; population, household, and residence characteristics; male and female subjects' characteristics; fertility; abortion; family planning; nuptiality and pregnancy risk; fertility preferences; maternal-child health; maternal-child nutrition and nutritional status; child and maternal mortality; HIV, AIDS, and STDs; women's status; men's attitudes on gender roles; male responsibility in reproductive health and parenting; domestic and spousal violence, and child abuse; availability of socioeconomic and health services; and health services use. Survey sampling and errors, data quality evaluation table, EMMUS-III participants, and survey questionnaires are presented in annexes.
Notes : Francés/français/French, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 164847Abstract : Reflexión desde la perspectiva humana y profesional de la salud acerca de la situación y experiencia de vida de mujeres amas de casa. Trabajo empírico sobre aspectos relacionados con la salud y la enfermedad de un grupo de amas de casa. Está escrito por una mujer que pretende huir de los condicionantes sexistas de la formación y procura utilizar la perspectiva femenina como marco de análisis
Notes : Español/espagnol/SpanishAbstract : En 1998 entraron en vigencia reformas al Código Penal de El Salvador que penalizan toda forma de aborto, incluida la interrupción del embarazo para salvar la vida de la mujer. Por consiguiente, ha incrementado el número de denuncias interpuestas por prestadores de servicios de salud de las pacientes que se sospechan de haberse practicado un aborto inducido. El propósito de este documento es presentar evidencias y análisis sobre la incidencia, los motivos y las consecuencias de la práctica de la denuncia por parte del personal de salud de las pacientes post aborto inducido en El Salvador.
Web site : http://www.ipas.org/publications/es/ELSALPAC_S04_es.pdfAbstract : A promulgação de um novo Código Penal que liberava o aborto e a eutanásia pouco após o primeiro golpe de estado uruguaio neste século (1934) suscita até hoje complexas questões. O exame de documentos da época <97> depoimentos de médicos, parteiras, pensadoras anarquistas e o debate na imprensa <97> permite traçar, além de um balanço dessa fugaz liberalização (que, extinta em 1938, enquanto durou provocou queda nas estatísticas oficiais de complicações de aborto), um panorama das políticas de população no país que, passando pela eugenia, neomalthusianismo e controlismo, contribuíram para que os temas da sexualidade humana e da reprodução alcançassem o domínio público, favorecendo o controle das mulheres sobre o próprio corpo.
Notes : Portugués/portugais/PortugueseAbstract : Entre reactivos y disidentes, desandando las fronteras entre lo religioso y lo secular" fuer elaborado por Juan Marco Vaggione, doctorado en derecho y ciencias sociales, joven argentino, ganador de la categoría legal e interdisciplinaria del concurso regional de ensayos sobre estado laico realizada por el CLADEM en apoyo a la Campaña por la convención. Es una provocadora reflexión acerca de los límites y riesgos de una visión reduccionista que podría opacar "importantes mutaciones de lo religioso". De otro lado, propone considerar la importancia política de lo que el autor llama las disidencias religiosas en los campos del género y la sexualidad.
Web site : http://www.convencion.org.uy/09Laicismo/latrampa-fin.pdfAbstract : This study evaluates the epidemiological characteristics of patients attended at the Hospital Central Militar (Service of Obstetrics), who had diagnosis of abortion. The study was prospective and was conducted through one year. There were 316 cases of abortion (12.4%) among 2,550 obstetrical patients. The most frequent type of abortion was the incomplete one (58.6%). Only 38 (12.0%) women had an septic abortion. From an epidemiological point of view, patients with abortion were young (mean age 26.45 +/- 6.49 years); married (87.4%); with mean parity of 2.20 +/- 2.16; 26.3% of them had their first pregnancy and 78.2% had their first abortion. Abortion were more frequent between 9 and 12 weeks of pregnancy. After the 10th week, the D C had more complications than before. The conclusion from this study is that in this group of population, abortion is not an important problem of health.
Web site : http://scielo-mx.bvs.br/scielo.php?pid=0300-9041 script=sci_serialAbstract : OBJECTIVE: To verify if any of the 15 congenital defects already reported in association with misoprostol can be found within an epidemiological registry of congenital defects. DESIGN: Case-control study including case-sick and case-health controls. METHODS: Comparison of misoprostol exposure for each specific defect, using the exposure for the rest of defects as a reference group. POPULATION: Four thousand six hundred seventy-three consecutive newborn infants with malformations of unknown aetiology, in the Latin American Collaborative Study of Congenital Malformation. RESULTS: There was no difference in exposure rate between the malformed (34/4,673) and nonmalformed (23/4,980) newborns. Four of the five more frequently cited defects in the literature were found to be in excess: constriction ring, terminal transverse-limb defects, hydrocephalus, and arthrogryposis. Equinovarus feet had a normal frequency in our study. Thirteen different defects not described in the literature were seen in our misoprostol exposed cases, but only holoprosencephaly and bladder exstrophy significantly exceeded the expected number. CONCLUSIONS: The confirmation from an epidemiological registry of an association for four of the five more commonly observed congenital defects among misoprostol exposed children described in the literature seems indicative of a real teratogenic effect. The defects are of vascular disruption type. However, additional attempts to achieve abortion could not be excluded as a concurrent contribution.
Web site : http://www.sciencedirect.com/science/journal/14700328Abstract : Resumen ; Introducción ; El perfil de las mujeres con abortos ; Los factores que influyen ; Análisis estadístico ; A manera de conclusión ; Referencia bibliográfica
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Consideran que el respeto a una persona es el respeto a su sexualidad. La Iglesia Católica debe abrir espacios de diálogo para comprender la diversidad sexual, señalan
Web site : http://www.notiese.orgAbstract : In this comment, we chronicle the development and expansion of a postabortion care model designed to promote interventions that address abortion-related public health concerns even when abortion laws and policies are restrictive. We review years of program experience with the original model, which led to the development of an expanded and updated model, Essential Elements of Postabortion Care (PAC). Implementing the model challenges global public health leaders, donors, technical assistance agencies and ministries of health to work with communities to ensure that all women who want to prevent or space pregnancies can obtain contraceptive services; that all women have access to services to manage complications abortion, whether induced or spontaneous; and that women receiving treatment also receive counseling and reproductive and other health services they need at the treatment visit, as well as follow-up care and contraceptive resupply. (excerpt)
Web site : http://www.agi-usa.org/pubs/journals/2910603.htmlAbstract : These nine tables concerning maternal and perinatal mortality in Mexico between 1980-97 are based on birth and death registers and the projections of the National Population Council. The first of 5 tables on maternal mortality gives the number of reported maternal deaths, the ratio per 10,000 registered live births, the rate per 100,000 women aged 15-49, and the percentage of deaths in fertile-aged women that were due to maternal causes for each year between 1980-97. The ratio, rate, and relative weight respectively declined from 9.5, 15.0, and 7.7 in 1980 to 4.7, 5.0, and 4.7 in 1997. The second table indicates that in 1980 and 1997 respectively, 8.4% and 8.5% maternal deaths were attributed to abortion and 89.9% and 88.0% to direct obstetrical causes, of which the most important were toxemia (22.4% and 32.8%) and hemorrhage (17.8% and 19.7%). The following tables provide data on maternal mortality by cause for specific age groups in Mexico in 1997, and give the ratio of maternal deaths per 10,000 recorded live births by cause for each state and the Federal District. The next table compares information from death certificates for maternal deaths and for all deaths in women aged 15-49. Fetal and perinatal mortality rates from 1980-97 are presented according to age and state of occurrence. The perinatal mortality rate declined from 19.4/1000 live births in 1980 to 13.7 in 1997. The final 2 tables provide data on mortality due to cervical and breast cancer from 1980-97, and by state for 1997.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0036-36341999000200009 lng=en nrm=iso.Abstract : This is the 4th evaluation by the Women's Institute in Santiago, Chile that includes statistical information on family planning (FP) service utilization and abortion in the country. Data was collected from the National System of Health Services which receives statistical information from institutions providing FP such as APROFA, The Red Cross, Banking Institutions and The Armed Forces. The limitations of the study are due to the absence of a national health information system that includes FP, private health, pharmaceutical sales, population surveys and follow-up on contraceptive users. The last National Survey on Fertility and Contraceptive Prevalence was done in 1972. Lastly, the information collected does not allow the creation of a social profile of users of contraception. In 1987 it was estimated that 20.9% of women 15-44 were using contraception, a significant drop as compared to utilization during 1964-70 and 1970-75. In 1989 APROFA conducted a survey in Santiago among women 15-44 demonstrating that 55.6% were followed by the pill. The information on abortion remains incomplete due to the lack of information on its incidence nationwide and the fact that it remains illegal. In 1987 it was estimated that there were between 120,000-190,000 illegal abortions registered in the hospitals. Out of every 2 births in 1987 (265,774) there was 1 abortion. Between 1970-88 hospitalization rates due to illegal abortions were for those between 25-34, but especially for those between 25-29.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - CPFH 27368cr990Abstract : En las diferentes culturas sigue arraigada la discriminación y la violencia contra las mujeres y niñas; se les niega el acceso a la educación y atención a la salud. Hace mención de la vulnerabilidad de los adolescentes a las enfermedades de transmisión sexual, al VIH y a los embarazos no deseados
Notes : Español/espagnol/SpanishAbstract : In countries where abortion is illegal, a range of approximate levels of induced abortion can be calculated from data on the number of women hospitalized for treatment of abortion complications, after correcting for underreporting and misreporting and adjusting to eliminate spontaneous abortions. An estimated 550,000 women are hospitalized each year as a result of complications from induced abortion in Brazil, Chile, Colombia, the Dominican Republic, Mexico, and Peru. About 2.8 million abortions are estimated to occur in these countries annually when women not hospitalized as a result of induced abortion are taken into account. If the situation in the six countries is assumed to be typical of the entire region, then about 800,000 women are probably hospitalized because of complications of induced abortion in Latin America in a given year, and an estimated 4 million abortions take place. The abortion rate most likely ranges from 23/1000 women aged 15-49 in Mexico to 52/1000 in Peru, and the absolute number ranges from 82,000 in the Dominican Republic to 1.4 million in Brazil. From 17% of pregnancies in Mexico to 35% in Chile are estimated to end in induced abortion. (author's)
Web site : http://www.guttmacher.org/Abstract : Although abortion is illegal in every Latin American country except Cuba, induced abortion is being widely practiced throughout the region. Health planners need reasonable estimates of the prevalence of this practice. A methodology is provided for estimating the numbers of illegal abortions being performed, based primarily on the numbers of abortion complications treated in hospitals. Estimates of the number of induced abortions and the ratio of abortions to births for Peru, Brazil and Colombia indicate that for every 10 women giving birth, 3-4 in Colombia and Brazil and two in Peru terminate their pregnancies." (SUMMARY IN FRE AND SPA) (EXCERPT)
Web site : http://www.guttmacher.org/Abstract : Data on abortion in sub-Saharan Africa are rare and non-representative. This study presents a new method to collect quantitative data on clandestine abortion, the confidants method, applied in 2001 in Ouagadougou, Burkina Faso. Preliminary qualitative work showed that individuals are aware of their close friends' induced abortions: women usually talk to their peers about the unintended pregnancy and ask them for help in locating illegal abortion providers. In a survey of 963 women of reproductive age representative of the city of Ouagadougou, we asked respondents to list their close relations, and, for each of them, and for each of the 5 years preceding the survey, whether they had an induced abortion. According to these data, there are 40 induced abortions per 1000 women aged 15-49 in Ouagadougou annually, and 60 per 1000 women aged 15-19. Adverse health consequences followed 60% of the reported induced abortions, and 14% of them received treatment in a hospital. Extrapolating these results to the entire city, we estimate that its hospitals treat about 1000 cases of abortion complications a year. Hospital data indicate that these centers admitted 984 induced abortions (adding all "certainly", "probably" and "possibly" induced abortions in the WHO protocol) in 2001; the age distribution of patients admitted for induced abortion also corresponds to the confidants method's projections ("certainly" induced abortions only). At least two biases could affect the abortion rates estimated by the confidants method, pertaining to the selection of the sample of relations and to the varying number of third parties involved in the abortion process. The confidants method, which is similar in its principle to the sisterhood method used to estimate maternal mortality levels, might generate accurate estimates of illegal abortion in certain contexts if these two biases are controlled for. Further testing is necessary.
Web site : http://authors.elsevier.com/JournalDetail.html?PubID=315 Precis=DESCAbstract : This study assessed the cost and quality implications of a new service model for women seeking care for incomplete abortion with an explicit aim of quantifying the savings resulting from the use of the manual vacuum aspiration (MVA) procedure. It examines the complete costs of a postabortion service model while simultaneously addressing the issue of patient quality care. The service delivery model was implemented by the Aurelio Valdivieso General Hospital in Oaxaca, with support from the Population Council and the European Union. The objective of this model was to improve the postabortion quality of care while conserving resources by 1) modifying hospital procedures to reduce wasting time, to improve pain management, and to ensure patient privacy; 2) using the MVA technique when indicated; and 3) providing postabortion contraceptive counseling and providing educational material and contraceptives to patients. Findings showed that the improved service delivery model achieved significant cost savings and simultaneously improved quality of care for patients undergoing postabortion treatment. A 32% cost reduction in treating patients was achieved with the introduction of the service delivery model. Assuming an annual case load of 600 postabortion cases, the potential cost savings could reach US$50,550 per year. Moreover, significant improvements were noted in patient-physician interaction and information exchange. This nurtures trust between the provider and the patient, leading to increased compliance with provider recommendations and advice.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 136514Abstract : Legal abortions are authorized medical procedures, and as such, they are or can be recorded at the health facility where they are performed. The incidence of illegal, often unsafe, induced abortion has to be estimated, however. In the literature, no fewer than eight methods have been used to estimate the frequency of induced abortion: the "illegal abortion provider survey," the "complications statistics" approach, the "mortality statistics" approach, self-reporting techniques, prospective studies, the "residual" method, anonymous third party reports, and experts' estimates. This article describes the methodological requirements of each of these methods and discusses their biases. Empirical records for each method are reviewed, with particular attention paid to the contexts in which the method has been employed successfully. Finally, the choice of an appropriate method of estimation is discussed, depending on the context in which it is to be applied and on the goal of the estimation effort. (author's)
Web site : http://www.popcouncil.org/publications/sfp/default.htmAbstract : OBJECTIVE: To compare two methods-the "ballot box" method and the "indirect questioning" method-for estimating the frequency of induced abortions in population-based studies. METHODS: A cross-sectional population-based study was conducted with a representative sample of 3 002 women between 15 and 49 years of age living in the city of Pelotas, Rio Grande do Sul, Brazil. The women were selected through multistage sampling and randomly assigned to answer questions concerning induced abortion with one of the two methods, after they had answered a general questionnaire that collected socioeconomic and demographic information. With the "ballot box" method, women received a small piece of paper containing direct questions on abortion. Each woman marked her answers on the paper and then deposited it into a small "ballot box" carried by the interviewer, thus assuring the confidentiality of the responses. With the second method, the interviewer verbally asked the woman a series of questions that indirectly inquired about abortion. RESULTS: Among the women assigned to the ballot box method, 7.2% reported having induced at least one abortion, versus 3.8% of the women assigned to the indirect questioning method. The ratio between the two methods was 1.89 (95% confidence interval: 1.39 to 2.60; P < 0.001). Of the women surveyed who were 4549 years old (at the end of their reproductive life) and answered using the ballot box method, 12% of them reported having had at least one induced abortion in their lifetime. Among the women who answered using the ballot box method, the main reasons they gave for having had an abortion were economic difficulties, being too young, and being single. Approximately half of the women responding to the ballot box method questions reported they had used unsafe procedures to induce abortion, with 13% of them using misoprostol. CONCLUSIONS: The ballot box method was suitable for studying the frequency of induced abortion and for researching other topics that may lead to underreporting by the persons interviewed, especially in population-based samples. Rephrasing the ballot box method question about abortion (for example, eliminating the word "child") would probably increase the method's sensitivity, that is, its ability to detect induced abortions that had occurred.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S1020-49892004000500008 lng=en nrm=isoAbstract : El objetivo de este proyecto es generar capacidad entre quienes realizan actividades para mejorar o incrementar el acceso al aborto, ya sea a través de la reforma de la ley, o de la ampliación del acceso y la calidad de los servicios. El proyecto ofrece ejemplo del activismo iniciado en el sur, que tiende puentes y facilita el aprendizaje entre regiones y países del norte y del sur
Notes : Español/espagnol/SpanishAbstract : Contenido: Las mujeres pobres no conocen el producto / Daisy Tourne ; Respetemos la libertad de las mujeres de decidir sobre su cuerpo / Piedad Córdoba ; En Chile la AE es una exigencia ciudadana. Se presentan entrevistas realizadas a dos parlamentarias asistentes a la Reunión Regional de Estrategias para promover la anticoncepción de emergencia Parlamentarios sobre Anticoncepción de Emergencia realizada en Santiago el 11 y 12 de abril de 2002 bajo el auspicio del Grupo Parlamentario Interamericano sobre Población y Desarrollo (GPI). anticoncepción de emergencia ; politicas de salud ; Comercializacion ; factores políticos ; movimiento de mujeres ; derecho al aborto ; salud de la mujer ; uguay ; Colombia ; América Latina
Web site : http://www.gire.org.mx/Abstract : El objetivo de este proyecto es generar capacidad entre quienes realizan actividades para mejorar o incrementar el acceso al aborto, ya sea a través de la reforma de la ley, o de la ampliación del acceso y la calidad de los servicios. El proyecto ofrece ejemplo del activismo iniciado en el sur, que tiende puentes y facilita el aprendizaje entre regiones y países del norte y del sur
Notes : Español/espagnol/SpanishAbstract : Los estudios clínicos exploratorios tienen el propósito de identificar y describir algunas características de las experiencias de veinte mujeres que a través de encuestas dan a conocer su percepción de sí mismas. Los resultados obtenidos sugieren de acuerdo a la hipótesis propuesta, que las experiencias de aborto provocado y su reincidencia en estas mujeres estuvieron contextuados en familias con características de disfuncionalidad, principalmente en lo organizativo, de interacción y comunicación
Web site : http://www.dgbiblio.unam.mx 132.248.67.65:8991/F/-/?func=find-b-0 local_base=TES01Abstract : Anualmente millones de jóvenes mujeres en todo el mundo, buscan poner fin a embarazos que no han sido planeados y deseados, por medio de abortos realizados en condiciones de riesgo que comprometen su futuro reproductivo y en muchos casos, le ocasionan la muerte. Este estudio exploró si existían diferencias entre las características psicosociales en jóvenes mujeres. Se captaron 100 pacientes con diagnósticos de aborto: 25 con aborto provocado y 75 con aborto espontáneo. La edad media de estas mujeres fue de 19 años , con una escolaridad de secundaria incompleta y en su mayoría en unión libre. Iniciaron vida sexual activa , la mayor parte, antes de los 15 años; Gran parte de estas tuvieron 2 parejas sexuales o más. Previo al estudio, un 36% de las de aborto provocado y 68% de las espontáneo habían usado métodos anticonceptivos (p>0.05). La gran mayoría de estos embarazos no fueron planeados (92% de los provocados y 68% de los espontáneos). La principal razón por la cual las pacientes se provocaron el aborto, fue porque el compañero no deseaba el embarazo (78%). En ambas poblaciones de estudio, percibieron el aborto como un asesinato o pecado y la depresión fue el sentimiento que predominó en estas mujeres, luego del legrado uterino. La gran mayoría de ambos grupos inició el uso de anticonceptivos post-intervención educativa.
Notes : Español/espagnol/SpanishAbstract : Contexto institucional ; Consideraciones generales del sistema de salud ; Políticas públicas en relación con adolescencia ; Programa seleccionado: Plan Nacional de Salud Integral del Adolescente ; Relación del Plan Nacional con las plataformas del El Cairo y Beijing ; Obstáculos y/o facilitadores para el desarrollo de programas de atención de salud integral del adolescente y de salud reproductiva ; Justificación de la elección de los servicios ; Características de los servicios ; Hospital Argerich ; Hospital Rivadavia ; Perfil sociodemográfico y epidemiológico de los adolescentes ; Características sociodemográficas ; Mortalidad ; Morbilidad ; Embarazo adolescente ; Uso de drogas ; Salud de los adolescentes desde la perspectiva de los proveedores ; Perspectiva de los proveedores sobre salud integral, salud reproductiva, derechos reproductivos y género ; Salud reproductiva: perspectiva de los proveedores ; Actividades realizadas en relación con la comunidad ; Percepción de satisfacción de los proveedores en el desempeño de la tarea ; Obtáculos para desarrollar su trabajo ; Relación entre las perspectivas de los proveedores y la propuesta del Plan Nacional ; La atención de la salud desde la perspectiva de las usuarias ; Características de la muestra ; Conocimiento y vinculación con el servicios de salud ; Motivos de consulta ; Percepción de los adolescentes sobre los problemas de salud ; Privacidad y confidencialidad ; Consideraciones finales ; Plan Nacional de Salud Integral del Adolescente ; Caracterización de los servicios de salud ; Percepciones y propuestas de las usuarias ; Sugerencias finales ; Referencias bibliográficas
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : A retrospective analysis of adolescent pregnancy in 11 institutions in Colombian cities was designed and implemented in the Colombian phase of a collaborative study of adolescent pregnancy with 4 other South American countries. 3364 women under 19 delivered in the institutions in 1987, but 112 were excluded for various reasons. 349 women were under 16. 1755 were married or in union and 1359 were single. The average age at menarche was 12.8 years. 2727 were in their 1st pregnancy, 416 in their 2nd, 55 in the 3rd, 5 in the 4th, and 2 in their 5th. 114 women had histories of 1 or more abortions. 58.2% received no form of prenatal care. Among those who had prenatal care, 25.7% of pregnancies had some type of pathology. Premature rupture of membranes occurred in 28.4%, infections in 18.9%, and hypertension in 18.1%. There were 7 maternal deaths before deliver. The most frequent infections were urinary infections, cervicitis and vaginitis, and sexually transmitted diseases. Almost half of the infections were sexually transmitted. Toxemia accounted for 86.5% of the hypertension associated with pregnancy. 76.4% of births were at term, 21.5% were premature, and 1.4% were postterm. .7% of pregnancies ended in abortion. 78.3% of births were spontaneous. Cesareans accounted for 74.9% of assisted births, and forceps or spatula for 20.9%. 82.6% of deliveries had no complications. 29.3% of complications were caused by cephalopelvic disproportion, 18.7% by dystocic presentation, and 9.1% by prolonged labor. 83.6% were of normal birth weight. 9.7% were low birth weight, and 5.3% were high birth weight. The average weight was 2970 g. 10.1% had Apgar scores under 7 at 1 minute and 3.5% had Apgars under 7 at 5 minutes. 86.9% of newborns had no pathologies. Prematurity accounted for 50.2% of pathology in the infants, congenital anomalies for 8.1%, respiratory difficulties for 7.4%, and 4.5% of mothers had some type of complication in the puerperium, with 67% having endometritis, 13% hemorrhage, and 9.6% other infections. There were 2 maternal deaths in the puerperium. 46.7% of the mothers stayed 1 day in the hospital, 31.9% 2 days, and 21.4% 3 or more days. Rates of all pathologies were higher for women who received no prenatal care. During the study period there were 3245 live births and 9 maternal deaths, for a maternal mortality rate of 27.7 per 10,000 live births. It is disquieting that 29.8% of these adolescent mothers had had previous births or abortions, suggesting a very great deficiency of postpartum and postabortal contraceptive programs for adolescents.
Web site : http://www.scielo.org.co/scielo.php?script=sci_serial pid=0034-7434 lng=pt nrm=isowww.fecolsog.org/ShowChannel.asp?ChannelId=300Abstract : The Colombian Federation of Societies of Obstetrics and Gynecology coordinated this prospective 4-nation study of abortion morbidity and mortality in 36 health facilities. Data were gathered in March-September 1990 from 5 facilities in Bolivia, 15 in Colombia, 6 in Peru, and 10 in Venezuela. 8871 of the 14,501 abortions occurring in the 36 facilities were analyzed. There were 12,382 deliveries and 948 abortions in the Bolivian facilities, 46,012 deliveries and 4930 abortions in Colombia, 16,962 deliveries and 2305 abortions in Peru, and 38,358 deliveries and 6268 abortions in Venezuela. In the 36 facilities there were 113,714 deliveries and 14,501 abortions; 12.75% of pregnancies ended in abortion. The proportions ending in abortion were 7.6% in Bolivia, 10.7% in Colombia, 13.1% in Peru, and 16.3% in Venezuela. Of the 8871 cases analyzed, 783 were in Bolivia, 4263 in Colombia, 1933 in Peru, and 1892 in Venezuela. 13.5% of the women were under 20, 27.4% were 20-24, and 25.7% were 25-29. The average age was 27.0 years. 4.0% were illiterate, 16.1% had incomplete primary and 12.8% had complete primary educations, and 56.0% had incomplete secondary educations. The average woman had had 6.95 years of schooling. 20.5% were pregnant for the 1st time. The average number of previous pregnancies was 2.48. 69.8% had no previous history of abortion. The average number of previous abortions was .43. 78.9% were in stable unions. 52.0% stated that the current pregnancy was desired and 42.9% that it was not. 51.8% of the women stated they wanted more children and 41.6% that they did not. 69.6% did not use a contraceptive method, 9.5% used less effective methods, and 15.5% used highly effective methods at the time they became pregnant. The abortions occurred at 10 weeks or less in 46.1% of cases and at 11 weeks or more in 48.4%. The average gestational age was 11.15 weeks. 75.6% of the abortions were classified as incomplete and 15.2% as septic at admission. 83.1% of the septic abortions were classified as endometritis, with the infection considered advanced in 16.9% 85.1% of abortions were classified as spontaneous and 11.6% as induced. 803 women (9.05%) had complications on admission, including 589 with excessive bleeding and 52 with uterine perforation. 94.8% of cases were treated by curettage, under general anesthesia in 65.5% of cases. A transfusion was necessary in 521 cases (5.9%). 43 also had hysterectomies. There were 36 deaths in the 8871 cases analyzed, for a rate of 406 per 100,000. The rates were 53/100,000 in Venezuela, 310 in Peru, 493 in Colombia, and 1022 in Bolivia. Only 36.6% of the women had a prescription for contraception on discharge. 22 of the deaths were in pregnancies of over 11 weeks, 25 were classified as incomplete abortions, and 27 were septic on admission.
Web site : http://www.scielo.org.co/scielo.php?script=sci_serial pid=0034-7434 lng=pt nrm=isowww.fecolsog.org/ShowChannel.asp?ChannelId=300Abstract : Reseña de dos decádas sobre género. Contiene los antecedentes de los estudios de la mujer en México, poco antes de la creación del PIEM, aborda el trabajo femenino, los espacios de visibilidad
Notes : Español/espagnol/SpanishAbstract : Foi realizado um estudo comparativo dos resultados obtidos em duas pesquisas sobre comportamento sexual da juventude de Porto Alegre. Ambas as pesquisas foram baseadas num questionário sigiloso, respondido espontaneamente, o primeiro com 50 perguntas e o segundo com 42, com a mesma estrutura, apenas o segundo com 8 perguntas a menos. A primeira pesquisa foi realizada aplicando o questionário a 682 estudantes universitários, compondo uma amostra calculada para uma população total de 18.870 indivíduos, na faixa dos 16 aos 22 anos de idade, da Universidade Federal e da Pontifícia Universidade Católica do RGS. A segunda pesquisa utilizou uma amostra de 884 estudantes de segundo grau, calculada para uma população total de 35.000 indivíduos, na faixa dos 13 aos 22 anos de idade, de escolas públicas e privadas de Porto Alegre. As médias de idade dos adolescentes que participaram das amostras foram 16,1 ±1,4 anos no grupo secundarista, e 19,9 ±1,45 anos no grupo universitário. Conforme o sexo, a proporção foi quase idêntica nas duas amostras, correspondendo no grupo secundarista 58,9% (95%IC:55,5-62,2} ao sexo feminino e 41,1% (95%IC:37,8-44,5) ao sexo masculino, e no grupo universitário 58,2% (95%IC:54,4-61,9) ao sexo feminino e 41.8% (95%IC:38,l-45,6) ao sexo masculino. Dos bancos de dados das duas pesquisas, compararam-se as questões relativas ao conhecimento sobre os fenômenos da reprodução e sobre Doenças Sexualmente Transmissíveis (DST); as fontes de informação; masturbação e sentimento de culpa em relação à masturbaçáo; relações sexuais; proporção dos iniciados e dos não iniciados sexualmente, idade do início, parceiro da primeira relação, freqüência e locais preferidos para as relações, satisfação com as relações, necessidade de envolvimento afetivo, orgasmo; homossexualismo; conhecimentos sobre os contraceptivos, percentual de uso; métodos mais utilizados; posicionamento sobre a questão do aborto e envolvimento com aborto.
Web site : http://ral-adolec.bvs.br/scielo.php?script=sci_arttext pid=S1414-71301997000100005 lng=pt nrm=iso tlng=ptAbstract : In a recent 37-nation survey of 2903 geneticists and genetic counselors, 29% would perform prenatal diagnosis (PND) for a couple with four girls who want a boy and would abort a female fetus. An additional 20% would offer a referral. The percentage who would perform PND in the United States (34%) was exceeded only by Israel (68%), Cuba (62%), Peru (39%), and Mexico (38%). In all, 47% had had requests for sex selection. There appears to be a trend toward honoring such requests since a similar survey in 1985. This paper discusses reasons for this trend and the ethical dilemmas of refusing patient requests in societies where individual autonomy is stressed.
Web site : http://www.sciencedirect.com/science/journal/02779536Abstract : Esta compilación recoge materiales que cubren una amplia gama de aspectos relacionados con el tema de la salud reproductiva desde diferentes perspectivas y disciplinas. La publicación se divide en cuatro secciones: aproximación a la ética, aproximación ética a la salud reproductiva, el ámbito institucionalizado de la salud y el ámbito institucionalizado de la reproducción. Se incluyen los siguientes artículos:· Introducción a la ética. A. Sánchez Vázquez. · Ética, ética ´femenina´ y ética feminista. S. Sherwin. · La bioética: proceso social y cambio de valores. M. Lamas. · Ética y reproducción humana: perspectivas internacionales. R. Macklin. · El feminismo y los cuatro principios éticos. R. Cook. · Declaración sobre proposiciones éticas en salud reproductiva y políticas de población. S. Isaacs, R. Macklin y R. Cook.N · Relaciones entre médicos y pacientes. S. Bloom y R. Wilson. · Hacia una ética feminista del cuidado de la salud. S. Sherwin. · Comportamiento reproductivo y salud: reflexiones a partir de la prestación de servicios. J. Figueroa Perea. · De mujeres, médicos y burócratas: políticas de población y derechos humanos en México. A. Cervantes Carson. · Concepciones alternativas sobre sexualidad, reproducción, anticoncepción y aborto. M. Mejía y G. Careaga Pérez. · La maternidad: relato de una contradicción. A. Pérez Duarte y Noroña.
Notes : Español/espagnol/SpanishAbstract : Este documento está dedicado a un área que no ha sido muy explorada en América Latina: los problemas éticos que surgen en la investigación que realizan científicos y científicas sociales. Tradicionalmente se han planteado problemas éticos en la investigación médica, aquella que involucra ensayos clínicos con drogas o terapias novedosas, porque podría poner en peligro la vida de los sujetos de investigación o tener serios efectos en su salud. Por el contrario, las investigaciones llevadas a cabo desde la psicología, la sociología y la antropología parecen innocuas pues a primera vista no se perciben daños o riesgos de las personas involucradas en ellas. Este documento pone de manifiesto varios conflictos y problemas que ciertas investigaciones pueden plantear. Incluye los siguientes artículos: Ética y salud reproductiva: beneficiencia, respeto por las personas y justicia, por Ruth Macklin. Respeto hacia las personas e investigación, por Florencia Luna. Algunas dimensiones éticas en la investigación social sobre sexualidad, por Juan Guillermo Figueroa Perea. Investigación científica versus impacto social, casos y comentarios. Conflicto de intereses: la independencia de quien investiga, casos y comentarios. Conflicto de obligaciones de los investigadores, casos y comentarios. Algunos dilemas éticos y metodológicos en la investigación con adolescentes, casos y comentarios. Problemas éticos en la investigación con mujeres embarazadas con SIDA, casos y comentarios. La confidencialidad en investigaciones con adolescentes, casos y comentarios. Estudio del aborto como una conducta ilícita, casos y comentarios. ¿Pueden los beneficios potenciales justificar intrusiones en la vida de las personas?, casos y comentarios. Desigualdades en las relaciones entre las investigadoras y los sujetos de investigación, por Maria Coleta de Oliveira. Antropología y cuestiones de ética en la investigación de campo, por Ondina Fachel Leal. Apuntes sobre los derechos de los investigadores y de los investigados en los procesos de generación de información, por Juan Guillermo Figueroa Perea.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Para fines análiticos el debate se desarrolló en tres ámbitos de los procesos reproductivos, a saber: el entorno sexual de la reproducción, el proceso del embarazo y el parto, y la socialización y crianza de los hijos e hijas. Algunas de las necesidades de investigación identificadas en el seminario se refieren a diferentes aspectos de sociología de las religiones en su vinculación con los procesos reproductivos. Entre ellos destacan: el significado del cuerpo como sustrato de la sexualidad y la reproducción a la luz de diferentes interpretaciones religiosas, así como el análisis sociológico de la forma en que las interpretaciones religiosas de ciertos dilemas éticos en la reproducción se tratan de legitimar en contextos sociales y políticos específicos. Un elemento más es el sentido de la libertad y la objeción de conciencia en diferentes tradiciones religiosas, en particular cuando se abordan dilemas éticos en el ámbito de la reproducción, para los que no se tienen respuestas acabadas en muchas de ellas. En este libro se presentan versiones revisadas de los documentos compartidos durante este encuentro latinoamericano.
Web site : http://www.gire.org.mx/Abstract : The evaluation of abortion-care programs and policies has been largely neglected by both national governments and international organizations. This article provides a conceptual framework forevaluating the intermediate outcomes of a safe abortion program, including laws and policies, women's care-seeking behavior, and the quality of, access to, and use of services. The methodological challenges in evaluating these outcomes are described. For each outcome, key indicators for measuring progress in program implementation are offered, along with country examples of successful evaluation approaches. The article concludes with recommendations for improvements in infrastructure, resource availability, and political commitment to support evaluation of safe abortion programs.
Web site : http://www.ipas.org/english/press_room/press_room_pdfs/Benson_SIFP_09_05.pdfAbstract : In Bolivian law, abortion is prohibited except in a few specific situations, such as cases of rape or incest or when the woman's life is in danger. However, the legislation provides little safeguard for women because it requires court approval for abortion. This paper presents the case of a 12-year-old girl who became pregnant due to physical and sexual abuse by her stepfather and how the Family Planning International Assistance (FPIA) project has helped her in gaining access to safe abortion services. When the girl sought help for the termination of her pregnancy, she was asked by the court to produce evidence of physical abuse from the forensic specialist and from the court-appointed gynecologist. Despite the painful delay, the judge approved the procedure. However, not a single physician would agree to perform the procedure. Fortunately, the young woman received help from a group of activists and from a project supported by the FPIA. This case underscores the enormous importance of the work FPIA does throughout the world, not only in Bolivia, but everywhere abortion is unavailable, severely restricted, or altogether illegal.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 154923Abstract : Cuba es un país en vías de desarrollo que ha avanzado significativamente en su transición demográfica y que cuenta con registros confiables sobre diferentes aspectos relacionados con el embarazo adolescente, lo cual ha brindado la posibilidad de reunir y presentar datos confiables sobre aspectos sociodemográficos de la gestación temprana, con lo que se han corroborado -o puesto en duda en otros casos- paradigmas existentes en torno a esta trascendente temática. Este trabajo tiene como objetivo mostrar la problemática del embarazo adolescente en términos sociodemográficos relacionados con su diferente grado de manifestación, condicionantes e implicaciones sociales en el contexto cubano.
Notes : Español/espagnol/SpanishAbstract : This study examined current levels and trends of fertility and excess fertility by regions of the world and determined the costs of excess fertility. Strategies and costs of preventing excess fertility were estimated, and case management of unwanted pregnancies was discussed. Fertility was lowest in Latin America and the Caribbean and in Asia and highest in Sub-Saharan Africa. Fertility was also high in the Middle East and North Africa. The rate of natural increase rose in Sub-Saharan Africa, declined in Latin America and the Caribbean, and was mixed in Asia and the Middle East. The World Bank has determined that a rate of natural increase greater than 2% is detrimental to economic development. Excess fertility can be determined by the number of births needed to reduce the rate of natural increase (RNI) to 2%, to reduce total fertility (TFR) to 4, or to eliminate births at high-risk ages. The result applied to aggregate data was the requirement of a 14% decline in births to decrease RNI, a 16% decline for reducing TFR, and a 31% decline in high-risk births. Excess fertility varied by country. All countries of Africa had high levels of excess fertility. Four countries in Latin America and the Caribbean had fertility higher than 4, but all countries with the exception of Trinidad and Tobago had a RNI of 2% or higher. Excess was highest in the Asian countries of Nepal and Bangladesh, followed by India. Malaysia and the Philippines had TFRs under 4 but RNI above 2%. All countries of the Middle East and North Africa with the exception of Turkey had excess fertility for TFR and RNI. Excess fertility can be determined also by stated fertility preferences, fertility with perfect contraception, or prevalence of abortions. Although abortion rates were higher in Latin America and Asia, desired family sizes were higher in Sub-Saharan Africa. A measure of births averted from contraceptive protection and the costs per disability-adjusted life-year gained indicated the lowest costs were in the highest mortality countries of Pakistan and Bangladesh and a higher life expectancy country, Egypt. Mortality would be reduced the most through birth spacing promotion in family planning programs. The savings for society in terms of education and health were calculated. 11.6 million births were estimated as unwanted in selected countries, at a cost of $1.5 billion for averting these births or $4.2 billion annually for all developing countries.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 102952Abstract : This executive report was designed to provide information to the authorities of the Peruvian Social Security Institute (IPPS) regarding fertility and induced abortion rates among its beneficiary population as well as costs and benefits projected for family planning services delivery. The report summarizes the results of a cost-benefits analysis for metropolitan Lima by comparing the costs from the cost reductions in maternity-related services, pediatric care, and maternity and lactation subsidies. This study used IPPS Informatics Department for Social Security registrations (1988) by year of birth and sex and statistics of dependents by region, zone, and office. The study also used: a base- line survey in metropolitan Lima carried out by IPPS National Survey of Nutrition and Health (1984), and the Demographic and Family Health Survey (1986). The important cost-benefits outlined included: break- even-point at 6 years, average internal rate of return at 39%; the benefit-cost ratio average was 1.6 dollars saved per dollar spent while a bank investment of the same investment was 1.7 dollars.
Notes : Inglés/anglais/EnglishAbstract : Emergency contraception was proven effective nearly 30 years ago yet remains greatly under-utilised. In the Latin American and Caribbean region, it would serve the goals of reducing unwanted pregnancy, unsafe abortion and related morbidity, and as a back-up to condom use and a bridge to longer-term contraceptive methods if made more widely known and available. The International Planned Parenthood Federation Western Hemisphere Region has developed a model for the integration of emergency contraception into sexual and reproductive health care services. This model is being tested in a two-year project with national affiliates in Brazil, Chile, Colombia, the Dominican Republic and Venezuela, and will contribute to the work of the Latin American Consortium for Emergency Contraception. Case studies of Brazil and Colombia describe how health sector reforms, e.g. decentralisation and managed competition among health insurers and service providers, have influenced promotion strategies. The experience of Profamilia Colombia with registration of a dedicated product and providing emergency contraception within its national network of clinics, with a focus on staff training and work with young people, is described. In Brazil, BEMFAM's study of different modalities for offering emergency contraception, e.g. through contractual agreements with municipalities and its own clinics, is highlighted.; Reprinted by permission of Reproductive Health Matters
Web site : http://www.rhmjournal.org.ukAbstract : The objective of this program was to increase the accessibility to quality postpartum/postabortion contraceptive services and to decrease the unmet need for contraceptive methods during these periods. The results showed that the project was a success in terms of process variables such as provision of information and offering of services, as well as in terms of the proportion of women who adopted a contraceptive method before discharge from the hospital and in the reduction of unmet need (as measured by the number of women who left the hospital without receiving the contraceptive method she wanted). (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - 171673Abstract : Este artículo se basa en una ponencia presentada en el Seminario Abierto "Mujer, Género y Salud", realizado en la ciudad de La Paz en marzo de 1994. A partir de esta iniciativa de la Sociedad Boliviana de Obstetricia y Ginecología, Filial La Paz, la Revista Boliviana del gremio dedicó un número a temas de Sexo, Género y Equidad de Género. El artículo presenta resultados de dos estudios realizados en 1993 en las ciudades de La Paz y El Alto, uno sobre historias y estrategias reproductivas, y el otro sobre vivencias de la atención postaborto. Las mujeres entrevistadas en ambas investigaciones destacaron algunas experiencias comunes que indican la existencia de problemas frecuentes de calidad de atención y trato.
Notes : Español/espagnol/SpanishAbstract : In January 1996, the US Congress approved reduced funding for family planning aid by 35%. This was $192 million lower than 1995 levels. In fact, USAID must release the funds in 15 equal-size monthly installments between July 1996 and September 1997. This delay will in effect lower new population funds during 1996 to $72 million, a reduction of more than 85%. Demographers from five population organizations calculated that, among couples who will lose access to modern contraceptives, more than 50% (about 4 million) will have an unplanned pregnancy. These 4 million unplanned pregnancies are likely to result in 1.9 million unplanned births, 1.6 million abortions, 8000 maternal deaths, and 134,000 infant deaths. In March, Republican Senator Mark Hatfield echoed these predictions as he attempted to convince his colleagues of the need to modify the spending restrictions on population funding. As a result, the Senate version included a provision that allows the President to release funds if the restrictions contribute to an increase in abortions or an unmet need for family planning. A House-Senate conference committee must approve the provision before it goes to the President for his approval or veto. A researcher with the American Enterprise Institute disagreed with the findings of the five population organizations because the demographers did not consider the ability of poor couples to change their behavior under the constraints that will occur after July 1, 1996. In his opinion, the couples may buy contraceptives, practice abstinence, or use a natural family planning method. When the Family Planning Association of Kenya heard about US funding cuts, it closed eight outreach clinics that provided contraceptives to 10,000 women in a remote mountainous region and terminated a new program targeting 15-19 year olds who have the highest abortion rates in Kenya. The manager of the teen program expects to see an increase in maternal deaths and illegal, septic abortions.
Web site : http://www.prb.org/template.cfm?Section=Population_Today1 Template=/PopulationToday.cfmAbstract : CONTEXT: The design and evaluation of adolescent health programs rarely account for socioeconomic differences in reproductive health needs and service utilization among young women in developing countries. METHODS: Nationally representative Demographic and Health Survey data for 12 developing countries were used to assess socioeconomic differentials in reproductive health outcomes and service utilization among young women. For each country, chi-square tests were performed to identify statistically significant differences between the poorest and the richest quintiles, which were constructed using a household wealth index. RESULTS: In most countries, young women from the poorest households were more likely than those from the richest households to be married by age 18 and to have had at least one child by that age; they were less likely to report a mistimed birth, to be practicing contraception, to use maternal health services and to know how to prevent sexual transmission of HIV. Economic autonomy, school enrollment and regular exposure to mass media were less common among poor than among rich adolescents. CONCLUSIONS: Poor adolescents may be overlooked by current service delivery modes that rely solely on mass media, clinics or schools. Alternative strategies, such as community-based outreach programs, must be implemented to serve the needs of poor young women.
Web site : http://www.guttmacher.org/pubs/journals/3011004.pdfAbstract : This study broadly explored women's perceptions of their most pressing problems and needs in the mostly rural Amazonian province of Orellana in Ecuador in mid-2000. In-depth interviews with community women and health and social service providers used two rapid structured, qualitative methods - free-listing and pile-sorting - to explore the 'insider's' perspective, with the participation of local organisations, and generated discussion on the emerging issues, giving an opportunity for action aimed at improving women's situation. Unequal gender relations, subordination of women, economic problems, men drinking too much and domestic violence were identified as the most pressing concerns. Several reproductive and sexual health problems were also identified and information about others elicited. This paper describes the methodology used in the research, reports on the 20 most cited problems and looks more closely at the findings in relation to violence against women, lack of access to contraception and ambiguities arising from the need to resort to clandestine abortion. Despite the existence of innovative national policies related to domestic violence and reproductive health, there is a scarcity of resources and poor infrastructure in Orellona. Patronising attitudes on the part of health service staff also greatly limit women's access to reproductive and sexual health services.
Web site : http://www.rhmjournal.org.ukAbstract : This paper reports on operations research conducted to investigate the feasibility of extending reproductive health services to rural indigenous communities of Ecuador. The long-term goal of the project was to make reproductive health/family planning services available to rural/indigenous communities through cost-effective strategies. A survey was conducted before commencing the services set up in two market towns; namely, Pillaro and Pelileo, which were served by Salcedo and Cajabamba clinics respectively. The service delivery package included 1) a wide range of modern contraceptive methods, excluding tubal ligation and vasectomy; 2) information, education, and communication (IEC) and counseling; 3) prenatal and postnatal services; 4) pediatric care and immunization; 4) breast-feeding support and maternal and infant nutrition; 5) gynecological services; and 6) diagnosis and referral of incomplete abortion. At the end of the 12-month period of service delivery the survey was repeated in order to measure changes in indicators such as IEC among the population on services provided at the itinerant clinics, desire to accept a method, prevalence of more reliable/modern methods, and use of services that were not previously used. All the measured indicators at the Pillaro center were encouraging while opposite was the case with the Pelileo center. Marginal cost of most services declined and stabilized at low levels in Pillaro whereas at both Pelileo and its host clinic at Cajamba the costs increased at unacceptable rates. In neither of the itinerant clinics were non-market days productive.
Notes : Inglés/anglais/EnglishAbstract : El aborto se ha utilizado como método de planificación familiar desde épocas remotas y se conoce que está en dependencia de algunos factores tales como: la edad de la mujer, el grado de escolaridad, la historia obstétrica, las relaciones con su pareja, el uso y conocimiento de métodos anticonceptivos, entre otros. Se identificaron los factores de riesgo que conllevaron a que el embarazo estudiado terminara en un aborto provocado, en la provincia de Matanzas, entre enero y marzo de 1994. Se seleccionaron variables y con la ayuda de la regresión logística se arribó a los resultados. Los factores de riesgo fueron: tiempo de unión con la pareja, uso de métodos anticonceptivos, cuándo quedó embarazada y edad al primer embarazo. A través de la estimación del riesgo relativo se pudo medir el grado de asociación de cada uno de los factores de riesgo con la forma de terminación del embarazo.
Web site : http://scielo.sld.cu/scielo.php?script=sci_arttext pid=S0138-600X1999000100011 lng=es nrm=isoAbstract : Using the available information on all the women that went to the doctor´s to take care of their pregnancies in the City of Havana from 1996 to 1997, it was determined that 7.7% of these pregnancies ended in an abortion. The objective of this study is to contribute to search for the determining abortion factors in these females. The large sample (5 413 females) had the characteristic of being made up of all the pregnant females recorded in 12 polyclinics for 18 months. For studying the abortion risk factors, firstly, an univariate statistical analysis was made from which the crude relative abortion risks of each factor were collected. Then to allow for the whole effect, the Cox´s regression was used with all the variables to make it possible to obtain the net relative risks contributed by each factor. The characteristics of women whose pregnancies ended up in abortions are: living in less than 4-room houses; having less than 3 previous abortions; living with large families; being female teenagers who had lagged behind in education; or being female adults with under ten-grade schooling; being a smoker and; keeping on smoking even if they are pregnant; and being single. The adolescence factor by itself is no longer statistically significant when the confounding effect of the other factors is eliminated, that is to say, being an adolescent does not lead to abortion if there are not other accompanying factors. Lastly, we concluded among other things that factors which have been fundamental in the multifactorial study may serve as an initial base for designing a usable model for detecting pregnant women at risk of abortion. (author's)
Web site : http://scielo.sld.cu/scielo.php?script=sci_arttext pid=S0864-34662001000100004 lng=es nrm=isoAbstract : A study was conducted of 43 women admitted to the Berta Calderon Roque Hospital in Managua between January 1996 and December 1997 to identify the principal reproductive and obstetric risk factors associated with maternal mortality. 103 unpaired controls were selected by systematic sampling from patients admitted to the high obstetric risk section. Direct obstetric causes accounted for 70% of deaths, with 25.5% due to sepsis, 23.3% to eclampsia, and 20.9% to hemorrhage. 74.4% of deaths occurred during the puerperium. The principal reproductive risk factors associated with maternal mortality were illiteracy (odds ratio (OR) = 3.7), rural origin (OR = 2.82), no prenatal care (OR = 2.21), short birth interval (OR = 1.63), multiparity (OR = 2.13), and history of malnutrition (OR = 3.51). Obstetric risk factors during pregnancy that were associated with maternal mortality were eclampsia (OR = 2.61), septic abortion (OR = 2.27), and anemia (OR = 1.99). Obstetric risk factors during delivery were eclampsia (OR = 4.54), hemorrhage (OR = 3.51), and birth at home (OR = 2.84). Obstetric risk factors during the puerperium were hemorrhage (OR = 6.67), puerperal sepsis (OR = 4), complicated septic abortion (OR = 3), and eclampsia (OR = 3.78). It was concluded that the most significant risk for maternal mortality occurred in the puerperium. The most important risk factors were hemorrhage, followed by puerperal infection and eclampsia, which might be subject to prevention at the primary level of care through early diagnosis and appropriate medical care. A review committee should be established in the hospital to reduce maternal mortality.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159777Abstract : The approximately 22,000 maternal deaths in Mexico between 1979 and 1990 were analyzed in order to establish sociodemographic profiles of the most important causes. The maternal mortality rate in Mexico declined from 52.9/10,000 live births in 1940 to 6.1/10,000 in 1990, but the decline has not been equally shared by all population sectors. Geographically, several northern states had rates under 3.1/10,000 in 1990. Most states in the center had intermediate levels, and states in the south had higher rates. 55% of maternal deaths over the 11 years occurred in localities with under 2500 inhabitants and 17% occurred in places with 2500 to 20,000 inhabitants. Risk of death from maternal causes was thus twice as high in smaller rural areas. Deaths during delivery and from hemorrhage and infection predominate in rural areas, while deaths from abortion or toxemia are more common in urban areas. The difference is undoubtedly due to lack of availability and accessibility of services in rural areas. To demonstrate the effect of social marginality as a determinant of maternal mortality, census data were used to create an index of marginality using multivariate techniques. In 1990, women living in municipios of very high marginality had maternal mortality rates of over 11.5/10,000, three times the rates in municipios of low marginality. The same relationship held true for different causes of maternal death. The maternal mortality rate was highest in women aged 30 to 35 years, and the average age at death was 29 years. An estimated 40 years of potential life were lost on average for each death. The educational level was reported for only 30% of the deaths, among which 26% of the women were illiterate, 33% did not finish primary school, 24% had complete primary, and 16% had secondary or higher education. In 1990, illiterate women had a maternal mortality rate of 14.5, those with three years of primary had a rate of 9.9, and those with four or five years of primary had a rate of 7.3. The risk of maternal death was thus negatively associated with education. 60% of the deaths occurred in medical facilities and 30% at home. The sociodemographic profiles for different causes of death varied. Deaths from problems during delivery, hemorrhage, and infection tended to occur in municipios with high degrees of marginality, in rural areas, and among poorly educated women. Toxemia, which caused 23% of maternal deaths, and abortion, which accounted for one-twelfth, were more common in municipios of low marginality and in urban areas.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103312Abstract : The objective of this study was to determine the impact of a Sexual Reproductive Health program as applied in clinics operated by the Caja Nacional de Salud (CNS). The study compared the characteristics of 60 insured persons who attended the Policlinic Manco Kapac with 117 insured persons who had not attended such programs in the last three years. Among the most interesting results are the following: The average income per family is 999.00 BS (US $170.00), for both groups. An average family constitutes 3 to 5 children. The average number of pregnancies per family was 3.73, the average number of live children per family was of 3.14 and the average number of abortions per family was 1.30. Eighty percent of the cases and 82 percent of the control group did not want anymore children. The use of IUDs among people who attended the program was 42.8 percent, and 26 percent among the population that was not part of the clinic's program. Approximately half of the population surveyed had knowledge of issues such as cervical and breast cancer, abortion, and sexual transmitted diseases. Since no significant difference appeared between the two groups compared during this study; the authors recommend an effort to identify better mechanisms of operation for the CNS Sexual Reproductive Health Program. These better mechanisms should permit one, over time, to compare a group of insured patients that are part of the program with insured patients that are not part of the program or do not demand any assistance from CNS clinics. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 173313Abstract : A 1984-1985 survey in 7 slum communities in Rio de Janeiro, Brazil, found that 7% of sexually active women ages 15-49 were pregnant, 20% had been contraceptively sterilized, and 5% were infertile. The remaining 68% were fecund. 42% were using a reversible method of birth control, and 27% were not pregnant or trying to become pregnant and were not using any contraceptive method. The pill and female sterilization were the 2 leading birth control methods among currently married women practicing contraception, used by 53% and 33%, respectively. The relatively high levels of sterilization and pill use among low-income found in the survey are striking. However, knowledge of and access to other methods are limited, and consequently, some women were found to using inappropriate methods. For example, 15% of sterilized women said they wanted to have another child. In addition, the survey found that 43% of current pill users also smoked, and 5% were both older than 45 and such contraindications to pill use as high blood pressure, heart problems, diabetes, kidney disorders, or varicose veins. Only 42% had seen a doctor before using oral contraceptives, which are available without a prescription.
Web site : http://www.guttmacher.org/Abstract : This discussion paper examines the rapid fertility decline which has occurred in Brazil in recent decades in terms of government population policy, the provision of contraceptive techniques, and the contraceptive technology used by poor women. After an introductory chapter, the second chapter traces Brazilian family planning (FP) policy from its earliest pronatalist stance through the FP policies of the last military presidents in the 1980s (who became concerned about population growth) to the expressed fears that FP is a malicious form of fertility control designed to benefit foreign imperialists. Chapter 3 notes that fertility decline was initiated and continued in a pronatalist political climate. To determine how Brazil underwent a rapid decline in fertility in the absence of a strong government policy, the paper then examines data from a survey and field research on contraceptive availability and usage undertaken in 1988 in a shanty town of approximately 80,000 people (Alto Vera Cruz). The fourth chapter presents the social setting in Alto Vera Cruz, and the fifth chapter details contraceptive knowledge, sources, and availability. Chapter 6 looks at contraceptive practice in the town and notes that oral contraceptives (OCs) are the most popular method and that younger women practice contraception more often than older women. Chapter 7 considers sterilization and the paradoxical situation in which women find themselves wherein the only way they can be sterilized is to become pregnant and arrange to have a Cesarean delivery and simultaneous sterilization. Sterilization is seen by the women as the only reliable method which is not an abortifacient and is, therefore, sought by many more women than have undergone the procedure. Sterilization is certainly considered more desirable than extra children to feed or the method of last resort, abortion, which is illegal in Brazil and is the topic of the eighth chapter. Most of the women surveyed know how to procure an abortion. The illegality of the procedure fails to reduce its incidence; instead, illegality increases a woman's risk and sense of degradation. Some of the social factors which are among the determinants of contraceptive practice discussed in Chapter 9 include the fact that cohabiting women are more likely than married women to be sterilized. Poorer women also depend more upon sterilization than upon OC use. Education was associated positively with contraceptive usage, and more Evangelical Protestant women than Roman Catholic women were depending upon OCs and sterilization (Catholic women tended to use the condom). The concluding chapter considers attitudes towards contraception and points out that FP is seen by both men and women to be the responsibility of the women. In Alto Vera Cruz, contraception is available at considerable cost to those who seek it out. Poverty, therefore, is one of the greatest constraints faced by these women. Poverty makes it harder to limit family size, and large families make it harder to escape poverty.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 114262Abstract : This news brief presents the US President's wife's statement on the association between use of family planning and a decline in abortions worldwide. Hillary Rodham Clinton attended the Sixth Conference of Wives of Heads of State and Government of the Americas held in La Paz, Bolivia. The conference was suitably located in Bolivia, a country with the highest rates of maternal mortality in South America. Bolivia has responded by launching a national family planning campaign coordinated between government, nongovernmental, and medical organizations. Half of Bolivian women experience pregnancy and childbirth without the support of trained medical staff. Mortality from abortion complications account for about half of all maternal deaths in Bolivia. Voluntary family planning workers teach women about the benefits of child spacing, breast feeding, nutrition, prenatal and postpartum care, and safe deliveries. Bolivia has succeeded in increasing its contraceptive use rates and decreasing the number of safe and unsafe abortions. Bolivia's program effort was supported by USAID. USAID provided technical assistance and funds for the establishment of a network of primary health care clinics. Mrs. Clinton visited one such clinic in a poor neighborhood in La Paz, which in its first six months of operation provided 2200 consultations, delivered 200 babies, registered 700 new family planning users, and immunized 2500 children. Clinics such as this one will be affected by the US Congress's harsh cuts in aid, which reduce funding by 35% and delay program funding by 9 months. These US government cuts in foreign aid are expected to result in an additional 1.6 million abortions, over 8000 maternal deaths, and 134,000 infant deaths in developing countries. An investment in population assistance represents a sensible, cost-effective, and long-term strategy for improving women's health, strengthening families, and reducing abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 129375Abstract : The impact of family planning on maternal mortality, the impact of increased contraceptive use in the Matlab subdistrict of Bangladesh, the issue of unwanted pregnancies, barriers to contraception, and integrated services are topics discussed. Family planning can decrease maternal mortality. In developing countries, maternal mortality contributes about 33% of mortality among women of reproductive age. The risk among African women is 1 in 21; for Asian women it is 1 in 54; and for South American women it is 1 in 73. North American women have a maternal mortality risk of only 1 in 6366. Maternal mortality can be reduced by lowering fertility or improving obstetric care. Maternal mortality in countries with little family planning should be lowered first through introduction of family planning. In Matlab subdistrict near Dhaka in Bangladesh, a comparison of maternal mortality was made between women receiving family planning through integrated services and those receiving family planning through standard government programs. Community health workers in the treatment area engaged in home heath visits and referrals as appropriate. Contraceptive prevalence increased from 8% in 1977 to 56% in 1989 in the intervention area; in the comparison areas. Obstetric complications were 57% higher than in the intervention area. Family planning reduced maternal mortality risk through a decreased number of pregnancies and high risk pregnancies. Maternal risk could also be reduced by preventing unwanted pregnancies by 17% in Africa, 33% in Latin America, and 35% in Asia. Maternal mortality could be prevented by putting women in touch with their own childbearing desires and by reducing unsafe abortion. There are an estimated 200,000 maternal deaths annually accounted for by unsafe abortions and their consequences (infection and hemorrhage). Reports from Brazilian women, who have a high abortion complication rate, have revealed that women have not been using contraceptives consistently or correctly. The differences between maternal mortality rates and ratios were pointed out as expressing different risks. Family planning is a cost-effective strategy to reduce maternal mortality, but it is certainly not the only means.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 093915Abstract : Amid attempts by anti-abortionists to reinstate the Mexico City policy restricting US population and family planning financial assistance to agencies which do not provide abortion services, even with other funds, the US Congress, in 1996, cut funds for international family planning programs by 35% and froze funding for 5-9 months under a complex compromise. Some population organizations issued reports on the benefits of family planning programs overseas just as Congress prepared to vote on whether to release fiscal 1997 international family planning funds in March. The Population Reference Bureau (PRB) released the revised and expanded third edition of Family Planning Saves Lives, which explores how family planning prevents maternal and child mortality; a new Rockefeller Foundation report described the success of family planning programs since the 1960s and charged the US government with backing away from its 30-year commitment; and a US Agency for International Development study examined family planning's role in preventing abortion.
Web site : http://www.prb.org/template.cfm?Section=Population_Today1 Template=/PopulationToday.cfmAbstract : Family Health International's (FHI) research and development activities in improving and developing contraceptives and making them available to the public are presented. While FHI, along with other agencies, has been actively promoting and contributing to ongoing international family planning efforts since its creation in 1971, the period 1971-91 has, nonetheless, witness more births, maternal deaths, induced abortions, and infant deaths than over any 20-year span in history. While family sizes have decreased over the period due to greater contraceptive awareness and use, politicians, civil servants, and theologians are indicted as partly responsible for retarding further positive change. The number of women of reproductive ages in developing countries will increase by almost 30% in the 1990s, and the world's population will at least double over the next century. 95% of new births will stem from developing countries. Concerted efforts and global commitments of policymakers must be forthcoming in the battle against both high fertility and AIDS prevention. Specifically, at least 130 million new contraceptive users must be recruited in the 1990s. Surveys and field experiences indicate a large degree of unmet need for contraceptive services, with 50-80% of married women in developing countries expressing their desire to limit or space future births. Demand for contraception only increases once a program is in place; rapid reductions of total fertility are exemplified in the cases of Thailand, Colombia, South Korea, Sri Lanka, and Indonesia. Given the resources and commitment, the number of users could be doubled within 10 years.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 068447Abstract : This study aimed to identify key risk factors and predictors of induced abortion. A cross-sectional population-based study was conducted with a representative sample of 3,002 women 15 to 49 years of age in southern Brazil, randomly assigned to answer questions on induced abortion using either the ballot-box method or the indirect questioning method. Socioeconomic, demographic, and reproductive data were obtained through a pre-coded questionnaire. Data analysis used epidemiological statistical inferences and Bayes' theorem to calculate a posteriori probability. Induced abortion was strongly associated with fetal loss for all age groups. In adolescents, the main predictors were low socioeconomic level, low schooling, elevated school drop-out, and knowledge of a large number of contraceptive methods. For all other women, socioeconomic characteristics and skin color were not associated with abortion. For women aged 20 to 49 years, marital status and reproductive characteristics, including knowledge of contraceptive methods, were the most frequent risk factors and predictors of induced abortion.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X2006000200014 lng=en nrm=isoAbstract : The aim of this study was to assess the feasibility of introducing manual vacuum aspiration (MVA) in Bolivia's public health facilities, with the understanding that this would contribute to higher-quality and lower-cost treatment of complications resulting from incomplete abortion. The study employed an in-depth, semi-structured instrument, and was conducted in four major cities located in diverse geographic and ethnic regions of the country, namely, La Paz, Santa Cruz, Cochabamba, and Sucre. It assessed a total of 64 clinical health care professionals and policy-makers on their knowledge of postabortion care (PAC) services; their familiarity with new reproductive health technologies; their perceptions of barriers to provision of PAC services; and the likelihood that he/she would participate in a pilot study of PAC with MVA at some future date. Overall, health care professionals were favorably disposed towards introducing MVA into public sector hospitals, and supported a proposal to carry out a pilot MVA project, preferably within 6 months. Their positive responses also indicates a high level of political support for introducing MVA, a critical element in incorporating PAC into the national public health system. The next stage in introducing MVA as part of PAC services should take the form of a pilot study of PAC in select hospitals with accompanying training in MVA use for public health providers.
Web site : http://www.popcouncil.orgAbstract : The aim of this study was to assess the feasibility of introducing manual vacuum aspiration (MVA) in Bolivia's public health facilities, with the understanding that this would contribute to higher-quality and lower-cost treatment of complications resulting from incomplete abortion. The study employed an in-depth, semi-structured instrument, and was conducted in four major cities located in diverse geographic and ethnic regions of the country, namely, La Paz, Santa Cruz, Cochabamba, and Sucre. It assessed a total of 64 clinical health care professionals and policy-makers on their knowledge of postabortion care (PAC) services; their familiarity with new reproductive health technologies; their perceptions of barriers to provision of PAC services; and the likelihood that he/she would participate in a pilot study of PAC with MVA at some future date. Overall, health care professionals were favorably disposed towards introducing MVA into public sector hospitals, and supported a proposal to carry out a pilot MVA project, preferably within 6 months. Their positive responses also indicates a high level of political support for introducing MVA, a critical element in incorporating PAC into the national public health system. The next stage in introducing MVA as part of PAC services should take the form of a pilot study of PAC in select hospitals with accompanying training in MVA use for public health providers.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 137489Abstract : Cet article presente les resultats d'une enquete longitudinale cas-temoins sur les jeunes meres de moins de 17 ans et le devenir de leurs enfants, realisee en Guadeloupe de fin 1988 a debut 1992 par la DASD et l'ORSTOM. A partir des donnees de l'etat civil et de l'analyse du contexte dans lequel surviennent les grossesses menees a terme des meres de moins de 17 ans ayant accouche en 1988, cet article s'efforce d'en cerner les determinants sociaux et de comportement. Il s'appuie essentiellement sur les donnees collectees 9 mois apres la naissance de l'enfant. (resume d'auteur)
Notes : Francés/français/FrenchAbstract : La fecundidad adolescente ha venido aumentando desde la década de los noventa, lo cual está relacionado con un inicio más temprano y más rápido de la actividad sexual, mientras que se ha retardado el inicio de las uniones estables. La tendencia en el inicio de la actividad sexual ha llevado a que se observe un aumento en la maternidad entre adolescentes solteras, con grandes diferenciales entre regiones. Los patrones de actividad sexual, unión, maternidad, en Bogotá y Cali son diferenciales por estrato. Las adolescentes del estrato bajo inician Relación sexual, se unen y son madres mucho más temprano y más rápido que las del estrato alto, lo cual está asociado tanto al pronto inicio de Relación sexual como al de las uniones. Aunque la planificación familiar juega un papel importante, su uso empieza después de que han iniciado Relación sexual. Esto se basa en la percepción de invulnerabilidad que tienen las adolescentes, en la creencia infundada de efectos secundarios, y en la creencia que no se necesitan métodos de control en la primera relación. De los determinantes socioeconómicos de los eventos sexuales (inicio de Relación sexual, primer embarazo, primer hijo), el conjunto de factores contextuales del hogar son los más importantes, sobresaliendo el papel de la familia -ambiente y supervisión- en el comportamiento reproductivo de las adolescentes. El estudio evidencia el efecto limitado que sobre el comportamiento de las adolescentes ha tenido la educación sexual que se imparte en los colegios desde 1993.
Web site : http://economia.uniandes.edu.co/documentocede2004-31.htmAbstract : El interés por trabajar sobre el tema de la salud reproductiva adolescente deriva de las consecuencias y de los problemas que ocasiona, a este grupo de edades, su desatención a nivel de las políticas públicas. Alrededor de estos problemas se ha encontrado una relación inversa entre riesgo reproductivo y cobertura asistencial, lo cual expresa desigualdad social al producirse preferentemente en los estratos sociales más bajos, y pone de manifiesto la carencia de atención diferenciada en favor de este grupo de edades de gran vulnerabilidad.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Peru's total fertility rate in 1991 was 2.1 in metropolitan Lima, 6.2 in rural areas, and 3.5 overall. It was 7.1 for illiterate women and 1.9 for those with higher education. Regional differentials were also marked. 11% of women 15-19 already had children or were pregnant. 39% of illiterate women and 25% of rural women aged 15-19 were pregnant or had children compared to 3% of those with higher education and 4% in metropolitan Lima. 47% of adolescent mothers stated they did not desire to have their child. 59% of rural women, 65% of illiterate women, and 41% of Peruvian women as a group use no method of contraception. 33% of fertile-aged women use a modern method, 13% use IUDs, and 8% sterilization. 26% use a traditional method, including 21% who use rhythm. Only 11% of illiterate women use a modern method. 71% of women aged 15-19 in union do not use any contraceptive method, but 42% report they want no more children. The average ideal family size for Peruvian women is 2.5 children. 30% of children born between 1985 and 1990 were unwanted. An additional 26% were desired, but at a later time. It was estimated that 85,000 induced abortions took place in Peru in 1982. Most abortion is illegal in Peru. In 1985, 60% of maternal deaths in Peru's hospitals occurred during delivery and 15% before delivery. 25% resulted from complications of abortion. Peru allows abortion only for therapeutic reasons. In Latin America, abortion is broadly legal only in Cuba and Puerto Rico.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 102216Abstract : Las mujeres en estudio ; La fecundidad y sus diferencias ; Fecundidad y pobreza ; Fecundidad y estado conyugal ; Fecundidad y escolaridad ; Fecundidad, edad y escolaridad ; Fecundidad y edad a la primera unión ; Abortos y nacidos muertos ; Prevalencia en el uso de métodos anticonceptivos ; Comentarios finales ; Referencias bibliográficas
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This is one in a series of studies examining the impact of structural adjustment programs on various Latin American countries. Particular attention is given to how the decline in the resources available for social and health services is affecting the sexual and reproductive health of women. This study concerns the situation in Argentina. Attention is given to general mortality, maternal mortality, services at delivery, abortion, adolescent childbearing, cesarean births, sexually transmitted diseases and AIDS, and infant health. (ANNOTATION)
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND RH91370Abstract : Induced abortion is illegal in Mexico except when pregnancy endangers the health or life of the mother, or in cases or rape or incest. For a price, however, individual physicians still provide abortions. Access to safe abortion is therefore strictly confined to wealthier women who can pay the high cost of a safe, confidential procedure. Lower income women suffer substantial morbidity and mortality from attempts to abort their fetuses or simply bear unwanted children. The author set out to identify the determinants of the decision to continue or interrupt an unplanned pregnancy among adolescents aged 12-19 years by examining the circumstances and sociocultural conditions underlying such a decision. The process included looking at factors such as the girl's sexual and reproductive behavior, her partner's and mother's response to the pregnancy, the partner relationship, her education and employment characteristics, and other factors. Interviews and focus groups were conducted with 72 girls requesting pregnancy-related services at the Hospital General Dr. Manuel Gea Gonzalez in Mexico City. 50% were pregnant and 50% had recently had an abortion. Abortions are expensive and there is no way given current legal conditions to be sure they will work. The most critical element in deciding whether and how to have an abortion is therefore economic in nature. If safe induced abortions were freely available to all women in need, there would have been many more abortions than pregnancies in the study group. Mothers and boyfriends also sway young women's decisions with regard to abortion or motherhood. Recommendations are made with regard to abortion policy, sexual and reproductive health education, family planning programs, and medical training and hospital services.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100675Abstract : This study sought to identify the determinants of the decision to continue or interrupt an unplanned pregnancy among adolescents 12-19 years old, by examining the circumstances and sociocultural conditions underlying such a decision. The study sample, gathered using the quota system, included 72 adolescent girls who requested services related to their pregnancies at the Obstetrics and Gynecology Clinic of the Hospital General Dr. Manual Gea Gonzales, Mexico City. Generally, mothers and boyfriends were the two most influential figures when a girl was faced with deciding whether to continue with the pregnancy or to have an abortion. A very significant factor in the Decision making process for low-income girls was her economic situation. Economic constraints lead girls to make several unsuccessful self-induced attempts at abortion, which include strong injections; injections of Metrigen; tea infusions of spices such as oregano and cinnamon; and infusions of xoapactle. From the findings, provision of sexual and reproductive health education, family planning programs, and medical training and hospital services are essential in reducing unwanted pregnancies and abortions.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : 1997: Mais de 100 projetos de interesse da mulher guardam votacao no Congreso Nacional
Notes : Portugués/portugais/PortugueseAbstract : Análisis de la trayectoria del feminismo en México en las últimas tres décadas
Notes : Español/espagnol/SpanishAbstract : The Mesa Feminista de Trabajosobre Aborto (Feminist Working Group on Abortion) is the initiative of a group of women interested in debating and analyzing this issue in a country with one of the most restrictive abortion laws in the world. Abortion is totally prohibited in Chile, even when the woman's life or health is at risk. Women who have abortions, those who provide abortion services, and anyone who helps a woman obtain an abortion can be punished with jail sentences. (excerpt)
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Compilación de artículos sobre aborto, anticonceptivos femeninos y masculinos, enfermedades de transmisión sexual y mortalidad femenina. Artículos de vanguardia de grupos como Católicas por el Derecho a Elegir, WomenWise, que plantean los problemas y las polémicas en torno a las cuestiones médicas y éticas. Dar poder a las mujeres mediante el manejo de la información que divulgan es el objetivo de estos paquetes que dan cuenta de la producción más reciente de los grupos feministas que trabajan en salud reproductiva
Notes : Español/espagnol/SpanishAbstract : In the 20th century, the population of most Latin American (LA) countries has experienced 3 significant changes. Beginning around 1940 to 1985, life expectancies climbed in LA from around 35 years to >60 years, and in 5 cases >70 years. This trend did not occur, however, at the same rate nor did all countries begin with and/or share the same life expectancies in 1985. For example, in 1940, the life expectancy for Uruguay and Argentina averaged 60 years while that of Bolivia was only 28 years. In 1985, it stood at 72, 71, and 53.1 years respectively. The 2nd shift involved a short significant increase in fertility after decades of decline among Chile, Costa Rica, Ecuador, El Salvador, and Panama between 1950-1960. The last shift consisted of a very abrupt and accelerated decline in fertility in most LA countries that started in the late 1960s and continued through the mid 1970s. Some countries did experience a decline in fertility prior to this period, however. As with the trend in mortality in LA, the decline in fertility was variable among the countries as were also the contributing factors for the decline. The total fertility rate (TFR) for Honduras stood at 7.2 in 1960 and fell to 6 in 1980-1985, while TFR for Cuba was 3.9 and 1.6 respectively. Relatively high numbers of sterilizations have contributed to the decline in fertility in Brazil, El Salvador, and the Dominican Republic while abortion contributed to it in Cuba. The nations which 1st had a decline in fertility reduced it without the presence of family planning programs, as did Brazil ; a latecomer. Conversely, even though Costa Rica and Colombia have witnessed rapid declines, actual fertility has recently slowed despite the presence of strong family planning programs.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 062325Abstract : A chronology of gradual advances of women's legal rights in France is presented. Latin American countries base their legal system on the Napoleonic Civil Code. In Latin America, divorce is only legal in a few countries. Contraception is not legal. Those who can pay can get it, but governments do not offer it for poor people. Sex education in schools does not exist, on the whole. Pregnancy prevention is not mentioned where it does exist. Voluntary agencies offer contraception at low prices, but 30-40% of the continent's population is very poor. Even in countries where the government does offer contraception, many cannot attain all the contraceptives that they want. Desire for pregnancy was studied in 2485 pregnant women in their homes. They were selected from among those attending an antenatal clinic. Desire was classified into 3 levels. The 1st was no desire; then there was intermediate desire ; they wanted to have children, but not at this time. The 3rd was real desire. Results are given in table form. The 1974 World Population Conference approved the right of couples to have as many children as they wanted, when they wanted them as a basic right. This is very poorly reflected in Chile. Abortion is illegal in all Latin American countries, except Cuba. It is not possible to estimate the number of illegal abortions done in Latin America every year. The total population of Latin America is shown in table form. More education and contraceptive services should be offered. Early induced abortion should be encouraged. The World Health Organization (WHO) has defined health as not only absence of disease, but a feeling of well- being ; a woman seeking an abortion is not mentally or socially healthy. Therefore, subsequent unwanted pregnancies should be prevented.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - CPFH 26475cr990Abstract : Objective: FIGO's Ethical guidelines regarding induced abortion for non-medical reasons offer guidance concerning women's right to safe abortion services and the medical community's attendant responsibilities. Ipas surveyed FIGO constituent societies to determine their agreement with the Guidelines' recommendations and their readiness to use them to improve and expand services. Method: Ten months after the Guidelines publication in IJGO, a ten-item questionnaire was mailed to 283 Officers of the 101 FIGO societies, with follow-up prompts to non-respondents. Results: Officers of 59 societies responded, divided evenly between those in countries whose laws permit induced abortion on non-medical grounds and those in countries prohibiting it. In 'permitting' countries all responding societies supported the recommendations, and 85% said they should adopt them or had already done so. Two-thirds in 'prohibiting' countries supported the recommendations, but less than half believed their FIGO society, or their government, should adopt them. However, 20% in the 'prohibiting' countries had adopted or formally considered the recommendations and 23% had already brought them to the attention of their governments. Conclusion: The FIGO constituent societies showed overall strong support for the recommendations, but efforts need to be made to encourage those in 'prohibiting' countries to promote implementation of the recommendations.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : This report presents results of an operation research project to test the acceptability, effectiveness, and cost-effectiveness of postpartum/postabortion family planning services in the Peruvian Social Security Institute (IPSS). A study was conducted at the Rebagliati Hospital in Lima, Peru. Postpartum women were assigned to experimental and control groups. Women assigned to the experimental group received family planning education and the offer of free family planning services, including IUD insertion. Controls received only regular hospital services, not including family planning. The contraceptive prevalence of the groups was compared at 40 days and 6 months postpartum. Both postpartum and postabortion family planning were found to be highly acceptable to IPSS clients. Over 70% in each service accepted a contraceptive method prior to leaving the hospital. The group which received family planning education and services had higher contraceptive prevalence at both 40 days and 6 months postpartum than did the control group. It was estimated that adoption of both periods of family planning by the Rebagliati Hospital would add over 5700 IUD insertions to the IPSS, resulting in a 38% increase in the acceptance of this method for the entire system. Moreover, the very low cost of postpartum insertions would replace about 8000 more costly visits by women to IPSS and the Ministry of Health for interval insertions. Cost savings would be the equivalent of 20% of all family planning visits to IPSS. They have decided to adopt postpartum family planning as a regular activity in all of its hospitals. (author's modified)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 070286Abstract : This article contains excerpts from H R Clinton's speech marking World Health Day on April 7, 1998. Clinton asserted that those present were joining other voices throughout the world calling for an end to maternal mortality. She noted that 1) every minute maternal mortality claims a victim, 190 women face an unplanned or unwanted pregnancy, and 110 women experience a pregnancy-related complication; 2) most of the 600,000 maternal deaths each year are avoidable; 3) maternal mortality is 150-200 times greater in impoverished than in wealthy nations; and 4) even the US has not yet reached its goal of halving its maternal deaths by the year 2000. After reporting that she has visited clinics in Bolivia that are delivering life-saving reproductive health services and a hospital in Brazil where women are receiving family planning (FP) counseling, Clinton maintained that reducing maternal mortality requires the sustained efforts of a range of partnerships. Then Clinton pointed out that nearly all of the maternal deaths in the world could be averted by an investment of $2/person/year and that this investment is tiny compared to the economic benefits gained. Clinton stressed that we have the strategies and resources to eliminate unnecessary maternal mortality, but we lack the collective will. Clinton called for investment in prenatal care, nutrition, obstetric care, and FP and pointed out that FP services help reduce abortion rates.
Notes : Inglés/anglais/EnglishAbstract : Informe final sobre el Forum ONG 1994 que se celebró junto con la Conferencia Internacional sobre Población y el Desarrollo
Notes : Español/espagnol/SpanishAbstract : Contiene las ponencias así como la sesión de preguntas y respuestas. Reseña las experiencias de ONG'S y la defensa y fortalecimiento de la cultura laica. Información sobre la campaña por el fortalecimiento del estado laico
Notes : Español/espagnol/SpanishAbstract : Introducción / Martha Inés Rosenberg ; El embarazo forzado y el aborto terapéutico en el marco de los derechos humanos / Susana Chiarotti, Mariana García Jurado, Gloria Schuster ; Deber del Estado y los derechos reproductivos : marco jurídico y social / Marco Antonio Avila, Claudia Nora Laudano ; María Ester en el país de las pesadillas o de cómo rescatar nuestros cuerpos / Mabel Alicia Campagnoli ; Historia de Ana / Alejandra Oberti, July Edith Cháneton ; Cómo persar el aborto terapéutico / Laura Klein
Notes : Español/espagnol/SpanishAbstract : The contributions of the International Planned Parenthood Federation (IPPF)'s Western Hemisphere Region are commemorated in this 40-year anniversary (1954-94) publication through the recollections of six individuals who have been at the forefront of IPPF's history. These pioneers recall the development of voluntary family planning in Jamaica, the founding of Colombia's Profamilia organization, the contributions of Ofelia Mendoza to Uruguay's family planning program, the role of young doctors in establishing family planning programs in Chile despite opposition from the Catholic Church and Communist rulers, contributions of the Panamanian Association for Family Planning to the region's development, and efforts in Ecuador to reach indigenous populations with family planning. IPPF Western Hemisphere Region's four decades of experience have 1) confirmed that most people want to plan their families; 2) demonstrated that family planning programs can reduce excessive population growth rates, decrease reliance on induced abortion, convince the poor that they have a human right to quality services, and contribute to the advancement of women; and 3) shown that political controversy must be faced rather than avoided. As IPPF prepares to enter the 21st century, an emphasis is being placed on the empowerment of women and a comprehensive approach to sexual and reproductive health.
Notes : Inglés/anglais/EnglishAbstract : This discussion of public health and ethical issues involved in unsafe abortion in Peru begins with an assessment of changing perceptions of the determinants of health and appropriate public health initiatives. It then discusses maternal mortality as a tragedy affecting fundamentally the most disadvantaged population sectors, those lacking economic resources and access to services. Abortion is one of the principal causes of the 585,000 maternal deaths estimated by the World Health Organization to occur each year. Some 20 million abortions performed each year cause an estimated 70,000 maternal deaths, usually following unsafe procedures. Peru's abortion mortality rate was estimated at 265/100,000 live births in 1996, one of the highest in Latin America. In the most impoverished regions of Peru, the maternal mortality rate may be as high as 650/100,000. Abortion is the second most frequent cause of maternal death in Peru. Innovations in the hospital treatment of incomplete abortion that would reduce the time and expense of treating abortion complications are examined next. The ethical dilemmas presented by public policy toward abortion are then aired. The responsibility of policy makers, scientists, and technical personnel should be to create a social awareness of problems, not to hide them. Finally, interventions to improve the quality of abortion care and attention to women's health are identified at the level of the state, intersectoral strategies, and health services.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159732Abstract : The process of democratization underway in Paraguay since 1989 will include a new constitution which increases women's rights. In addition, the government is strengthening maternal and child health programs and including a family planning (FP) component in response to the fact that Paraguay has one of the highest rates of maternal mortality in Latin American (more than 300/100,000 live births). The population of Paraguay is mostly rural, and only 8% of the rural population has access to health services. The major causes of maternal mortality could be avoided if the mothers could reach facilities for prenatal care. Therefore, midwives are being trained to provide better health care, including prenatal care and FP services. A government-run FP begun in 1972 was closed down in 1979, and a natural FP project was initiated in the late 1980s. In 1988, the government made FP part of its maternal and child health program, concentrating on women over age 35 and under 20, and those with 4 or more children, in other words, using FP as a health initiative, not a demographic program. In Paraguay, all abortion is illegal, but 35% of Paraguayan women have had at least one abortion, and 26,000 take place each year, with only 3% carried out by doctors. Abortions account for a third of all maternal mortality. With the promised democratization, women's health can be made a community-level concern and women's issues can finally receive the attention they deserve.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 081436Abstract : Bolivia, long considered one of the most conservative countries in Latin America with respect to reproductive health, is now among the most progressive. How did this policy change occur? In the 1960s allegations in the widely distributed film "The Blood of the Condor" that foreigners were sterilizing Andean women without their consent led to the proscription of family planning. Despite the highest maternal mortality rate on the continent, contraception was taboo, even within the medical and public health communities. Without access to family planning, many women resorted to unsafe abortion to control their fertility, often with tragic consequences. The public health community in Bolivia has built consensus to address the problem of high maternal mortality through an integrated reproductive health program. Broad public participation, and openness of the public health sector, along with regional and international attention to the issue have encouraged the development of a well-planned, comprehensive approach toward reproductive health, family planning, and abortion in Bolivia. The Bolivian delegation to Cairo brought the wealth of the country's expertise and leadership on the issue, and the international outcome reflected Bolivia's experience with reproductive health and abortion. (author's)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 113271Abstract : The Programme of Action of the International Conference on Population and Development 1994 enshrines an almost-feminist vision of reproductive rights and gender equality in place of the old population control discourse but retains a mainstream model of development under which that vision cannot possibly be realised. This 'fault line' is highly dangerous for feminists, because it configures a gap between the politics of the body, sexuality and reproduction and the politics of social development and global economic transformation. An analysis that makes explicit the concrete links between macro-economic policies and the materialisation of reproductive and sexual rights for all the world's women is needed.
Web site : http://www.rhmjournal.org.ukAbstract : Discusses Roman Catholic church response to the clerical sexual abuse scandal in Ireland and resulting cover-up by church leaders, focusing on need for church accountability, responsibility, and care for victims
Web site : http://www.catholicsforchoice.org/conscience/archives/default.aspAbstract : Contenido: 1. The intersection of gender politics and democratization process ; 2. Methods for examining gender politics and democratization ; 3. Women´s political participation around the globe ; 4. Legal gender equality across Latin America ; 5. The political and policy process (PPP) model ; 6. Sex crimes reforms and democratization in Mexico ; 7. Affirmative action electoral quotas for women in Mexico ; 8. Confronting gender discrimination in the workplace in Mexico ; 9. The decriminalization of abortion in Mexico: feminists for "choice", catholics for "life", and the state for controlled compromise ; 10. Conclusions: symbolic policy gains for women supercede ideals of democratic transformation
Web site : http://www.gire.org.mx/Abstract : O estudo ; As hipóteses, sua operacionalizacao e alguns resultados ; Discussao.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Esta carpeta contiene un módulo de capacitación, 17 hojas temáticas par el desarrollo de talleres dirigidos a jóvenes o a quienes trabajan con este sector poblacional, en las áreas de género y salud reproductiva y hojas de trabajo con preguntas, evaluaciones, etc. Contiene: Prefacio ; Introducción ; ¿A quién va dirigido este módulo de capacitación? ; ¿Cómo esta organizado? ; ¿Por qué es necesario contar con este material? ; ¿En qué supuestos se basa el contenido del módulo? ; Preparación y planificación ; ¿Qué deben saber los facilitadores? ; Guía para aplicar el módulo educativo ; ¿Cómo distribuir el tiempo para la puesta en práctica del módulo educativo? ; ¿Qué hacer después del taller? ; La estructura del taller para comenzar ; Introducción del taller ; Definición de género y sexo ; Dinámica IA: Sexo y género: ¿qué significan? ; Dinámica I B: Apareando refranes y dichos ; Dinámica 2: Cuando era joven ; Dinámica 3: Género, no sexo ; Resumen delas dinámicas 1-3 para facilitadores ; Aprendiendo sobre género y sexo ; Introducción al trabajo en grupos pequeños ; Dinámica 4: Juego de género ; Dinámica 5: El lenguaje del sexo ; Dinámica 6: Aprendiendo sobre sexo ; Dinámica 7: Analizando imágenes de publicidad ; Resumen de las dinámicas 4-7 para facilitadores ; Aplicando el concepto de género a la salud sexual y reproductiva (SSR) ; Introducción ; Dinámica 8: ¿Qué es la violencia? ; Dinámica 9: Experimentando la violencia ; Dinámica 10: Historia del ciclo vital ; Dinámica 11: Juego de roles: ¿por qué? ; Dinámica 12: Arbol de problemas ; Dinámica 13: Diseñando servicios de SSR amigables a los jóvenes ; Resumen de las dinámicas 8-13 para facilitadores ; Conclusión y evaluación ; Tareas para la casa ; Prejuicios de género y sensibilidad al género en nuestra cultura ; ¿Qué aprendieron mis padres sobre el sexo? ; Diseñando avisos de publicidad sensibles al género ; Elaborando planes de acción para mejorar los servicios de SSR ; Materiales de apoyo ; Definiciones de términos relacionados con el sexo ; Definiciones de términos relacionados con el género ; Definiciones de términos relacionados con la salud sexual y reproductiva ; Información sobre la violencia ; Información sobre el embarazo precoz y no deseado y el aborto ; Información sobre el VIH/ITS y el SIDA ; Cuestionario sobre temas de SSR ; Lista de verificación sobre la sensibilidad al enfoque de género ; Dinámicas adicionales ; ¿Cuáles son nuestras actitudes y valores? Una dinámica para los facilitadores ; Los efectos dañinos de los mitos ; Admirando el sexo opuesto ; Refexionando sobre los prejuicios ; Usando historias para explorar temas de género y SSR ; Referencias y recursos.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Reune textos relacionados con la mujer, con las niñas, con las personas de la tercera edad, con indígenas y homosexuales, además de que se abordan los temas del sexismo, los derechos laborales, el aborto, la situación mexicana de los derechos humanos, la violencia, el zapatismo de Chiapas, la libertad sexual entre otros
Notes : Español/espagnol/SpanishAbstract : 3. Problemas vinculados a la vida sexual y reproductiva de las mujeres. 3.1. La competencia de la Policía para el registro y control del trabajo sexual. Bolivia. 3.2. La exclusión de pena en algunos supuestos de aborto. A. México. 1. El cuestionamiento al artículo 334º fracción III del Código Penal del Distrito Federal. 1.1. Distinción entre la excusa absolutoria y la excluyente de responsabilidad. 1.2. Falta de motivación de la disposición. 1.3.Vulneración del principio de certeza en materia penal, establecido en el artículo 14º de la Norma Fundamental. 1.4. Vulneración de la garantía de igualdad contenida en el artículo 1º, la del respeto a la vida, consignada en los numerales 14º y 22º, en relación con el 17º de la Constitución Federal, así como de aquellos tratadosinternacionales signados por México en los cuales se establece la protección a la vida. 2. El cuestionamiento al artículo 131º bis del Código de Procedimientos Penales del Distrito Federal. B. Colombia. 1. Funciones y requisitos de la pena. 2. Excusa absolutoria y exclusión de la punibilidad. 3. Exclusión de la pena en el delito de aborto.
Web site : http://europa.eu.int/comm/europeaid/projects/eidhr/pdf/report-idpc-activity-publication_en.pdfAbstract : Difusión de los enfoques y perspectivas de los estudios sociales, sobre la salud de las mujeres, no sólo como se concebía tradicionalmente (sólo reproducción), sino de un conjunto de aspectos que incorporan otras dimensiones como el trabajo y la sexualidad
Notes : Español/espagnol/SpanishAbstract : El texto se organiza a través de tres ejes temáticos fundamentales: la anticoncepción, el aborto y las nuevas tecnologías reproductivas, tomando en cuenta un enfoque de género, ético y de derechos humanos. Se incluyen los siguientes capítulos: Introducción / Lucila Scavone ; Ciudadanía reproductiva y salud: el debate en su contexto ; Anticoncepción, aborto y tecnologías conceptivas: entre la salud, la ética y los derechos / Lucila Scavone ; Feminismo y ciudadanía: la producción de nuevos derechos / María Betania Avila ; Contracepción, relaciones de género y ética ; Anticoncepción, salud reproductiva y ética / Aurélio Molina ; La experiencia con nuevas metodologías anticonceptivas en el contexto mexicano: algunas reflexiones éticas / Juan Guillermo Figueroa Perea y Verónica Sánchez Olguín ; Esterilización masculina, dinámicas conyugales y ámbito de poder: un estudiode caso colombiano / Mara Vivieros Vogoya ; EL aborto provocado en América Latina: salud, religión y derechos ; Una mirada a la situación del aborto en México / Deyanira González de León Aguirre ; El aborto en Cuba: un reto para los educadores / Carmen Luisa Aguila Acebal y Antonio Neyra Reyes ; Soledad y abandono: una constante entre las mujeres que abortan / Eleonora M. de Oliveira y Lucila Amaral C. Vianna ; Aborto: un tema de discusión en la Iglesia Católica. El surgimiento de las Católicas por el derecho a decidir/ María José Fontelas Rosado Nunes y Regina Soares Jurkewicz ; Nuevas tecnologías conceptivas en América Latina: género y política ; Nuevas formas de procreación / Susana E. Sommer ; vertientes valorativas actuales frente a las nuevas tecnologías reproductivas / Alejandra Ana Rotania.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : An estimated 80,000 women die each year from complications related to unsafe abortion. Globally, about 13% of pregnancy-related deaths are due to this cause. In several countries in Latin America, where other determinants of maternal deaths have been addressed and reduced substantially, abortion deaths have become the main cause of maternal mortality. In developing countries, the risk of death following complications of unsafe abortion may be several hundred times higher than that of an abortion performed professionally under safe conditions. Both the incidence of unsafe abortion and resulting mortality appear to be rising among unmarried adolescents in urban areas where abortion is illegal and access to fertility regulation services is inadequate. Access to sexuality and contraceptive information and services targeted to the young could help reduce the incidence of unwanted pregnancies. Ongoing surveillance of trends in unsafe abortion is essential. Sustained reductions in abortion-related mortality require a combination of changes in abortion laws, increased access to safe abortion services and/or menstrual regulation, more widespread access to contraception, increased skills on the part of abortion providers outside the formal health care system, and the availability of treatment facilities for abortion-related complications.
Web site : http://www.prb.org/template.cfm?Section=Population_Today1 Template=/PopulationToday.cfmAbstract : Se discuten los temas más controvertidos y de vanguardia sobre salud y derechos reproductivos. Se aborda la población internacional y la planificación familiar desde la perspectiva feminista. Los derechos reproductivos como derechos humanos sirven de base para la creación de un enfoque de vanguardia cuya intención es modificar las políticas de población y dar poder a las mujeres. Afirma que la democratización de la sociedad en su totalidad y la eliminación de la subordinación de las mujeres en particular, no depende directamente del incremento, reducción o conservación de las tasas de crecimiento de la población, por lo que son las mujeres quienes deben exigir su derecho a elegir cuando, cómo y dónde embarazarse y concebir
Notes : Español/espagnol/SpanishAbstract : At present, there are 50 countries where abortion is either prohibited or permitted only to save the mother's life, 44 countries with strictly defined justifications over and above a threat to the mother's life (e.g. rape or incest), 13 countries that permit abortion for social or sociomedical as well as medical reasons, and other 22 whether abortion is available on request. In Africa and Latin America, strict abortion laws remain the norm; however, several countries in Asia and Eastern Europe have demonstrated a trend toward liberalization of abortion laws. The annual number of abortions worldwide is estimated at 36-53 million; about 25% of all pregnancies are terminated. The abortion rate is actually higher in countries where abortion is illegal (30-60/1000 women in Latin America) than areas where it is available (14/1000 in Western Europe). The rate of abortion is primarily a reflection of the availability and quality of family planning services and sex education in a country. In countries where abortion is legal, the mortality rate is under 1/100,000 procedures. About a quarter to a third of maternal deaths are attributable to complications of illegal abortions. If abortion were legal on a global level, the current 150,000 abortion-related maternal deaths/year would drop to 250/year. Other consequences of illegal abortion include permanent infertility, the need for 50% of maternity hospital budgets to be allotted to treatment of complications of abortion, and a diversion of a large share of scarce blood supplies.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 092571Abstract : Programs in Sierra Leone, Brazil, India, and Turkey Illustrate diverse approaches to the need for post-abortion family planning. At Marie Stopes International clinics in Freetown, Sierra Leone, the content and timing of contraceptive counseling of women who have undergone abortion is tailored to the individual woman's needs. Since the clinics offer comprehensive reproductive health services, women who present for abortion complications or post-abortion counseling are not stigmatized as abortion clients. In addition, range of approaches ; audiotapes in the clinic waiting room, home visits, and radio programs ; is available for the dissemination of family planning information. In Brazil, where post-abortion family planning is a political issue, the Sao Paulo Feminist Health and Sexuality Collective has focused on creation of a regional referral center for treatment of incomplete abortions and dialogue with the medical profession to sensitive physicians to women's health needs. India's Parivar Seva Sanstha clinics have found personal contact by doctors, pharmacists, government health workers, and community promoters to be the most effective means of reaching women with information about available family planning services. In Turkey, government health officials responded to high rates of repeat unwanted pregnancies after legal menstrual regulation by training abortion providers in post-abortion family planning and integrating the two services in government clinics.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : The 1994 International Conference on Population and Development (ICPD) Programme of Action represented a positive step toward legitimising abortion as a component of basic reproductive health services. This paper reviews how the ICPD principles and recommendations have been applied in the past decade toward increasing women's access to affordable, safe and legal abortion services. It examines advocacy efforts to increase understanding of abortion among policymakers and the public, policy and action at the global level, progress made in national-level policies and services, and obstacles encountered. Research and advocacy are helping to break the silence globally about unsafe abortion, and there is an emerging global movement supporting women's right to safe abortion. A great deal has been accomplished in the ten short years since ICPD, in spite of serious setbacks in some countries and continuing obstacles. A synthesis of public health and rights-based approaches, and strategic partnerships with other social justice movements are called for, as a foundation for effective legal reform efforts and to ensure that women have access to safe abortion services.
Web site : http://www.rhmjournal.org.uk/Abstract : About 25% of all married women in developing countries want to space or limit their childbearing but do not have access to the means to do so. Whether or not to practice family planning should be the right of every human. It is clear, however, that when given the choice, many people prefer to space and limit their childbearing in the interest of improving their economic condition, their health, and the health of their children, as well as to secure the best possible education for their children among other reasons. Family planning is an investment in the future which enables people to better control their primary living conditions. Most sexually active people in Africa with unmet need desire to space their childbearing, so reversible methods are called for. There is equal need for birth spacing and birth limiting in Asia and North Africa, while the demand for birth limiting dominates in Latin America. The concept of unmet need has been extremely useful in defining national family planning policies and in prioritizing the need for international assistance. This concept, however, is too quantitative and omits several groups who have or may have an unmet need for family planning. The author discusses the use of unreliable methods, abortion as a family planning method, the unmarried, the potential growth of unmet need, and the need for greater efforts.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 095597Abstract : This chapter on Guatemala is part of a comprehensive examination of the laws and policies that affect the reproductive lives of women in nine Latin American and Caribbean countries. Each report begins with a page of statistical information on population, the economy, status of women, and reproductive health and a brief summary of the nation's recent history. The first main section describes the country's legal and political framework, including the structure of national and local governments and national and international sources of laws. The second section examines laws and policies regarding health and population. The objectives of national health policy and the financing, infrastructure, and regulation of health services and patients' rights are analyzed. Population policy, legislation affecting reproductive health, and government- provided family planning services are then examined. Discussions of contraception, abortion, and HIV/AIDS and sexually transmitted diseases examine relevant legislation and prevalence. The third major section assesses the social and juridical status of women as an influence on the exercise of their reproductive rights, including civil rights within marriage, socioeconomic rights, and the right to physical integrity. The characteristics of marital and family relations and women's educational level, access to economic resources and legal protection determine their possibilities of satisfying their reproductive health needs and rights to services. The final major section examines the rights of adolescents in the areas of reproductive health, marriage, sexual crimes against girls and young women, and sex education. Efforts to improve observation of the reproductive and other rights of adolescents are important for self-determination and health of women in general.
Web site : http://www.crlp.org/Abstract : This presents the declaration adopted during the Central America Safe Motherhood Conference, which identifies the causes behind the high level of maternal mortality and morbidity in the region and proposes strategies for addressing the problem. Held in Guatemala City on January 27-31, 1992, the conference brought together health and other professionals, international experts, representatives from nongovernmental organizations, and government officials from the Central American countries, as well as from Cuba, the Dominican Republic, Mexico, and Panama. 1 in 73 Central American women die from pregnancy-related causes, compared to 1 in 9,850 among Northern European women. Many more women suffer serious physical and psychological injuries. Maternal mortality and morbidity also undermines child health, family welfare, and the socioeconomic development of the countries. The Guatemala Safe Motherhood Declaration identifies the following socioeconomic and health factors responsible for the high rate of maternal mortality and morbidity: poverty, nutritional deficiencies, discrimination against women, women's lower educational status, violence against women, lack of adequate prenatal care, illegal abortion, and unwanted pregnancy (due to limited family planning and sex education programs). For each of these factors, the declaration provides a recommendation for action. The declaration also provides recommendations to ensure that safe motherhood is promoted as part of a multi-sectoral approach and with political will.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 072051Abstract : Recopilación de notas bibliográficas con resúmenes y descriptores sobre el tema principal. Las publicaciones presentadas son de 1981 a 1992
Notes : Español/espagnol/SpanishAbstract : IPPF/Western Hemisphere Region has published a detailed account of the 1991-1992 Guyana Contraceptive Prevalence Survey (GCPS) as well as an analysis of its findings. The report's introduction covers a brief socioeconomic background of the country, the economic situation, migration, family planning in Guyana, the survey itself, the fieldwork, and the sample. Chapter 2, entitled Fertility Performance and Intentions in Guyana, specifically addresses fertility rates; public health, infant mortality, and fertility; age of first intercourse; childbearing contexts; mean parity; desire for children; need for family planning; and ideal family size. Contraceptive awareness is discussed in chapter 3, which includes number of methods known; knowledge of specific methods and outlets; awareness by age, race, and residence; and abortion. The next chapter describes contraceptive prevalence. Subtopics include ever-use of contraceptives, prevalence rates (a brief comparison), a comparison of the GCPS and the Guyana Fertility Survey, contraceptive use by region, method preference, a comparison with Trinidad and Tobago, fertility intentions and contraceptive use, contraceptive outlets, user satisfaction, satisfaction with method, client satisfaction with personnel and outlets, partner involvement in family planning, partner involvement and contraceptive use, dynamics of first use, timing of first use and parity, ever-use of abortions in Guyana, and contraceptive use and program interventions. Chapter 5, entitled Non-Contraceptors, covers previous and never users, reasons for method discontinuation, future use, future method and source, committed non-users, and perceptions of service delivery systems.
Notes : Inglés/anglais/EnglishAbstract : Illegal abortion is a major public health problem in Guyana. Although Guyana law stipulates life imprisonment for abortion providers, and estimated 30% of sexually active women have undergone an illegal abortion. Septic abortion accounts for 25-50% of maternal mortality in the country. In the late 1980s, a Ministry of Health bill focused on abortion law reform won Cabinet approval; however, the draft was never presented to Parliament. A study conducted by F E Nunes, a Pan-American Health Organization advisor in Guyana, suggests that medical professionals are amenable to liberalization of the country's current abortion law. 78% of physicians, 72% of nurses, and 70% of pharmacists surveyed indicated that they had no moral objections to abortion and support for abortion counseling was even more widespread. Since the medical profession would be charged with administering any revisions in Guyana's abortion law, these attitudinal findings are encouraging and offer hope that the country may soon be able to improve women's reproductive health.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 097903Abstract : Esta publicación atiende una demanda de información e insumos para el debate creciente sobre el aborto, a raíz de la Conferencia Internacional sobre Población y Desarrollo de El Cairo (1994) y la participación de diferentes organizaciones de la sociedad y del gobierno de Bolivia en dicho proceso. El texto busca extender el debate a la gente "común", que al igual que los expertos, conoce el problema del aborto muy de cerca. Ofrece una información resumida en un lenguaje claro para facilitar las discusiones entre grupos diversos de la sociedad. Pretende ayudar a emprender acciones concretas, en la vida personal o a nivel más colectivo, que favorecen a la salud y una calidad de vida para todas las ciudadanas y ciudadanos.
Notes : Español/espagnol/SpanishAbstract : El aborto terapéutico desde la perspectiva biomédica ; El aborto terapéutico desde las ciencias sociales ; El aborto terapéutico desde el género y la experiencia de las mujeres ; El aborto terapéutico desde el derecho y la legislación ; Debate y cierre del simposio ; Anexo.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This work calls attention to the need for constructing a research agenda on induced abortion, which constitutes a serious pubic health problem in Latin America because of its illegality, clandestine practice, and ramifications for women's health, their families, and the health services. The incidence of abortion in Latin America is estimated, in the absence of reliable statistics, at 4-6 million annually. Over half the women in some countries are believed to resort to abortion during their reproductive lives. The concept of reproductive health emerged in the past decade from two distinct sources, the field of health and the feminist movement, as contraception became an increasingly accepted component of primary care. Reproductive aspects acquired a central role in the expanded concept of women's health, and reproductive health was converted into a new objective of service programs. The World Health Organization in 1988 for the first time unofficially defined reproductive health, and in 1994 an official definition was proposed. The definition did not mention abortion directly. Abortion is increasingly a topic of political debate in Latin America, where it is legal only in Cuba. The resolute opposition of the Catholic Church undoubtedly affects health policies. The feminist movement is perhaps alone in raising the issue and seeking means of legalizing abortion, based on human rights and public health considerations. The new definition of reproductive health challenges researchers from many disciplines to provide reliable information on poorly known aspects of abortion. The ultimate goal of the research is to reduce the frequency of abortion and eliminate morbidity and mortality caused by illegal abortions. Recommended topics for research include the incidence of abortion, undesired adolescent pregnancy and abortion, abortion and working women, the influence of cultural and social patterns on abortion, the role of men in reproductive decisions and abortion, the relation of abortion and contraception, costs of abortion, attitude of abortion practitioners and illegal abortionists, evaluations of the legal status of abortion, and models of risk detection and prevention.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 127873Abstract : Presenta elementos para comprender la realidad que viven las mujeres salvadoreñas en torno a la interrupción voluntaria del embarazo y la nula coherencia entre esta realidad y sus necesidades. Plantea los mitos, sentimientos de culpa y formas de simbolización y conducta en torno al aborto, denuncia la ausencia de conocimientos sobre salud reproductiva y métodos anticonceptivos
Notes : Español/espagnol/SpanishAbstract : A strong policy is needed to permit development of national and international programs. The lifetime risk of death from causes related to complications of pregnancy is estimated at 1/16 in Africa, 1/65 in Asia, 1/130 in Latin America and the Caribbean, 1/1400 in Europe, and 1/3700 in North America. A minimum of 585,000 women die of maternal causes each year, with nearly 90% of the deaths occurring in Asia and Africa. Approximately 50 million womensuffer from illnesses related to childbearing. A principal cause of maternal mortality is lack of medical care during labor, delivery, and the postpartum period. Motherhood will become safe if governments, multilateral and bilateral funding agencies, and nongovernmental organizations give it the high priority it requires. Women also die because they lack rights. Their reduced Decision making power and inequitable access to family and social resources prevents them from overcoming barriers to health care. Women die when they begin childbearing at a very young age, yet an estimated 11% of births throughout the world each year are to adolescents. Adolescents have very limited access to family planning, either through legal restrictions or obstacles created by family planning workers. Maternal deaths would be avoided if all births were attended by trained health workers; an estimated 60 million births annually are not. Prevention of unwanted pregnancy and, thus, of the 50 million abortions estimated to take place each year would avoid over 200 maternal deaths each day. Unsafe abortions account for 13% of maternal deaths. The evidence demonstrates that rates of unsafe abortion and abortion mortality are higher where laws are more restrictive.
Notes : Español/espagnol/Spanish, nbsp;12348799Abstract : Aborda el tema del aborto en un contexto político patriarcal, en donde la creación de tabús ha sido tradicionalmente uno de los métodos de la política mexicana para sostener el sistema patriarcal y autoritario. Señala los aportes del movimiento feminista con respecto a impulsar la cultura del debate y la participación activa de los ciudadanos
Notes : Español/espagnol/SpanishAbstract : Este trabajo presenta los resultados de una investigación cualitativa realizada entre los meses de diciembre de 1996 y diciembre 1997. El trabajo exploró el conocimiento, opiniones, actitudes y necesidades sobre sexualidad y procreación de hombres provenientes de sectores urbanos pobres de la CapitalFederal y el Conurbano Bonaerense de la Argentina. El documento esta dividido en cinco secciones en las cuales se presenta un marco conceptual y la metodología de la investigación, se presentan los resultados (conocimiento y actitudes acerca de métodos anticonceptivos, los métodos anticonceptivosmasculinos, enfermedades de transmisión sexual, aborto y prevención y los papeles e imágenes de género) y finalmente se presentan los principales hallazgos y conclusiones.
Notes : Español/espagnol/SpanishAbstract : In Mexico, complication arising from abortion is one of the main causes of maternal morbidity and is the third cause of maternal death. This is because the country's national laws consider abortion a crime, forcing the women to endanger their lives by turning to clandestine, highly unclean and unhealthy abortion clinics. Although exceptions exist, they come under specific circumstances, and are usually difficult to use due to the lack of clear procedures, corruption and bureaucratic tangles. To offer an integral answer to the problem surrounding illegal and unsafe abortions, it is necessary for the government to change its abortion law. The framework should offer legal protection to all women that choose to have an abortion, as well as improve the procedures to make this legal protection effective, and include the right of women to have counseling before or after an abortion. Moreover, the rights of women should be promoted, recognized and defended.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 156300Abstract : Maternal mortality in Haiti is high. 460 women die, on average, per 100,000 deliveries annually; the death rate is over 1200 in Port-au-Prince. This should have won the country more than a brief mention during the International Conference on Population and Development in Cairo (September,1994). At that time, UN assistance was limited to humanitarian aid alone. The Cairo Programme of Action asks that policy makers focus on improving standards of reproductive health care for women; Haiti would be an excellent place to begin. Public hospitals are dilapidated and lack supplies. Abortions, which are illegal in Haiti, are performed in backstreet shops by quacks known as "charlatans". The women who survive are usually sterile. According to a recent study, 50% of the teenage clients at a leading Port-au-Prince clinic had had 1 or more abortions. 8% of Haiti's pregnant women are infected with human immunodeficiency virus (HIV). Greater than 35% are infected with other sexually transmitted diseases (STDs). Because of the embargo, Haiti is isolated. Public health services have collapsed. Over 70% of deliveries are performed by midwives in unsanitary conditions, and, when a crisis strikes, there is no fuel to reach the hospital. Family planning could save lives by removing the need for abortions and by preventing the spread of STD and acquired immunodeficiency syndrome (AIDS). It would also decrease the birthrate, which, at present, is leading to a population of 13.9 million in the year 2025 in an already impoverished country. Although demand for family planning is increasing, less than 10 % of Haitian women have access to contraceptives. The embargo exempts contraceptives; however, operating through a naval blockade is expensive and inconvenient, and supplies are often interrupted. Due in part to UN Population Fund (UNFPA) messages, condom use is increasing, in spite of its association with loose living and prostitution, and the disapproval of the Catholic Church.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100636Abstract : Treinta años después del caso Roe versus Wade, que produjo un nuevo paradigma en el marco legal respecto al derecho al aborto en Estados Unidos, hay poco que decir sobre el tema que no se haya repetido una y otra vez. Los partidarios del derecho a decidir han argumentado que es importante reconocer a las mujeres como personas autónomas con la capacidad moral y el derecho moral para decidir si abortarán o llevarán a término un embarazo. El más poderoso de los mensajes a favor del derecho a decidir ha sido la multifacética pregunta "¿Quién decide?", que subraya, sin mencionarlos explícitamente, tanto los derechos de las mujeres como la necesidad de mantener al gobierno fuera de nuestra alcoba.
Web site : http://www.catolicasporelderechoadecidir.org/publicacionesAbstract : Chile is now facing the prospect of even harsher anti-abortion laws than those already in place. The democratically elected Congress has been presented with two bills that would increase criminal sanctions against abortion. One bill seeks to increase the penalties for women, physicians and other practitioners found guilty of performing an abortion, for whatever reason. The second bill introduces the possibility of plea-bargaining, which would allow guilty parties to receive reduced sentences if they cooperate with prosecutors.
Notes : Inglés/anglais/EnglishAbstract : A comparative study of six Latin American countries shows that between 17 and 35 percent of all pregnancies end in abortion, reports Women's Health Journal (April 1994). The 1994 report, Clandestine Abortion: A Latin American Reality, conducted by the Alan Guttmacher Institute, surveys abortion incidence in Brazil, Mexico, Colombia, Peru, Chile and the Dominican Republic. According to the study, for every 10 births, four abortions are performed. The study also looks at the number of women who suffer complications from abortion and who are hospitalized due to complications. The publication, is available in English and Spanish from The Alan Guttmacher Institute, 120 Wall Street, New York, NY 10005, USA.
Notes : Inglés/anglais/EnglishAbstract : It is estimated that 20-30% of maternal deaths results from complications of unsafe induced abortions in many developing countries. Poor quality legal abortion can still be a serious health problem as in India and in parts of Central Europe and the former Soviet Union, where induced abortion remains a primary means of fertility regulation. There are around 35-55 million annual abortions, of which some 26-31 million are legal. It is estimated that at Kenyatta National Hospital in Nairobi, some 10,000 admissions a year are attributed to complications from incomplete abortion. Central European countries, parts of the former Soviet Union, and China (with some 10-11 millions abortions/year) have low fertility owing to different mixes of abortion and contraception. Women in Central and Eastern Europe have up to 6-7 abortions/each 10 conceptions. At these levels abortion becomes the main method of birth control. As M.E. Khan's paper reports, in India in 1990, legal abortions reached nearly 600,000, the official estimate. The more believable annual estimate of induced abortion is somewhere between 5 and 6 million with the more well-to-do women obtaining legal abortion, while poorer women resort to illegal, unsafe abortions. A study conducted in Mexico City by Pick de Weiss indicates that untrained employees in pharmacies provide inefficient and/or dangerous drugs or herbal preparations to abort. Studies in Latin America indicate that younger unmarried women are most exposed to risks of morbidity and mortality. The paper by Anderson, Katus, Puur, and Silver on Estonian women found that because of late gestational age abortions, single women are most likely to face severe complications and health risks. The paper by Sbatello describes the Israeli policy situation and the rise in abortion in recent years, mainly among large numbers of Soviet immigrants using abortion as a primary means of fertility control. The study of abortion should be a priority for demographers, epidemiologists, health and population policy experts, and women's rights advocates.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 084942Abstract : This paper considers maternity and mothers to be disdained by society, medical institutions, and medical practitioners who seek to dominate women, especially those women who are dependent upon state public health services. Many women, in fact, die from abortions, pregnancy complications, and/or undernourishment in the care of inadequate state services, and at the hands of negligent, thoughtless practitioners. a personal testimony is provided as witness to ill treatment received by expectant mothers in medical care. Instead of productively working to truly defend dignified maternity for the majority of women in the country, anti-abortionist groups only produce negative social and institutional effects which lead to new aggressions. The feminist position, however, implies support for women to control their bodies as they please, with society offering opportunities for choice. The paper notes the designation of May 28, as the International Day of Action against Maternal Mortality for deaths from medical ill treatment and negligence. It further encourages those who have witnessed or been subjected to such treatment to write in their experiences. Poor treatment may range from imposition of contraceptives to death through negligence.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 069335Abstract : Abortion is illegal in many countries, yet health systems in every country do provide emergency treatment for abortion complications. Nearly every country allows abortion in cases of rape, incest, and/or risk to the mother's life. Health systems in a country where abortion is illegal neither admit the magnitude of the need for abortion related care not plan legally indicated services effectively. Thus nearly 200,000 women die annually from complications of unsafe abortion and many more face serious injuries. 99% of the deaths and injuries happen in developing countries. A proactive approach by the health systems, even within their present legal framework, would improve the quality and effectiveness of current abortion care. 1st they must acknowledge the problem of unsafe abortion. They then need to integrate abortion care into the comprehensive reproductive health care system. Most importantly, they must decentralize both preventive and curative services. Nigeria, Nicaragua and Bangladesh have been able to provide needed abortion care, despite the restricted legal environment. Nigeria now trains medical students in manual vacuum aspiration (MVA) to treat incomplete and septic abortions which has fewer complications than does dilation and curettage (D C). Nigeria also added family planning counseling and services to women undergoing MVA. Nicaragua changed its penal code to allow therapeutic abortion to not only save the mother's life, but also in cases of rape or incest and if the fetus is severely abnormal. Like Nigeria, Nicaragua also replaced D C with MVA. Bangladesh promotes menstrual regulation, despite restrictions on abortion. Romania, Turkey, and Zambia are examples of countries that liberalized their abortion laws resulting in reduced maternal deaths.
Notes : Inglés/anglais/English, nbsp;popline067912Abstract : A controversial law approved by the Buenos Aires legislature would allow women and girls access to reproductive health and contraceptive information, limiting unwanted pregnancies and deaths from illegal abortions
Notes : Inglés/anglais/EnglishAbstract : Estudios de caso con respecto a mujeres que intentaron abortar y no pudieron hacerlo, dando a luz sin desearlo. Es un seguimiento durante veinte años de las vidas de estas mujeres con sus hijos, observando en éstos la repercusiones en su desarrollo personal, familiar y social al no haber sido deseados. Expone el limitado conocimiento que existe sobre los efectos que tiene en los hijos negarle el aborto a la madre. Se refiere al embarazo no deseado desde una perspectiva histórica, demográfica y psicológica de la mujer
Notes : Español/espagnol/SpanishAbstract : In November 1996 during her address to the Sixth Conference of Wives of Heads of State and Government of the Americas in La Paz, Colombia, and in her weekly newspaper column, US first lady Hillary Rodham Clinton pledged her own and the Clinton administration's complete support for reversing the severe reduction in funds for the international family planning program imposed by the 104th Congress. This revelation reflected the administration's preparation for a strong and vocal defense of the international family planning program, which will be facing its greatest political test in February 1997. Bolivia has the highest maternal mortality rate in South America, and half the deaths are due to illegal, unsafe abortions. Mrs. Clinton presented a $2.25 million USAID award to a $5 million Pan American Health Organization program that aims to reduce maternal mortality. In her December 3, 1996, column, she used family planning campaigns in Bolivia as an illustration of sensible, cost-effective, and long-term strategies for improving women's health, strengthening families, and reducing the abortion rate. Such programs educate people about the benefits of birth spacing, breast feeding, good nutrition, prenatal and postpartum visits, and safe deliveries. Mrs. Clinton has also visited other poor countries to learn about the special needs and conditions of women's lives. UN Ambassador Madeleine Albright has recently been nominated to be the first female Secretary of State. Many people see her commitment to improving the status of women through development efforts and her recognition of the close relationship between development and diplomacy as encouraging. The concern and commitment of these two powerful women could prove valuable in the upcoming test for international family planning aid. Congress must vote on a resolution to approve Clinton's report that the reduced funding is having a negative impact no later than February 28. If both the House and the Senate pass the resolution, already appropriated funds will be released in March rather than in July.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 120393Abstract : A finales del 2002 Rosa, una niña nicaragüense de nueve años, fue violada y embarazada en Costa Rica. La solicitud de la madre y del padre de la muchacha que a su hija se le practicara aborto terapéutico puso a prueba muchas cosas, incluyendo la laicidad del Estado nicaragüense, y generó una tremenda polémica. En aquellas circunstancias, no hubo oportunidad para que Rosa, María y Francisco expusieran en detalle su versión de los hechos. Un año después, María López Vigil transformó más de 40 horas de grabación de las entrevistas con las y los protagonistas de la historia en un extenso relato testimonial. La historia une el frescor de la oralidad a una estructura narrativa precisa, límpida, eficaz
Notes : Español/espagnol/SpanishAbstract : 352 women aged 15-49 years living in an urban health area of Havana, Cuba, were interviewed concerning their contraceptive usage and obstetrical history. 75% of the women interviewed reported they were married or in union, 15% were single, and 10% were divorced or widowed. A majority in all age groups had partners except among women aged 15-19, 62% of whom were not in union. The proportion with partners increased from 81% in the 20-24 cohort to its maximum of 93% in the 35-39 cohort and declined to 63% in the 45-49 cohort. 82% of the women had had their current partners for more than 1 year, 47% for more than 5 years, and 31% for more than 10 years. The 300 women who had ever been pregnant had a total of 812 pregnancies or an average of 2.7 each. 36% of the women had had 0-1 pregnancy and 29% had had 4 or more. 375 of the 812 pregnancies (46%) ended in a live birth and 371 (46%) in an induced abortion. 13 ended in stillbirth and 49 in spontaneous abortion. 4 pregnancies were ectopic. The results indicate .99 induced abortions/live birth and 1.44 induced abortions/woman ever pregnant. 248 of the 265 women currently in union stated they did not desire to become pregnant at present. 239 of the 248 reported using a contraceptive method. 74% reported they had ever used IUDs, 515 oral contraceptives, 6% condoms, 3% diaphragms, 3% each lactation and periodic abstinence, and 1% injectables. The frequency of induced abortion suggests that contraceptive use is inadequate and that abortion is used as a method to regulate family size.
Web site : http://www.bvs.sld.cu/revistas/enf/indice.htmlAbstract : 1000 women hospitalized for childbirth or abortion in a public hospital of metropolitan Santiago, Chile, were interviewed during May-July 1991 on their marital and reproductive histories. The sample represented 12.4% of births and 7.6% of abortions in the hospital in 1991. The women ranged in age from 13 to 47 years and averaged 25.6 years. 6.1% were under age 18 and 9.9% were 35 and older. 56% were married, 27% were in union, and 18% were single. 1.2% were illiterate, 79% had at least 8 years of education, and 30% had more than 12 years of education. 78% were housewives. 67% were at parity 1 or 2, 25% at parity 3 or 4, and 6% at parity 5 or more. 2% were nulliparous. 74.6% of the single women were at parity 1 and only 2% were at parity 3 or higher. Education and parity were generally inversely correlated. The first pregnancy occurred at an average age of 20 years. 27% of first pregnancies occurred before age 18 and 0.3% after age 34. The median age was 18.0 for first-order births and 35.2 for sixth-order births. The proportion of births that were desired declined from 72.6% of first-order births to 58.7% of third-order births. Use of contraception before a pregnancy increased with birth order, with 15.6% practicing birth control before a second pregnancy and approximately 28% doing so before a fourth and fifth pregnancy. Only 1.3% used contraception before a first pregnancy, although 27.4% did not desire the pregnancy or were undecided or doubtful. The proportion of single women declined from 62% for first pregnancies to 9.3% for second pregnancies. 40-45% of birth intervals between the second and fifth pregnancies lasted 24-59 months. The proportion of abortions increased with birth order.
Web site : http://www.scielo.cl/scielo.php?pid=0034-9887 script=sci_serialAbstract : Durante un estudio etnográfico en un hospital urbano, la autora tuvo una experiencia crítica relacionada con el dolor de una mujer en un procedimiento clínico. Compiló un dossier de cinco relatos acerca del caso: los de la mujer tratada, su esposo, una residente médica, el ginecólogo y la propia investigadora. La autora encontró que, no obstante las diferencias entre las historias, todas habían contribuido al logro de un efecto común: la anulación discursiva de la responsabilidad médica en la producción del dolor. En la discusión reflexiva del caso, se aborda dilemas éticos y epistemológicos en el manejo de construcciones diversas de la realidad.
Notes : Español/espagnol/SpanishAbstract : El propósito de este trabajo fue comprender el papel de los hombres en las decisiones reproductivas de las parejas, específicamente en la práctica anticonceptiva antes y después de un embarazo indeseado y en su resolución, con el fin de establecer los factores que inciden en su participación, y a partir de esta información proponer estrategias de intervención para los servicios que respondan a las necesidades de las parejas.
Notes : Español/espagnol/SpanishAbstract : Apresentaçao ; Introduçao ; Sexualidade e reproduçao: dimensoes do masculino ; Os homens e o cuidado infantil: permanencias erupturas ; Relatando experiencias.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This article insert describes a program in Cali, Colombia, for training hospital staff in family planning counseling of postabortion patients. Hospital staff at Hospital Universitario del Valle treats about 250 women per month for complications of incomplete abortion. Many are repeat clients. Unwanted pregnancies are attributed to lack of contraception, incorrect use of contraception, and mistaken beliefs about the protective properties of drinking seven glasses of water after intercourse. Postabortion patients range in age from 12 years to over 49 years. 14% are aged under 20 years. The number of women with abortion complications or women with miscarriages puts pressure on inadequate staff and facilities. Therefore, the hospital introduced a new program for postabortion patients. The program includes family planning counseling and provision of contraceptives before release from the hospital. Women are also informed of where to obtain contraceptive supplies in their local communities. The hospital must refer women seeking sterilization to secondary health facilities due to the intensive use of operating rooms. Family planning counseling includes information about the use of traditional and modern methods. Staff members who are trained in family planning include all levels from volunteers to physicians. The hospital is trying to improve client-provider relations by eliminating the fear factor. Emergency room department staff are also trained in family planning. The hospital is reaching out to the special needs of indigenous people who are unfamiliar with hospital settings and family planning information. Hospital staff provide each patient or client with a card that indicates the date of the woman's next menstrual cycle on a calendar. Staff inform the client that family planning must be used before the cycle begins. A variety of methods are explained.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 127585Abstract : A cost study methodology developed by Ipas was implemented among 400 women presenting with incomplete abortion in 6 African and Latin American countries. The 23 studies involved observation of postabortion care services provided to women and documented the amount of time spent with providers and the costs of supplies and medications used during the treatment and recovery. Overall, results suggest that women treated with manual vacuum aspiration (MVA) (n = 213) had a one-third lower average length of stay compared to women treated with dilatation and curettage (D C) (n = 210). The median cost of treating incomplete abortion per patient was US$78.81 for D C and US$8.50 for MVA patients (89% lower median costs for women treated with MVA). A subset of analysis of the 9 pre- and post-intervention studies (n = 248) showed that switching to MVA significantly reduced the average length of stay from 36 to 15 hours per patient. Generally, researchers found that the bulk of postabortion care costs, regardless of whether MVA or D C was used, could be attributed to salaries and costs associated with in-patient, overnight stays. It is also noted that MVA training and reorganization of services has improved the quality of postabortion care while reducing resource use and costs.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 160229Abstract : In Latin America and the Caribbean, where most countries have severely restrictive abortion laws and access to safe abortion is limited, complications of unsafe abortions are one of the major causes of maternal mortality. Even where some services are available, limited resources, lack of adequate provider training, and stigma surrounding abortion further limits women's access to quality abortion services. Providers may also be reluctant to offer any abortion services and/or unaware of the legal parameters for doing so. To address these barriers to accessing quality abortion services, IPPF/WHR and Gynuity Health Projects conducted a quantitative assessment of IPPF staff and provider knowledge, attitudes and practices in 6 LAC associations (1,811 staff, including 799 providers in 74 association sites). Data on provider perceptions and clinical practices suggest several important findings related to the quality of services offered and the potential to improve both access to and quality of abortion services in the 6 countries.
Web site : http://iussp2005.princeton.edu/download.aspx?submissionId=52409Abstract : Recent court decisions, for instance in South Africa and Latin America, have held states bound to respect and serve HIV/AIDS patients' human rights to indicated and available medical care. HIV/AIDS is estimated to affect over 36 million people worldwide, including 16.4 million women of reproductive age. In the last 20 years, nearly 58 million people have been infected. This article reviews national responses to mounting concern with the HIV/AIDS pandemic, particularly in China, India and Africa, medical professional responses, notably by the World Medical Association, and international guidelines on human rights responses. These pay special attention to patients' rights to be treated without discrimination. It addresses national and international approaches to advancing HIV prevention, treatment and research on which UNAIDS and the UN High Commissioner for Human Rights have collaborated. Special issues in clinical care concern abortion services for HIV-positive women, breastfeeding and patients' involvement in research.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : AbstractIn the Universal Declaration of Human Rights, the foundation of human rights, the text and negotiating history of the "right to life" explicitly premises human rights on birth. Likewise, other international and regional human rights treaties, as drafted and/or subsequently interpreted, clearly reject claims that human rights should attach from conception or any time before birth. They also recognise that women's right to life and other human rights are at stake where restrictive abortion laws are in place. This paper reviews the International Covenant on Civil and Political Rights, the Convention on the Rights of the Child, and the Convention on the Elimination of All Forms of Discrimination Against Women, the European Convention for the Protection of Human Rights and Fundamental Freedoms, the Inter-American Human Rights Agreements and African Charter on Human and People's Rights in this regard. No one has the right to subordinate another in the way that unwanted pregnancy subordinates a woman by requiring her to risk her own health and life to save her own child. Thus, the long-standing insistence of women upon voluntary motherhood is a demand for minimal control over one's destiny as a human being. From a human rights perspective, to depart from voluntary motherhood would impose upon women an extreme form of discrimination and forced labour.
Web site : http://www.rhmjournal.org.uk/Abstract : Since 1994, the Bolivian government has explicitly promoted humane treatment of women who have had abortions or miscarriages. Research in two urban teaching hospitals found contradictions between this component of official health policy and physicians' use of depersonalising language in treating women with incomplete abortion. This study was followed up through an action-research project in the La Paz State University Medical School which explored concepts of humane treatment at different stages of medical education. Among problematic issues identified were exclusionary practices to reduce numerical pressure of students, a rigid academic model censuring expressions of ambivalence, and gender discrimination. Two reflection exercises were tested with first-year students, interns, residents and teachers. The first involved group discussion of a story dossier developed from hospital study data, with varying accounts of one woman's therapeutic abortion treatment. In a subsequent exercise, participants wrote first-person narratives of a critical event in their medical education or practice. The study recommends systematically promoting humane treatment within medical schools and teaching hospitals. Women receiving postabortion care can benefit from increased provider awareness concerning plurality of experience, gendered and cultural difference, applied bio-ethics and the rights of health service users.
Notes : Inglés/anglais/EnglishAbstract : The easiest person to blame for abortion is the woman who has the abortion. This attitude singles women out, forces them to seek an illegal abortion, and threatens and eventually punishes them. If a pregnancy is terminated because a male partner does not take on his economic and emotional responsibilities, physically or sexually abuses the woman, or is addicted to a drug, it is the man who is truly responsible. When the couple cannot afford to support another child (as is often the case in Mexico), another child is detrimental to the health of either parent, or the fetus has known congenital effects and the couple chooses abortion, the couple is responsible. When a society denies women motherhood outside marriage, expels a pregnant teen from school, fires a working pregnant woman, and discriminates against a child of a single mother, the society is responsible for the abortion. Abortion belongs to all of us if the child is born in utter poverty. The government does not ensure the health, education, and well-being of citizens when it fails to provide enough child care centers and support services for working mothers, offer family planning information and services, and provide sex education. The abortion law in Mexico punishes the woman and the person performing the abortion. Since abortion is a crime, women seek midwives and medical students for an abortion or use knitting needles, acid, hangers, or dangerous herbs to induce abortion themselves. Rich women are above the law and can afford the best medical care to terminate an unwanted pregnancy. The House of Representatives refused to consider the 1980 bill on Voluntary Motherhood which called for legalization of abortion, women to decide the number and timing of children, and research on male and female contraceptives. The debate did lift the consciousness of many social sectors. Abortions are the 3rd leading cause of death for pregnant women in Mexico.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 099333Abstract : Norman Martinez died in 1991. She died from AIDS in a town outside of Mexico City at age 32 years weighing 57 pounds and leaving behind 5 children. Mrs. Martinez died after she was widowed by her husbands who contracted HIV by giving blood professionally. While her husband learned 7 years before his death that he had HIV, he did not know what it was. The last child was born after Mrs. Martinez found that she, too, was HIV-seropositive, but the child was carried to term and also carries HIV since abortions are permitted in only select circumstances. The 16-year-old son works to provide for the family, while the 13-year-old daughter cares for the family and house at the expense of her education. Even though her family was poor, had barely enough to eat, and could not afford the AZT which she needs, Mrs. Martinez at least hoped that her children would not be stigmatized by the community. Mrs. Martinez goes on to state that the realization of her impending and untimely mortality made her stronger. She hopes that readers will learn from this depiction of her experience and educate the uninfected while being sensitive to the infected.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 083032Abstract : The Paragraph 8.25 of the International Conference on Population Development calls for safe abortion, where it is legal, clearly identifies unsafe abortion as a public health problem, and outlines a number of approaches that governments, intergovernmental agencies, and nongovernmental organizations can take to improve the situation. This document offers a preliminary and non- exhaustive review of progress achieved, obstacles encountered, and key areas for attention in the future for those working on the issues addressed in Paragraph 8.25.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 169972Abstract : Con el objetivo de identificar factores asociados con la mortalidad materna que podrían ser modificados a través de intervenciones concretas, el Comité Nacional de Maternidad Segura en México llevó a cabo un estudio de autopsia verbal de todas las muertes maternas en 1995 en los estados de Guerrero, Querétaro y San Luis Potosí. Esas muertes ocurrieron mayoritariamente entre mujeres pobres y no escolarizadas. Solo la mitad de las mujeres que murieron tuvieron atención médica durante el parto; el 44 por ciento murió en la comunidad y 71 por ciento durante el parto y el puerperio. Las causas de muerte identificadas a través de la autopsia verbal fue consistente con aquella registrada en los certificados de fallecimiento, excepto en los casos de aborto inducido. El comportamiento de búsqueda de atención médica fue analizado utilizando el modelo conceptual de las "tres postergaciones". La falta de reconocimiento de la seriedad de las situaciones, la tolerancia a un alto nivel de dolor, la creencia de que algunas complicaciones son naturales, los costos, y la percepción de que la calidad de los servicios es mala, disuaden a las mujeres de la búsqueda de ayuda. Se realizó una comparación con un grupo integrado por mujeres con similares complicaciones a las que tenían aquellas mujeres que murieron y que fueron atendidas en los mismos hospitales, pero que sobrevivieron. Las mujeres que sobrevivieron fueron cinco veces más propensas a consultar y pedir la ayuda que necesitaban que aquellas que murieron; también tenían una mayor cantidad de años de escolarización. Las postergaciones interactúan con la naturaleza y la seriedad de las complicaciones y ocurren en todos los niveles. Esto es importante para desarrollar criterios y recomendaciones destinadas a evitar y reducir las postergaciones de atención médica. Estos resultados fueron presentados a autoridades locales y nacionales que desarrollaron un extenso programa para llevar el tema de la mortalidad materna a nivel nacional.
Web site : http://www.rhmjournal.org.uk/Abstract : This article reports the nonapplication of Article 266 in the case of an 11-year-old pregnant girl in Bolivia. Article 266, is a policy on unpunishable abortion. It explicitly states that in extreme cases of pregnancy, such as the consequence of rape, abduction for sexual purposes not followed by marriage, statutory rape, or incest, abortions are not punishable by law. In the case of a developmentally disabled girl in Santa Cruz, who was raped by her stepfather and became pregnant, she was denied the choice of aborting the baby despite the order of the juvenile court judge. This was because the doctors of certain hospitals in the city refused to perform the act and leaders of the Catholic Church and conservative groups opposed the abortion. However, abortion could have been pushed through if the justice system upheld Article 266. In addition, problems in the said article are cited. The article is not sufficient for enforcement as it lacks legislation, which subsequently leaves the rights of women at the mercy of police, doctors, and judges. Although women's rights groups have presented a revised version of Article 266, it still needs the approval of the Chamber of Deputies, the Senate, and finally the president of the Bolivian Congress.
Web site : http://www.catholicsforchoice.org/conscience/archives/default.aspAbstract : An exploratory study of the perceptions of 156 abortion clients in Mexico suggest that perceived quality of service was the main reason for choosing physicians while cost and anonymity were the major reasons for choosing nonphysicians. "Too young" was the most often cited reason for pregnancy termination, followed by economic situation and having too many children already. Cost was, on the average, equivalent to 3-4 weeks minimum wage; physicians' charges were about 3 times higher than those of nonphysicians. (author's)
Web site : http://www.ajph.org/cgi/content/abstract/80/6/715Abstract : Each year half of the 40-60 million abortions that are performed are illegal and/or performed in an unsafe manner. Thus, abortion accounts for 200,000 maternal deaths in developing countries annually. Treating women who had illegal abortions strains health systems, and the women face longterm morbidity and social disability. Abortion will continue to exist as long as women face unwanted pregnancies, and unwanted pregnancies will continue to occur until women gain the power to dictate their sex behavior. The severity of abortion consequences is minimized when abortion is legal and adequate services are available. Immediate consequences vary according to gestational age and the abortion setting, both of which depend upon the age and socioeconomic status of the woman. In India, abortion is legal, but legal abortion is difficult to access, so 90% of India's estimated 6.7 million annual abortions are carried out in unhygienic conditions. In countries where abortion is permitted in cases of rape or if the pregnancy endangers a woman's life, physicians must make judgements or must seek the approval of a judge. Most women who become pregnant after a rape in such countries resort to clandestine abortions. The public hospitals in Mozambique, however, interpret risk to the woman's life in the broad sense and offer safe abortions. As women's status in societies improves, the abortion rate will decrease and safety will improve. It is important to emphasize the actual implementation of current laws and to note that gynecologists and obstetricians should be sensitive to the suffering of women with unwanted pregnancies. Providing safe abortions to desperate women is not the same as promoting or even favoring abortion. Gynecologists and obstetricians can help create conditions where legal abortion is accessible to rape victims. Procedures should be developed to optimize implementation of prevailing abortion laws.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : A picture is worth more than a thousand words. Based on their confidence in that idea, Pro-Life activists in Mexico have increasingly used a series of pictures for propaganda-the miniscule feet of a fetus in the hand of a surgeon (in a photo that appears on the cover of the video The Silent Cry) or the torn head of another (on a poster hung on the streets of Mexico City during the electoral campaign for the government of the Federal District last year). These are terrible images that pound three basic ideas into one's head (or try to): (1) the fetus is a baby; (2) a baby is an innocent and defenseless person; and (3) the deliberate death of an innocent and defenseless person is the worst of homicides. The secret of the images in anchored in a reality expressed by the second and third ideas. All of us spontaneously admit that babies are innocent and defenseless persons and that killing them is the worst of homicides. However, some philosophers believe that babies are not, in fact, persons because they do not comply with a number of established requisites like, for example, intentionality. Others, like Fernando Savater, believe that it is incorrect to establish the innocence of a being before that being is capable of guilt. That is, innocence or guilt are moral choices that suppose free will, which is absent in a baby. (excerpt)
Web site : http://www.gire.org.mx/Abstract : El estudio se propuso hacer una exploración cualitativa del evento de interrumpir un embarazo no deseado. Se mira a la construcción social de lo femenino y lo masculino, acudiendo a la categoría de género como estrategia para defeminizar el análisis y para considerar las relaciones culturales y los procesos sociales en la conformación de las identidades. Puesto que la decisión del aborto inducido y el hecho mismo ponen en crisis la noción de capacidad de procreación, es un evento privilegiado para analizar la identidad "natural". Metodológicamente, se ha querido articular el componente de laidentidad genérica con las representaciones masculinas a través de los imaginarios. La investigación incluyó la realización de 60 entrevistas a profundidad, abiertas y estructuradas según diferentes componentes. Se presentan dos entrevistas paradigmáticas para caracterizar la experiencia masculina de acuerdo a la procedencia y clase social y de acuerdo al tipo de relación de pareja.
Notes : Español/espagnol/SpanishAbstract : Annotation: Far-reaching discussion of how women in highland Ecuador imagine and talk about the unborn. Compares views of abortion and fetal personhood in highland Ecuador to those predominating in US, particularly within US reproductive rights debates. Excellent research informs this ethnographic analysis. Judiciously documents men's and specialists' views of fetal personhood.
Web site : http://www.feministstudies.org/Abstract : In 1992 more than 50% of married women of reproductive age were using contraception. Between 1960-65 and 1985-90 the number of contraceptive users in the developing world increased from 31 million to 381 million: in East Asia from 18 million to 217 million, in Latin America from 4 million to 44 million, in South Asia from 8 million to 94 million, and in Africa from 2 million to 18 million. The World Health Organization defined health as a state of complete physical, mental, and social well-being, and family planning is part of this well-being. FP prevents unwanted pregnancies and the maternal mortality and morbidity that often are associated with them. The maternal mortality rate in developing countries is estimated to be 450 per 100,000 live births. There have been positive changes: the total fertility rate declined from 6.1 in 1965-70 to 3.9 in 1985-90, mainly as a result of contraceptive use. Providing FP services to women who want to avoid unwanted pregnancies could probably save the lives of 900,000 women. The estimate of abortions worldwide is 36-53 million annually, of which about 15 million are clandestine abortions. A quarter of the 500,000 maternal deaths that occur per year may be attributable to complications of unsafe induced abortions. According to a Matlab, Bangladesh, study, maternal mortality could be reduced by 14% by eliminating births to women under 20 or over 39. Adolescent births carry a 24% excess mortality, high order (7+) births a 21% excess mortality, and closely spaced births a 52% excess mortality. Sexually transmitted diseases (STDs) occur in 130 million cases annually, with more serious sequelae for women than for men. These are various asymptomatic ascending infections leading to pelvic inflammatory disease, permanent infertility, and the risk of ectopic pregnancy. Contraceptive safety has become an important issue in women's health, but safety has to be weighed against the potential noncontraceptive benefits and the inherent risk of carrying out a pregnancy.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 110073Abstract : Desde la Conferencia del Cairo, en 1994, sobre Población y Desarrollo (ICPD) , el empoderamiento de las mujeres ha sido un tema ampliamente debatido. También se ha puesto énfasis en que tal empoderamiento se tome en cuenta en los programas sociales y servicios a la población, lo que ha tenido mucho impacto en los programas de planificación familiar, en los servicios de salud reproductiva y en las políticas de población de los países latinoamericanos. En esta ponencia, nos planteamos las siguientes preguntas: ¿cómo se observa el empoderamiento de las mujeres? ¿cuáles son sus relaciones con la fecundidad? y finalmente ¿se pueden observar esas relaciones con los datos de los que disponemos?
Web site : http://www.eclac.cl/publicaciones/Poblacion/7/LCL2097P/LCL2097.pdfAbstract : Impases de la paternidad: la reproducción desde la perspectiva masculina: El tema de la paternidad ha sido abordado, generalmente, desde una perspectiva más negativa que positiva; es decir, desde los problemas que genera la ausencia del padre y no planteando una reflexión en torno a su presencia. Por ello, esta publicación se propone divulgar los resultados de las investigaciones realizadas en Brasil, Chile, Colombia, México y Perú. Ellas se centran, específicamente en el significado que tiene la paternidad para la población masculina, qué lugar ocupa en sus proyectos de vida y cuáles son las dificultades que enfrentan en esta tarea.
Notes : Español/espagnol/SpanishAbstract : El objetivo de este proyecto es generar capacidad entre quienes realizan actividades para mejorar o incrementar el acceso al aborto, ya sea a través de la reforma de la ley, o de la ampliación del acceso y la calidad de los servicios. El proyecto ofrece ejemplo del activismo iniciado en el sur, que tiende puentes y facilita el aprendizaje entre regiones y países del norte y del sur
Notes : Español/espagnol/SpanishAbstract : Introducción ; Acceso desigual al cuidado de la salud ; Diversidad cultural y social ; Calidad de la atención y selección de métodos anticonceptivos ; Integración de los servicios de atención de enfermedades transmitidas sexualmente con los de planificación familiar ; Aborto clandestino e inseguro ; Percepción de riego y protección contra las ETS y el VIH ; La salud reproductiva y sexual de los jóvenes ; Impacto de estos estudios sobre las políticas y programas
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : In Bolivia, 50% of pregnant women experience pregnancy and childbirth without any medical attention. Bolivia has the highest rate of maternal mortality in South America. Family planning programs not only teach women about the benefits of spacing children several years apart, breast feeding, good nutrition, prenatal and postpartum visits, and safe deliveries, they also reduce the incidence of abortion, help to alleviate poverty and contribute to the economic stability of a country. The government, nongovernmental organizations, and the medical community therefore joined forces to launch a nationwide family planning campaign in Bolivia. The US Agency for International Development has provided Bolivia with financial and technical assistance to establish a network of primary health care clinics. The author, US First Lady, visited one of the clinics during her trip to participate in the Sixth Conference of Wives of Heads of State and Government of the Americas. The US Congress recently slashed funds for international family planning program assistance by 35% and added restrictions on the delivery schedule of aid for the first 9 months of the fiscal year. Similarly harsh cuts and delays are included in the current budget. A recent analysis by five population organizations found that these funding cuts will result in 1.6 million more abortions, more than 8000 maternal deaths, and 134,000 infant deaths in developing countries. Policymakers must be made to understand that family planning campaigns in operation in Bolivia and elsewhere are sensible, cost-effective, and long-term strategies for improving women's health, strengthening families, and lowering abortion rates.
Web site : http://www.prb.org/template.cfm?Section=Population_Today1 Template=/PopulationToday.cfmAbstract : This paper describes patients' and providers' perceptions of the quality of care in the treatment of 132 women who arrived at the emergency room of a public hospital in Oaxaca, Mexico, with complications of abortion, whether spontaneous or induced clandestinely. This hospital was interested in assessing and improving its services. Questionnaires, on-site observation and indepth interviews revealed insensitive personal treatment by rushed staff, apparent lack of concern for women's emotional state, lack of privacy during examinations, poor attention to pain management, and long waiting times for treatment. Women were getting insufficient information about their condition before and after treatment, the treatment itself and contraception. Dilation and curettage was almost always used for uterine evacuation, although manual vacuum aspiration is the preferred method. Post-abortion uptake of contraception by women wishing to avoid pregnancy was low. Based on these findings, an intervention was developed to improve quality of care, both from a medical standpoint and as regards access to information, counselling and personal interaction.
Web site : http://www.rhmjournal.org.ukAbstract : The setting ; Before the intervention ; The intervention: improving the quality of postabortion care ; Results of the intervention ; Lessons learned ; References.
Notes : Inglés/anglais/English, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This article outlines the project undertaken in Oaxaca, Mexico, from June 1995 to December 1997 by the Population Council and the Dr. Aurelio Valdivieso General Hospital. The project aimed to test a model for improving the quality of postabortion care in Mexico's public services. A comprehensive design was utilized and emphasis was on exchange of information: listening to patients and providing good counseling. Overall, the project study showed that it is possible to improve the quality, effectiveness, and efficiency of postabortion care programs in public hospitals that are often underfunded, understaffed, and short in medical supplies. Using both quantitative and qualitative methods to assess impact of the program, findings indicate that attitudes and practices of clinicians can be favorably modified, even in dealing with sensitive matters like abortion. In addition, it is evident that women appreciate good quality care and welcome a greater cluster of services when the attention provided is more humane and adapted to their physical as well as emotional needs.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 147371Abstract : Complications from abortions are among Latin America's primary causes of maternal morbidity and mortality. This study assessed the quality of postabortion services provided through the hospital and train health providers in the use of safer medical techniques and better family planning (FP) counseling and services. Researchers interviewed and examined the medical records of 132 postabortion patients and interviewed service providers. Overall, the study developed a profile of the women who come to the hospital with incomplete or complicated abortions, and provides information on the quality of care provided. It humanized the postabortion procedure by presenting information about the fear, pain, and waiting times endured by women seeking treatment for incomplete abortion, and demonstrated the high health system costs of the procedure. Based on the results, project staff designed an intervention to improve quality of care. The strategies included: adopting standardized protocols for postabortion treatment and routine provision of FP counseling and methods; staff training in manual vacuum aspiration and provider-patient relations; and development of a series of information, education and communication pamphlets on complications for patients; and development of a series of posters for providers on interpersonal relations.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159893Abstract : This paper presents the findings of an operations research project that assessed the effects of integration of treatment of abortion complications with postabortion family planning counseling and services in Lima, Peru. The study focused on clinical treatment services, postabortion family planning, information provided to patients, women's pain perceptions, service delivery organization, costs to both the hospital and patient, and potential for long-term sustainability of the integrated model. It used a quasi-experimental, pre-post intervention design and was conducted at National Hospital "Daniel Alcides Carrion. The information sources for the study include the following: patient exit interview; clinical history form; cost and resource use component; logbook review; and in-depth interviews with patients, providers, and policy-makers. Findings showed that in most hospitals in the region, family planning offered to postabortion patients was virtually nonexistent prior to the implementation of the integrated model. Improvements in postabortion family planning were facilitated by the presence of a strong family planning clinic in the hospital. Sustainability should be a major goal of any postabortion care (PAC) model. Incorporation of manual vacuum aspiration and other PAC content into routine obstetrics-gynecology training for residents and other staff was a landmark for sustainability. Hospital officials rated the prospects for sustainability of the integrated PAC services as high.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 136511Abstract : Every year in Latin America about 800,000 women are treated in hospitals for complications due to unsafe abortions. Post-abortion care (PAC) services are often characterized by low quality and high costs. In order to address this, an operations research study was conducted at the Carrion Hospital in Lima, Peru. A baseline survey identified multiple problems, including inadequate linkages to family planning (FP) services and inefficient care leading to an average hospital stay of over 33 hours. The intervention phase included training in post-abortion FP and manual vacuum aspiration (MVA), changes in clinical and counseling protocols, delivery of FP information and services and reorganization of PAC from an in-patient to an out-patient service. PAC services improved dramatically, including an increase in the use of MVA from nil to 89% of appropriate cases and an increase in the proportion of women receiving FP information from 18% to 78%. There were significant cost savings to the hospital, from US$119 for sharp curettage in hospitalized patients in the baseline to US$45 for patients treated with MVA as out-patients. Based on this information, the hospital director lowered the fees charged to patients by half. 3 years after completion of the study, high quality services continue at the hospital. (full text)
Web site : http://www.rhmjournal.org.ukAbstract : A pilot project aimed at assessing the feasibility of carrying out a program to improve the quality of services for postabortion complications, including contraceptive counseling and services, and the impact on client satisfaction was undertaken in Bolivia. In this paper, the results of the pilot project undertaken in three public-sector hospitals from October 1995 through December 1997 are presented. Overall, findings show that it is feasible to implement a postabortion program that significantly improves the quality of care, including contraception acceptance, in the postabortion period, and in resource-constrained facilities. Success of the project is indicated in the request from the Ministry of Health and the directors of the women's health division to maintain the activities in the hospitals and to replicate the project in other regions of the country. These organizations are not those who authorized and initiated the project. In conclusion, the challenge for the three hospitals is to maintain and improve the quality of services being provided after exhaustion of resources and full adoption of the service activities.
Web site : http://www.fhi.orgAbstract : In October 1998, Pathfinder undertook an evaluation study of the Pathfinder/Ministry of Health postabortion care project in six participating hospitals in Peru. The study assessed the impact of training, postabortion family planning acceptance, and client satisfaction. Furthermore, it also examined institutional issues as whether or not trainees were still using the new skills they had learned. Evaluators interviewed 38 physicians and 24 nurses and midwives, observed 16 physicians performing the manual vacuum aspiration (MVA) procedures, and observed the counseling skills of 6 nurses/midwives. Evaluators also conducted interviews with 46 clients. Results revealed that MVA was used to treat incomplete abortion, that there was availability of family planning services in all participating hospitals, and that there was a change of staff attitude towards postabortion patients (93%), with 48% treating patients with respect while 37% paid more attention to clients. On the other hand, 24% of postabortion patients were using a family planning method at the time of their pregnancy, with an increase in contraceptive acceptance from 0 to 43% (pill, 45%; injectable and IUD, 20%). Several reasons were cited for contraceptive rejection: assurance of recovery (35%); not being offered contraception (35%); unavailability of and lack of information about family planning (15%). The majority of clients were satisfied with the program. This evaluation reveals a significant improvement in the delivery of postabortion services, with plans of future expansion of the project to 20 more hospitals.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 147306Abstract : A major abortion study was carried out in three peri-urban communities of metropolitan Santiago, Chile. Its aim was to assess ways of identifying women at high risk of induced abortion and to lower the rates of induced abortion in areas where the occurrence of induced abortion was known to be high. The first phase consisted of a baseline survey of three low-income urban communities in metropolitan Santiago. On the basis of the results of this survey a predictive instrument was devised that was later used to identify women at high risk of abortion. The survey and work on the predictive instrument was followed by an intervention phase which lasted 18 months. This included: improved family planning services and visits to households of women classified as being at a high risk of induced abortion in one of the communities; improved services but no special home counselling in the second community; and no intervention in the third (control) community. An important finding was that even with highly committed and very well trained interviewers women underreported induced abortions or reported them as spontaneous abortions. The study, however, demonstrated clearly the impact of the intervention. Over a two-year period, the abortion rate fell by 20%, and in the area of some intervention by 9%; the rate increased by 30% in the control community. These findings have been used to improve family planning services in low-income communities and in the design of reproductive health services for adolescents in poor areas of the city. (full text)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 099573Abstract : In September 1993, a two-day symposium on abortion legalization was held in Chile, where abortion, which had been legal since the 1930s, was banned by the outgoing military junta in 1989. Organizers of the symposium labeled the ban "a law to punish and to be flaunted," and, indeed, each year approximately 200,000 Chilean women resort to abortion and more than 30,000 are hospitalized for abortion complications. It has been estimated that one woman has died of abortion complications in Chile each week for the past five years. Legislation proposed in 1991 to reinstate therapeutic abortion has stalled because of broad spectrum political opposition, pressure from the Roman Catholic Church, and upcoming elections. In this politically hostile climate, 43% of respondents in a poll said abortion should be permitted in certain cases, 3% said it should be available to all women, and nearly 53% upheld the ban. Research on public support for abortion has indicated that opinions about abortion depend upon the phrasing of the questions and that women's attitudes towards abortion are shaped by their experiences and those of their relatives and friends rather than by legal or religious prohibitions.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : This paper characterizes the Mexican abortion laws using the case of a girl aged 14 years, Paulina Ramírez Jacinta, who was raped, became pregnant, and chose to terminate the unwanted pregnancy, yet was denied an abortion. This case clearly showed that Mexican abortion law, despite its legality, is highly restrictive in nature and, in a way, violated the human rights of Paulina. Even though it permits first-trimester abortion procedures for rape victims or women whose lives are endangered by the pregnancy, many pregnant women still resort to illegal abortion. To further aggravate the restrictive nature of the law, Baja California state Rep. Martin Dominguez Rocha made a proposal to eliminate the rape exception in the state's penal code. The case of Paulina will be handled by the lawyers at the Center for Reproductive Law and Policy in order to arrive at a settlement favorable to Paulina.
Web site : http://www.crlp.org/rfn_2001.htmlAbstract : A study was conducted at the Women's Hospital in Mexico City, Mexico, to understand the reasons why women resort to induced abortion. Another objective was to assess the opinions of health personnel that provide care for abortion complications. A sample of 300 women hospitalized for abortion complications were interviewed as well as 120 physicians, nurses, social workers, and family planning staff. Abortion complications represented close to 20% of the yearly maternity ward admissions at the hospital. A total of 28% of the women studied were under 20 years of age, 60% had only some primary schooling or less, and 68% were single or living in common-law unions. 46% had never used a method of contraception, yet 70% did not want to become pregnant. Some women decided to abort for economic reasons in order to be able to provide adequately for the children they already had; others reported that they could not have the child because they were not married. The methods used for inducing abortion included injections and falling from heights or down a flight of stairs. The study found that for most women the decision to abort entailed anguish, fear, and a painful journey to the hospital to seek help when complications became serious. Men were not reported to be involved in this process. The results have been presented to the Director-General of Maternal and Child Health Care of the Ministry of Health of Mexico, who has used them to seek improvements in the service conditions in public hospitals. The authorities at the Women's Hospital have also agreed to take steps to improve the general quality of service. Another important aspect is that the issue of abortion is being studied as a reproductive health problem, particularly in Mexico where abortion is illegal.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 099517Abstract : Paternostro, a journalist, senior fellow at the World Policy Institute, and native of Columbia (she's lived in the United States since age 15), examines the influence of traditional Catholic policy and male machismo on Latin American women, whose success is measured by marriage and motherhood. . . . Young Latinas (she argues) become victims of unwanted pregnancies, clandestine abortion, and, increasingly, AIDS, as a result of this church- and male-dominated culture, which prohibits legal reproductive choice while simultaneously condoning promiscuous male bisexual practices." (Libr J) Index.
Notes : Inglés/anglais/EnglishAbstract : Niveles estimados de aborto inducido en seis países latinoamericanos / Susheela Singh y Deirdre Wulf ; La incidencia del aborto en Colombia / Lucero Zamudio, Norma Rubiano y Lucy Wartenberg ; Interrupções da gravidez no Brasil / Mário F.G. Monteiro ; El aborto en el Perú : estudio epidemiológico hospitalario en las ciudades de Iquitos, Piura y Puno, Perú / Jesús L. Chirinos, Luis Sobrevilla y Elsa Alcántara ; Aborto complicado : la punta de iceberg de la práctica clandestina / Elena Prada ; Mortalidade por aborto : a causa não declarada / Néia Schor ... [et al.].
Notes : Español/espagnol/SpanishAbstract : La población mundial a través de los años ha mostrado un crecimiento progresivo y constante, sin embargo; en el último siglo tuvo un incremento sorpresivo, por un elevado nivel de fecundidad en muchas regiones del mundo que contrastaba con que empezando el siglo XX la fecundidad bajó drásticamente en países desarrollados, sobre todo en Europa, y a fines de los sesentas empezó a caer en la América Latina debido a fenómenos que serán examinandos. Para explicar el descenso tan marcado de la fecundidad en los últimos años no es suficiente el hecho de que las mujeres deseen tener menos hijos, sino que actúen otros factores llamados determinantes contextuales o indirectos, y determinantes próximos. La presencia del aborto inducido como un determinante de la fecundidad debería tener la menor influencia dentro del resto de variables intermedias, como expresión de una comunidad saludable
Web site : http://www.eclac.cl/publicaciones/Poblacion/7/LCL2097P/LCL2097.pdfAbstract : Unsafe abortion constitutes a significant public health problem throughout the world. WHO defines unsafe abortion as a procedure either by persons lacking the necessary skills, or in an environment lacking the minimal medical standards, or both. Approximately 20 million women undergo an unsafe abortion each year; and estimated 70,000 women die from related complications, such as uterine perforation, sepsis or poisoning, and countless others suffer short and long-term consequences, such as chronic pain and infertility. Globally, 13-14% of all pregnancy-related deaths are attributable to unsafe abortion, while in some settings this figure rises to as high as 60%. This translates into 75-80,000 women each year who dies because of restrictive abortion legislation, lack of implementation of existing legislation allowing abortion under certain conditions, and lack of accessible safe services. In developing countries, 65% of all women face legal restrictions related to abortion, while in developed countries 71% has unrestricted access to safe abortion services. (author's)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 170445Abstract : Esta publicación tiene el propósito de compartir un breve análisis situacional del acceso al aborto seguro y legal en Centroamérica,elaborado a partir de un foro con los puntos focales de la Campaña 28 de Septiembre de Nicaragua, Costa Rica, El Salvador y Guatemala y otras activistas de la región que están luchando para que las mujeres centroamericanas que enfrentan un embarazo no deseado, tengan la opción de interrumpirlo de forma legal y sin restricciones, con acceso a servicios seguros y de alta calidad.
Web site : http://www.ipas.org/publications/es/INCACNI_S03_es.pdfAbstract : Es un llamado a activistas, legisladores y a los diseñadores de políticas para cumplir con los compromisos establecidos por los gobiernos del mundo en la Conferencia Internacional sobre Población y Desarrollo en El Cairo, en 1994. Un compromiso para garantizar que el aborto, donde es legal, sea seguro con el fin de proporcionar servicios de calidad para las mujeres y asegurar la reducción del aborto riesgoso
Notes : Español/espagnol/SpanishAbstract : This article discusses the problems of unsafe abortion globally. Maternal mortality from pregnancy-related causes is an estimated 500,000 women per year, of which 99% occurs in developing countries. An estimated 30-50% of all maternal deaths in Africa and Latin America and 20-25% of maternal deaths in Asia are due to induced abortion. This amounts to about 100,000-200,000 women per year dying of complications of induced abortion. Abortion-related deaths are a product of unsafe abortion procedures resulting in lacerations, bleeding, and/or infections. For every maternal death, 10-15 women suffer from pregnancy-related morbidity. This results in about 5-7.5 million women suffering from nonfatal health problems related to pregnancy and childbearing yearly. Morbidity related to induced abortion may result in disabilities such as infertility, genito-urinary problems, and/or chronic pain. Developing countries with limited health resources are faced with expensive emergency treatment and demands on facilities and personnel for abortion complications. A 1971 study in Egypt found that abortion complications consumed about 50% of the entire budget of one maternity hospital. Abortion laws vary by country. About 25% of women live in countries that prohibit abortion except in life-threatening circumstances. About 12% live in countries that prohibit abortion, except in cases of rape or life-threatening illness. About 23% of women live in countries where abortion is permitted for medical and social reasons. About 40% of women live in countries that legally permit abortion. Findings suggest that legally available abortion is a prerequisite for medically safe and early abortion. The risk of death is 25-250 times greater for a woman who undergoes an unsafe abortion in a developing country compared to a woman in a developed country. The most effective way of reducing unsafe abortion is to reduce unwanted pregnancy.
Web site : http://www.blackwellpublishing.com/journal.asp?ref=0001-6349Abstract : This is a continuation of a series of reports presenting data on induced abortion around the world. It contains a reprint of an article by Stanley K. Henshaw, together with selected tables updating the data presented in the sixth edition. The data are mainly by country and include time series. (ANNOTATION)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - 091295Abstract : Induced abortion is a serious public health problem in Latin America. Compared to conditions in the more developed countries, induced abortions in Latin America are accompanied by relatively high abortion-related mortality. Moreover, large numbers of women suffer serious health complications from the procedure. It is clear, however, that almost all health complications and abortion-related deaths could be avoided through the combination of accessible and appropriate family planning services together with the provision of high quality abortion services. Much remains to be done to improve the quality of services available and to ensure that women with abortion complications receive prompt and appropriate care. Liberalization of abortion legislation combined with the provision of appropriate and accessible services is the most effective approach and solution. However, even within the context of restrictive legislation, efforts should continue to improve the quality of services and referral systems.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 121347Abstract : This study aimed to identify the factors associated with induced abortion in the first pregnancy in young women and in the first time young men got their partners pregnant. The methodology was a household survey with face-to-face interviews in a probabilistic sample in three stages with 4,634 subjects, aged 18 to 24 years of age residing in the cities of Salvador, Rio de Janeiro, and Porto Alegre, Brazil. Logistic regression analysis was used with a hierarchical strategy for entering variables into the model. Abortion was the reported outcome of the first pregnancy for 16.7% of the women and 45.9% of the men (in relation to their partners). Key factors associated with abortion included higher schooling and the occasional nature of the relationship with the male or female partner in the respective pregnancy. Inclusion of males in the study provided new elements for understanding the abortion phenomenon, including in the gender issues in discussion of the theme. The authors recommend greater public investment to warrant access to information and means for young people to achieve their reproductive plans in a security and healthy way, respecting their sexual and reproductive rights.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X2006000700008 lng=es nrm=isoAbstract : This paper analyses the present state of knowledge on induced abortion in Latin America based on a critical review of information from regional meetings and seminars in the 1990.3 and articles in international journals in the field. It focuses on the incidence of abortion, the abortion Decision making process, and the political and public dimensions of induced abortion, and discusses theoretical and methodological aspects of abortion research, and ethical and political concerns. It calls for the consolidation of the data obtained to date; the introduction of new theoretical frameworks and approaches from other disciplines; the reduction of inequalities in the available knowledge between countries in the region through national and comparative research; and deeper analysis of the political dimensions of induced abortion, particularly matters of legislation, public debate and health programme development.
Web site : http://www.rhmjournal.org.ukAbstract : This study examined the reasons for induced abortion among women in Matlab, Bangladesh, and the multiple determinants of abortion. Data were obtained from the longitudinal surveillance system among about 75,000 pregnancies during 1982-91 in Matlab and comparison areas. Explanatory variables were age, parity, pregnancy interval, contraceptive use prior to pregnancy, maternal education, household space, study area, and calendar year of pregnancy termination. Of the 33,473 pregnancies during 1982-91 in the treatment area, 30,110 were live births, 1689 were miscarriages, 1064 were stillbirths, and 610 were induced abortions. The abortion ratio was 20/1000 live births in the treatment area and 33/1000 in the comparison area. Abortion ratios increased over time in both areas. The induced abortion ratio increased with maternal age and parity. The risk of induced abortion was much higher if the former pregnancy interval was under 12 months. Likelihood of induced abortion increased with maternal education and household space in both areas. The induced abortion ratio in the treatment area among contraceptive users in the former pregnancy were twice that of nonusers. Proportional hazards models indicate that abortion was more common among women with higher parity, shorter pregnancy intervals, more education, and higher socioeconomic status. During 1992-95, induced abortion and miscarriage declined in the treatment area. Higher ratios among users of some contraceptive methods suggests a link with use-failure rates. The lower level of abortion in the treatment area suggests successful maternal-child health and family planning programs.
Web site : http://www.guttmacher.org/pubs/journals/2412898.pdfAbstract : To enable donor agencies and family planning program managers to estimate future needs for contraceptive supplies in developing countries, data drawn from 106 Demographic and Health Surveys and Contraceptive Prevalence Surveys conducted in 35 Third World countries between 1974 and 1992 were reviewed. At least 2 surveys, conducted a minimum of 2 years apart, were used to permit calculation of changes in total and method-specific prevalence and annual rates of change. At the time of the most recent survey, 44% of respondents were using contraception and 35.5% were using a modern method; these rates were 31.6% and 24.0%, respectively, at the initial survey. Total contraceptive prevalence increased at an annual rate of 5%, while modern method use increased by 6%. Sterilization acceptance increased by 8% each year, while use of the pill, IUD, and condom registered annual increases under 2%. In 30 of the 33 countries for which data were available, the prevalence of sterilization grew at a substantially faster rate than that of other modern methods. Overall, these findings suggest a need for caution against unrealistically high forecasts of the demand for supply-based contraceptive methods. On the other hand, the population group eligible for contraception is increasing by 2-3% each year. It remains uncertain whether the increased availability of injectables and implants will result in greater overall contraceptive prevalence or simply substitute for pill, IUD, and condom use.
Web site : http://www.agi-usa.org/pubs/journals/2210896.pdfAbstract : The worldwide trend toward liberalization of abortion laws has continued in the last 4 years with changes in 10 countries. Laws have also become more restrictive in 4 countries but in ways that will affect few women. 40% of the world's population now lives in countries where no specific justification is required to obtain an abortion, and 25% lives where an abortion is allowed only if the women's life is in danger. Legal abortion rates range from a high of at least 112 abortions/1,000 women of reproductive age in the Soviet Union to a low of 5/1000 in the Netherlands. In recent years, abortion rates have been increasing in Czechoslovakia, England and Wales, New Zealand and Sweden and declining in China, France, Iceland, Italy, Japan, the Netherlands and South Korea. Mortality from legal abortion averages 0.6 deaths/100,000 procedures in developed countries with data. Abortion services are increasingly being provided outside of hospitals and for those performed in hospitals, overnight stays are becoming less common. Suction curettage and dilation and evacuation, the safest methods, are increasingly being used in developed countries but are unavailable in some developed as well as developing areas, especially where abortion is legally restricted. (Author's).
Web site : http://www.guttmacher.org/Abstract : The worldwide trend toward liberalization of abortion laws has continued in the last 4 years with changes in Canada, Czechoslovakia, Greece, Hungary, Romania, the Soviet Union and Vietnam. 40% of the world's population now lives in countries where induced abortion is permitted on request, and 25% lives where it is allowed only if the woman's life is in danger. In 1987, an estimated 26 to 31 million legal abortions and 10-22 million clandestine abortions were performed worldwide. Legal abortion rates ranged from a high of at least 112 abortions/1,000 women of reproductive age in the Soviet Union to a low of 5/1,000 in the Netherlands. In recent years, abortion rates have been increasing in Czechoslovakia, England and Wales, New Zealand and Sweden and declining in CHina, France, Iceland, Italy, Japan and the Netherlands. In most Western European and English-speaking countries, about 1/2 of abortions are obtained by young, unmarried women seeking to delay a 1st birth, while in Eastern Europe and the developing countries, abortion is most common among married women with 2 or more children. Mortality from legal abortion averages 0.6 deaths/100.000 procedures in developed countries with data. Abortion services are increasingly being provided outside of hospitals, and for those performed in hospitals, overnight stays are becoming less common. National health insurance covers abortions needed to preserve the health of a pregnant woman in all developed countries except the United States, where Medicaid and federal insurance programs do not cover abortion unless the woman's life is in danger. (author's)
Web site : http://www.guttmacher.org/Abstract : contenido: A pesar de la magnitud y de la visibilidad social del aborto ilegal enBrasil, prácticamente no existe información sobre las opiniones y las prácticas de los médicosrespecto de esta cuestión. Este estudio se basó en entrevistas en profundidad realizadas a 151médicos que trabajan en 4 grandes hospitales públicos de Río de Janeiro. La muestra se estratificópor especialización y por género, e incluyo a obstetras/ginecólogos, pediatras y especialistas enortopedia, seleccionados al azar dentro de estos estratos. La información no evididencia que lasmédicas brasileñas sean mas favorables a la legalización del aborto que los médicos. Los patronesde las diferencias por especialidad sugieren que es importante prestar atención a las diferenciasinternas de la medicina. La especialidad médica parece ser una variable que, al hacer análisisgeneral de las actitudes de los médicos acerca del aborto, tiene mas poder explicativo que elgénero o la práctica religiosa. Por otra parte, estos factores sociales pueden haber influido sobreel ingreso a ciertas especialidades medicas. La especialidad interactua con el género y la prácticareligiosa en una forma compleja en el tiempo.
Notes : Inglés/anglais/English, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Documentación sobre el infanticidio y el aborto durante la Colonia, reseña a partir de sucesos documentados del tratamiento legal (auspiciado por la iglesia) que se llevaba a cabo, así como los castigos señalados a las jóvenes que decidían por cualquiera de éstas dos opciones
Web site : http://www.rtve.es/tve/informa/enotras/Abstract : En los últimos treinta años, América Latina ha experimentado un descenso sostenido de las tasas de fecundidad y un incremento marcado en el uso de métodos de planificación familiar. Sin embargo, muchas mujeres aún se encuentran atrapadas en el círculo de embarazos no deseados y de prácticas ilegales del aborto, lo que evidencia una inmensa necesidad insatisfecha de contar con métodos que sean seguros, eficientes y de bajo riesgo para la salud de la mujer. El objetivo de esta investigación fue determinar sí el ofrecimiento de una técnica de consejería, la que incluía aspectos sobre riesgo reproductivo y planificación familiar post-aborto, ofrecía iguales o mejores resultados de aceptación y continuidad en el uso de métodos de planificación familiar comparado con una técnica de información que brindaba una orientación más superficial y escueta. Se trató de un estudio clínico randomizado, multicéntrico con una muestra de 945 mujeres con diagnóstico de abortos incompletos y que no presentaron complicaciones. En Panamá, los resultados indicaron lo siguiente: se obtuvieron 134 pacientes de información y 132 de consejería. La mayoría de éstas estaban entre los 20 a 29 años, mantenían uniones consensuales y tenían entre 3 hijos y más. La mayor parte no presentaban antecedentes de aborto y habían utilizado métodos anticonceptivos en algún momento, aunque al presentarse este embarazo, no usaban ninguno. El 71% de las pacientes de información aceptó utilizar cualquier método después de la técnica educativa, en contra de un 74% de las de consejería. Existieron diferencias significativas en lo que respecta a visitas a clínicas posterior a la técnica educativa, donde se observó que las pacientes de consejería tuvieron mayor asistencia al centro de salud que las de información (p<0.05). Es sumamente importante que los profesionales de la salud aprovechen el momento del post-aborto para ayudar a la mujer a encontrar una solución que funcione para postergar o espaciar embarazos no deseados.
Notes : Español/espagnol/SpanishAbstract : Diagnóstico con los resultados de programas sobre salud reproductiva implementado en Cuba. Comprende las estrategias del enfoque de riesgo de los programas de planificación familiar, el cual consiste en identificar a aquellas parejas con algún riesgo reproductivo antes de decidir el embarazo. Acepta el principio de que el derecho a los servicios de aborto seguro es un derecho reproductivo
Notes : Español/espagnol/SpanishAbstract : Uniendo esfuerzos ; Introducción ; Antecedentes ; Objetivos de la reunión ; 42 Preparación de la reunión ; Presentaciones RMMDR-RSMLAC ; Debate ; Informe de diagnóstico de las condiciones de salud y la mortalidad materna en los diferentes países de la región ; Región del Caribe ; Región Andina ; Región México y América Central ; Región del Cono Sur ; Análisis político de la situación actual y del movimiento de salud de las mujeres ; Temas, propuestas y estrategias ; Rol de las oficinas y de las redes ; Plenaria de acuerdos ; Opiniones de las participantes acerca del encuentro ; Directorio de las participantes.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : La Ley 18 del 22 de septiembre de 1982 y el resuelto 02007 del 2 de febrero de 1988, crean la Comisión Multidisciplinaria Nacional de Aborto Terapéutico, la cual es la responsable de elaborar las normas nacionales que rigen la materia. Para tener derecho a este tipo de aborto, las solicitantes deben llenar solicitudes que contengan el consentimiento por escrito de la mujer, informe médico que especifíque o sustente el o los diagnósticos motivos de la solicitud y exámenes de laboratorio o complementarios que confirmen el diagnóstico. Esta solicitud es evaluado por la Comisión la cual determina si las causas ameritan la interrupción del embarazo y se informa de inmediato y por escrito a la paciente y al médico referente a la decisión tomada. De 1990 a 1998 se presentaron 193 solicitudes, de las cuales se aprobaron un 67%. De entre ellas, el 17% correspondía a madres adolescentes entre 10 y 19 años. En este grupo fue rechazado el 43% de ellas, de las cuales, la gran mayoría (73%) estaba asociada al abuso sexual, situación que no fue de competencia de la Comisión, sino del Instituto de Medicina Legal, que es ordena el aborto, luego de haber hecho investigaciones. Entre las principales causas estuvieron asociadas razones como: infección por rubéola en el primer trimestre (58%); malformaciones congénitas (10%); VIH/SIDA (10%); pero es importante destacar que a partir de 1995 las solicitudes por este motivo son rechazadas a no ser que existan motivos que indiquen lo contrario. Los rechazos de solicitudes se debieron, sobre todo , a casos relacionados con rubéola no comprobada serológicamente, solicitudes por retraso mental de la madre, antecedentes de embarazo producto de violación o incesto y madres con VIH/SIDA con embarazo de 23 semanas.
Notes : Español/espagnol/SpanishAbstract : La investigación aporta insumos cualitativos para el diseño de políticas y estrategias de salud reproductiva, desde una perspectiva sociocultural y de género. Tuvo el objetivo de contribuir a la disminución de la morbimortalidad asociada al embarazo no deseado y el aborto en el Distrito III de la ciudad de El Alto. En la Fase I, se realizaron 100 entrevistas en profundidad con 92 usuarias/os y proveedores/as de servicios de salud del Distrito. El estudio sirvió para elaborar un diagnóstico y recomendaciones para estrategias dirigidas a abordar factores que influyeron en la incidencia del embarazo no deseado y el aborto en el Distrito.
Notes : Español/espagnol/SpanishAbstract : Since 1998, CHANGE has been working with colleagues in Peru to expand the reproductive health options available to women. Their work has included conducting secondary research and analysis on the constraints women face in exercising reproductive choices and advocating for donor and government policy changes to address these constraints, including expanded access to emergency contraception (EC). (author's)
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Contenido: Prólogo ; Presentación ; REFLEXIONES Y PUNTOS DE VISTA, Una respuesta factible , Todos estamos convocados , A favor de la vida , Una lectura desde la medicina preventiva , Un esfuerzo positivo y serio , El aborto provocado: su dimensión psicosocial, Responsabilidad a través del conocimiento , Reflexiones para la adecuación jurídica , Comisión de Género y Políticas de Salud del Sindicato Médico del Uruguay ; INICIATIVAS SANITARIAS CONTRA EL ABORTO PROVOCADO EN CONDICIONES DE RIESGO, Normativa de atención sanitaria, Fundamento epidemiológico, Fundamentos bioéticos, Fundamentos médico-legales , Breves referencias al delito de aborto ; PAUTAS DE IMPLEMENTACIÓN, Guías clínicas de la normativa sanitaria ; ANEXO I, Formulario de recolección de datos, Implementación de las guías de práctica clínica ; ANEXO II, Formulario de notificación obligatoria
Web site : http://www.smu.org.uy/biblioteca/libros/aborto.pdfAbstract : Prólogo ; El panorama mundial ; El cambio demográfico ; La discriminación en contra de las mujeres ; La planificación familiar ; La mortalidad materna ; El aborto ; El SIDA ; Los adolescentes ; Los derechos de la mujer
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : To identify reproductive intentions and fertility regulation practices, including contraception and abortion, in a group of high schooling adolescents and young adults. METHODS: The data were gathered from a large quali-quantitative study carried out among University of São Paulo undergraduate students aged up to 24 years. The study sample consisted of 952 students who attended the university courses and were randomly drawn. In this first step, a self-administered questionnaire was applied to the students in the classroom. On the next step, in-depth interviews were applied to 33 volunteer students in a preset place. RESULTS: It was observed that the students' idealized family model is to have up to two children. The optimal age for having a first child is close to 30. The students referred high contraceptive use, especially condoms and the pill. High proportion of abortion was also observed. Consequently, fertility is considerably low in the study group, i.e., 27 students reported having one or more pregnancies. Qualitative data were not analyzed. CONCLUSIONS: Although the idealized family size reflects a general trend in the Brazilian society, it can be noted that the group delays maternity/paternity for the sake of a life project of getting a university degree and having autonomy. Despite that, contraception and prevention of sexually transmitted diseases are poor.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89102004000400003 lng=en nrm=isoAbstract : The objectives were to review the published literature on abortion in three regions in order to identify gaps and recommend future research efforts. Databases were searched in-depth from sub-Saharan Africa covering 1980-94. Annotations were prepared on 99 articles dealing with epidemiology, clinical, cost, and legal issues, male perspectives, contraception, and postabortion family planning. Limited search of the abortion literature from Latin America and Asia for 1985-94 was also carried out, and abstracts were completed on 14 Latin American and 25 Asian articles. Major findings for 41 epidemiology studies from Africa revealed maternal mortality of 2-6/1000 live births; 18-35% of maternal mortality from abortion; 27-60% of gynecology admission attributable to abortion; sepsis and hemorrhage were the main causes of abortion with young women overrepresented in septic cases and abortion deaths; abortion patients were young, unmarried, and low parity was overrepresented. Findings from 19 clinical studies from Africa indicated the disproportionate impact of major complications on mortality and length of hospital stay; manual vacuum extraction had same or lower complication rates and same or better effectiveness as dilatation and curettage; sexually transmitted diseases and pregnancy-related infections were major contributors to infertility. Findings from 18 studies on abortion and the law from Africa showed narrow legal indications and restrictive laws, administrative barriers, and consequent detriment to women's health. Gaps in research in Africa included cost use of abortion complications, postabortion family planning, and male perspectives. The findings of 14 studies from Latin America demonstrated the social context of abortion, women's and providers' perspectives, and low contraception knowledge and use. Finding from 25 Asian studies revealed the focus on mortality rate and second trimester, family planning use prior to index abortion, and postabortion family planning. Recommended research topics consisted of impact of abortion, access to services, contraceptive use pre- and postabortion, underserved populations, new technologies, social context of abortion, and feasibility of legal reform.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 101572Abstract : Contenido: Introduction ; Abortion: the global situation ; Legalizing abortion: a key step in making abortion safe and accessible ; Making safe abortion accessible: issues of service provision ; Medical advances in abortion: developments and implications ; Advocating aabortion as an issue of public health and women´s rights: the challenges ; Linking abortion to sexuality, desire and subjectivity ; Countering the opposition to abortion ; Strategies to promote access to safe, legal abortion ; Advocacy at the international level: actors, agenda, possibilities ; International solidarity campaign ; Conclusion: recommended action steps ; Program Directory of participants ; Abortion situationers.
Web site : http://www.gire.org.mx/Abstract : Presenta un panorama de las posturas que se debaten en torno al tema del aborto; adoptando la reconceptualización del término y eliminando su carga moral al definirlo como la"interrupción voluntaria del embarazo
Web site : http://serpiente.dgsca.unam.mx/ceiich/publicaciones.php?vId=210 vId_h=9 vTitulox=Feminismo%20y%20Alternativas%20SocialesAbstract : Los compromisos establecidos en El Cairo y Beijing, reconocen que el aborto inseguro constituye un problema grave de salud pública, en tanto que ponen en peligro la vida de un sinnúmero de mujeres, por ello recomendó que las mujeres que han acudido a su práctica deben ser atendidas de manera pronta y humanitaria. El tratamiento punitivo que se le ha dado al aborto en estos países, no viola únicamente las obligaciones contraídas por los Estados al suscribir los tratados internacionales de derechos humanos, sino que limita el goce y ejercicio de los derechos y libertades fundamentales de las mujeres reconocidos a nivel mundial, entre ellos, el derecho a estar libre de discriminación debida al género, el derecho a la intimidad, a la salud, a la vida, a la libertad y a la seguridad.
Web site : http://www.catolicasporelderechoadecidir.org/publicacionesAbstract : Le nombre d'interruptions volontaires de grossesse (IVG) est évalué à 203 300 en France métropolitaine en 2003, soit une réduction de 1,6 % par rapport à l'année précédente. Le nombre d'IVG pour 1 000 femmes âgées de 15 à 49 ans est ainsi estimé à 14,1 en 2003, contre 14,4 en 2002. 80 % des femmes concernées en 2003 avaient entre 20 et 39 ans. Les taux de recours à l'IVG demeurent néanmoins très différenciés selon les générations, allant de 26,7 pour 1 000 chez les 20-24 ans à 5,6 pour 1 000 chez les femmes âgées de 40 à 44 ans. 11 000 mineures ont en outre eu recours à une IVG en 2003, ce qui correspond à un taux de recours de 9,6 pour 1 000 en 2003, en croissance régulière depuis le milieu des années 90. Deux IVG sur trois ont toujours lieu à l'hôpital public, et 38 % des IVG se font désormais par voie médicamenteuse (+3 points). La part de ces dernières devrait continuer à augmenter avec l'élargissement, à partir de 2004, de cette pratique à la médecine de ville. Les IVG restent plus fréquentes dans le sud de la France, en Île-de-France, et dans les départements d'outre-mer, indépendamment de la structure par âge de la population concernée. Avec l'élargissement de l'Union européenne à 25 membres, la France occupe désormais une position médiane en termes de taux d'interruption de grossesse.
Web site : http://www.sante.gouv.fr/drees/etude-resultat/er431/er431.pdfAbstract : This paper presents a prospective study of home administration and a one-treatment-visit regimen of mifepristone-misoprostol for medical abortion in Guadeloupe. The administration of this contraceptive method usually requires a standard 3-clinic visit regimen, which would sometimes lead to discontinuation of the abortion process. The study consisted of 92 medical abortion cases conducted over a 13-month period. The intervention involved a 1-day treatment visit with patients receiving 600 mg of mifepristone and instructions on ingesting 2 tablets (400 mcg) of misoprostol orally after 2 days and another 200 mcg misoprostol if bleeding had not occurred within 6-12 hours. A follow-up was conducted among these women after 10-15 days of initial clinic visit and contraceptive administration. The total success rate was 95.4% in comparison with those who received a 3-clinic visit regimen and the statistical result of a study conducted in the US. Several adverse effects have been associated with the administration of abortive methods, which include bleeding (19.6% in mifepristone users and 68.2% in misoprostol users) and vomiting. Strict monitoring of mifepristone and misoprostol distribution and patient follow-up was ensured by French legislators. The authors conclude that home administration of misoprostol must be made available to women in developing countries.
Web site : http://www.sciencedirect.com/science/journal/14700328Abstract : Para todos y todas es claro que los movimientos que luchamos por la DESPENALIZACION DEL ABORTO en Colombia, no defendemos el aborto como un método de planificación, lo deseable es que no haya abortos, que ninguan mujer tenga que pasar por esta situación, pero para ello hay que generar las condiciones adecuadas, hay que prevenir los abortos inseguros y los embarazos no deseados, tenemos que compormeternos con la búsqueda de soluciones reales y estructurales a un problema de SALUD PÚBLICA, DE JUSTICIA SOCIAL Y DE DERECHOS HUMANOS, que jamás se va a resolver desde medidas punitivas y desde postulados de fe, que lo único que logran es profundizar y fortalecer relaciones injustas y excluyentes, con la persistente vulneración de los derechos fundamentales de las mujeres...
Web site : http://www.despenalizaciondelaborto.org.co/data/documentos/200510211558560.Audiencia.pdfAbstract : Induced abortion continues to result in the needless deaths and serious illnesses of the poorer women in the developing world. The Task Force for Social Science Research on Reproductive Health of the Special Programme of Research, Development and Research Training in Human Reproduction launched a major research initiative in 1989 on the determinants and consequences of induced abortion, with a focus on developing countries. Emphasis was given to projects from countries where abortion laws were restrictive, although some studies were supported in countries where abortion was legal, but services were not always accessible nor of good quality. The primary goal of the project was to increase knowledge of why women seek abortion, even in contexts where family planning services are widely available and where abortion is punishable by law. This paper provides a brief overview of the research studies conducted in developing countries worldwide.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : Certain characteristics ; biological, demographical, social and institutional ; based on data collected from the recorded case histories of 2,588 women suffering complications after abortion, attended in a hospital of Santo Andre, an industrial urban area of Greater S. Paulo, State of S. Paulo, Brazil, in the period from January 1978 to December 1982, are identified Data show a two-fold increase in the number of women with complications after abortion over the period studied, rising progressively from 302 in 1978, to 672 in 1982. However, the number of births attended at the same hospital underwent an increase of only 14% in the same period, resulting in an average abortion/birth ratio of 1:3.6 and 1:1.8 in 1978 and 1982, respectively. The majority of the population under study (60%) professed non-skilled occupations. Age presented a statistically significant relationship with martial status, colour, profession and gestational results. A significant relationship was also observed between age at first menstruation, age at first sexual relationship and age at first pregnancy among those women belonging to the primigesta group.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89101990000200010 lng=en nrm=isoAbstract : Investigacion operativa en planificacin familiar y reproductiva
Web site : http://www.popcouncil.orgAbstract : Este libro presenta informes en profundidad sobre las intervenciones de investigación operativa que se llevaron a cabo en América Latina entre 1995 y 1998, así como los cambios programáticos que se lograron, en las cinco áreas siguientes: el acceso y la calidad de los servicios; la integración de servicios de planificación familiar con otros de salud reproductiva; el sostenimiento financiero; la atención post-aborto; y la anticoncepción de emergencia. Cada uno de estos temas está representado por tres estudios, por lo menos, realizados en dos o más países. Los proyectos de investigación operativa que se analizan bajo cada tema no son reproducciones exactas de un solo estudio; se utilizan diferentes diseños de investigación y abordan cuestiones distintas. Sin embargo, cuando se analizan globalmente, pueden proporcionar a los administradores y tomadores de decisiones, información programática relevante sobre cada uno de los temas incluidos. Contiene los siguientes trabajos: · Evaluación y mejoramiento del acceso y la calidad de atención. F. León. · Revisión sistemática de las neceSIDAdes de los clientes para aumentar la prestación de servicios preventivos de salud reproductiva: hallazgos en América Latina. R. Vernon y J. Foreit. · Atención post-aborto en América Latina: un resumen de investigación operativa. T. King; D. Billings; A. Friedman y J. Benson. · Experiencias en la difusión de la anticoncepción de emergencia en América Latina. R. Vernon. · Estrategias para lograr el autosostenimiento financiero de instituciones privadas de salud reproductiva. C. Brambila.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Los Resúmenes de Proyectos de Investigación Operativa presentan resultados clave de proyectos de investigación operativa y asistencia técnica realizados en todo el mundo con apoyo del Population Council y otras agencias colaboradoras. Cada resumen se identifica por tema y por país. Los temas presentados son Maximizando la Accesibilidad y la Calidad de Atención; Opciones Anticonceptivas; Atención Postparto; Enfermedades de Transmisión Sexual y VIH/SIDA; Género y Empoderamiento; Jóvenes; Costo y Sostenimiento e Institucionalización de la Investigación Operativa
Notes : Español/espagnol/SpanishAbstract : El análisis de la presente investigación se basó en la recopilación de información sobre el aborto, desde 1985 hasta 1997. La metodología utilizada fue la técnica de recolección de datos, entrevistas individuales e institucionales, revisiones bibliográficas y periodísticas desde la perspectiva del derecho, la salud, la iglesia , del movimiento de las mujeres y la opinión de la población a través de los medios de comunicación, la cual permitió la estructuración en seis partes del estudio sobre la regulación jurídica del aborto en nuestro país. Desde el punto de vista jurídico del Derecho: La investigación señala que el sistema de leyes es restrictivo, es decir, sanciona el aborto provocado en todas sus formas, pero a pesar de ello el Código Penal actual, contempla eximentes de responsabilidad basadas en la indicación ética, terapéutica y eugenésica. En estos casos, la realización del aborto sólo puede ser autorizada por la Comisión Multidisciplinaria nombrada por el Ministerio de Salud. Al entrar en vigencia el Código de la Familia, la figura del aborto debe ser revisada, por la Comisión Codificadora para la Modificación del Código Penal, ya que al introducir un nuevo concepto del menor, el tipo penal del aborto, como tal dejaría de existir porque al atentar contra la vida de un nasciturus, se está atentando contra un menor configurándose dentro del delito de homicidio agravado, tal cual lo expresa el artículo 132 del Código Penal actual. Se revisaron antecedentes del aborto en Panamá, tomando en cuenta las diferentes normas penales aprobadas desde inicio de la época republicana ( Dr. Belisario Porras y Dr. Angel Ugarte , 1916, basado en el Código Penal hondureño) que representaron las primeras normas jurídicas en materia aborto aprobadas en el país, que contemplaba Aborto cometido con o sin el consentimiento de la mujer, si el aborto es preterintencional o el auto aborto. También se penalizaba el aborto causado por facultativos o farmacéuticos. Las sanciones se imponían de acuerdo al grado de participación e iban desde los 6 meses a 2 o hasta 10 años de prisión . El Código de 1922 se basó en el Código Italiano de 1989 de Zanardelli y contemplaba también el auto aborto, el aborto cometido con el consentimiento de la mujer separado de aquel aborto que se realizaba sin el consentimiento de la mujer; ya para este entonces, se tomaba en cuenta al feto como ente y las penas se establecían de acuerdo a los medios y participación en el aborto: las penas iban de los 2 hasta los 15 años de prisión. El Anteproyecto de 1970 del Dr. Arístides Royo, en relación con el delito en estudio, se contempló en el Capítulo III, Título V, Libro II, el cual establecía normas referentes al aborto provocado por la propia mujer, al aborto consentido y no consentido, a las atenuantes y eximentes de responsabilidad. El auto aborto o aborto intencional se penalizaba con uno a tres años. Aquel aborto cometido con el consentimiento de la mujer conllevaba una pena de 2 a 4 años; en el caso del aborto provocado se introduce el término de Aborto Honoris Causa en donde se introduce la parte ética, que establece el indicador configurado por la salvación del propio honor de la esposa o parientes, en el caso de violación. El aborto por razón de la comisión del delito de violación carnal se realizaba habiéndose comprobado la violación carnal y que contará con el consentimiento de la mujer. También se contemplaba el aborto por razón de graves causas de salud que pusieran en peligro la vida de la mujer o del producto de la concepción y el aborto por razones de angustia económica, además del aborto preterintencional. El Código Penal de 1982 establecía al aborto provocado por la propia mujer sería penalizada con prisión de uno a tres años, en donde se presentaba a la mujer como el sujeto activo y al feto como el pasivo. También introduce la formas de aparición del aborto: tentativa y consumación; autoría y participación. El aborto provocado con el consentimiento de la mujer y sin el consentimiento de la mujer, en los cuales también se tomaban en cuenta las formas en que aparecía el aborto y los participantes. Los eximentes de responsabilidad del delito del aborto se enlistaron como: indicación ética, indicación terapéutica e indicación eugenésica. Por último, se analiza el Anteproyecto de Código Penal de 1997, del Dr. Ernesto Pérez Balladares, el cual fue realizado por una Comisión Codificadora; en este se introduce en la sección de delitos contra la vida y la integridad personal que sancionan las lesiones al feto como las que tutelan la reproducción y la manipulación genética. En relación al capítulo que trata el aborto provocado se observa que se aplican penas más severas que las existentes en el ordenamiento penal actual, al marido, a los médicos, y a todo personal que participa en este tipo de práctica, al igual que se contemplan eximentes de responsabilidades por razón de causas de salud que pongan en peligro la vida de la madre o del feto y por razón de violación carnal o inseminación artificial no consentido, previamente acreditada. También se introducen figuras novedosas como las lesiones al feto, la reproducción y manipulación genética, con la finalidad de evitar que se dilate un poco la responsabilidad, debido a que en nuestro país no existe regulación alguna sobre la inseminación artificial.
Notes : Español/espagnol/SpanishAbstract : This consultant's report on results of a study of abortion and its prevention in District 3 of the city of El Alto, Bolivia, identifies ten priority actions to reduce abortion morbidity and mortality. Six women and five men trained in interviewing techniques conducted 100 in-depth interviews between March and July, 1994. A preliminary report was prepared on each of 15 themes concerning abortion, sex education, contraception, and related topics. The ten priority actions to combat abortion were selected according to four criteria: the need for the action was expressed in the interviews, an impact could be anticipated on abortion morbidity and mortality from the action, the proposed action was feasible sociopolitically and financially, and the action had potential for interinstitutional coordination to avoid duplication of efforts. For each proposed action, a diagnosis was given, the action was described, and an example of an existing program that could serve as a model was suggested. The first recommendation was that workshops, programs, and courses be offered on sexuality, reproduction, gender, and self-esteem to help satisfy the very widespread need for information. Second, health personnel should be trained in contraceptive technologies and counseling techniques to enable them to provide objective and complete information. Women should be permitted to seek contraception without spousal consent, and IUDs should be inserted without waiting for the results of the Pap test. The third recommendation was that male family planning promoters be trained and that sexual and reproductive health services be made available to unmarried persons. Services should also be made available at special times and/or places for young people. Lack of information and of access to services is an important factor in adolescent pregnancy, and contributes to abortion. Workshops should be held in which health workers discuss their experiences in treating women for complications of abortion, in order that the topic be brought into the open and solutions sought. Women treated for complications of abortion should be provided with information on contraception. A campaign to promote family planning use to plan pregnancies and avoid unwanted pregnancies should be undertaken in diverse communications media. Actions by the city of El Alto to prevent domestic and sexual violence should be supported. Pharmacy personnel, who often are asked for abortifacients, should receive training in reproductive health and in dispensing products that may affect pregnancy. Finally, a quantitative study of induced abortion in District 3 should be based on hospital records of women treated for incomplete abortion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103680Abstract : Esta colección de resultados de investigaciones operativas realizadas en cuatro países latinoamericanos ilustra cómo en el transcurso de una década se ha logrado incorporar el modelo de APA (Atención Postaborto) en una gama importante de servicios de salud. Organizaciones internacionales como Ipas y Population Council han estado a la vanguardia en estas investigaciones, en donde los resultados se traducen en mejores prácticas y políticas. APA ha contribuido a mejorar la calidad de la atención recibida por un número importante de las mujeres que sufren complicaciones del aborto practicado en condiciones inseguras.
Notes : Español/espagnol/SpanishAbstract : Studies on induced abortion started dwindling after 1984 when the US government stopped financing abortion-related activities. Recently much interest has focused on induced abortion because it is a major cause of maternal mortality in developing countries. A summary of methodological studies is provided. The sources of data for such studies are somewhat deficient official records of legal abortions. In most developing countries abortion is illegal, and scrutiny of hospital records on complication (a 49% rate in a study in Latin America and 46% hospitalization) is a source. Induced abortion surveys of women in reproductive age and retrospective household surveys are other approaches. The World Fertility Survey, a population-based survey, missed 20-50% of spontaneous abortions and even more induced abortions. Expensive prospective studies requiring large samples did not always provide more accurate information either, e.g., in a Sao Paulo, Brazil, study 25% of 1801 women were lost to follow-up. Pregnant women often do not admit their condition. The measurement of complication rates from induced abortions requires examination of the often incomplete and inconsistent records of emergency, surgery, intensive care, pathology, and anesthesia wards and morgue registers. Some women never go to hospitals or are cared for by traditional healers. The measurement of induced abortion mortality could rely on data of vital registration systems (often shoddy), health service records, and community-based surveys. In a 1967 Latin American study, 33% of deaths were misclassified, and 53% were attributed to circulatory causes in an Egypt study. Abortion case identification is confounded by unintentional (16-83% of menstrual regulations are done on nonpregnant women) and intentional reporting errors (50% of those getting an abortion did not report it in Hungary in 1978 according to WHO data).
Web site : http://www.popcouncil.org/publications/sfp/default.htmAbstract : All women deserve better access to high-quality reproductive health care, including abortion services, and all women should be able to make the sexual and reproductive choices that are right without fearing for their lives. This document highlights Ipas' efforts in protecting women's health and advancing women's reproductive rights worldwide. Since 1973, Ipas has dedicated its work to stopping the senseless deaths and injuries of women from unsafe abortion. Making a vision of universal access to safe abortion care a reality requires a multi-pronged approach. Hence, Ipas has developed multidisciplinary expertise in: 1) training; 2) research; 3) advocacy; and 4) informing stakeholders and communities and building support for safe abortion. This document highlights Ipas' intensive efforts in protecting women's health and advancing women's reproductive rights. It presents the organization's work in Africa, Latin America, the Caribbean, Asia, North America, and Europe.
Web site : http://www.ipas.orgAbstract : It is estimated that between 40,000 and 50,000 unsafe abortions are performed in Bolivia annually. One-third of all maternal deaths are attributed to unsafe abortion. This document describes Ipas activities to address these issues.
Web site : http://www.ipas.orgAbstract : Majority of the estimated 1.4 million abortions in a year in Brazil are performed clandestinely and under unsafe conditions; many are self-induced by women desperate to terminate an unplanned or unwanted pregnancy. This document describes Ipas activities to address these issues.
Web site : http://www.ipas.orgAbstract : The six Spanish-speaking countries of Central America have the most restrictive environment related to women's rights in the western hemisphere. Guatemala, Honduras, El Salvador, Nicaragua, Costa Rica and Panama have scarce maternal and reproductive health services, high maternal mortality, limited reproductive choices and a great risk from unsafe abortion. This document describes Ipas activities to address these issues.
Web site : http://www.ipas.orgAbstract : Indications for legal abortion exist in every state in Mexico, yet access to these services if severely limited in some states and nonexistent in others. Abortion is permitted in every state in cases of rape, and in several states when there are sever congenital defects and when the life or health of the woman is in danger. This document describes Ipas activities to address these issues.
Web site : http://www.ipas.orgAbstract : Maternal mortality in Peru has historically been one of the highest of Latin America. Though abortion in Peru is legally permitted only to save the woman's life or to prevent serious injury to her health, incidence of abortion is high. It is estimated that five out of every 100 women of reproductive age have abortions each year; almost half of the women who undergo an abortion suffer complications. This document describes Ipas activities to address these issues.
Web site : http://www.ipas.orgAbstract : Even though Brazil's BEMFAM program stopped providing sterilization services over a year ago, many sources hostile to BEMFAM in the Brazilian government are still accusing it of misconduct. BEMFAM is sponsored by the International Federation of PLANNED Parenthood and was investigated and cleared of any wrong doing by the Brazilian government. In Brazil it is against the law to perform sterilization for the purposes of birth control, yet it is estimated that there are between 6-20 million such operations each year. Over 65% of the births in Brazil are by Caesarian section and it is common for women to ask their doctors to perform a tubal ligation at the same time. Abortion is illegal in Brazil, but there are an estimated 1.4-2.4 million abortions each year. 56% of Brazilian women use contraceptives, with 90% using either the pill or illegal sterilization. 90% of those who use the pill obtain it over the counter at pharmacies with inadequate knowledge on how to use it. 80% of the people receive their health care from the Brazilian government.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 070426Abstract : In both countries of Ireland and Mexico, bishops worry little about women's lives or suffering. Irish bishops lobbied hard in favor of a referendum that would increase the consensus between church and state. Mexican bishops, meanwhile, spoke out against a Supreme Court decision that will make it possible for a significant number of women in Mexico to get a legal abortion. However, it is noted that such Catholic rulings have caused Irish and Mexican women throughout history nothing but pain and suffering. The discouragement of divorce for much of the 20th century kept women in both countries in abusive marriages. Lack of access to family planning kept them pregnant and caring for children all of their lives. However, in Mexico, a large majority of Catholics believe that abortion should be legal in some circumstances and that women can be trusted to make good decisions about when and whether to have children.
Web site : http://www.catholicsforchoice.org/conscience/archives/default.aspAbstract : Brazilian women's reliance on Cytotec ; a prostaglandin commercially marketed for the treatment of gastric ulcers but with abortifacient potential ; demonstrates the depth of determination of poor women to control their fertility in countries where abortion is illegal. An estimated 1-4 million clandestine abortions are performed in Brazil each year. After Cytotec's introduction in 1986, sales rose rapidly to 50,000 units/month by 1991. In 1991, however, the Ministry of Health altered the regulations surrounding sales of Cytotec. Its sale was prohibited in 1 state, its use was restricted to hospitals in another, and the remaining states required 2 prescriptions. As a result, sales dropped to 5000 units/month in 1992. At the time these restrictions were enacted, Cytotec was the agent used to introduce half the abortions induced by Brazilian women. Women found this method acceptable because of its low cost, accessibility, and privacy. The major complication of its use, uterine bleeding, is far easier to treat than the uterine perforation and pelvic infections associated with other methods of self-induced abortion. In fact, the improved abortion-related mortality/morbidity statistics in Brazil in recent years are probably a direct result of Cytotec use. Restricted access to this agent is expected to reverse this trend.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 092623Abstract : On January 22, 1993 ; the 20th anniversary of the legalization of abortion in the US ; President William Clinton signed 5 abortion-related memoranda that reversed almost a decade of conservative Republican policies in the field of reproductive health. Perhaps most significant on a global level was termination of the 1984 "Mexico City policy" ; federal money can once again be assigned to international family planning programs that provide abortions or abortion counseling as part of their work. The International Planned Parenthood Federation lost millions of dollars in US aid for refusing to sign the Mexico City agreement, and anti-abortion forces in the developing world gained in strength. Most affected were poor women and adolescents in Latin America and the Caribbean who were forced to obtain unsafe illegal abortions. Although President Clinton's action creates the necessary political climate for a renewed battle against unsafe abortion in developing countries, an intensive campaign will be required to undo the "chill factor" created by a decade of neglect of abortion rights.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 092566Abstract : Información para orientar desde un nuevo enfoque y perspectiva el embarazo. Toma en cuenta a la mujer, sus miedos y presiones que vive antes y después del embarazo. Pretende ser un trabajo diferente a los demás que se han publicado con respecto al mismo tema. La protagonista principal es la mujer embarazada, en sus malestares, sus pensamientos, sentimientos, emociones, cambios biológicos, mitos de la maternidad y la depresión postparto
Notes : Español/espagnol/SpanishAbstract : This chapter on Jamaica is part of a comprehensive examination of the laws and policies that affect the reproductive lives of women in nine Latin American and Caribbean countries. Each report begins with a page of statistical information on population, the economy, status of women, and reproductive health and a brief summary of the nation's recent history. The first main section describes the country's legal and political framework, including the structure of national and local governments and national and international sources of laws. The second section examines laws and policies regarding health and population. The objectives of national health policy and the financing, infrastructure, and regulation of health services and patients' rights are analyzed. Population policy, legislation affecting reproductive health, and government- provided family planning services are then examined. Discussions of contraception, abortion, and HIV/AIDS and sexually transmitted diseases examine relevant legislation and prevalence. The third major section assesses the social and juridical status of women as an influence on the exercise of their reproductive rights, including civil rights within marriage, socioeconomic rights, and the right to physical integrity. The characteristics of marital and family relations and women's educational level, access to economic resources and legal protection determine their possibilities of satisfying their reproductive health needs and rights to services. The final major section examines the rights of adolescents in the areas of reproductive health, marriage, sexual crimes against girls and young women, and sex education. Efforts to improve observation of the reproductive and other rights of adolescents are important for self-determination and health of women in general.
Web site : http://www.crlp.org/Abstract : Se evalúa material de investigación que se ha producido de 1986 a 1996 sobre la juventud, el último capítulo aborda la organización de las bandas juveniles
Notes : Español/espagnol/SpanishAbstract : Contenido: 1. Perfil mundial de la salud de los adolescentes; 2. La adolescencia: una etapa de cambios y aprendizaje; cambios corporales y aprendizaje sobre el sexo; confusión y mitos (recuadro); expectativas de la sociedad: control sobre las niñas, motivación a los niños; 3. Tradiciones y prácticas que ponen a los adolescentes en riesgo; la preferencia por los hijos varones; La mutilación genital femenina (MGF); el matrimonio precoz; ahora nadie me quiere: una joven viuda comparte su experiencia (recuadro); la violencia sexual y la violencia basada en género; 4. Riesgos inaceptables para los adolescentes ; el embarazo precoz y no deseado; el embarazo entre las adolescentes peruanas: una cuestión preocupante (recuadro); el aborto en condiciones de riesgo y la falta de atención postaborto; la prisión para las adolescentes que abortan en Nepal (recuadro) ; asesinos silenciosos: las ITR y el VIH; 5. El debate: la educación sexual y los servicios de salud reproductiva ; la educación sexual; los adolescentes de la india triunfan donde los adultos han fallado (recuadro); el acceso a los servicios de salud sexual y reproductiva; 6. Empoderamiento de los adolescentes; decir que no y decir que sí: cómo aprender a expresar las opciones (recuadro); straight talk: un periódico para adolescentes (recuadro); 7. Servicios de salud reproductiva acogedores para los adolescentes; lo que los jóvenes quieren de los educadores y de los prestadores de servicios: contribuciones de adolescentes a diversos sitios web (recuadro); 8. ¿qué funciona?; 9. La influencia de los medios de comunicación; contactos; Referencias
Web site : http://www.ipas.org.www.ipas.org/spanish/publications/adolescents.aspAbstract : En este documento se presentan algunos resultados correspondientes a las representaciones y experiencias de salud sexual y reproductiva entre varones adolescentes y jóvenes adultos en Lima, encontrados en dos de nuestras investigaciones recientes: una sobre las culturas sexuales juveniles, y otra que enfatizó aspectos de conocimiento, necesidad y uso de servicios de salud reproductiva. Antes de ello, sin embargo, se resumen algunas conclusiones acerca de las construcciones identitarias acerca del ser hombre que pueden encontrarse actualmente en esta población (AU).
Notes : Español/espagnol/SpanishAbstract : Almost all developing countries consider family planning to be a human right, although few assume this responsibility as a democratic right whose benefits can be made accessible to all persons, regardless of culture, social condition, martial status, religion, or gender. The reality is far from this goal. Moreover, in the majority of these countries, young people are those most exposed to the consequences of the lack of information and services. Policies that discriminate on the basis of age or marital status primarily affect teenage girls, among the youth population. The price they pay includes high levels of teenage pregnancy, significant rates of clandestine or unsafe abortions, elevated maternal mortality, and the loss of opportunities, not to mention the terrifying dimension added by the threat of AIDS. (excerpt)Casi todos los países en desarrollo conciben la planificación familiar como un derecho humano, aunque pocos asumen esta responsabilidad como un derecho democrático que puede hacer accesibles sus beneficios a toda persona, sin distinción de cultura, condición social, estado civil, religión o género. Lejos está la realidad de este logro. Más aún, en la mayoría de estos países es la juventud la más expuesta a las consecuencias de la falta de información y de servicios. Políticas discriminatorias que toman como punto de partida la edad o el estado civil propician que entre la juventud sean las mujeres, en mayoría adolescentes, las que se vean mas afectadas Altos niveles de embarazo precoz, tasas significativas de abortos clandestinos o pocos seguros, mortalidad maternal elevada y perdida de oportunidades es el precio que pagan, sin contra la dimensión estremecedora que agrega el advertimiento del SIDA. (extracto)
Notes : Español/espagnol/Spanish, nbsp;179826Abstract : Two reproductive technologies-emergency contraception and medical abortion-have the potential to reduce unintended pregnancy significantly in Latin America. Lack of knowledge and negative attitudes about the methods may limit their impact, however. Results from focus group discussions with middle-class men and women of reproductive age residing in Mexico City indicate that knowledge about emergency contraception and medical abortion is low. After being informed about both methods, participants supported emergency contraception but tied their support for medical abortion to its legal status. Participants remained concerned about the methods' efficacy, mechanism of action, and potential to encourage sexual risk-taking. While almost all desired greater dissemination of information about and access to both methods in Mexico, participants cited religious and cultural concerns, as well as barriers in communication with providers and within families, as significant challenges. Participants hoped, however, that both emergency contraception and medical abortion might play important roles in preventing unwanted pregnancy and abortion-related morbidity and mortality in Mexico in the future. (excerpt)
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?iss=6 vol=66 viewtype=issueAbstract : CONTEXT: Mexican states' abortion laws vary, but in all states and the Federal District, induced abortions are legal in some circumstances. Public knowledge and opinions about abortion laws affect access to safe services. METHODS: Survey data from a nationally representative sample of 907 men and women aged 15-24 in 2000 were analyzed to explore knowledge and opinion about abortion laws. Logistic regression was used to identify factors associated with participants' knowing that abortions are sometimes legal in their state and with participants' attitudes toward abortion. RESULTS: Fifty-four percent of participants did not know the legal status of abortion in their state. Of these, 82% believed that abortion is never legal, and the rest did not know or thought that it is always legal. The odds of having correct information were reduced for respondents with low levels of education, those living in certain regions outside Mexico City and rural residents (odds ratios, 0.3-0.7); they were elevated among those with liberal attitudes toward emergency contraceptive pills (2.2). Some 70-83% of participants supported legal abortions when pregnancies result from rape or endanger a woman's life or health. Only 11-22% supported legal abortions for single women or minors, those with economic constraints and women who experience contraceptive failure. Low education and conservative attitudes toward emergency contraceptive pills were associated with conservative attitudes toward abortion. Knowing that abortion is sometimes legal did not affect opinion about it. CONCLUSIONS: Understanding young people's knowledge and opinions about abortion may help in designing programs to reduce the problem of unsafe abortion in Mexico. (author's)
Web site : http://www.agi-usa.org/pubs/journals/2820502.pdfAbstract : Cette publication consiste en une revue de la littérature sur la question de l'avortement en Afrique. Elle comprend une base de données bibliographiques contenant environ 600 références, interrogeables à partir de mots-clés, ainsi qu'une synthèse thématique organisée autour de 6 chapitres (les conditions du droit à l'avortement - difficultés méthodologiques des études sur l'avortement - l'analyse du profil sociologique des femmes qui recourent à l'avortement et les motifs de ce recours à l'avortement- les méthodes d'avortement - les conséquences sanitaires et sociales de l'avortement et les relations entre avortement et contraception). (Résumé d'auteur)
Web site : http://ceped.cirad.fr/avortement/switch.htmlAbstract : Este libro ofrece una mirada panorámica de las y los adolescentes argentinos en la actualidad, con especial énfasis en diversos tópicos sexuales y reproductivos, en la situación legal de la salud sexual y reproductiva en el país, aspectos laborales y educativos, y lo que la autoras llaman deudas pendientes en el reconocimiento de derechos. Utilizan diversas fuentes para dar cuenta de la situación de las y los jóvenes en Argentina. Las autoras mencionan algunas preguntas que surgen en el trabajo con adolescentes: ¿cómo hablar a los adolescentes de sus derechos? ¿cómo lograr que se inserten como ciudadanos plenos, con derechos y no solo obligaciones¿ ¿cómo favorecer su autoestima y dignidad?. Este trabajo no da respuestas a estos interrogantes pero si nos plantea el problema y aspira a generar la búsqueda de soluciones y respuestas que hoy necesitan y exigen los adolescentes. Incluye: Radiografía de la situación de las y los jóvenes en Argentina ; Hambre universitario ; Desocupados de toda ocupación ; Escolaridad vs. Exclusión ; Desamparados por el sistema de salud ; Verdad y consecuencia: la violencia ; Las dos caras de la inseguridad ; Jóvenes y crisis: un cóctel peligroso ; Las y los jóvenes y la salud reproductiva: un problema silenciado ; Dime cuánto ganas y te diré cuantos hijos tienes ; Embarazo adolescente ; El aumento del aborto ; Machismo argentino ; El SIDA y la vulnerabilidad de las mujeres ; Fantasías ; Sexo en vivo y silencio en directo ; Situación legal y política sobre la salud sexual y reproductiva de las y los adolescentes ; La necesidad de acción: una deuda pendiente ; Contexto internacional ; Algunas reflexiones finales ; Bibliografía ; Anexo 1: Síntesis estadística
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Contenido: Dialogar para construir ; Con palabras jóvenes ; Los Derechos Sexuales y Reproductivos ; El cuerpo y el derecho a decidir ; Siempre hay alguien a quien agradecer. ; La realización de un sueño ; Encuentro de Jóvenes y Sector Salud: un espacio abierto al diálogo ; Comunicación y Derechos Sexuales y Reproductivos, crónica de una metodología ; Son tiempos en que no podemos hacer algo sin que la ciudadanía esté de acuerdo ; La adolescencia es el futuro, pero también es el presente ; Propuestas de las y los jóvenes sobre Derechos Sexuales y Reproductivos a los Servicios de Salud ; Los derechos sexuales y reproductivos desde la perspectiva juvenil ; Nueva cultura de derechos sexuales y reproductivos ; Revolución desde el interior ¿Defender y/o ejercer mis derechos? ; Mujeres jóvenes y derechos sexuales y reproductivos ; El cuerpo, poder de nuestras decisiones ; Libertad sobre mi cuerpo ymi sexualidad ; La juventud tiene derecho a decidir ; Derecho a decidir sobre nuestra sexualidad y reproducción ; Las particularidades de los derechos ; exuales y reproductivos ; Las y los jóvenes participando ; Las mesas de trabajo durante el Encuentro ; Éste es apenas el comienzo ; Breve imagen de las y los jóvenes autoras y autores ; Violencia de género. Ser mujer Hoy, Autocuidado masculino en jóvenes, ¿Existe.? ¿Nos importa.?, Reforma a los códigos penales sobre aborto: una exigencia de la realidad, Un giro a lo que conocemos como educación sexual para una mejor salud sexual, Más y mejor acceso a la información sobre métodos anticonceptivos, Virus del papiloma humano (VPH) en adolescentes y jóvenes, Vida sexual y reproductiva en las y los jóvenes en situación de calle, Articulando diversidad y derechos sexuales, Desde el clóset buscando la equidad, Homosexualidad y familia. cuando la familia sale del clóset, Participación juvenil para la creación de servicios médicos, Relatoría de las mesas de trabajo, SONRÍE, Cruzada Nacional por la Calidad de los Servicios de Salud, Palabras de clausura del Encuentro
Web site : http://www.ipas.org/publications/es/DIAJOV_S05_es.pdfAbstract : Bolivia's maternal mortality rate, estimated at 390/100,000 live births between 1989 and 1994, is one of the highest in Latin America. The previous official estimate of 480/100,000 was accepted for over two decades despite its anecdotal basis. The goal of reducing maternal mortality by 50% by the year 2000 approved by the World Conference on Children would require an annual reduction in Bolivia of about 5%, but the declines achieved thus far have amounted to less than 1.3% annually. At this pace, the rate in the year 2000 will have dropped only as far as 348/100,000. Three-fourths of maternal deaths occur during pregnancy or delivery, and two-thirds occur at home. The principle causes are hemorrhage, complications of abortion, hypertension, and infection. Most of the deaths would be fairly easily preventable if adequate information and medical care were available. The great distances of geography, language, and culture must be overcome as must the barriers of discrimination, resignation, and fatalism associated with poverty. The maternal mortality rate reflects inequity. It is four times higher in rural than urban areas. The 1994 National Demographic and Health Survey found a rate as high as 929/100,000 in the rural altiplano. A recent survey of the Bolivian social and political elite found considerable consensus on the principle demographic problems of the country. Few, however, were able to estimate the infant or maternal mortality rates. National resources invested in health and especially in obstetrics and family planning services have been scant. To develop economically, Bolivia must invest in transforming the condition of women, including the provision of appropriate attention in their reproductive lives.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 113254Abstract : Antecedentes ; Solución del problema ; Objetivos ; Metodología ; Desarrollo de materiales de IEC ; Capacitacióndel personal del centro de terapia de apoyo ; Establecimiento de centros de referencia ; Resultados ; Difusión y extensión ; Actividades de divulgación ; Actividades de extensión ; Recapitulación ; Referencias
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : El marco de referencia: los derechos reproductivos de los/las adolescentes ; El acceso de los/las adolescentes a la atención en salud reproductiva ; Educación y adolescentes ; Matrimonio a edad temprana ; Embarazo a edad temprana y anticoncepción ; El aborto en malas condiciones ; El VIH/SIDA y otras enferemdades de transmisión sexual (ETS) ; Violencia sexual y adolescentes - Circuncisión femenina/mutilación genital femenina (CF/MGF) ; Conclusiones ; Notas
Web site : http://www.crlp.org/Abstract : The 5535 abortions performed at the Maria Auxiliadora Hospital in Lima, Peru, between January 1990 and December 1993 represented 28.9% of the 20,519 deliveries and 299 per 1000 live births. 1088 of the abortions (18.3%) were septic. Hospital records indicate that 4151 of the abortions were managed on an outpatient basis and 1784 of the women were hospitalized. The proportion of septic abortions treated at the hospital increased steadily from 12.0% in 1988 to 22.8% in 1993. The rate of abortions also increased, from 193/1000 live births during 1988-89 to 307 in 1993. Endometritis occurred in all 1088 cases. There were 46 cases of pelviperitonitis, 40 of septicemia, 37 of septic shock, 13 of uterine perforation, 7 of endomyometritis, 5 of disseminated intravascular coagulation, 2 each of salpingitis and multisystemic failure, and 1 each of intestinal obstruction, acute renal insufficiency, meningitis, gangrene of the lower member, and tetanus. 27% of the patients were nulliparous and 13% had 5 or more previous births. 32.4% of the abortions occurred at under 9 weeks of gestation, 30.3% at 9-12 weeks, and 37% at over 12 weeks. 974 women (89.5%) underwent curettage only and 114 (10.5%) underwent hysterectomy with or without adnexectomy. 64% of the women hospitalized for septic abortion were discharged in 3-7 days. 12 of the 49 maternal deaths at the hospital during the study period (24.5%) resulted from septic abortion. The death rate for septic abortion was estimated at 60.3/100,000 live births. The greatest frequency of septic abortion is in women 20-29 years old.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 110520Abstract : Analizan el tema abarcando la situación de la mujer en nuestro país desde la perspectiva histórica, educativa, social familiar, de participación política, víctima de violación, etc. Presentan algunas experiencias de trabajo con mujeres en diversos puntos del país, que hablan de las condiciones específicas por regiones, pero que dejan ver claramente la unicidad en el estereotipo patriarcal que el sistema implanta a lo largo y ancho de México
Notes : Español/espagnol/SpanishAbstract : Habla sobre la relación que hay entre la eutanasía y el aborto como un método de planificación que se está aplicando en todo el mundo y llama a una revisión a la no legalización del aborto y la eutanasia pues la vida inicia desde el primer día de gestación y acaba hasta el ultimo día de la muerte.
Web site : http://www.vidahumana.org/vidafam/aborto/devalua.htmlAbstract : Introducción ; Antecedentes y características de la Conferencia ; Los [corchetes] ; Cómo fueron remplazados los [corchetes] ; Conclusiones ; Referencias bibliográficas.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Information on contraceptive knowledge and practice in Haiti is available from four national surveys taken over 20 years: the 1977 Haiti Fertility Survey, the 1983 Contraceptive Prevalence Survey, the 1989 National Survey of Contraception, and the 1994-95 Survey of Mortality, Morbidity, and Use of Services. The proportion of Haitian women in union declaring knowledge of at least one contraceptive method increased from 83% in 1977 to 99% in 1994-95. The influence of educational level and rural or urban residence on knowledge declined over time and was virtually nil by 1995. The surveys indicated that, among women in union, 18% used a contraceptive method in 1977, 7% in 1983, 10% in 1989, and 17% in 1995. Educated and urban women had higher rates of contraceptive usage. The use of traditional methods has declined since 1977, while the proportion of women using modern methods increased from 5% in 1977 to 13% in 1995. Combining the survey results reporting contraceptive practice with analyses of the proximate determinants indicates that contraceptive usage only partially explains the decline in Haiti's total fertility rate from 6 in 1982-83 to 4.8 in 1995. Assuming that the natural fertility rate has remained constant at 17.7 children/woman over the past 2 decades, it was estimated, using the Bongaarts method, that in 1994-95 7.4 births were avoided due to marriage patterns, 3.6 due to breast-feeding and postpartum infecundity, 1.3 due to contraception, and 0.6 due to abortion. It is very likely that the impact of duration of union will decline in the future, as premarital sexual activity increasingly becomes the norm.
Notes : Francés/français/French, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 134203Abstract : Presentación del proyecto y metodología de la investigación ; El equipo de investigación ; Muestra ; Instrumento ; Análisis ; Presentación de los grupos elegidos y de las entrevistadas ; Servicio, Desarrollo y Paz, A. C. (Sedepac) ; Unión Popular Nueva Tenochtitlan (UPNT) ; Sindicato Independiente de Trabajadores de la Universidad Autónoma Metropolitana (SITUAM) ; Salud Integral para la Mujer, A. C. (Sipam) ; Comunidad de Desarrollo Integral Copilco (Codic) ; Esquemas de análisis ; el significado del grupo en la vida de las mujeres ; Hallazgos y reflexiciones ; Apropiación ; Sexualidad ; Anticoncepción e interrupción del embarazo ; Embarazo y parto ; Crianza ; Toma de decisiones ; Resistencia y acomodación ; Condiciones sociales, económicas y políticas para el ejercicio de los derechos reproductivos ; Conocimiento de la ley ; 7 Conclusiones ; Glosario ; Bibliografía. Descriptores:
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : En México el aborto clandestino sigue siendo un importante problema de salud pública y diversos estudios muestran que los hombres son corresponsales en la ocurrencia de embarazos no deseados en la decisión misma de abortar y en los riesgos a la salud de las mujeres. Considerando que los procesos de razonamiento moral son un eje central de legitimación social en el plano de las responsabilidades, se consideró necesario explorar estos procesos en el presente estudio. Para ello se aplicó una entrevista semiestructurada a 14 hombres residentes en la ciudad de México que habían vivido cuando menos un aborto inducido de su pareja. Los resultados mostraron que la responsabilidad de los hombres ante el aborto se expresa en un abanico muy amplio de comportamientos y sentimientos que van desde la más absoluta indiferencia y una responsabilidad entendida solo como aporte económico, hasta la más completa solidaridad y una responsabilidad asumida como apoyo físico, emocional y moral.
Web site : http://www.ciesas.edu.mxAbstract : Introducción ; Algunos datos acerca del contexto ; El aborto y la reforma de la Constitución Nacional ; La Iglesia Católica y el gobierno nacional ; El movimiento de mujeres ; La prensa escrita y la opinión pública ; Conclusiones ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : For the third time in a decade, Mexico's National Action Party (PAN) has proposed that "protecting the right to life from conception to natural death" be added to a local constitution, that of Nuevo Leon. The first proposal was approved in Chihuahua and the second defeated in Baja California. PAN party members argue that their proposal concerns a demand of society in general, but it coincides with their federal election platform, which states that health should be defined in biological, psychological, and social terms based primarily on the right to life from conception to death. A review of PAN legislative initiatives regarding sexuality and reproduction indicates that the proposal is mainly directed at eliminating the exceptions for which abortion is not punished in each state. The intention of penalizing all abortions without exception is not new in the PAN party, but was not openly disclosed in Nuevo Leon. The debate about the proposal has been strikingly intense. Members of PAN, the Catholic Church, and ultraconservative groups may have been surprised at the questioning of their proposal by a significant portion of society, which they may have perceived to be homogenous and conservative. Initial criticism focused on the form in which signatures purportedly supporting the measure were obtained. Many signatures were of children and others were obtained through pressure on Catholic school parents or by trickery. Media pressure resulted in a clarification by PAN members of their intention of totally outlawing abortion. A survey showed that 73% of the Nuevo Leon population believes abortion should continue to be legal for selected indications.
Web site : http://www.gire.org.mx/Abstract : Ponencia presentada por Gire ante la Cámara de Diputados, dentro de las sesiones de análisis para la revisión del Código Civil. Plantea la problemática del aborto en nuestro país en el aspecto social y jurídico, así como el análisis de las diversas razones que se sostienen para su penalización, sustentando la necesidad de despenalizarlo para el mejoramiento en las condiciones de salud de la mujer y el bienestar de la familia
Notes : Español/espagnol/SpanishAbstract : Introducción ; Moralidad y legalidad: tendencias generales ; Causas legales ; El sexo, la moralidad sexual y la valoración de la vida ; Discusión y conclusiones ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Examina por qué se propone la despenalización del aborto voluntario en el Código Penal del estado de Chiapas, y por qué dentro de los primeros noventa días de gestación. Además de conocer la problemática que se suscitó en 1990 por la abrogación de los artículos relacionados con el aborto
Notes : Español/espagnol/SpanishAbstract : Induced abortion has been discussed in Brazil for many years without producing changes in the Penal Code in force since 1940 and according to which it is illegal and a crime against life. There are only two circumstances in which induced abortion is allowed: when there is no other recourse for saving the pregnant woman' life, and when the pregnancy resulted from rape and the abortion is preceded by the woman's informed consent. The purpose of this article is to show how the abortion problem has been dealt with under executive and legislative policies, focusing especially on discussion in Congress considering the role of organized women's groups. The study focuses on the legislative debate on induced abortion and how it was preceded, accompanied, and followed by actions by the women's groups. Other political and social actors involved in the debate, such as the Catholic Church, sectors of the medical community, and protestant religions are mentioned.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X1996000200015 lng=en nrm=isoAbstract : Consecuencias de la práctica del aborto clandestino ; Morbilidad ; Costo económico ; Soluciones a los dilemas del aborto clandestino ; Ofrecer mayor seguridad ; Estrategias legales ; Conclusiones.
Web site : http://www.guttmacher.org/Abstract : Las políticas de población aplicadas en Europa los últimos siglos han servido de base a la iglesia católica romana para regular el destino de las mujeres y su vida sexual, presenta la evolución histórica del magisterio de la iglesia y desenmascara la concepción patriarcal y sexista que se refleja en su doctrina en torno a la anticoncepción y el aborto
Notes : Español/espagnol/SpanishAbstract : Este artículo analiza los métodos de medición y las cifras disponibles de aborto para el Estado de México. Asimismo, propone un método alternativo para la estimación de abortos inducidos, al igual que el uso de modelos de simulación para crear escenarios y descartar niveles de estimación exagerados. Por último, se presenta un breve análisis de las perspectivas teóricas usadas en la temática.
Web site : http://redalyc.uaemex.mx/redalyc/src/inicio/ArtPdfRed.jsp?iCve=11203808 iCveNum=777Abstract : El Population Council y el Instituto Alan Guttmacher promovieron la conferencia con el propósito de aprender y compartir información sobre el tema, el informe muestra un panorama global de los temas tratados
Web site : http://www.gire.org.mx/Abstract : This article reports on the recent Uruguayan experience with the debate on sexual and reproductive rights. While the Bill for the Defense of Reproductive Health did not pass in the Senate, both the prior process and the subsequent impacts have been relevant, generating a social debate that is still incipient but has involved the mass media, academia, and the political parties and spawning a discussion that has involved both houses of Congress for the first time. Within this context, an outstanding role has been played by NGOs devoted to the defense of women's rights (especially sexual and reproductive), who established a coordinating body that included the trade union movement, which supported the bill. The debate also led to international ties that projected it beyond the country's borders. The article briefly reviews the background and basis for the bill, the research it entailed, and the international commitments assumed by Uruguay, before concluding with a summary of the bill itself and the challenges it poses in terms of sexual and reproductive rights, specifically with regard to voluntary interruption of pregnancy.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X2005000200031 lng=en nrm=isoAbstract : Los objetivos del proyecto, de caracter exploratorio, fueron: · Aportarelementos de análisis desde las. ciencias sociales al problema de la prac-tica del aborto inducidoen Colombia. · Reconstruir itinerarios reproductivos masculinos, a partir de entrevistas enprofundidad realizadas a hombres que hayan tenido la(s)experiencia(s)voluntariamentecompartida(s)o no de un aborto inducido de su companera sexual. · Mediante el uso de lasmismas entrevistas, explorar las representaciones sociales masculinas presentes en el momentode decidir un aborto inducido y analizar: el tipo de participacion del hombre en las decisionesprocreativas; las representaciones en torno a la paternidad y a la construccion del deseo de unhijo, y el papel de la identidad de género en la vivencia de la experiencia y en la toma de decisiondel aborto inducido. Sujetos y tipo de muestra. Se utilizo una muestra intencionada de 72entrevistas a hombres de entre 20 y 50 anos, con la experiencia de un aborto inducido, sea cualfuere la condicion en que se hubiesen enterado o participado de ello, residentes en cuatrociudades de Colombia: Bogota, Medellin, Cali y Barranquilla.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : After a judge in Bolivia agreed that a 12-year-old girl who had been raped should be allowed to have an abortion, leading Bolivian church leaders threatened him with excommunication. Doctors in the girl's hometown had refused to perform an abortion, but the judge allowed the abortion in La Paz after protests and petitions led by women's organizations. This was only the second legal abortion in Bolivia. The La Paz diocese has said that the judge should consider himself excommunicated `in the event he does not repent'. (full text)Después del fallo de un juez en Bolivia que permitió que una niña de 12 años que fué violada pudiera tener un aborto, los líderes de la iglesia Católica de Bolivia han amenazado con excomulgarlo. Los doctores en el pueblo de la niña han rehusado a realizar el aborto, pero el juez ha permitido que el aborto sea realizado en La Paz después de peticiones y protestas encabezadas por organizaciones femeninas. Éste ha sido solamente el segundo aborto legal en Bolivia. La Diócesis de La Paz dijo que el juez puede considerarse excomulgado en 'el caso de que no se arrepienta'. (texto completo)
Web site : http://www.rhmjournal.org.uk/Abstract : Context: Legal abortion rates vary widely among countries with nonrestrictive laws. Data on trends in legal induced abortion may provide insight for policymakers into factors that influence rates of legal induced abortion and the levels of abortion that might be achievable in their own countries and in other parts of the world.Methods: Numbers of legal induced abortions were estimated for 54 countries from official statistics or other national data. Abortion rates per 1,000 women aged 15-44 were calculated for the years 1975 through 1996.Results: The most striking recent trend is a sharp decline in abortion incidence in Eastern and Central Europe and the successor states to the Soviet Union. For example, rates fell by 28-47% in the four former Soviet states with reasonably complete data (Belarus, Estonia, Kazakhstan and Latvia), and by 18-65% in six states with less-complete reporting. Similar patterns were seen in such nations as Bulgaria, Hungary and the Czech and Slovak Republics. Rates have also declined in several other developed countries. Since 1975 the abortion rate in such countries as Denmark, Finland, Italy and Japan has dropped by 40-50%. In only a few developed countries (among them Canada, New Zealand and Scotland)have abortion rates shown an increase over time. In the few developing countries with reliable data, some (China, South Korea, Tunisia and Turkey) have experienced a declining abortion rate. while others (such as Cuba and Vietnam) have seen increases in levels of abortion.Conclusions: In developed countries with high abortion rates, use of abortion is likely to fall rapidly when a range of contraceptive methods become widely available and effectively used. Legalization of abortion and access to abortion services do not lead to increased reliance on abortion for fertility control in the long term; in developed countries with these conditions, the predominant trend in abortion rates has been downward.
Web site : http://www.guttmacher.org/pubs/journals/25spa01699.htmlAbstract : En este documento se presentan cuatro trabajos sobre diferentes aspectos de la reproducción abordados desde una perspectiva feminista aplicada a la bioética. Se considera necesario explicitar la dimensión feminista en esta reflexión filosófica ya que el desglose de los supuestos subyacentes a las normas que rigen los comportamientos humanos estuvo ausente durante muchas generaciones de la consideración explícita a las desigualdades de género, lo que dificultó realizar un trabajo estratégico para reducir tales discriminaciones. Esto impidió también el desarrollo de categorías analíticas para decodificar los diferentes componentes de las relaciones de poder que las legitiman y reproducen. Incluye los siguientes capítulos: Introducción ; Algunas reflexiones sobre las implicaciones bioeticas por el abuso de las tecnologías reproductivas en la India ; ¿La privacidad y el consentimiento informado son culturalmente específicos?: Una reflexión ética sobre el estudio del aborto en mujeres de la China Continental ; Autonomía, consentimiento informado y acceso a la anticoncepción en Argentina ; Algunos elementos de la investigación sobre el proceso reproductivo de los varones
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : El enfoque de salud reproductiva adoptado en El Cairo en 1994, en la medida en que expresa de manera más adecuada y realista las necesidades y demandas de los individuos en los componentes básicos de sus vivencias reproductivas, tiene implicaciones sumamente relevantes y sobre todo novedosas que plantean grandes retos tanto en el campo de las políticas públicas y los movimientos sociales como en el de la producción y difusión de conocimientos científicos y su traducción en políticas y acciones de la sociedad civil. No obstante, también se han levantado voces que advierten sobre diversos problemas y conflictos en torno a la viabilidad de la aplicación de este concepto. A partir de tal enunciado se presentan en este texto los resultados de una investigación documental sobre la génesis del enfoque de salud reproductiva desde la diversidad de lógicas que orientaron la investigación sociodemográfica y las intervenciones en México. Las posibilidades de diálogo entre la investigación académica y la acción social en dicho campo se ilustran mediante la descripción de actividades de investigación, de debate y de interacción con los programas gubernamentales y la sociedad civil que ha emprendido el Programa de Salud Reproductiva y Sociedad de El Colegio de México.
Notes : Español/espagnol/SpanishAbstract : El perfil está basado cómo han mejorado las perspectivas de salud y educación en comparación con generaciones pasadas; sin embargo el número de inscripciones a la escuela secundaria es bajo, las complicaciones en el embarazo, parto y aborto siguen siendo una de las principales causas de muerte, las estadísticas sobre violaciones y enfermedades de transmisión sexual siguen siendo altas
Web site : http://www.prb.org/Abstract : El proceso de la ley en Córdoba ; ¿Por qué como Católica por el Derecho a Decidir estamos a favor?
Web site : http://www.geocities.com/catolicas/conciencia/www.catolicasporelderechoadecidir.orgAbstract : The topic of abortion was excluded from the September 1999 revision of the penal code for the Federal District. Three proposals, developed by the Institute for Juridical Investigation of the National Autonomous University of Mexico, jurists representing different institutions, and a network of 40 organizations involved in the "Access to Justice for Women" campaign, however, demonstrate the interest of different parties in revision of abortion law. The recently approved penal code, like its predecessor, defines abortion as "the death of the product of conception", and permits abortion under three specific circumstances: that produced without intention, to save the mother's life, and in cases of rape. Recommendations of one or more of the three groups included adding artificial insemination without the woman's consent, serious genetic or congenital anomaly, danger to the woman's health, and grave economic causes to the list of exonerating conditions. The three proposals are very dissimilar, but some criteria exist for evaluating their relevance. Since 1871 abortion has tended to be distinguished from homicide according to juridical concepts shared by the majority of specialists and legislators. Sanctions for abortion have been increasingly light in comparison to those of homicide, and the number of exceptions has increased. The legal evaluation of the crime of abortion has followed the moral valuation made by society of women in comparison to that of the product of conception. This valuation has been increasing in recent decades. Recent opinion surveys have supported liberalization of abortion legislation and measures to reduce mortality from illegal abortions. In the political realm, significant proportions of Catholics and membership in conservative political parties support revision of abortion legislation.
Web site : http://www.gire.org.mx/Abstract : A Colombian woman reflects on the desirability of legalizing abortion from her perspective as a psychologist and feminist. Abortion has always been a difficult topic for women because of the way they have been manipulated and made to feel guilt over their maternal roles. The free choice between motherhood or voluntary interruption of pregnancy should be available for women because every infant born has a right to be wanted, loved, and nurtured by the parents. The concept of life that informs support for the choice of abortion goes beyond the merely biological. An infant, to become fully human, requires language, culture, and affection. An infant should represent a human life that is planned, desired, and hoped for, whose arrival is an occasion for joy rather than despair, and that gives motherhood its true character of privilege. If the minimal conditions of caring for an infant are absent, the greater crime is in allowing him to be born to a life of privation and misery.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 095946Abstract : Abarca desde los años treinta hasta la actualidad, expone acontecimientos políticos y sociales que dieron lugar a algunas reformas estatales, así como los que obstaculizaron los procesos en Chiapas y el Dsitrito Federal. Aborda también el contexto internacional que dio sustento y voz a las demandas de los grupos feministas en el país, que culminaron con la modificación de los códigos penales en varias entidades federativas
Web site : http://serpiente.dgsca.unam.mx/ceiich/publicaciones.php?vId=210 vId_h=9 vTitulox=Feminismo%20y%20Alternativas%20SocialesAbstract : Presenta la lucha del movimiento feminista brasileño por legalización del aborto.
Notes : Español/espagnol/SpanishAbstract : Presenta un panorama completo sobre el estado actual de la salud reproductiva de la mujer en América Latina enfatizando los factores demográficos, enfermedades de transmisión sexual, patrones culturales, factores medioambientales y otros, relacionados con la morbilidad y mortalidad materna. Incluye capítulo de propuestas para mejorar la situación de la mujer y su salud reproductiva; recomendaciones a nivel internacional para la maternidad sin riesgos y reducir la discriminación contra la mujer así como la movilización de recursos financieros para lograrlo. Incluye datos estadísticos
Notes : Español/espagnol/SpanishAbstract : The study of maternal morbidity and mortality is a useful means of assessing the quality of maternal health care. Most women either have completely normal pregnancy and delivery or only slight problems. Women with serious disorders who obtain high quality health services may reduce their reproductive risk. A remaining group, variable according to socioeconomic and cultural context, do not use health services and their health problems remain unidentified and untreated. This group comprises women at highest risk of maternal death. In many cases, however, their deaths are not identified as related to reproduction. Two studies in Mexico have demonstrated that maternal mortality is underestimated by 40 to 50%. The study of maternal mortality and the identification of priorities for research and action requires a conceptual framework to guide efforts. Problems derived from the inferior position and role of women in society determine a greater degree of reproductive risk for large population sectors. Women conscious of their increased risk may seek services to control their unfavorable conditions. Women not conscious of the risks or who obtain poor quality services have higher probability of an unfavorable outcome. The social character of maternal mortality is demonstrated by its correlation with various socioeconomic variables. In Mexico, maternal mortality has declined from approximately 53/10,000 live births in 1940 to 6/10,000 in 1990, with most of the decline in the earlier years. In 1989, 8.7% of deaths were caused by abortion, 21.3% by toxemia, 25.6% by hemorrhage, and 1.6% by indirect maternal causes. Deaths from hemorrhage and infection have declined significantly but deaths from abortion and toxemia have changed little. Maternal mortality rates have consistently been highest in women aged 35-39, but the rate for this age group has shown the sharpest decline over the past half century. Maternal mortality rates in Mexico are among the highest in the Americas despite the decline. Much less is known about maternal morbidity than mortality because of the lack of a universally accepted definition. Most data on maternal morbidity concern acute morbidity during pregnancy, birth, or delivery in women attended in hospitals. The 70% of Mexican women who deliver in hospitals are not a representative sample. Data obtained in the community on maternal morbidity outside of hospitals remain unavailable in Mexico.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103309Abstract : In Argentina, as in most countries, complications of pregnancy and delivery are important causes of mortality of fertile-age women. At the 1994 International Conference on Population and Development in Cairo, governments agreed on the objective of promoting maternity without risk in order to reduce maternal mortality. Maternal mortality rates in many developing countries are much higher than the 10/100,000 live births in the most developed countries. Deficiencies in reporting due either to failure to report deaths or errors in the cause of death are a major impediment to study of maternal mortality. Two studies were conducted recently to provide more accurate data on maternal mortality in Argentina. A study carried out during 1987-89 was designed to measure underregistration of maternal mortality in the federal capital in 1985. Data from death registers were paired with the corresponding clinical histories. The true maternal mortality rate was found to be 91/100,000 rather than the official 50. 38% of maternal deaths rather than the previously estimated 57% were found to be due to complications of illegal abortion. The degree of underreporting in the federal capital, which has the highest proportion of hospital deliveries and most developed infrastructure, suggests that the maternal mortality rate is also much higher than official estimates in other parts of Argentina. Official estimates for 1993 showed a maternal mortality rate of 46/100,000, with very significant regional differentials. A study using the indirect sister survival method was conducted in a low income neighborhood of Zarate in 1991. 8041 persons in 1679 households were interviewed. The resulting estimate of 140/100,000 corresponded to the early 1980s.
Web site : http://www.un.org/popin/regional/latam/argentina/cenep/sidema.htmAbstract : This document is the report of the Andean Conference on Maternity Without Risks, which was attended by government officials; representatives of nongovernmental organizations, women's groups and donor organizations; and health workers from Bolivia, Colombia, Ecuador, Peru, and Venezuela. The Conference was part of the Motherhood Without Risks World Initiative launched in 1987. The introduction discusses the problem of maternal mortality, which occurs almost exclusively in the developing world. Reported maternal mortality rates in the Andean countries range from 60/100,000 live births in Venezuela to 480/100,000 in Bolivia. The regional average is 185. A significant underestimation may occur, and variations are considerable in rural and urban areas and in different socioeconomic groups. The socioeconomic, demographic, and cultural correlates of maternal morbidity and mortality in the region are discussed, including the labor situation and juridical status of women and of maternity, discrimination and violence against women, and nutritional disadvantages of women. The coverage and quality of reproductive health services are then assessed. Programmatic strategies to reduce maternal morbidity and mortality are outlined. Reproductive rights and family planning, abortion, and sex education for adolescents are each examined. The final chapters discuss resource allocation and financing of health programs and the need for participation of all societal sectors in controlling maternal mortality.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 116703Abstract : Introducción ; Estrategia metodológica ; Obtención de la información ; Características de las defunciones femeninas adultas ; Las muertes maternas ; Muertes maternas y madres sobrevivientes: comparación de las defunciones maternas con los grupos de control y de contraste ; Conclusiones ; Bibliografía
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : ¿Que es la mortalidad materna? ; ¿Que sabemos sobre la mortalidad materna? ; ¿Como se estima la mortalidad materna? ; ¿Cual es la magnitud materna? ; ¿Cuáles son las causas de la mortalidad materna? ; ¿Cuales son las estrategias más eficaces para enfrentar la mortalidad materna? ; La mortalidad materna es una cuestión de derechos humanos ; ¿Que pueden hacer los gobiernos y la sociedad civil para reducir las muertes maternas ; ¿Cual es la situación de la mortalidad materna en la Argentina? ; Anexo: El largo camino a la muerte materna
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : La situación y el balance estadistico de las mujeres mexicanas en areas como la salud, el trabajo, la educación, pobalción, la toma de desiciones, las mujeres indígenas y las Organizaciones no gubernamentales, el trabajo que realizan con las mujeres.
Web site : http://www.unifem.org.mxAbstract : Annotation: Special issue on the Mexican woman consists of short, journalistic articles on topics such as women in Mexican law, feminist movement in Mexico, women in science, female sexuality, abortion, and interviews with some prominent female artists. Informative but without academic pretensions.
Notes : Español/espagnol/SpanishAbstract : Based on a multi-question scale, the authors posit five types of religiosity (traditional, transitional, modern-social, modern-cum-economic liberalism, and 'unknown'). Interviews with 200 women of Managua (half Catholic and half Protestants [the latter of two types]) serve to place them among the five types, with comparisons made on range of attitudes and traits: class distribution, family planning and abortion, schooling, etc. Religious confessions are analyzed separately" ;
Notes : Español/espagnol/SpanishAbstract : Antecedentes generales de Guatemala ; Población y demografía ; Historia reciente y Acuerdos de Paz ; Condiciones e indicadores de salud ; Pobreza y distribución económica ; Necesidad actual insatisfecha de información y servicios de planificación familiar ; Situación jurídica y social de la mujer ; Educación, incluida la educación sexual ; Papel de la Iglesia católica y de la religión ; Intentos infructuosos de implantar una ley o política de planificación familiar ; Prestación gubernamental de atención sanitaria, incluida la salud reproductiva ; Prestación de servicios públicos de salud ; Inversiones y calidad inadecuadas de los servicios de salud del gobierno ; Legislación, políticas y programas de salud recientes que afectan la prestación de atención en salud reproductiva ; Sistema integral de atención en salud ; Normas de Atención ; Plan nacional para reducir la mortalidad materna y perinatal ; Integración inadecuada de una perspectiva basada en los derechos, las políticas y los programas actuales de salud reproductiva ; Violaciones de derechos humanos como resultado de la negativa del gobierno a proporcionar servicios de planificación familiar ; Derechos humanos nacionales e internacionales implicados ; Fuentes de derecho internacional ; Instrumentos internacionales de derechos humanos ; Carta de las Naciones Unidas ; Declaración Universal de Derechos Humanos ; Pactos internacionales de derechos humanos ; Convención para la Eliminación de Todas las Formas de Discriminación Contra la Mujer ; Convención sobre los Derechos del Niño ; Convención sobre la Eliminación de todas las Formas de Discriminación Racial ; Instrumentos regionales de derechos humanos ; Declaración Americana de los Derechos y Deberes del Hombre ; Convención Americana sobre Derechos Humanos ; Protocolo de San Salvador ; Convención Interamericana para Prevenir, Sancionar y Erradicar la Violencia contra la Mujer ; Conferencias internacionales ; Conferencia Internacional sobre Población y Desarrollo ; Cuarta Conferencia Mundial sobre la Mujer ; El deber de Guatemala de poner en práctica los derechos humanos ; Fuentes de derecho nacional ; Constitución de Guatemala ; Acuerdos de Paz ; Código de Salud ; Conclusión: El hecho de que Guatemala no ofrezca información y servicios de planificación familiar viola los derechos de sus ciudadanas y ciudadanos ; Recomendaciones: protección del derecho humano a la planificación familiar en Guatemala ; Recomendaciones con respecto a acciones a escala nacional ; Abogar a favor de una ley o política de planificación familiar ; Iniciar demandas administrativas por las violaciones a derechos humanos ; Entablar una acción judicial ; Ofrecer educación pública sobre el derecho a la atención de la salud reproductiva ; Buscar el apoyo de MINUGUA para garantizar la acción del gobierno en planificación familiar ; Recomendaciones sobre el sistema interamericano de derechos humanos ; Recomendaciones sobre el sistema internacional de 66 protección de los derechos humanos ; Comités de supervisión de los tratados de derechos humanos de la ONU ; La Comisión de Derechos Humanos de Naciones Unidas y los relatores especiales ; Conclusión y Anexo ; ANEXO 1: Resumen del cambio legislativo reciente y el desarrollo dc nuevas políticas públicas ; Notas
Web site : http://www.crlp.org/Abstract : This study describes the main characteristics of the demographic transition that has occurred in Cuba over the course of the twentieth century. It analyzes trends in mortality and fertility and describes factors affecting fertility such as contraception, abortion, and nuptiality. The author also discusses the participation of women in the development process, the role of population policy, and future population perspectives. (SUMMARY IN ENG) (ANNOTATION)
Notes : Francés/français/French, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND RH65196Abstract : In this article, the authors propose several reflections on different ways in which males participate in the process of interrupting a pregnancy, as a practice per se and within the process of defining normative criteria for influencing said process. They propose certain hypothesis regarding the reasons why males are a secondary actor in models for interpreting reproduction and show how this produces conceptual problems, practical ambivalences, and instances of confusion in the process of defining rights and responsibilities in the sphere of reproduction, despite the fact that males are also identified as relevant actors when defining the moral discourse that attempts to regulate the possibility of abortion. The authors are interested in taking into account several contributions made by feminist thought when analyzing the double moral standard used as a reference for males' and females' sexual and reproductive experiences. While this is an exploratory text, the authors do not limit themselves repeating some of the proposals made by feminist thought, but rather diversify them by directing their attention to "masculinity studies" in terms of the use of language, how discourse is handled, and males' experiences involving two dynamisms related to reproduction, sexuality and health. (author's)
Web site : http://redalyc.uaemex.mx/redalyc/src/inicio/ArtPdfRed.jsp?iCve=11202504 iCveNum=0; www.flacso.cl/flacso/biblos.php?code=404Abstract : The authors propose several reflections on different ways in which males participate in the process of interrupting a pregnancy, as a practice per se and within the process of defining normative criteria for influencing said process. They propose certain hypothesis regarding the reasons why males are a secondary actor in models for interpreting reproduction and show how this produces conceptual problems, practical ambivalences, and instances of confusion in the process of defining rights and responsibilities in the sphere of reproduction, despite the fact that males are also identified as relevant actors when defining the moral discourse that attempts to regulate the possibility of abortion. The authors are interested in taking into account several contributions made by feminist thought when analyzing the double moral standard used as a reference for males' and females' sexual and reproductive experiences. While this is an exploratory text, the authors do not limit themselves repeating some of the proposals made by feminist thought, but rather diversify them by directing their attention to "masculinity studies" in terms of the use of language, how discourse is handled, and males' experiences involving two dynamisms related to reproduction, sexuality and health. (author's)
Notes : Español/espagnol/SpanishAbstract : In this article, the authors propose several reflections on different ways in which males participate in the process of interrupting a pregnancy, as a practice per se and within the process of defining normative criteria for influencing said process. They propose certain hypothesis regarding the reasons why males are a secondary actor in models for interpreting reproduction and show how this produces conceptual problems, practical ambivalences, and instances of confusion in the process of defining rights and responsibilities in the sphere of reproduction, despite the fact that males are also identified as relevant actors when defining the moral discourse that attempts to regulate the possibility of abortion. The authors are interested in taking into account several contributions made by feminist thought when analyzing the double moral standard used as a reference for males' and females' sexual and reproductive experiences. While this is an exploratory text, the authors do not limit themselves repeating some of the proposals made by feminist thought, but rather diversify them by directing their attention to "masculinity studies" in terms of the use of language, how discourse is handled, and males' experiences involving two dynamisms related to reproduction, sexuality and health. (author's)
Notes : Español/espagnol/SpanishAbstract : Reseña del libro "Aborto clandestino: una realidad latinoamericana" editada por The Alan Guttmacher Institute
Web site : http://www.gire.org.mx/Abstract : Define lo que es un aborto y los métodos para realizarlo. Presenta estudios de la situación socio política y legal relacionada con el aborto en Puerto Rico, incluyendo mitos y opiniones de personas reconocidas aparecidas públicamente. Analiza las enmiendas propuestas al Código Penal en 1992, incluyendo las que fueron eliminadas posteriormente
Notes : Español/espagnol/SpanishAbstract : Two salient features of abortion in Puerto Rico were the imposed legalization of abortion in this US territory in 1973 via the U.S. Supreme Court's Roe v. Wade decision, and the history of Puerto Rico in the 1960s as a source of illegal though safe abortions for hundreds of women from the U.S. In theory the abortion network was illegal, but in practice it enjoyed a certain air of legality. Because of Puerto Rico's particular abortion history, complications and deaths from abortion have almost disappeared from the national memory. 423 women interviewed in 1991 and 1992 in ten of the 13 abortion clinics in Puerto Rico provided information on differential access to abortion for the Women's Studies Project of the University of Cayey. The study found that large segments of the population remained unaware that abortion is legal and safe. The clandestine nature of abortion is reflected in the limited provision of information to the public, including absence of mention in the yellow pages. 93% of induced abortions in Puerto Rico occur in private clinics. An estimated 15,869 abortions are performed each year in private clinics by no more than 15 physicians. Ten of the 13 clinics are located in two of Puerto Rico's eight health regions, leaving large areas without services. Apart from distance, the average cost of US $225 for a first trimester abortion limits access for adolescents and women lacking financial resources. Puerto Rico has one of the lowest proportions of women under 20 seeking abortion in the world. Although only 4% of abortions in Puerto Rico occur after the first trimester, the proportion is 16% for adolescents, perhaps because of the economic and geographic obstacles they face in obtaining abortion. A comparison of abortion rates of Puerto Rican women with those of women from the Dominican Republic living in Puerto Rico underscores the importance of geographic and economic access in the timing of abortions. 59% of the respondents reported they had used contraception in the month in which they conceived, but two-thirds used rhythm or withdrawal. The case of abortion in Puerto Rico clearly demonstrates that formal legality is not always reflected in accessibility.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100718Abstract : Reflexiona sobre el impacto, en el Perú, de esta Regla, concebida durante la administración de Reagan y reimpuesta por el gobierno de G.W. Bush, que prohíbe a las organizaciones gubernamentales extranjeras, que reciben fondos de USAID para proyectos de población, desarrollar cualquier actividad o emitir cualquier opinión respecto al aborto.
Notes : Español/espagnol/SpanishAbstract : Presentación ; La percepción de los servicios de salud ; Mujeres integradas al sistema - El interés médico - La conciencia privatizadora como sostén ; Mujeres fluctuantes ; La importancia de los hábitos preventivos ; Referencias bibliográficas
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Introducción ; Adolescencia y sociedad ; Condiciones de salud ; Servicios de salud ; Estrategias ; Epilogo.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Esta es la segunda obra que la OPS publica sobre este tema, en realidad poco común en la bibliografía médica. El libro presenta 53 artículos, organizados en ocho secciones, que abarcan un enfoque integral de la adolescencia, con estrategias que deben aplicarse para satisfacer las necesidades biopsicosociales y de los microambientes, así como los efectos del marcado cambio social; la adolescencia normal, con distintas facetas del desarrollo del adolescente, como la sexualidad, su relación con los grupos de pares, la socialización y la nutrición; los riesgos y daños para la salud del adolescente, inclusive problemas como la discapacidad, la drogadicción, las enfermedades crónicas y la mortalidad por causas violentas; la salud reproductiva y los servicios y programas de atención de adolescentes; estudios de casos y experiencias en diversos países; las investigaciones, y la capacitación del recurso humano para la atención del adolescente
Notes : Español/espagnol/SpanishAbstract : Prólogo ; Prospectivas sobre población / Alejandra Pantelides ; Políticas de salud / Pedro de Zarasqueta ; Prospectivas sobre políticas sociales / Rubén Lo Vuolo ; Políticas de Población y Salud ; Cambios recientes en la política de población en la Argentina / Susana Novick ; Políticas sanitarias y salud colectiva (1983-1991) / Adriana Redondo ; Empobrecimiento y salud: nuevos riesgos, condiciones de acceso y exclusión / Gabriel Kessler ; Todo lo solidario se desvanece en el aire: la libre afiliación a las obras sociales / Claudia Danani ; Las prestaciones medico-asistenciales a los trabajadores de la energía eléctrica / Stella Maris Cabral ; Modelos de Prevención en Salud ; La prevención desde una perspectiva de género / Graciela Zaldua, Graciela Fabi y Graciela Di Marco ; Alcohólicos anónimos. La salud, la unidad y la fe / Ricardo Martínez Mazzola ; Sida, campañas y medios de comunicación / Mónica Petracci ; Representaciones de las mujeres desde la construcción médica del HlV-Sida: "Tomadoras Activas" y "Víctimas Propicias" / Mabel Grimberg ; Actores no gubernamentales y Sida / Graciela Biagini ; Sexualidad y Salud Reproductiva ; Información y conducta sexuales en jóvenes argentinos / Ana Lia Kornblit y Ana María Mendes Diz ; Aborto inducido en mujeres del conurbano de Buenos Aires: opiniones y evidencias / Elsa López y Alicia Masautis ; Significaciones socio-culturales acerca de la salud reproductiva / Liliana Findling y Susana Masseroni ; Comportamientos reproductivos de las mujeres de sectores populares: estrategias tradicionales y modernas / Graciela Climent y Diana Arias ; Las adolescentes frente a la maternidad / Graciela Infesta Dominguez ; Las prácticas reproductivas en mujeres pobres urbanas con alta paridez / Maria Cristina Ventura
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : La salud en las Américas es la principal publicación de la OPS que analiza la situación de salud y sus tendencias en las Américas. En esta edición de 2002, el análisis de La salud en las Américas está orientado a documentar las desigualdades en el ámbito de la salud. Con la finalidad de exponer mejor el análisis tanto a nivel regional como de país, esta edición, al igual que la anterior se presenta en dos volúmenes. Los ocho capítulos del volumen I ofrecen una perspectiva regional acerca de la situación actual de la salud en las Américas. Este volumen abarca un análisis de la situación y las tendencias de varios de los principales indicadores o factores determinantes de la salud, o relacionados con ella, que van desde la mortalidad y los cambios en la esperanza de vida hasta el impacto que las desigualdades en el nivel de ingreso y su distribución tienen sobre la salud de la población. En el volumen II se presenta el análisis de la situación de salud más actualizado para cada uno de los países y territorios de las Américas. Este volumen es el resultado de un esfuerzo analítico que abarcó toda la Región y se realizó mediante un marco común que incluye un análisis del estado general de la salud y de los problemas concretos de salud, y la respuesta del sistema y los servicios de salud.
Web site : http://www.paho.org/spanish/dbi/mds/SEA_2002.htmAbstract : The demographic scene in the Americas in 1980 was characterized by the fact that there were 86 million women in reproductive age in Latin America and the Caribbean; this figure will increase to 150 million by the year 2000. In North America this population will increase from 65 million to only 76 million. The urban population of Latin America made up 65.4% of the total population in 1980, and it will increase to 75% by the year 2000. In recent decades internal migration has increased because of political tensions, and more than 10% of the population is composed of refugees who have been displaced. The reproductive health of women is determined by the age at which they give birth (prematurity, low birth weight, and obstetrical traumas are more frequent in those under age 20); by the nutritional status during pregnancy (undernutrition results in similar complications); by environmental factors and medications that affect pregnancy (radiation, tranquilizers, diethylstilbestrol, streptomycin, salicylates, lithium and diazepam, sulfonamides, and antibiotics); by the effect of smoking on pregnancy (reduction of oxygen and higher incidence of spontaneous abortion); by the effect of alcohol use on pregnancy (alcoholic fetal syndrome with microcephaly); by the effect of some addictive drugs on pregnancy (marijuana and heroine); and by the effect of stress on pregnancy (cardiac rhythm and arterial tension). The occupational health of women is seriously influenced by the use of pesticides, especially organic phosphates. The serious economic situation in the 1980s also had a negative influence on maternal health because public health programs were curtailed. The reproductive risks in maternal health care are biological, medical, behavioral, familiar, environmental, and those related to health care. The causes of morbidity include sexually transmitted diseases, malaria, tuberculosis, hepatitis, diabetes, heart diseases, and hypertension. The main causes of maternal mortality are due to complications of pregnancy and delivery. Strategies of action embrace legislation, community action, programs for the regulation of fertility, and training of health personnel.
Notes : Español/espagnol/SpanishAbstract : La voluntad política y la salud reproductiva ; La presión de los sectores sociales y los derechos reproductivos ; La salud reproductiva y sus componentes sociales y demográficos ; Bibliografía
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Presentación ; La salud reproductiva: un nuevo enfoque de la salud de las mujeres ; Nudos críticos de la salud reproductivas ; Reflexiones finales
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Resumen y contenido: Presentación ; La salud reproductiva: un nuevo enfoque de la salud de las mujeres ; Estado de situación de la salud reproductiva: sus problemas críticos ; Reflexiones finales ; Referencias
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Mujer y servicios de salud ; Algunos aspectos de la investigación ; Conclusiones ; Bibliografía
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Introducción ; Aproximaciones conceptuales ; Mujer y servicios de salud ; Características de la investigación, abordaje metodológico ; Análisis de las entrevistas ; Organización del servicio ; Percepción de la demanda ; Percepción de la salud reproductiva y el aborto inducido ; Conclusiones ; Bibliografía
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Contenido: Voces y propuestas desde la sociedad civil : reforma de la salud en Chile ; Un acercamiento desde el ejercicio de los roles de las/os profesionales ; Propuesta desde la perspectiva de género y la ciudadanía ; Vivencia de su salud y autocuidado a partir de la construcción de la identidad femenina
Web site : http://www.gire.org.mx/Abstract : Con el apoyo de la OPS/OMS, UNICEF, UNFPA, USAID, BID y GPI, del 2 al 5 de octubre de 1996 se realizó en Santa Cruz de la Sierra, Bolivia la Primera Conferencia Panamericana de Médicos Parlamentarios, bajo el lema "La Salud como Cuestión de Estado". Los productos de la conferencia reunidos en este informe se destinan no sólo a los parlamentarios sean médicos o no, sino a todos los estudiosos de la temática vinculada a la salud, al bienestar de la población y al desarrollo. Sus textos son una contribución al debate siempre inconcluso de cómo ubicar la defensa de la salud colectiva, de cómo priorizar la atención de los grupos más vulnerables como la mujer y el niño, y de cómo asimilar mejor los nuevos conceptos de salud sexual y reproductiva, en el marco de los cambios que tan aceleradamente se están produciendo actualmente en el mundo. El libro está dividiso en tres partes. En la primera se presenta un informe de los antecedentes y la constitución de la IMPO y de la preparación de la Primera Conferencia Panamericana, un relato de la Conferencia misma, y los acuerdos de organización interna aprobados en el desarrollo de la misma. En la segunda parte se reproducen los discursos del acto inaugural, las conferencias presentadas, el debate que protagonizaron los parlamentarios, y las conclusiones aprobadas sobre cada uno de los temas por separado. En la tercera parte se presenta el resumen de las principales actividades cumplidas hasta noviembre de 1997 en seguimiento a las conclusiones y resoluciones de la Conferencia.
Notes : Español/espagnol/SpanishAbstract : L'article analyse le concept de "santé de la reproduction" dans une perspective historique à partir des déclarations et des actions des organismes internationaux d'où il a émergé sous l'influence des organisations non gouvernementales et des mouvements féministes. Se substituant à la notion de "santé maternelle et infantile", il inclut aujourd'hui la santé sexuelle et la régulation de la fécondité. La santé de la reproduction ne concerne donc plus uniquement la santé de la mère et de l'enfant mais aussi celle des adolescents, des femmes ménoposées et des hommes. Elle dépasse le strict cadre médical pour poser la question de la responsabilité individuelle et collective dans les comportements sexuels et reproductifs. De cette évolution conceptuelle découle la notion de "droit reproductif" qui implique une liberté de choix en matière de sexualité et de fécondité. Ces déclarations et revendications restent néanmoins en grand décalage avec l'organisation sociale et politique des pays concernés. Même si les états qui ont participé à la Conférence du Caire sur la population en 1994 ont manifesté un certain consensus sur les orientations générales en matière de santé de la reproduction, ils ont laissé, malgré tout, transparaitre des divergences sur des questions religieuses et politiques. Le cas de l'avortement, décrit ici, en est une bonne illustration (Résumé d'auteur)
Web site : http://ceped.cirad.frAbstract : La situación del embarazo en la adolescencia no puede determinarse únicamente por la fecundidad; en muchos países de la región existe una alta incidencia de aborto. Por ello, deben analizarse conjuntamente embarazo y aborto en la adolescencia. La fecundidad adolescente tiene mayor incidencia en mujeres que en varones, aunque éstos inician su vida sexual más temprano. La gran mayoría de los hombres que embarazan a las adolescentes, no son adolescentes. Esta heterogamia aumenta a menor edad de la mujer, y se vincula con inequidades de género producto de un contexto sociocultural que asigna comportamientos de nupcialidad, sexualidad y reproducción distintos en hombres y mujeres Aunque la incidencia del embarazo adolescente varía entre los países de la región, no se puede afirmar que estamos frente a una epidemia de embarazos adolescentes. Si bien en Brasil, Colombia y República Dominicana la tasa de fecundidad entre 15-19 años de edad ha aumentado, en la mayor parte de la región esta tasa se ha mantenido estable o incluso ha disminuido. En cuatro países latinoamericanos (Brasil, Colombia, Perú y República Dominicana) entre 25 y 30% de los embarazos adolescentes terminan en aborto. Al menos en dos países, el riesgo de aborto tiende a ser mayor en adolescentes, lo que podría indicar una nueva tendencia hacia mayor riesgo de abortos en estas edades.La preocupación por la alta incidencia del embarazo y el aborto en la adolescencia está fundamentada, sobre todo en los sectores de mayor pobreza y baja escolaridad. Merece especial atención el embarazo en adolescentes menores de dieciséis años, en quienes los riesgos fisiológicos y psicológicos pueden ser más altos.
Notes : Español/espagnol/SpanishAbstract : Los trabajos de la reunión plantean desde ángulos diferentes, la situación de los puntos en común que viven las mujeres centroamericanas: la pobreza, las condiciones de trabajo y familiares, salud sexual y reproductiva, maternidad, legalidad y violencia; así como los logros por sus derechos y el empoderamiento y liderazgo. El hilo conductor de los análisis son los cambios dados a partir de la globalización
Notes : Español/espagnol/SpanishAbstract : Introducción ; El planeamiento familiar en Brasil ; El aborto ; Los derechos reproductivos ; Conclusiones ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This article discusses the illegality of abortion in Colombia, situating this country within the 0.4% of the world population where abortion is completely banned. Absolute criminalization of abortion turns it into a public health matter and produces social inequality. The Colombian legislation has always disregarded women as individuals and as persons in full possession of their legal rights. In contrast to a comprehensive conceptualization of sexual and reproductive rights, the various abortion bills merely refer either to "morally unacceptable" situations such as pregnancy resulting from rape or to therapeutic motives. Contradictions between illegality and reality give rise to a public discourse that features rejection of abortion practices, in keeping with the prevailing stance of the ecclesiastic hierarchy, while in practice, and at the private level, people resort to voluntary interruption of pregnancy under conditions of safety and confidentiality, at least for women from the higher socioeconomic strata. This situation not only causes social inequality but also reflects how laws lose meaning and create the collective impression of being useless or unnecessary, thus undermining the state's governing role.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X2005000200030 lng=en nrm=isoAbstract : Introducción ; La situación de los derechos reproductivos y sexuales en la Argentina ; Derechos reproductivos y sexuales y los tratados internacionales de derechos humanos ; Violaciones a los derechos reproductivos y sexuales y responsabilidad del Estado ; Algunas consideraciones respecto al aborto
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Abortion refers to the interruption of pregnancy before viability is achieved at around 20 weeks of gestation, 500 g of weight, or 25 cm of length. Illegal abortion is a serious public health problem, as demonstrated by its prevalence, possible complications, and the favorable cost-benefit ratio of preventive actions. The true incidence of abortion is unknown. Some 10 to 15% of all pregnancies are estimated to end in abortion. Indirect estimates of the proportion of pregnancies ending in abortion in Peru have ranged from 10% to 13.5%. There is indirect evidence that the number of induced abortions is increasing, including research findings that abortion has replaced infection as the second major cause of maternal death, hospital reports of septic abortion, abortion deaths, and the increased incidence of adolescent pregnancy, which is associated with abortion. Of the 37 hospital deaths from abortion in 1985, 27 were definitely the result of induced abortions and 9 of the remaining 10 probably also were. Septic shock is the usual terminal cause of death. 60% of the abortions were induced between the 13th and 20th weeks of pregnancy. An estimated 10% of women undergoing induced abortions may lose their reproductive capacity. Most abortions could be avoided by means of an intense educational campaign and maximal accessibility of contraceptive methods, especially for groups at high risk, such as single women. The Peruvian Society of Obstetricians and Gynecologists supports the proposed 1992 revision of the Health Code as it relates to abortion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 110512Abstract : Una de las tareas más importantes que el Procurador General de la República ha encomendado al Instituo Nacional de Ciencias penales (INACIPE) es la de dar a conocer a la sociedad civil el modo en el que se crea, se aplica e interpreta el Derecho Penal en México. Con este espíritu el INACIPE pública hoy La Suprema Corte de Justicia y el derecho a la vida, para que los lectores conozcan la forma de pensar y trabajar de la Suprema Corte de Justicia de la Nación a la hora de decidir si una conducta debe o no penalizarse, de acuerdo con el espíritu de nuestra Carta Magna. El libro da cuenta rigurosa de la génesis de una de las decisiones más importantes que ha tomado nuestro Máximo Tribunal en su Novena Epoca: ¿Fue constitucional la reforma sobre el aborto en el Distrito Federal? Independientemente de la postura que tengamos en torno a este tema, la decisión resultó histórica por donde se le mire. En estas páginas queda de manifiesto la seriedad con la que trabaja la Suprema Corte en México, la bullente prularidad de su Pleno y, sobre todo, el avance incontenible de nuestro país hacia el estado Democrático de derecho que todos anhelamos".
Notes : Español/espagnol/SpanishAbstract : La Campaña 28 de setiembre día por la despenalización del aborto en América Latina y el Caribe,la Campaña por una convención interamericana de los derechos sexuales y los derechos reproductivos y la Campaña Tu boca contra los fundamentalismos se unen para publicar este libro en el entendido de que la existencia real de Estados laicos es una premisa fundamental para la profundización de la democracia en América Latina y el Caribe. Un Estado verdaderamente laico garantiza la pluralidad de ideas y el respeto a la diferencia en las opiniones y creencias, situación que todavía no conocen la mayoría de los Estados en nuestra región.Estas tres campañas tienen diferentes objetivos y propósitos pero tienen también muchos puntos en común, uno de ellos es considerar a la sexualidad y a la reproducción como campos centrales de realización humana y advertir que estos han sido constreñidos históricamente por normas limitantes y represivas. El origen de nuestros Estados, construidos -salvo algunas pocas excepciones- bajo el imperativo de un orden tutelar, se ancló sobre los principios de una moral única, la de la Iglesia Católica, moral con pretensiones de verdad y validez universal. Los cuatro ensayos que publicamos tienen en común su calidad argumental, la seriedad en el tratamiento del tema y la convicción en la necesidad de fortalecer órdenes democráticos e incluyentes. El primero, titulado "El Orden Tutelar, para entender el conflicto entre sexualidad y políticas públicas en América Latina" de Guillermo Nugent sociólogo y psicoterapeuta peruano, hace una lúcida caracterización de lo que el autor llama tutelaje y re.exiona en torno a la importancia de desarrollar una cultura pública democrática. El segundo, "Estado laico, base del pluralismo", escrito por los paraguayos Patricio Dobrée, licenciado en filosofía y Line Bareiro, abogada y politóloga, desarrolla un recuento histórico sobre las disputas por la laicidad de la educación en el contexto de la formación de los Estados nacionales a partir del siglo XIX y hace una interesante re.exión sobre la importancia del pluralismo y los riesgos del pensamiento único. Los dos últimos, "Entre reactivos y disidentes, desandando las fronteras entre lo religioso y lo secular", y "¿Estado laico o Estado liberal?, reflexiones sobre las estrategias jurídico-políticas del feminismo en el mundo actual", fueron elaborados por Juan Marco Vaggione, doctorado en derecho y ciencias sociales, y Diego Freedman, abogado especialista en derecho penal y tributario respectivamente. Los autores son dos jóvenes argentinos, ambos ganadores de la categoría legal e interdisciplinaria del concurso regional de ensayos sobre estado laico realizada por el CLADEM en apoyo a la Campaña por la convención. El primero de ellos, es una provocadora reflexión acerca de los límites y riesgos de una visión reduccionista que podría opacar "importantes mutaciones de lo religioso". De otro lado, propone considerar la importancia política de lo que el autor llama las disidencias religiosas en los campos del género y la sexualidad. El segundo desarrolla una argumentación que problematiza los límites y dilemas de la conexión entre Estado laico y Estado liberal, con la intención de apreciar las mejores condiciones para garantizar la vigencia en los derechos de las mujeres. Esperamos que esta publicación contribuya a generar debates que fortalezcan la laicidad y la democracia. Incluidos todos aquellos temas que los defensores del pensamiento único se empeñan en silenciar.
Web site : http://www.convencion.org.uy/09Laicismo/latrampa-fin.pdfAbstract : This work examines the determinants and most important consequences of the Brazilian fertility decline. Brazil's total fertility rate declined from 6.2 in 1940 to around 3.5 in 1985. the decline began in the 1960s and amounted to 45% in about 20 years. The most rapid drop began in the late 1970s, with much of it concentrated in 2 specific periods: 1970-75 and 1980-85. The early period coincided with Brazil's so-called "Economic Miracle", a period of rapid growth accompanied however by deteriorating living conditions for the poorest population sectors. The second period coincided with the international economic crisis of the early 1980s, which was felt more strongly in Brazil than elsewhere in Latin America because of Brazil's greater degree of industrialization and closer integration into the world economy. Most of the fertility decline has been accomplished by use of just two contraceptive methods, oral contraceptives and sterilization, which together account for around 85% of contraceptive usage throughout Brazil. The third most common method, rhythm, accounts for just 6%. No reliable data on abortion are available, but it appears to be a common practice equally accessible to all socioeconomic strata despite greater associated health risks for poorer women. Brazil's fertility transition appears to have been a response to the process of proletarianization and urbanization underway in the country as well as to particular circumstances in the country. The most evident and immediate consequence of the continuous fertility decline over more than 20 years is the change in the age structure of the population. The proportions of children under 5 will decline from 14.4% in 1980 to 9.2% in 2010. The proportion aged 5-14 will decline from 24.5% to 17.4%, while the proportion aged 65 and over will increase from 4.0% to 5.6%. Brazil's recent demographic changes are scarcely reflected in development plans and political and social projects. There is almost no mention of the new demographic dynamics which entail new problems to be faced, but also new and more favorable conditions for overcoming some old problems. Most planners retain a conception of Brazil's population as very young, rapidly growing, and with a constant age distribution. Some promising areas for social investment are health, nutrition, and preschool education for small children; improvement and expansion of the public educational system; and improvement in the quality of the labor force. The growing elderly population will require health services, pensions, and alternative living arrangements for the increased proportion without close relatives. A regional development strategy should be developed to assure that conditions do not deteriorate in any region as demographic changes progress.
Web site : http://www.eclac.cl/cgi-bin/getProd.asp?xml=/celade/agrupadores_xml/aes51.xml xsl=/celade/agrupadores_xml/a18l.xslAbstract : The authors analyze the fertility decline in Colombia at the household level based on a comparison of cohorts of women who represent behavior before and after the demographic transition. The focus is on changes in the different stages of family formation, as well as the effect of women's status on these stages. The first two chapters provide an overview of the demographic transition and socioeconomic change in Colombia and describe the survey design and methods of analysis. In Chapter 3, regional and socioeconomic characteristics are described. In Chapter 4, the authors use retrospective life histories to analyze trends in family formation as well as the socioeconomic determinants of those events, with a focus on women's productive and reproductive behavior over the life course. Chapter 5 provides a discussion of women's own perceptions of their life course, with a focus on sexual behavior, maternity, abortion, family planning, dependency, division of labor, and use of time. Data are from surveys conducted in 1984 and 1986 in Bogota and in the rural area of a central Andean region.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND 8017671Abstract : A través de diferentes e interesantes trabajos se abordan reflexiones de los temas en relación a la violencia; para entender la realidad de éstos hechos y delitos sexuales en nuestro país. Los autores plantean que es a partir de ver integralmente las soluciones y de entender la violación como fenómeno social, que se desprende la posibilidad de que se pueda brindar ayuda por parte de personas sensibles, con cierta capacitación e interesadas en que la violencia hacia las mujeres desaparezca
Notes : Español/espagnol/SpanishAbstract : En muchas sociedades, existe una tolerancia general de la violencia contra las mujeres. La violencia puede contribuir a embarazos no deseados y a la mortalidad y morbilidad relacionadas con el aborto.
Notes : Español/espagnol/SpanishAbstract : Metodología ; El consenso normativo dominante: la perspectivaheteronoma ; El consenso normativo emergente: la perspectiva autonómica ; Conclusiones ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Recopilación de comentarios y propuestas sobre la legislación de los derechos de la mujer en la constitución mexicana. Revisa la legislación en el Código Penal sobre la violencia contra la mujer en el estados de Morelos, la ley federal del trabajo, ley general de salud y los acuerdos de la convención sobre la eliminación de todas las formas de discriminación contra la mujer en la ONU
Notes : Español/espagnol/SpanishAbstract : Narra las situaciones por las que tuvo que pasar Paulina, quien al ser violada recurre a las autoridades para denunciar el delito, protegida por el código penal tiene derecho a abortar, sin embargo las circunstancias la llevan a vivir una maternidad que ella no deseaba
Notes : Español/espagnol/SpanishAbstract : Balance de los logros y desafíos para México a cinco años de la firma de los acuerdos de la Plataforma de Acción Mundial. La mirada evaluatoria en torno a cada una de estas temáticas fue realizada por mujeres especializadas en cada una de las mismas, con una experiencia basada en la práctica política y un fuerte compromiso con el movimiento feminista en México
Notes : Español/espagnol/SpanishAbstract : Información relevante con relación a las causas principales de mortalidad de las mujeres en países en vías de desarrollo relacionada con la reproducción biológica, esto incluye, el ejercicio forzado de la sexualidad, procreación obligatoria, embarazos riesgosos y gestaciones no deseadas. Así mismo otras causas de la mortalidad se encuentran en las condiciones no satisfactorias de la calidad de vida y atención de la salud. Incluye testimonios con mujeres de Ocuituco, sobre su sexualidad y la anticoncepción
Notes : Español/espagnol/SpanishAbstract : An analysis of the status of human rights in the Catholic Church should begin with an examination of the theme of human rights in the Bible. The rights of the poor was a primary theme in both the New and Old Testaments. The poor referred to the impoverished and to those excluded by society, who today comprise 3/4 of the world's people. A Church that aspires to be the Church of Jesus Christ must defend the excluded. To defend the rights of the excluded meant, for the prophets, to defend the rights of God. The Church must safeguard truths but must also be merciful. Biblical mercy is not sentimental commiseration, but rather involves solidarity with the needy and joint search for the causes of their problems and for a solution. Some serious shortcomings are evident in the internal practices of the Church with regard to human rights. A Church in which the majority of members are women but all decisions are made by a small group of men is a Church practicing sexual discrimination. Lack of tolerance for dissent and denial of freedom of expression are other violations of human rights of which the Church is sometimes guilty. Decisions in the Church are made by the few; the majority of members and even of priests are denied a voice. The right to life should be defended and safeguarded in the Church. But for many groups that call themselves defenders of life (the "pro-life" organizations), concern with life appears to end at birth. Incorporating the excluded into the Church and society is a contribution to the Kingdom of God on Earth.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 115494Abstract : Resumen y contenido: La disminución de la natalidad y la "amenaza a la raza" ; La regulación de la natalidad, el infanticidio, el abandono de niños y el aborto ; El aborto ; Los médicos y la construcción de un ideal maternal ; La madre: desviaciones y resignificaciones ; La "pobre" madre pobre ; La "solitaria" madre soltera ; Reflexiones finales
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : El objetivo de éste proyecto es generar capacidad entre quienes realizan actividades para mejorar o incrementar el acceso al aborto, ya sea a través de la reforma de la ley, o de la ampliación del acceso y la calidad de los servicios. El proyecto ofrece ejemplo del activismo iniciado en el sur, que tiende puentes y facilita el aprendizaje entre regiones y países del norte y del sur
Notes : Español/espagnol/SpanishAbstract : La difícil conceptualización de la juventud ; La situación social de los jóvenes mexicanos ; Escolaridad ; Actividad laboral ; Prácticas sexuales y reproductivas ; Estado conyugal ; Edad a la primera unión ; Prácticas sexuales ; Embarazos ; Fecundidad ; Conocimiento de métodos anticonceptivos ; Uso de métodos anticonceptivos ; Infecciones de transmisión sexual ; Drogadicción ; Alto riesgo reproductivo ; Abortos ; ; Educación sexual ; Otros elementos que deben ser tomados en cuenta ; ; Estrategia analítica ; Conclusiones
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : The average estimated annual population growth rate in the Latin America and Caribbean region has fallen to 1.7% from an estimated 2.71 in the 1960s. At the macro-level, this trend is due primarily to the decline of regional total fertility over the period from 6 to 3 children/woman. Overall infant mortality rate (IMR) has also fallen since the 1950s from 125/1000 to 53/1000 live births, albeit varying according to country, region, and socioeconomic factors. The IMR for Cuba and Puerto Rico is 15/1000, while it is 100/1000 in Bolivia and Haiti. Increased literacy, reduced poverty, and the growth of the mass media over the 1960 and 1970s, not family planning strategies and interventions, have brought about the demographic transition in the region. Recently, however, representatives of countries in the region have agreed to support each others' family planning and population education programs. Actions programs must target the poorest and most difficult to reach in the face of national economic setbacks and restructuring of the 1980s and 1990s. Representatives also discussed the need to check maternal mortality due to illegal, unsafe abortions; Mexico's proposal to develop a plan of action for the region; and international migration. Cuba is presently the only country in the region which offers legal abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 083440Abstract : This book chapter provides an overview of the fertility transition in Latin America, including rates of decline, age distribution of population, adolescent fertility changes, and fertility patterns by country, educational status, and occupation. Patterns indicate that fertility was high, at about 6 children/woman from the 1950s until the mid-1960s, at which point most countries began their fertility decline. By 1985-90, the total fertility rate (TFR) declined to about 3.6 children/woman. Fertility varies widely between countries and can be characterized by 4 transitions: very advanced transitions with TFR under 3 (Argentina, Uruguay, Cuba, and Chile); advanced transitions with TFR between 3 and 4.5 (Brazil, Colombia, Costa Rica, Ecuador, Mexico, Panama, Peru, Dominican Republic, and Venezuela); intermediate transitions with TFR between 4.5 and 5.5 (El Salvador, Haiti, and Paraguay); and beginning transitions with TFR over 5.5 (Bolivia, Guatemala, Honduras, and Nicaragua). The contribution to fertility of women aged 20-29 years has increased in all Latin American countries. There has also been a worrisome increase in unwanted pregnancies, teenage pregnancies, premarital teenage pregnancies, and incidence of abortion. Fertility transition is more advanced in urban areas and among the upper and middle classes. Change is occurring among agricultural classes and in rural areas, following low fertility in urban areas. Educated women have lower fertility. The large number of women in reproductive ages will lead to continued increases in fertility. However, total births and births to teens and women over 30 years are declining.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 136367Abstract : In July 1993, the Latin American and Caribbean Women's Health Network hosted a meeting on Women and Population Policies in preparation for the 1994 International Conference on Population and Development (ICPD). Among the nearly 70 women participants were representatives of women's health groups, development agencies, universities, and governments. The presentations at the meeting covered such topics as the need for sexual and reproductive rights to be explicitly addressed in legal instruments, the work of nongovernmental organizations in promoting the right to health, efforts to open debate about abortion and restore legal therapeutic abortion, antinatalist policies which have been adopted without the inclusion of the views of women, ways in which women have participated in preparing for the ICPD, and "North versus South" demographic policies. Participants reached consensus on the need to 1) base population policies on principles of social justice and equity, 2) clearly define reproductive and sexual rights, 3) achieve guarantees of reproductive and sexual rights, 4) empower women, and 5) build alliances with those involved in formulating population policies. Participants also agreed to ask the Secretary General of the ICPD to allow the women's health movement to have the broadest participation possible in the ICPD.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : September 28, the Latin American and Caribbean Day for the Decriminalization of Abortion, was designated by the women participants during the 5th Latin American and Caribbean Feminist Encounter held in Argentina in 1990. It was established as an annual day to focus public attention on the problem of unsafe abortion and its important role in maternal mortality and morbidity in the region. Its objectives are to 1) change the legal status of abortion; 2) defend the right of women to choose motherhood; 3) draw attention to unsafe abortion as a public health problem; and 4) end preventable maternal deaths due to complications from clandestine abortions. In over 10 years of the September 28 campaign, participating organizations have acquired a growing commitment to the annual event, despite the complex reality of abortion in the region. The Latin American and Caribbean Women's Health Network participates every year as a focal point for the distribution of information about this day of activism, publicizing its Call for Action and the reports of the participating groups.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Approximately 4 million women undergo illegal abortions each year in Latin America and the Caribbean, and hundreds of thousands of women with postabortion medical emergencies or incomplete abortions seek hospital care. Once in an emergency ward, a woman may await treatment for 24 hours, bleeding, frightened, and in pain. A woman in such a situation may also experience nurses who chastise her for becoming pregnant or committing a sin, be examined with several staff members observing, undergo unexplained treatment without anesthesia, and/or leave the service facility without knowing whether she is still fertile or how to avoid pregnancy. INOPAL, Population Council's operations research program on family planning and reproductive health in the region, is working to find the best ways, medically and financially, for hospitals to deliver high-quality, comprehensive services to postabortion patients. Most maternal deaths and injuries could be prevented by access to family planning services and information about contraceptive use. The Population Council and colleagues from hospitals, governments, and nongovernmental organizations are conducting studies in Guatemala, Peru, and Mexico on the emergency treatment of incomplete abortions with the goal of improving and standardizing postabortion services.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 128230Abstract : This document provides a broader understanding of the role of abortion in the fertility behavior of Latina women in the US. Data were collected from published data and from original analyses of abortion use by Latino subgroups based on estimates from the Hispanic Health and Nutrition Examination Survey. In the data, it is apparent that Latinos in the US are not a homogenous group. Different subgroups, although sharing a common base of language, religion, and Spanish colonization, can have strikingly different cultures shaped by the particular historical processes to which they were subject. Fertility behavior is only one example of the extent to which American Latinas differ among themselves. Although there appear to be strong effects of traditional Latino cultural values on their use of abortion, these effects appear to be mediated by country or area of ancestry or origin, acculturation or biculturalization in the US, and socioeconomic status. It is noted that Latinas hold a range of attitudes and opinions about abortion from pro-life to pro-choice. The majority are ambivalent about abortion, recognizing the need for it under certain circumstances, yet still regarding it as a serious moral issue. This ambivalence and the struggle over the morality of abortion will continue to be reflected in the abortion decisions made by women throughout the world.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 161723Abstract : The single Section of this Law amends Sec. VI of the Preliminary Title of Legislative Decree No. 346 of 6 July 1985 promulgating the Law referred to in the title (see IDHL, 1985, 36, 980, Peru 95.1), which now reads as follows: "VI. The National Population Policy excludes abortion as a family planning method. The methods adopted shall, under all circumstances, be based on the free exercise of an individual's wishes, without recourse to any incentives or material reward." (full text)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 114052Abstract : There is a lack of contraceptive services in Argentina, resulting in many adolescent pregnancies and illegal abortions. The quality of obstetric care is very low. It is not necessary to be a specialist in obstetrics to perform a cesarean section. 5 weeks of medical studies are needed for obstetrics. Argentina leads the world in the number of cesarean sections. Maternal mortality is underreported. Of 120 death certificates examined, 13 had occurred in a cesarean section. Only 5 had been reported this way. Underreporting was close to 50% in Buenos Aires in 1985. Catholicism is the main religion in Argentina. 2 decrees prohibit contraception ; decree 659 and decree 3938. In 1985, the Feminist Movement campaigned against this. The President of Argentina "derogated" decree 659 in 1986. Family planning and sex education are now legal, but little has been done. Contraceptives are not paid for by Social Security for the average women. One requirement to make family planning services available is to have had 2 cesarean sections. Cesarean sections are being promoted. The fertility rate for girls aged 14 to 19 increased from .3 children per woman to 1.3 in 1980, an increase of 333%. There are about 400,000 abortions done a year. 10% are performed under safe conditions. 1 in every 250 ends in death, it is estimated. That is 4 deaths/day. In 1988, resolution 463/88 was passed. The National Institute of Health Schemes is to make family planning services available for only high-risk populations. 1 of the requirements is to have had an abortion. Thus, health service is available only if women have committed a crime.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - CPFH 26459cr990Abstract : Between August 1994 and January 1995, at the University Hospital Center in Fort de France, Martinique, obstetricians administered misoprostol to 129 nulliparous women requesting an induced abortion at a gestational age of 7-12 weeks. All the women received misoprostol 12 hours before vacuum aspiration to dilate the cervix in preparation for vacuum aspiration. The researchers divided the women into three groups so they could compare the efficacy and side effects of vaginal insertion of misoprostol with those of oral insertion. Women in group A received 200 mcg intravaginal misoprostol, women in group B received 400 mcg intravaginal misoprostol, and women in group C received 400 mcg misoprostol via the oral route. Group B experienced significantly higher cervical dilatation and maximal dilation achieved with Hegar dilatator than the other groups (8.97 mm vs. 7.74 mm for group A and 8.2 mm for group C, p = 0.002; and 9.65 mm vs. 9.18 mm and 9.17 mm, p = 0.01, respectively). Partial abortion before vacuum aspiration was more likely to occur in group B women than in those in the other groups (35% vs. 12% for group A and 6% for group C; p = 0.003). Nausea/vomiting, diarrhea, pain, and fever occurred at a similar rate in all three groups. The metrorrhagia and hemorrhage rates were higher in group B than the other groups (93% vs. 70% for group A and 43% for group C, p = 0.00002; and 56% vs. 28% and 16%, p = 0.001, respectively). These findings suggest that 400 mcg misoprostol inserted 12 hours before vacuum aspiration is an effective, practical, safe, inexpensive, and well-tolerated regimen for cervical preparation before abortion.
Web site : http://doccem.icl-lille.fr/Reference.htm?numrec=191913479919520Abstract : En Guadeloupe, l'avortement est légalisé depuis 1975, mais il était déjà largement pratiqué auparavant. Les avortements clandestins représentent encore un tiers du total des avortements et l'ensemble de ces avortements représetnent également 40% des naissances vivantes. L'article présetne une étude sur l'utilisation du RU 486, méthode qui rentre dans le cadrede l'interruption volontaire de grossesse. Ce RU486 associé au misoprostol, s'est montré efficace dans 95 % des cas. Les raisons invoquées par les femmes pour le recours à l'IVG correspondaient surtout à un besoin d'espacement des nais- sances ou d'arrêt dans la constitution de la descendance. Le RU 486 est un moyen de faire face aux avortements illégaux, il reste un procédé abortif et nécessite un cadre législatif qui fait défaut dans nombre de pays du sud.
Notes : Francés/français/FrenchAbstract : The introduction to this issue of the newsletter "MotherCare Matters" notes that MotherCare has been working since 1989 to improve maternal health and has determined that the pathway from life-threatening illness to survival depends upon 1) recognition of the problem, 2) Decision making regarding care, 3) access to quality care, and 4) quality care. Research conducted according to this framework has led MotherCare to target efforts towards 1) improving quality of care, 2) changing behaviors, and 3) supporting policy formulation. This issue illustrates how MotherCare operates by highlighting three demonstration projects and two applied research projects. The first demonstration project involves training midwives in Indonesia to improve their technical and interpersonal skills, the second and third, in Bolivia and Guatemala, involve improving quality of care given by physicians, nurses, nurse auxiliaries, and traditional birth attendants. Use of IEC (information, education, and communication) materials during counseling is an important component of all three projects. The first applied research project described is MotherCare's effort to reduce deaths from unsafe abortion in Ghana by training non-physician providers in postabortion care. The second project seeks to determine the effectiveness of an innovative approach undertaken in Uganda to control sexually transmitted diseases, particularly reproductive tract infections that can be transmitted to the fetus of newborn. Important lessons that MotherCare has learned during the first decade of the Safe Motherhood Initiative have been that community involvement is essential for ensuring culturally relevant interventions and that it is necessary to change the health care delivery system to connect providers at different levels in a new way.
Notes : Inglés/anglais/English, nbsp;popline 129328Abstract : This chapter in a book about sexuality opens with an autobiographical account of the author's life as she moved from being a model daughter, wife, and mother in Venezuela to her first job as a psychologist, when she became conscious of the social and cultural implications of being a woman. Working as part of a support team for pregnant working-class women in a large, urban maternity hospital led the author and her coworkers to understand that gender-based violence and sexual repression are the primary obstacles to achieving sexual and reproductive health in women. This understanding led to the creation of AVESA, Venezuela's first nongovernmental organization that offers women alternatives to achieve greater control over their health and sexuality. AVESA activities include consciousness-raising sessions; health and sex education; treatment for rape victims; as well as counseling, contraception, and clinical services for women who have obtained an illegal abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 113342Abstract : Rosario Taracena reports on legal responses to rape in Mexico where abortion is allowed. Taracena takes three publicly debated events where the right to abortion due to rape was challenged in Mexico as offering some important lessons for reproductive and sexual rights activists. (author's)
Web site : http://www.ingentaconnect.com/content/pal/dev/2001/00000044/00000003Abstract : Despenalización y legalización ; Plazos ; Motivos ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : L'avortement est l'une des principales causes de mortalité maternelle en Amérique latine. Pourtant on en connaît mal la distribution et l'évolution en raison des carences des systèmes d'information en général, et de la mauvaise image de l'avortement provoqué en particulier. La présente étude a pour objectif la description des statistiques hospitalières de l'avortement dans cinq régions de l'Équateur depuis qu'existent ces données, c'est-à-dire 1965. Cependant afin de réduire les variations de l'accès aux soins au cours de la période, on étudie le taux (par année et par région) d'avortements pour 100 grossesses et accouchements ayant donné lieu à une hospitalisation. L'analyse met en évidence les faits suivants : l'évolution suit une courbe passant par un maximum plus ou moins aplati, légèrement plus élevé dans les zones à prédominance urbaine que dans celles principalement rurales, et plus précoce dans les régions côtières que dans les provinces andines. L'interprétation de ces phénomènes nouveaux - en particulier la diminution rapide de l'avortement durant les cinq dernières années - doit être prudente dans la mesure où il s'agit de données institutionnelles ne reflétant qu'imparfaitement la situation réelle, où l'on dispose de peu d'informations sur les populations rurales n'accèdent pas aux structures sanitaires, et où l'on n'a pas les moyens de différencier les avortements provoqués et spontanés. Malgré ces réserves, il semble bien que la tendance évolutive observée traduise un recul effectif de l'avortement, en particulier induit, ce que les études complémentaires devront confirmer et expliquer.
Notes : Francés/français/FrenchAbstract : Ce document decrit l'evolution des I.V.G. (Interruptions Volontaires de Grossesse) a la Martinique de 1975 a 1992. Il presente une comparaison interregionale avec la Guadeloupe et la Guyane, ainsi qu'avec la Metropole. Deux analyses completent cette etude : l'analyse plus fine des bulletins statistiques d'IVG de 1992, ainsi que l'analyse de la demande d'IVG en Martinique de 1981 a 1991 (experience de l'AMIOF : Association Martiniquaise pour l'Information et l'Orientation Familiales)
Notes : Francés/français/FrenchAbstract : En 1998, le nombre d'interruptions volontaires de grossesses (IVG) s'établit à 214 000, soit 6 % de plus qu'en 1990. Dans le même temps, le taux d'IVG pour 1 000 femmesde 15 à 49 ans a légèrement diminué (de 13,6 à 13,3). Si l'on restreint l'observation aux femmes de 15 à 44 ans, il s'est au contraire un peu accru (de 15,0 à 15,4.). En fait, ce taux, stable après 25 ans, a plutôt crû pour les jeunes et très jeunes femmes, ce qui révèle peut-être un changement de comportement. Le secteur hospitalier public assure les deux tiers des IVG. Son activité n'est minoritaire en ce domaine que dans douze départements, situés en Ile-de-France et dans le sud de la France. Ces régions sont, par ailleurs, celles où le taux d'IVG est plus élevé que la moyenne de France métropolitaine. Les départements d'Outre-mer présentent des taux d'IVG plus importants. Le secteur public assure, en outre, la majeure partie de la prise en charge des IVG par mode médicamenteux qui concerne désormais le cinquième des IVG pratiquées
Web site : http://www.sante.gouv.fr/drees/etude-resultat/er-pdf/er069.pdfAbstract : Since the early 1990s, three major public sector institutions in Mexico have been dealing with abortion-related complications ; the fourth most frequent cause of maternal mortality in the country. Despite relatively conservative abortion legislation, Mexico has the broadest experience in scaling-up post-abortion care. All three institutions have developed long-term strategies that over time have made improvements at all levels of the health system. To date, more than 30,000 providers in nearly 60% of Mexico's public hospitals have been trained in manual vacuum aspiration for treating incomplete abortions, and post-abortion contraceptive services, monitoring and information systems have also been improved.
Web site : http://www.rhmjournal.org.ukAbstract : Introduction ; Methodology ; Poverty among women of reproductive age ; Reproductive behaviour and poverty ; Pregnancy, abortion, and poverty ; Summary and conclusions ; Notes ; References.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 111116Abstract : PRASSAR/CENEP/OMSAbstract : Este libro es la continuación de otro libro con el mismo título (Capítulo 1o) publicado en septiembre de 2004. En el presente libro se puede seguir paso a paso el proceso de discusión de la Ley Marco de Derechos Sexuales y Reproductivos, desde agosto 2004 en que se concluyó el Capítulo 1o hasta diciembre de 2005. El libro presenta noticias, artículos de prensa y testimonios de quienes vivieron ese proceso desde el activismo para conseguir que los derechos sexuales y los derechos reproductivos algún día sean una realidad en Bolivia. Incluye puntos de vista tanto de quienes estuvieron a favor como en contra de la Ley Marco: Iglesia Católica, Evangélica, grupos de poder, padres de familia, por un lado; y por otro, organizaciones no gubernamentales de todo tipo, autoridades nacionales, Defensor del Pueblo y activistas de los derechos humanos.
Notes : Español/espagnol/SpanishAbstract : Prólogo ; Ley nro. 418, texto definitivo con las modificaciones introducidas por la Ley 439 ; Intervención de la Diputada Clori Yelicic
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Modifying the laws on abortion in Mexico, in order to make them more liberal, raises a number of questions that can be clarified through a brief review of the state of the law in other parts of the world. Given that abortion is permitted only in determined circumstances in Mexico, our country forms part of the nations with very strict laws on this issue. This situation goes against the world trend that has, for a number of decades, aimed towards the liberalization of said laws. The liberalization of abortion laws, whether through decriminalization or legalization, began in the 1950s when the central European countries began to allow abortions as a woman's choice. (excerpt)Modificar las leyes sobre el aborto en México, para hacerlas más liberales, plantea un conjunto de interrogantes que pueden aclararse a través de una revisión somera del estado que guarda la ley en otras partes del mundo. Como en México el aborto está permitido solo en determinadas circunstancias, nuestro país forma parte de las naciones que tienen leyes muy estrictas en la material. Esta situación va en contra de la tendencia mundial que, desde hace varias décadas, apunta hacia la liberalización de dichas leyes. A partir de los años cincuenta -cuando los países de Europa central comenzaron a admitir el aborto por voluntad de las mujeres- se inició la liberalización de las leyes de aborto, sea a través de la despenalización o la legalización. (extracto)
Notes : Español/espagnol/Spanish, nbsp;179647Abstract : 30 kilometers north of Rio de Janeiro, in Belfort Roxo, Brazil, women have 6 births compared with the national average of 3.2 births, and have a higher maternal mortality rate than the national average of an estimated 140 maternal deaths/100,00 live births. Despite these grim statistics, family planning and health services have suffered crippling budget cuts, a temporary national freeze on all bank accounts, and the transfer of control from federal to local government. Poor women and teenagers resort to illegal, unsafe abortions; patients with complications must go miles to reach a hospital, and then they must go from emergency room to emergency room seeking treatment because of overcrowding. Women have over a million abortions annually with an estimated 24,000 deaths occurring within 40 days of the abortion; deaths after 40 days from abortion complications are uncounted. Brazil's 1988 Constitution guaranteed the right to government-provided family planning information and services. Some local governments lack money to provide contraceptives, medicine, or medical supplies, leaving only expensive oral or permanent female sterilization contraceptive choices that are provided mainly by the private sector, and account for nearly 80% of contraceptive use. The clinic in Belfort Roxo, service the poor, survives on the kindness of now unpaid workers who continue to provide care for those even more financially desperate than themselves. As part of a newly organized municipality, the clinic hopes to receive increased funding when the bank accounts are thawed and a new budget installed.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 075113Abstract : Este artigo analisa a opinião apresentada por Adrienne Asch em "Diagnóstico pré-natal e aborto seletivo", presente na coletânea da Revista Physis n.2 de 2003. A posição de Asch, acerca do caráter discriminatório do aborto seletivo, será apreciada a partir da qualidade de sua retórica argumentativa. Em seguida, será revista à luz da realidade sócio-cultural do Brasil, país periférico, caracterizado, para fins de comparação com os Estados Unidos, como país de legislação proibitiva para o aborto, de incipiente mobilização política organizada das pessoas deficientes e no qual a história de doutrinas e práticas eugênicas percorreu outras trajetórias.
Web site : http://www.anis.org.br/serie/artigos/sa30(barros)asch.pdfAbstract : Resultado de los talleres de consulta entre representantes de sectores del Estado, instituciones públicas, gobiernos locales, organizaciones no gubernamentales y organizaciones civiles
Notes : Español/espagnol/SpanishAbstract : Por primera vez en Colombia una ciudadana, la abogada Mónica Roa interpone, una demanda ante la Corte Constitucional, argumentando la necesidadde despenalizar el aborto: cuando la vida de la mujer o su salud está en peligro, cuando el embarazo sea resultado de una violación y cuando existan malformaciones fetales incompatibles con la vida extrauterina.
Web site : http://www.catolicasporelderechoadecidir.org/publicacionesAbstract : Este reportaje, realizado por una red de comunicadoras feministas, reveló prácticas discriminatorias aplicadas en hospitales estatales donde se intentaba cobrar la atención postaborto a mujeres sospechadas de haberse practicado el aborto. El Seguro Materno-Infantil aplicó una política temporal de brindar el servicio gratuitamente a mujeres cuyos abortos eran calificados como espontáneos. La tendencia expresada por el director del Hospital de la Mujer en la ciudad de La Paz era "desconfiar" de las mujeres, desde el inicio, con respecto a su explicación sobre las circunstancias de su pérdida de embarazo
Notes : Español/espagnol/SpanishAbstract : The study involved 438 individuals, of whom 315 were men and 123 were women. They were divided into 3 age groups: 17-20, 21-25, and over 25 years of age. There were 122 men and 50 women in the first age group; 161 men and 65 women in the second group; and 32 men and 8 women in the third age group. An anonymous questionnaire was administered to them. In the 17-20 age group 84.22% of the 122 men were sexually active and 68.9% used contraceptives, mainly condoms (98.6%). In the same group 28% of the 50 women were sexually active, of whom 100% reported contraceptive use, mainly menstrual cycle control (71.42%) and condoms (21.43%). In the 21-25 age group 83.22% of the 1612 men were sexually active and 76.86% were using contraceptives, mainly condoms (70%). 44.61% of the 65 women were sexually active in this group, of whom 82.75% were using contraceptives, mainly cycle control (58.33%) and pills (25%). In the age group of over 25 years 65.62% of the men were sexually active and 71.42% were using contraceptives, mainly condoms (66.66%). In this group 87.5% of the women were sexually active and 51.14% of them were using contraceptives (100% menstrual cycle control). In the 17-20 age group no pregnancy was reported by the men and only 1 abortion. 7.14% of the women in this group reported pregnancy but no abortion. In the 21-25 age group none of the men reported pregnancy and 1.49% said that their partner had undergone an abortion. Among women 20.68% reported having been pregnant and the same percentage reported having had an abortion. In the over 25 age group 14.28% of the women reported pregnancy. Among men abortion was disapproved by 68%, 62.11%, and 65.62%, in the respective age groups, while abortion was approved by 27.87%, 24.22%, and 6.25%, respectively. Among women 70%, 67.7%, and 62.5%, respectively, were opposed to abortion, while 22%, 20%, and 37.5%, respectively, approved abortion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 117235Abstract : Positions regarding abortion in penal law range between the extremes of granting women an absolute right to decide whether to seek abortion, and regarding abortion as equivalent to murder. The Peruvian penal code under most circumstances calls for a maximum penalty of two years in prison for the woman and the practitioner. The penal code of 1991 called for reduced sentences in cases of rape or congenital malformations. Criminal law is usually regarded as the last resort of the state after the family, education, psychology, or religion have failed to assure desired behavior or discourage undesired behavior. Only the social interests of maximum priority in a society should be protected by criminal law. In the case of abortion, the penal code has not been used as the last resort. Criminalization is the first and only solution for eradicating abortion. But since laws were passed to punish abortion in Peru, their number has consistently increased along with the size of the population. The prison terms specified in the penal code are largely symbolic, but a series of other measures in addition to the stigma and inconvenience of a criminal charge also constitute sanctions. Abortion is not desirable as a method of population control. In principal, however, criminal law can contribute nothing to the problem. Abortion should be decriminalized, which does not mean that the state should promote abortion. Considering abortion a crime generates a series of grave indirect costs. The principal of equality is violated when women with resources are able to secure medically safe abortions, legal or not, but poor women are unable to do so. The more compelling argument for decriminalization is the significant contribution of unsafe abortion to maternal mortality.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159733Abstract : El folleto informa de la investigación realizada al Programa de Acción del Cairo, en cinco países latinoamericanos. Contiene indicadores de contexto y proceso, indicadores de impacto y resúmenes
Notes : Español/espagnol/SpanishAbstract : Introducción ; Cuando la política roza el sexo de los cuerpos de mujeres y varones ; ¿Qué opinan las mujeres hoy, aquí? ; Propuestas para el cambio.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : A study of the knowledge of residents of Asuncion concerning reproductive rights and health was conducted by means of a survey of 400 men and women, semi-structured interviews with legislators, and a working breakfast with a group of legislators and other opinion leaders. The work begins with a discussion of attitudes toward and consequences of abortion legislation in Paraguay, attitudes toward abortion of the indigenous peoples of Paraguay, and the antecedents to the study. Analysis of existing literature on the topic includes a brief history of attitudes toward sex, especially among women, and discussion of works on reproductive rights, maternal mortality, and the declarations of the recent UN international conferences. The working hypothesis of the study was that the population of Asuncion and the legislative representatives lack theoretical knowledge of sexuality, reproductive health, and reproductive rights. The survey methodology and sampling procedures are descried, and demographic and socioeconomic characteristics of the 400 survey respondents are summarized. Survey results are discussed in terms of perceptions of health, images of sexuality as primarily procreative or pleasure-oriented, ideal age for the first birth, ideal number of children and family planning, adolescent pregnancy, knowledge and opinion of reproductive rights, and knowledge of abortion. The opinions of the political leaders are discussed in the area of images of reproductive rights and health, perceptions of gender, sexuality and education, possible contents of sex education, and perception of fertility and its determinants in Paraguay.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 145287Abstract : 561 women aged 15-49 of low socioeconomic status living in peripheral areas of Buenos Aires were surveyed in late 1992 to early 1993 to determine the factors involved in the persistence of relatively high fertility among them. The fertility decline in Argentina as a whole was consolidated in the 1930s, and the average family size has fluctuated around 3 children. Argentina's moderate population growth is associated with public policies discouraging contraceptive usage. Contraception and abortion are shared traditions among middle and upper class women with access to private services and in many lower class sectors. The study examines possible factors motivating higher fertility in the sociodemographic characteristics, contraceptive knowledge and usage, opinions concerning family formation and size, and degree of autonomy of the sample women. A significant finding was that respondents had somewhat smaller families than their mothers, suggesting that a transition may be underway. Pretransitional fertility patterns in the older women were related to larger family size models, completion of childbearing before massive diffusion of modern contraceptive methods, migration from high fertility areas in Argentina or abroad, and low educational attainment. Although respondents had high levels of fertility for Argentina, they were experienced in contraception. 75% of those aged 25-34 used a method. Younger respondents reported an earlier initiation into sexual activity, union, and childbearing than did older women. Several factors may encourage future fertility decline: higher educational levels, greater knowledge of contraception, incorporation of contraception into some public sector health services, and declining family size preferences. A broad spectrum of actions influencing aspects of gender, work, and equity may also be necessary.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159705Abstract : Introducción ; La moralidad como problema empírico ; Reprobación ypenalización del aborto: tendencias segun el idealismo y el relativismo morales ; La influencia delsexo y del idealismo y relativismo morales en relación a las actitudes generales hacia el aborto ; Conclusiones generales y discusión ; Notas ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Contenido: Una mirada al proceso feminista en la región, Actoras, estrategias y espacios de actuación, Las continuidades y los cambios, A modo de conclusión
Web site : http://bibliotecavirtual.clacso.org.ar/ar/libros/grupos/mato/Valente.rtfAbstract : The validity and persuasive force of arguments employed by antiabortion forces in Puerto Rico and counter arguments from the pro-choice side are analyzed in the context of Puerto Rican law and the influence of the US. Although abortion is legal in Puerto Rico, the right to abortion has been attacked, and its accessibility has been affected. Abortion has assumed a symbolic character in reference to broader views of society and the world, definitions of women, gender roles, sexuality, reproduction, the family, and social problems. The central argument of the antiabortion offensive is that human life begins at conception. The primary theme is fetal right to life, while the definition of women and control over their moral agency and reproductive capacity are secondary themes. The pro-choice forces argue that choice is essential to women s equal treatment as persons with the full range of human prerogatives and potentials. Forcing a woman to carry an unwanted pregnancy to term is a moral and ethical matter. The most dramatic argument employed on the pro-choice side concerns the hundreds of thousands of maternal deaths and injuries caused by illegal abortion. The need to respect the diversity of positions regarding the definition of human life and the separation of church and state, the biological reductionism of the view that the fetus is a human being, and the dehumanization of women implied by humanization of the fetus are other issues.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 145536Abstract : This research project explores doctors' views regarding induced abortion. Abortion's penalization in Mexico greatly conditions its relevance as a social and public health problem. Physicians constitute a professional sector that can play an important role in reforming current laws on abortion. As a professional group, they have taken a conservative stance towards abortion. Their attitudes are to a great extent influenced by the medical training they receive. In this article we present results from a survey of 96 medical students from the Universidad Autonoma Metropolitana Xochimilco, in Mexico City. Data were processed with the SPSS program. Simple frequencies show that students have limited knowledge concerning the legal status of abortion and that they tolerate it with restrictions and in limited situations. Women students apparently take a more conservative stance, but statistical analysis with the c-square test did not show significant differences by gender. The article poses the need to modify doctors' training in the reproductive health field, allowing future doctors to acquire a broader view of health problems related to sexuality and reproduction. In the long run, this should also promote a kind of comprehensive health care practice in medical services, thus responding more satisfactorily to women's needs.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X1997000200012 lng=en nrm=isoAbstract : Doctors on Contraception and Abortion: An Ideological Transition? presents the results of research on gynecologists and obstetricians serving the poorest sectors of the population in the public hospitals of Buenos Aires. The physicians shared their views on issues of reproductive health, including contraception, abortion and sexual and reproductive rights. The authors of the study hope that this information will help improve quality of care and promote sexual and reproductive rights, especially for women.Silvina Ramos, Monica Gogna, Monica Petracci, Mariana Romero and Dalia SzulikBuenos Aires: CEDES, 2001. 144 p. Send requests for more information to salud@clacso.edu.ar
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Introducción ; El estudio: objetivos e hipótesis ; Los médicos/as en el contexto de transición política de la salud reproductiva en la Argentina ; Contexto social y político de la anticoncepción y el aborto en la Argentina ; Anticoncepción ; Situación política y normativa de la anticoncepción ; El comportamiento anticonceptivo de la población ; Los nudos críticos de la anticoncepción ; Aborto ; Diseño y metodología ; Los sujetos de la investigación ; La estrategia metodológica del estudio: utilización de varias técnicas de recolección de la información ; El trabajo de campo ; La administración de la entrevista semiestructurada ; La implementación de la encuesta autoadministrada ; La aplicación de los grupos focales ; Opiniones de los tocoginecólogos/as del área metropolitana de Buenos Aires sobre la salud reproductiva ; Dos problemas de salud pública: la anticoncepción y el aborto ; Las orientaciones de la política pública en anticoncepción ; Las políticas públicas sobre la anticoncepción ; La implementación de programas ; El rol del hospital público y los servicios de planificación familiar ; La valoración de la anticoncepción como práctica asistencial ; Los jefes/as de servicio: actores relevantes ; ¿Cuán prestigiosa es la anticoncepción para los medicos/as? ¿Existe una jerarquía de prácticas preventivas? ; La perspectiva de los tocoginecólogos/as acerca de las mujeres pobres y la anticoncepción ; Métodos, tipos de pacientes y decisiones anticonceptivas ; Las decisiones anticonceptivas ; Los/as adolescentes y la anticoncepción ; Métodos anticonceptivos: información, provisión y prescripción ; Los criterios prescriptivos ; Los metodos "excepcionales": anticoncepción de emergencia y ligadura tubaria ; El aborto es un problema de salud pública ; Perspectivas acerca de la práctica y la legislación sobre el aborto ; Perspectivas sobre la interrupción voluntaria de la gestación ; Perspectivas sobre la legislación acerca del aborto ; La estrecha relación entre la legislación sobre el aborto y la disminución de la mortalidad materna ; La atención de las mujeres que se internan por complicaciones de aborto en los hospitales públicos ; La opinión acerca de los aspectos legales: la denuncia policial y la sanción penal ; Conclusiones y recomendaciones de políticas ; La metodología aplicada: algunos aprendizajes ; Sobre la anticoncepción ; Sobre el aborto ; La investigación y las políticas públicas ; Referencias bibliográficas
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : The position of physicians regarding induced abortion in Mexico deserves closer attention. The attitudes of physicians towards induced abortion have been a subject of study in different countries. It has been observed that such attitudes depend on ethical, religious, legal, political, or medical factors. In those countries where abortion is not penalized, physicians sustain different positions regarding this issue. The experiences of some countries indicate that the institutional provision of abortion services is a controversial and politically serious matter, and that offering or denying them generally depends to a great extent on the physician's discretion. In contexts like Mexico, where abortion is penalized, legal and other restrictions do not prevent many physicians from practicing it in a concealed way, generally for profit. On the other hand, even though abortion is recognized as an important social and public health problem, and laws regulate the conditions for its legal practice, the majority of medical professionals and health institutions maintain a conservative and reserved position on this matter. The professional training of physicians and the legal status of induced abortion as a criminal practice, are central elements in their attitudes towards this problem. (author's) (summaries in ENG, SPA)
Web site : http://www.scielosp.org/scielo.php?script=sci_serial pid=0036-3634 lng=en nrm=isoAbstract : This article traces the origins of fertility changes, of attitudes towards contraception and of lower family size values in Latin America, on the basis of information collected during the 1960s and 1970s on abortion, fertility and contraceptive prevalence. It explores the origins and the role of family planning programmes and suggests that they acted as facilitators of the 'mass' transition rather than as the agents that unleashed this process. (SUMMARY IN ENG) (EXCERPT)
Web site : http://www.eclac.cl/cgi-bin/getProd.asp?xml=/celade/agrupadores_xml/aes51.xml xsl=/celade/agrupadores_xml/a18l.xslAbstract : Expone el problema de la morbimortalidad materna en América Latina, sus causas subyacentes, como son, desnutrición, machismo, falta de información y educación sexual, embarazo de adolescentes, el aborto practicado en condiciones peligrosas e insalubres. Se ilustran las diferentes causas a través de casos. Incluye algunos datos estadísticos sobre embarazo en adolescentes, mujeres maltratadas, abortos y muertes por abortos.
Notes : Español/espagnol/SpanishAbstract : On 4 May 1995, after two years of intense public debate, the National Assembly of Guyana passed the Medical Termination of Pregnancy Bill, making Guyana the second country in the English-speaking Caribbean to introduce such legislation. For the entire two years scarcely a day went by without letters or articles in the press, and at least once a week there was a programme on television and radio. This paper describes the history and content of the campaign in support of the new law by the Pro-Reform Group, whose main slogan was 'Pro-Life, Pro-Choice, Pro-Reform'. This campaign sought common interests with the opposition, their public education was based on research among health and legal professionals, students and the public and on facts about abortion and women's experiences. It was carried out mainly through the media. The paper ends with a description of the new law and efforts to begin implementing it.
Web site : http://www.rhmjournal.org.ukAbstract : The euphoria of success with abortion law reform, followed by the practical difficulties of implementation and the impact of the law are described in this paper. Some doctors are complying with the detailed reporting requirements and the Ministry ofHealth has produced a comprehensive report based on that information. There is a high rate of repeat abortion and little counselling is taking place. However, the balance of power between women and doctors providing abortions has been altered by the newlaw and, in spite of lack of action by government, within six months there was a 41 per cent reduction in hospital admissions for septic and incomplete abortion. This paper discusses the role of the non-governmental advisory board which monitors the law, a new NGO formed to support the implementation of the law, the importance of the local media, and the difficulties of sustaining action for change where civil society is weak. It comments on these events, in which both authors were active participants.
Web site : http://www.rhmjournal.org.ukAbstract : Globally, abortion mortality constitutes at least 13% of maternal mortality. Unsafe abortion procedures, untrained abortion providers, restrictive abortion laws and high mortality and morbidity from abortion tend to occur together. Preventing abortion mortality and morbidity in countries where they remain high is a matter of good public health policy, based on good medical practice, and an important part of initiatives to make pregnancy safer. This paper examines the changes in policy and health service provision required to make abortions safe. It is based on a wide-ranging review of published and unpublished sources. In order to be effective, public health measures must take into account the reasons why women have abortions, the kind of abortion services required and at what stages of pregnancy, the types of abortion service providers needed, and training, cost and counselling issues. The transition from unsafe to safe abortions demands: changes at national policy level; abortion training for service providers; the provision of services at the appropriate primary level health service delivery points; and ensuring that women access these services instead of those of untrained providers. Public awareness that abortion services are available is a crucial element of this transition, particularly among adolescent and single women, who tend to have less access to reproductive health services generally.
Web site : http://www.rhmjournal.org.ukAbstract : The state of maternal health and infant survival in Bolivia is briefly discussed. Government plans to reduce maternal and infant mortality began in 1989. A priority was placed on training doctors in rural medicine and midwives in sanitary procedures. Midwives receive a Sanitary Birthing Kit with a razor blade for cutting the umbilical cord, a bar of soap, and a brush for cleaning fingernails. Making births safer in Bolivia will continue to be a challenge. Current conditions are such that only 53% have potable water, 30% need social security, and 63% are illiterate. One out of 200 women die in childbirth or within 42 hours following childbirth. One of three deliveries occur at home in unsanitary conditions. Bolivian women desire three-to-four children but have an average of six children. Women reportedly use any method available to abort an unwanted fetus, including a stick or a Coca Cola bottle, traditional herbal medicines, or drug overdoses. Maternal mortality is particularly high in rural areas where there is only one doctor for every 1600 people, and many physicians are not trained to deal with rural health conditions (they can not treat diarrhea or recognize parasites). Women have not received health education and are unaware of the importance of cleanliness at birth. The health service infrastructure is weak. The Church and government have a long record of opposing any form of family planning.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 092412Abstract : Abortion is legal in Brazil if it is the only means to save the woman's life or if the pregnancy is the result of rape. Although this has been the law for over 60 years, it has almost never been applied until recent years. In the past five years, the number of hospitals providing care to women victims of sexual violence has increased from 4 to 63, of which 40 are currently providing legal abortions. This paper describes a sensitization project and advocacy work carried out from within the obstetric and gynaecology establishment which has succeeded in motivating many key individuals and hospital staff to provide services for pregnancy termination in cases of rape. The dialogue between medical leaders and women's rights advocates and the emphasis on comprehensive care of women who have suffered sexual violence are key elements in the success of this initiative. The support of medical professionals, the organization and strength of the women's health and rights movement, the political support at federal, state and city government levels, including from the Federal Ministry of Health, and ongoing advocacy within the medical establishment have all been important elements in making the provision of services a reality.
Web site : http://www.rhmjournal.org.ukAbstract : This article describes the participation of feminist groups who work in the area of women's reproductive health and rights in campaigns for the provision of legal abortion in public hospitals in Brazil. Brazilian criminal law permits therapeutic abortion in cases where pregnancy is the result of rape orposes a serious risk to the life of the woman. Today, as a result of the combined efforts of feminists, health professionals and policymakers, more than 20 hospitals in Brazil are officially permitted to perform therapeutic abortions within the existing law. A model programme has also been developed to train service providers to do legal abortions, where the agreement of a hospital board can be obtained. This training has also improved care for illegally obtained, incomplete abortions in those hospitals but not in hospitals where doctors have not been trained. Problems with lack of access and concerns about the lack ofpublic acceptance of abortion remain. Women not only need the right to abortion but also more services and health professionals who are trained to perform abortions across the whole country.
Web site : http://www.rhmjournal.org.ukAbstract : The Bolivian government and other organizations aim to reduce maternal deaths and improve maternal health through a variety of initiatives. The goal is to reduce infant mortality by 1997 from 480 to 250 per 100,000 births. In a rural area of Inquisivi, maternal mortality in 1990 was 1400 per 100,000 births. Hospital and family planning service improvements are targeted, as well as increases in prenatal visits and training of birth attendants. The Protection a la Salud (PROSALUD) is concerned with improvements in technical, managerial, and interpersonal quality of care. The complaint has been difficulties with access and availability of services, and poor quality of services. PROSALUD centers have a referral system aimed at reducing maternal death. Training is provided in family planning counseling, because preventing unwanted pregnancies reduces complications from unsafe abortions that cause 27% of maternal mortality nationally. Lack of knowledge about contraception was reported by many women who were hospitalized for complications from unsafe abortion. Modern contraceptive usage is 12%, compared to 57% in Brazil and 55% in Colombia. Contraceptives only recently have become available in public facilities, but availability is still limited. Women avoid hospitals because of fears that their traditional practices will not be respected. Quechua and Aymara women deliver their children in upright positions, because of the ease of delivery. The placenta is delivered carefully, because it is viewed as a body combining the spirits of the mother and infant and deserving a proper burial. The traditional hospital delivery requires lying down in a cold room with unfamiliar attendants, and the patients complain of having to walk too early and leave the hospital too early. In rural areas, modern and traditional approaches that are put into action with the participation of the community work best. Mothercare and Save the Children/Bolivia have been successful in encouraging hospital delivery by allowing family presence during delivery. Family planning has increased in parts of Inquisivi to 60%, and harmful traditional practices were curbed or revised through educational efforts. Birthing chairs are being considered for replacing prone hospital delivery. Another rural education project had traveling doctors give talks about safe delivery practices, fetal development, prenatal care, risk assessment, and emergency care.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 093911Abstract : Abortion rights activists are seeking new ways to educate the public about the realities of abortion and to help women gain access to abortion services. One such initiative was launched in May 1999 by Women on Waves, founded by Dutch doctor Rebecca Gomperts. The organization developed a mobile gynecological unit, the "A-Portable," which can easily be loaded onto a ship and transported to wherever it is needed. In Dublin, Ireland, the Aurora, carrying the A- Portable was welcomed and denounced at the same time. To this effect, the question on the value of the Women on Waves experiment was put to several women whose work involves advocating for legal abortion in Europe, the US and Latin America. Christina Zampas, staff attorney, International Program, Center for Reproductive Law and Policy, USA; Juliet Bresson, founding member, Doctors for Choice, Ireland; Maria Consuelo Mejia, Guadalupe Cruz and Gillian Fawcett of Catolicos por el Derecho a Decidir/Mexico; and Marge Berer, of Reproductive Health Matters, UK, expressed their view about the Women on Waves project. It is emphasized that the Aurora is a symbol of the exile that women experience from their bodies and decisions within their own countries.
Web site : http://www.catholicsforchoice.org/conscience/archives/default.aspAbstract : Guía diseñada para los trabajadores de la salud en la prevención de la muerte y complicaciones por aborto. Contiene gráficos en forma de árbol de decisiones que muestran los pasos esenciales en la evaluación y el tratamiento de la paciente; como la identificación y tratamiento de las condiciones más urgentes que identifica la evaluación: shock, sangrado vaginal leve moderado severo, lesión intra abdominal y sepsis
Notes : Español/espagnol/SpanishAbstract : Contenido del libro por capítulo Cap. 1 Origenes, difusión y definición de la bioética ; Cap. 2 Justificación epistemológica, fundamentación del juicio bioético y metodología de la investigación en bioética ; Cap.3. La vida : sus formas, su origen y sentido ; Cap. 4. La persona humana y su cuerpo ; Cap. 5. La bioética y sus principios ; Cap. 6. Bioética y medicina ; Cap.7. Bioética y genética ; Cap. 8. Bioética y sexualidad: la procreación humana ; Capítulo 9. Bioética y aborto ; Capítulo 10. Bioética y tecnologías de fecundación humana ; Cap. 11. Bioética y esterilización - Cap. 12. Bioética y modificación del sexo: aspectos éticos del transexualismo ; Cap. 13. Bioética y experimentación en el hombre ; Cap. 14. Bioética y transplantes de órganos en el hombre ; Cap. 15. Bioética, eutanasia y dignidad de la muerte ; Cap. 16. Bioética y tecnología
Web site : http://www.gire.org.mx/Abstract : Bolivia tiene una de las tasas más altas de mortalidad materna de América Latina, y una de las principales causas son las complicaciones hemorrágicas de la primera mitad del embarazo. Por este motivo, el Ministerio de Salud y Deportes está empeñado en la ejecución de estrategias concretas, confiables y sostenibles, dirigidas a la prevención y atención de las complicaciones del aborto, en el marco de la atención primaria de salud, la promoción de la salud y las políticas de reducción de la mortalidad materna. La Dirección de Desarrollo de Servicios de Salud ha elaborado esta segunda edición del Manual deNormas y Procedimientos Técnicos para el manejo de las hemorragias de la primera mitad del embarazo, como instrumento de trabajo esencial para apoyar en los procesos de capacitación y formación de profesionales en el país, y como aporte para el mejoramiento de la calidad de la oferta de los servicios de salud a las mujeres bolivianas.
Notes : Español/espagnol/SpanishAbstract : Proporciona información sobre el uso del método que consiste en la aspiración manual endouterina, conocida como legrado uterino por aspiración. Explica la técnica para tratar los abortos incompletos, espontáneos o inducidos. Información destinada a médicos y otros profesionales de la medicina debidamente acreditados y para los programas de adiestramiento en América Latina
Notes : Español/espagnol/SpanishAbstract : This manual is a revision of scientifically approved principles and practices of available contraceptive methods. It explores themes that complement and enrich family planning and helps understand the profile of the clientele, the need for and mechanisms of prevention of STDs including AIDS, postabortion and postpartum care, menopause, and sterility. Module I discusses the quality of care in reproductive health (RH) including sexual health, the organization and administration of RH services, prevention and control of infections, evaluation of contraceptive users, and family planning counseling. Module II deals with contraceptive methods, including the anatomy and physiology of sexuality and reproduction, behavioral methods, barrier methods, IUDs, combined oral contraceptives, combined injectable contraceptives (ICs), pills containing only progestagens, ICs containing only progestagens, implants containing only progestagens, and voluntary surgical contraception. Module III addresses special situations in RH care, such as emergency contraception, post-abortion care, post-abortion contraception, assistance in menopause, and marital infertility. Module IV recounts the prevention of cancer, including the early diagnosis of breast cancer and prevention of cervical cancer. Module V reviews STDs and family planning as well as HIV-AIDS including the main symptoms of the most common STDs, STDs in adolescence, the combined therapy of genital ulcers, urethral and vaginal discharge and pain, mechanisms of HIV transmission, and treatment and prevention of AIDS. The manual is the result of the efforts of a team which, while often working under adverse conditions, succeeded in turning the RH project of the state of Bahia into effective, real, and vigorous action.
Notes : Portugués/portugais/PortugueseAbstract : Exposición de los derechos reproductivos legitimizados en las conferencias internacionales y aprobados por el gobierno mexicano. Análisis y síntesis de los derechos incorporados a las leyes de salud pública con comentarios y agregados elaborados por las ONG's de mujeres especializadas
Notes : Español/espagnol/SpanishAbstract : In Brazil, women have been noted to attempt using misoprostol, a prostaglandin marketed for the treatment of gastric ulcers, as an agent to terminate unwanted pregnancies. Two hospital-based studies, one conducted in Rio de Janeiro and one in Fortaleza, Brazil, revealed that majority of the women receiving hospital treatment following an induced abortion in 1991 had used misoprostol. Primary reasons given state that the drug was less expensive than traditional methods of illegal abortion and the women can administer it by themselves. However, it was noted that misoprostol is an inefficient abortifacient; many of the women who used it required surgical evacuation of the uterus for incomplete abortion. Moreover, misuse of the drug was attributed to the lack of knowledge of and access to family planning services, the illegality of abortion in Brazil, and poor control over the distribution of prescription drugs.
Web site : http://www.guttmacher.org/Abstract : Introducción ; "Peligro para la vida y la salud de la madre" ; De madre a mujer: persona y ciudadana ; Nuestro habitual espacio: "la mujer es un ser humano" ; Bioética, ser persona ; ¿Ser mujer, es ser persona? ; ¿Qué ves, cuando me ves? ; Bioética y género ; Ciudadanía, ser ciudadano ; ¿Ser mujer, es ser ciudadana? ; Ciudadanía y género ; La salud de las mujeres ; Peligro para la salud de la mujer ; La vida de las mujeres ; Peligro para la vida de la mujer ; Conclusión: quienes deben oír, que oigan: los expertos ; Coda: Argentina fin de milenio ; Corolario: el aborto no es un tema ético
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Studies offer strong evidence of a widely supposed but difficult-to-demonstrate benefit of reproductive health (RH) services: that increasing the use of effective contraception leads to declines in induced abortion rates. The results of such studies can help dispel misconceptions about the relationship between family planning and abortion. They can also help policymakers, program managers, and providers identify ways to improve RH services. It is noted that demonstrating that increased contraceptive use leads to fewer abortions is particularly important in countries where unsafe abortion poses a serious threat to women's health and survival. Studies on trends in contraception and abortion can point to ways of improving RH services.
Web site : http://www.fhi.org/en/index.htmAbstract : Maternal health in Latin America and the Caribbean continues to be an important issue, which is significantly affected by access to appropriate health technology and quality care, which in turn may be dependent upon economic conditions. Although contraceptive knowledge was high, only 53% of couples used some method of contraception. About 32% and 37% of maternal mortality in Mexico and Colombia could have been averted if contraception had been used. One study of 240 maternal deaths in Mexico indicated that 85% were potentially preventable, and 70% could have been potentially avoided with better medical and institutional care. The table gave the number and rate of maternal mortality and risk by country. In 23 countries, maternal mortality was one of the ten leading causes of death among women. The five prominent causes tended to be abortion, hemorrhage, toxemia, complications of the puerperium, and indirect causes among women aged 15-49 years. Countries can be grouped by level of maternal mortality: 227/100,000 live births, 133/100,000, and 50/100,000. About 280,000 to 420,000 episodes of severe intercurrent obstetric problems potentially occurred annually among the 12 million women of reproductive age in the region. In the United States about 1 out of every 5 pregnancies involved pregnancy related hospitalization in 1987. In Mexico in 1989, of the 740,000 obstetric related discharges for obstetric reasons, 80.5% were related to delivery and 19.5%, to morbidity during pregnancy. During the prenatal period, the five leading causes of morbidity have been identified as premature rupture of membranes, urinary tract infection, potential premature delivery, pre-eclampsia, and pregnancy induced hypertension. Latin American is also a region with increasing numbers of cesarean section deliveries. Maternal deaths in Latin America and the Caribbean would be reduced 47 times and 85% of deaths could be avoided if the health systems paralleled those in Canada.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - 095096Abstract : Peru has the second highest maternal mortality rate in Latin America (303/100,000 live births), ranging from 257/100,000 in Lima to 353/100,000 in Ayacucho. Poverty, underdevelopment, and inequalities in distribution of maternal health care facilities contribute to the high maternal mortality. Around 49% of persons in urban areas are below the absolute poverty income level, while this percentage is 35% for all of Latin America. Inflation exacerbates the already existing poverty. The health services' share of total government has decreased from 4.5% in 1981-1982 to 2% in 1990, preventing the expansion of maternal health services to unserved populations (e.g., those in rural and marginal urban areas). The total fertility rate in Peru is 4.6 children/woman. It is highest in poor families (at least 10 children). In the Andes, the people in Apurimac and Huancavelica are poor, have access to almost no health care, face constant delays in medical assistance, and have high fertility and maternal mortality. The leading causes of hospital maternal deaths include hemorrhage (23% of all causes), abortion (22%), and infection (18%). Small birth intervals contribute to maternal deaths. The main causes of abortion-related hospital maternal deaths are septic induced abortion (43%), damaged viscera (24%), and incomplete septic abortion (24%). Key causes of hospital maternal deaths by hemorrhage are retained placenta (18%), abruptio placenta (16%), uterine rupture (16%), and uterine atony (16%). Leading causes of puerperal infection-related hospital maternal deaths are postpartum endometritis (27%), corium amniotitis (27%), and retained or adherent placenta (27%). Adolescent pregnancy is increasing, particularly in cities. Infant mortality is 90/1000 live births. Low immunization levels, nutritional deficiencies, poor personal and environmental hygiene, high fertility, and the socioeconomic situation contribute to the high infant mortality. Improved socioeconomic conditions are needed to reduce maternal and infant mortality in Peru.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 102523Abstract : his booklet on maternal health in Latin America is part of a new strategy of the Pan American Health Organization for 1991-94 to integrate women into health and development programs. It provides an overview of the problems affecting women, focuses on the circumstances that affect maternal health, and proposes activities that will improve women's lot. In 1980 there were an estimated 86 million women of childbearing age in Latin America and the Caribbean, projected to grow to 150 million by 2000. There are an estimated 34,000 maternal deaths annually in Latin America, not including unreported illegal abortion deaths. The percentage of maternal deaths due to nonmedical abortion ranges from 25% in Venezuela to 54% in Trinidad. Some of the key problems affecting women's reproductive health are economic disadvantage and isolation, malnutrition, poorly timed pregnancy, lack of medical care, environmental hazards affecting pregnancy, the direct and indirect effects of drugs, alcohol, and stress on pregnant mothers, and especially inequity. Women bear the brunt of the economic crises of the region, suffer more than their share of occupational health hazards, and do so with the dual burden of full-time work and child care. These issues prompt the use of the risk approach in women's health care. Risks are classified into biological factors such as age and parity, medical factors such as chronic illness, personal habits, family situation and support system, environmental factors, and accessibility of health services. Risk determination is essential to improve equity in disposition of health resources. Strategies for improving maternal health are discussed in general, with 4 recommendations: 1) enact legislation protecting the right to health for women; 2) organize learning activities for women's groups; 3) develop integrated birth control programs for women and men emphasizing the safest and most effective methods; and 4) train community health care workers in maternal health. Whole communities should be made aware of danger signs for women's health, and political leaders will need the will to implement these strategies.
Notes : Inglés/anglais/EnglishAbstract : Concurrent with advances in health care, infant mortality rates and maternal mortality ratios have declined dramatically in the more developed countries since 1900. These advances and declines, however, have been slow to spread to the more poor developing countries of Asia, Latin America, and Africa, especially with regard to women's health and maternity care. A high differential in maternal mortality ratios has therefore resulted between the developed and developing worlds. Maternal mortality in the developed world, 1700 to the present; monitoring maternal mortality; maternal mortality and morbidity in the developing world; causes of maternal mortality in the developing world; interventions and lessons learned; and community interventions are discussed. Case reports of obstructed labor in Nigeria, postpartum hemorrhage in Yemen, and illegal abortion in Colombia are also presented.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 120988Abstract : Every day, 1643 women die from factors related to pregnancy, delivery, or puerperium, for a total of 600,000 deaths/year. The overwhelming majority of such mortality occurs in developing countries. The maternal mortality ratio in Argentina is 44/100,000 live births. A study was conducted to investigate the death of women who died by intentional or nonintentional violent injury, including death by induced abortion, in the Province of Cordoba, Argentina, 1992-96, and to perform a bibliographic review on maternal death due to violence. Government records of autopsies of all violent deaths among women aged 12-44 years were reviewed to determine the cause of death for cases of suicide, homicide, accident, or induced abortion. A bibliographic review was also conducted through MEDLINE. 272 women died due to violence, including 22 who died due to induced abortion-related complications. The remaining 250 deaths were due to suicide (17.6%), homicide (20.4%), and traffic accidents (62%). 2 pregnant women died by suicide, 1 by homicide, and 3 by accident. Violence against women and pregnant women is a growing problem in developing countries.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : The purpose of this retrospective study was to discern trends in maternal mortality in Barbados over the period 1970-89 and to identify the major cause of, and risk factors contributing to pregnancy-related deaths. Maternal deaths were identified from the death register and labor ward records of the Queen Elizabeth Hospital, by reviewing all death certificates kept at the Ministry of Health and by discussions with relevant doctors, nurses and records officers. The definition of maternal death used in calculating maternal mortality rates was that of the International Classification of Diseases, Injuries and Deaths (ICD9). There were 104 maternal deaths of which 92 (88%) occurred during pregnancy or within 42 days of termination (ICD9 definition). 12 deaths occurred in women who died after 42 days but within 1 year of termination of pregnancy. In patients who died when gestation was less than 28 weeks (38 or 37% of all deaths), 79% died from ectopic pregnancy or septic abortion. Hypertensive disease, post-partum hemorrhage and puerperal sepsis were the most frequent causes of death in those dying after 28 weeks gestation. Deaths most commonly occurred between ages 21 and 25. There was a 4-fold decline in deaths from puerperal sepsis and a 45% decline in those due to hypertensive diseases. The average annual maternal mortality rate for the period 1970-89 was 90.76/100,000 live births, and has declined gradually over the 20-year period. (Full text).
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - CPFH 26932cr990Abstract : Maternal mortality trends between 1960 and 1990 for Sao Paulo district, the interior, and Brazil were described and compared to official statistical data corrected in special studies at 3 key points in time. Cause of death data needed correction due to classification changes in the periods 1960-68, 1969-78, and 1979-90. The results reveal that maternal mortality declined from about 100/100,000 live births in the early 196-s to lower levels until 1985, after which there was a slight increase. By 1990, maternal mortality was higher than in other parts of the country, when during the 1960s maternal mortality was lower in the municipal area of Sao Paulo. Data were constructed to reflect rates for the periods 1960-62, 1970-72, 1980-82, and 1988-90. Comparisons with other parts of the state showed a slower reduction in maternal mortality in Sao Paulo. For example, between the first and last periods, mortality declined by 53.7% in Sao Paulo and 70.8% in the rest of the state. Survey data differ from official estimates for the district of Sao Paulo in the direction of being twice as high as official figures. Careful examination of the data showed that registration had included deaths by place of occurrence rather than residence before 1968. In the corrected data on cause of death, maternal deaths due to abortion complications were found to be 19.5% of all maternal deaths in 1962-63, 25.0% in 1974-75, and 10.7% in 1986. The explanation for the trend was given as a change in medical practice and the widespread use of contraceptives. The largest cause of maternal mortality was complications of pregnancy, which increased from 28/100,000 live births in 1962-63 to 48.8/100,000 in 1974-75 and 64.0/100,000 in 1974-75 and 64.0/100,000 in 1986. The leading causes of these deaths were toxemia of pregnancy (22.2% of pregnancy complication and 14/2% of maternal mortality) and parasitic infectious diseases (8.9% of maternal mortality). There was a decline after 1974-75 in pregnancy complications in delivery and the puerperium. In 1986, pulmonary embolism and puerperal infections were the leading causes of puerperium-related maternal mortality. In 1991, a Committee for the Study and Prevention of Maternal Mortality was established and found that many maternal deaths could have been avoided with an improvement in the quality of medical services.
Web site : http://publications.paho.org/english/moreinfo.cfm?Product_ID=557Abstract : The Maternal Health and Safe Motherhood Programme under WHO's Division of Family Health has compiled maternal mortality data in its 3rd edition of Maternal Mortality Ratios and Rates. The report contains data up to 1991. These data come from almost all WHO member countries. 1988 estimates reveal that 509,000 women die each year from causes related to pregnancy and childbirth. Most die from preventable causes such as aseptic abortions and lack of adequate health care. 4000 of these maternal deaths occur in developed countries. Thus developing countries, where 87% of the world's births occur, experience 99% of maternal deaths. In fact, the lifetime risk of death from causes related to pregnancy and childbirth in developing countries is 1:57 compared to 1:1825 in developed countries. Women in countries of western Africa have the greatest risk (1:18) and those in North America the smallest risk (1:4006). Even though the maternal mortality ratio for developing countries fell from 450-520 per 100,000 live births between 1983-1988, it increased in western African countries (700-760). This report consists mainly of tables of maternal mortality estimates for each country and in some cases certain areas of each country, for the world and various regions and subregions, and changes in maternal mortality since 1983 for the world and various regions and subregions. The world comparison table includes live births, maternal deaths, maternal mortality ratios and rates, lifetime risk, and total fertility. Country tables list year, data sources, maternal mortality ratio, indication if abortion deaths were included or not, and reference.
Web site : http://www.who.int/Abstract : Maternal mortality refers to death of women during pregnancy or within 42 days of delivery from any cause related to or aggravated by the pregnancy or its management. Even though the most accurate means of measuring maternal mortality is a population based study, few such studies exist. Maternal mortality ratios which give the obstetric risk of pregnancy vary in developing countries from 110 deaths/100,000 live births in Jamaica to 2362 in Gambia. Indeed pregnant women in Africa are at highest risk of dying (640 vs. 420 for Asia, 288 for South America, 240 for Central America and Mexico, 220 for the Caribbean, 236 for Oceania, 21 for Europe, and 7.7 for North America). Yet some developing countries have reduced maternal mortality (China=25 and Cuba=32). The leading causes of death in developing countries are hemorrhage (>25%), induced abortion (<20%), eclampsia and preeclampsia (<17%), prolonged labor (<10%), and sepsis (<10%). Women also often experience acute or short term complications, chronic problems, or associated illnesses. Various cultural and socioeconomic factors (distant determinants) are the roots of maternal death. The Safe Motherhood project has identified distant, intermediate, and proximate determinants of maternal health. Intermediate determinants include reproductive and health behavior, health and nutritional status, and access to and quality of family planning and maternal care. The proximate determinants are pregnancy, complications, their management, and delivery. 2 proximate determinants account for most of the variation in maternal mortality rates of 69 countries (p<.001): percent of deliveries done by trained personnel (35% of the variations) and the total fertility rate [TFR](43%). In fact, a 1% change in delivery by trained attendants reduces the maternal mortality ratio by 6.1 and maternal mortality rate by 1.1. A unit fall in TFR reduces the rate by 12.8. These findings provide the evidence needed for governments to take serious action maternal mortality.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 073219Abstract : La salud perinatal tiene como misión asegurar una maternidad saludable y sin riesgos, que permita reducir los riesgos de enfermar y morir por complicaciones del embarazo, parto y puerperio. Es un logro que se incorpa en 1995 en el Programa de Salud Reproductiva vinculado con la planificación familiar y la salud de la mujer incorporando la perspectiva de género
Notes : Español/espagnol/SpanishAbstract : El valor de problematizar los temas ; El poder de los discursos ; Descubrimiento de la muerte materna ; Del binonio madre-niño a los derechos sexuales yreproductivos ; Debate público sobre el aborto: avances y retrocesos ; El Seguro Nacional deMaternidad y Niñez ; Aborto inseguro: profecía que se encarga de su propio cumplimiento ; Madre-útero, embrión-sujeto ; Desmaternalizar la seguridad, asegurar el aborto ; Mortalidadmaterna: una cuestión política ; Consolidar los avances, renovar los discursos ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : La calidad de los servicios médicos y el análisis de la maternidad en Mexico.
Web site : http://www.unifem.org.mxAbstract : This work is intended to provide communicators with information on the extent of the maternal mortality problem and to back up demands for improvement. An estimated 500,000 women worldwide die each year of maternal causes, 99% in developing countries. Maternal mortality is associated with poverty, high fertility, pregnancies at the extremes of reproductive age, lack of access to health care, and cultural factors. Maternal mortality rates are 2-9 per 100,000 live births in developed countries, but range from 50 to over 500 per 100,000 in developing countries. Complications of pregnancy are among the 5 main causes of death for women in Central America and the Caribbean. 94% of maternal deaths in the region are considered avoidable by the Pan American Health Organization. Health and educational advances and contraceptive use are among factors associated with improvements in maternal mortality. Maternal mortality declines have not been uniform in all countries of the region, and they have slowed in recent years. Some 4 million abortions are estimated to occur annually in Latin America, and abortion is believed to be a factor in about 1/3 of maternal deaths. In 1991, an estimated 111,000 women were treated in Mexico for complications of abortion. Around 50 episodes of obstetric or gynecologic morbidity are believed to occur for each maternal death. The reported Mexican maternal mortality rate was 50/100,000 live births in 1992, but underreporting was estimated at 40 to 50%. A new death certificate, used since 1994, should provide improved data. In general, Mexico's northern states have the lowest maternal mortality and the southern states have the highest. The risk of maternal death is higher in marginal population groups and in the poorly educated. The Committee to Promote Motherhood Without Risks in Mexico was founded in 1993 and has carried out several joint public and private sector projects.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 116701Abstract : The 1993 Day of Action for Women's Health focused on the number of deaths which occur as a result of unsafe and illegal abortion. In Argentina, a signature campaign to support decriminalization of abortion enlisted the aid of more than 100 influential citizens. The campaign in Brazil coincided with the introduction of reforms which would decriminalize abortion. In Chile, a nationwide campaign was launched to reinstate therapeutic abortion. The day was commemorated in Colombia with several events which advocated the decriminalization of abortion. Women in Costa Rica demanded being treated as subjects, not objects, of health policies, while Ecuadorian activists spent the day distributing an article analyzing the importance of the day and discussing the health problems of Ecuadorian women, especially those related to overwork, subordinate status, and illegal abortion. A new study was released in Mexico which revealed that four women die every day of pregnancy and child-birth related causes (40% of these are the complications of induced abortion). Nationwide activities were coordinated in Nicaragua including forums, theater presentations, festivals, and a women's march. A labor group joined the campaign in Peru, and efforts in Puerto Rico centered on preventing and surviving breast cancer. Elsewhere in the world, genital mutilation was the topic of a seminar in Canada, women in the Philippines launched a campaign against "needless" maternal mortality, and a Spanish group issued a publication analyzing abortion around the world and discussing the introduction of RU-486 to Spain. The next important date is September 28, when women's health groups in Latin America and the Caribbean will join to call for the legalization of abortion.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Me lo quiero sacar: discursos y sentimientos de las mujeres cuando van a abortar ; De qué hablamos cuando hablamos de aborto ; Discursos en torno a la maternidad y el aborto ; Con quién lo hablan ; El después ; A modo de reflexión final.
Notes : Español/espagnol/SpanishAbstract : Objectives : We compare four methods of collecting information on abortion through survey research to measure the levels of induced abortion in Mexico. Methods : We tested four methods for collecting data on abortion attempts: face-to-face interview (FTF), Audio Computer-Assisted Self-Interview (ACASI), self-administered questionnaire (SAQ), and a random response technique (RRT). We tested all methods in three samples: 1) hospital patients in Mexico City; 2) rural women in Chiapas; and 3) women randomly chosen as part of a house-to- house survey in Mexico City Results : In each of the three samples, RR T found the highest rate of attempted induced abortion (21.7% in hospital sample, 36.1 % in rural sample and 17.9% in household sample), followed by the SAQ (19.3% (hospital), 10.1 % (rural) and 10.8% (household". The ACASI and FTF interviews yielded fewer reported abortion attempts. Conclusion :The RRT seems the most promising methodology to measure the levels of induced abortion. With SAQ, we obtained detailed information and the reported frequency rates were slightly lower than the RRT rates in urban areas.
Notes : Inglés/anglais/English, nbsp;source : CepedAbstract : Background: We wanted to determine the outcomes of medical abortions in four family practice centers.Methods: This study was a retrospective case series of consecutive medical abortions in four community health centers between November 2000 and April 2002. We defined a successful medical abortion as one that required no further intervention after the administration of the medications mifepristone and misoprostol. The subset of abortions in patients who had suction procedures were called failures.Results: In this series of 236 abortions, only 1 woman had a viable pregnancy after taking the medication as directed, and she had an elective suction procedure to terminate the pregnancy. None of the patients under the complete care of family physicians received suction procedures for other indications. Two patients underwent suction procedures at other institutions for unknown indications. Eight were lost to follow-up. One did not adhere to the protocol and so was excluded from the data analysis. The failure rate of the protocol for patients cared for by the family physicians at follow-up was 0.4%.Conclusions: Medical abortion in a family practice setting is a safe and effective procedure. If practiced widely, it could make abortion care much more accessible to women.
Web site : http://www.jabfp.org/Abstract : Rates of unsafe and illegal abortion vary throughout the world, with rates of 0-4/1000 women in the US, western Europe, Australia, and China and rates of >25/1000 in the Soviet Union, Africa, Southeast Asia, and South America. Although thousands of women die from unsafe and illegal abortion annually, several countries still have no plans of adopting medical abortion. The introduction of the mifepristone pill in France in 1980 as a safe and effective method of abortion is limited to a minority of countries. Women who used the drug expressed their satisfaction, since 1) it seemed a natural way of having an abortion, 2) anesthesia is avoided, and 3) it is more compatible with their lifestyle. Complaints in using the drug include pain, bleeding, and uncertainty. The drug has a success rate of 98% in clinical trials in the US.
Web site : http://bmj.comAbstract : Although more than one method of abortion has been available for many years, in most countries the provider chooses the method and may be skilled in one method only. This paper discusses choice and acceptability of medical abortion from the perspective of both women and abortion providers and argues that choice of method is important for both. Safety, efficacy, number of visits, how the method works, how long it takes for the abortion to be complete and cost all affect acceptability. Medical abortion is considered more natural because it happens in women's own bodies and can take place at home before nine weeks of pregnancy; surgical abortion with vacuum aspiration is simple and over quickly. Unless the costs of both methods are similar, however, women and providers will tend towards whichever is the cheaper option, limiting choice. Medical abortion is effective from when a woman misses her period through 24 weeks of pregnancy, and more women and providers need to be made aware of this. In legally restricted situations, complications tend to be less serious and easier to treat with early medical abortion than after unsafe invasive methods. Ideally, both medical and surgical methods should be available, but each can be provided without the other.
Web site : http://www.rhmjournal.org.uk/Abstract : Researchers, health care providers, women's health advocates, donors, and representatives of ministries of health convened in Bellagio, Italy, in July 1998, to assess the potential of medical methods of early pregnancy termination to improve the reproductive health of women in developing countries. Consensus was reached that a mifepristone-prostaglandin (e.g., misoprostol) regimen can be delivered in a manner that is safe, effective, and acceptable in developing country settings. As long as back-up care is available for complicated cases, medical abortion can be used safely even in the most rudimentary settings and provided by non-physician health workers. Given access to clinical assessment and counseling, some women can have the option of undergoing medical abortion outside of a clinical setting without direct medical supervision. Although the mifepristone-misoprostol regimen is most effective in women in the earliest durations of pregnancy, it has acceptable efficacy even after 57-63 days of amenorrhea. Medical abortion methods represent a critical advance in reproductive rights in countries where the consequences of unsafe abortion are most severe. If women are denied access to these methods, an unsafe "black market" for abortifacient agents may result.
Web site : http://www.arhp.org/healthcareproviders/onlinepublications/arhpjournal/journal.cfm?ID=300Abstract : The safety, efficacy, and acceptability of medical abortion compared to surgical abortion were assessed in a study of 500 women in Cuba with amenorrhea of less than 56 days. 119 participants (23.8%) were adolescents. Volunteers were given a choice of surgical or medical abortion and enrolled sequentially until 250 women had ben recruited to each arm of the sample. The medical regimen entailed 600 mg of mifepristone followed 48 hours later by 400 mcg of misoprostol. Women choosing medical abortion had a higher level of education, greater height, and a lower gestational age than their counterparts in the surgical abortion group. The failure rate for medical abortion (7.2%) exceeded that for surgical abortion (4%). Among adolescents who took the abortifacient agents, the failure rate was only 1.7%. Women who underwent medical abortion experienced more side effects, including bleeding, cramping, nausea, and vomiting. Only fever was more frequent in the surgical abortion group. A significantly higher percentage of women in the medical abortion group than in the surgical group were highly satisfied with the method they chose (68.5% vs. 54.4%).
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : In this document, we review the relevant aspects of the different medical methods of abortion. We describe the principal medical regimens currently used in North America, Europe, and a growing number of developing countries. We also describe specific treatment regimens (which usually involve a combination of two drugs), physiological methods of action, potential side effects and complications, method requirements, including follow-up visits, any existing contraindication, and acceptability of these methods among patients. Finally, we comment on the potential role of medical abortion in Mexico and throughout Latin America.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : On June 21, 1994, in Sao Paulo, a meeting took place of reproductive health professionals: service providers, university professors, representatives of nongovernmental organizations, secretaries of health of states and municipalities. They issued a manifesto on reproductive health in Brazil. In view of the preparations for the 3rd International Conference on Population and Development to take place in Cairo in September, 1994, it is hoped that these points will be incorporated into the official platform and in government action plans. Reproductive health is a basic human right. The growth of population decreased in Brazil in the 1980s, yet assistance in the area of reproductive health is still insufficient and unsatisfactory. The population decrease did not result in the improvement of health care and family planning. Maternal morbidity and mortality rates are still high in Brazil, especially in the north-northeastern regions, where it is 10 times higher than the national rate. There are 5 maternal deaths per 100,000 live births in Canada, 8 in the US, and 140 in Brazil. 90% of these deaths could be avoided by routine reproductive health measures. Important causes of infant mortality in Brazil are malnutrition and infectious diseases, which could be prevented by lifting the low socioeconomic level and through vaccination and birth spacing. Although fertility has been on the decline, the fertility of 10-19 year old adolescents has increased significantly, leading to high mortality rates for their infants. An estimated 1.4 million abortions occur per year in Brazil with frequent complications because of its illegal, clandestine nature. It is also estimated that 6-8 million women have been sterilized, which is the primary means of family planning because of the lack of other contraceptive options. The combination of cesarean-tubal ligation operations has been institutionalized in health services, which creates major distortions in the delivery of health care. Sexually transmitted diseases are on the rise, and HIV infections are contracted mainly from sexual intercourse and IV drug abuse. Furthermore, it is absolutely necessary for men to participate in family planning education in order to raise the status of women.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 100081Abstract : Algunas reflexiones acerca de la metodología ; Resultados y conclusiones ; La cuestión del poder ; Poder y biomedicina ; Saber y poder, el recismo de lainteligencia ; Poder y sexualidad ; Criterios en torno a la causalidad ; Consideraciones finales ; Bibliografía citada.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : The overview of this report, illustrated with tables, discusses the size and proportion of the population ages 10-19; the definition of young adult; the falling age of puberty; sexual activity among young adults (including premarital sexual activity); the rising age at marriage; fertility patterns; contraceptive usage (including factors that inhibit usage, such as a lack of information, of access, of Decision making ability, and/or of power); and unmet contraceptive needs. The report's essay on growth, change, and risk behavior associated with youth deals with the specific topics of sexually transmitted diseases, sexual violence and coercion, the health risks of early pregnancy, unintended pregnancy and the complications of unsafe abortion, the social and economic consequences of early childbearing, and ways to meet needs and, thus, prevent problems. This last subject leads into an overview of programs available for young adults, including large school programs, small health programs, and European youth programs and social norms. A table gives types of reproductive health programs for young adults that defines the audience/activities, extent of the program, special issues addressed, and research findings for 1) family life education programs, 2) clinic-based programs, 3) AIDS prevention programs, 4) condom distribution programs, 5) school clinics, 6) communication through the entertainment media, and 7) peer education. In the next major section of the report, evaluations of the various types of programs for youth are reviewed to determine whether the programs lead to a delay in initiation of sexual intercourse, an increase in sexual intercourse, and/or an increase in contraceptive usage. Consideration is then given to what makes programs work and how to win support for programs from the community and from young adults. These major essays are punctuated with short highlights on such topics as whether adults and youth have differing views about sex behavior, whether young people are different today than they were in the past, reaching boys with services, where young people learn about sex, contraceptive choices for youth, and lessons learned from youth programs.
Web site : http://db.jhuccp.org/popinform/docs/111406.pdfdb.jhuccp.org/popinform/docs/111406POR.pdfdb.jhuccp.org/popinform/docs/111406SPA.pdfdb.jhuccp.org/popinform/docs/111406FRE.pdfAbstract : This article describes family planning (FP) program activities supported by the UN Population Fund (UNFPA) in the Caribbean. UNFPA has provided continuous, strong support for FP programs in the Caribbean, despite other donors' shifting of funds to other regions. UNFPA funding supported the development of a Caribbean Platform of Action at the 1994 Cairo Conference on Population and Development. UNFPA supports advocacy efforts, training, research, and the provision of contraceptives. IPPF/WHR and UNFPA jointly supported three studies on FP and reproductive health services. One study examined the dynamics of decision making among 375 women in Barbados, St. Lucia, and Dominica concerning education, career choices, partner selection, the timing and number of children, abortion, migration, and community participation. Another study examined abortion use among teenagers in St. Lucia, Antigua, and Trinidad, where abortion is illegal. Abortion was secured by different means in each country: abortifacients, herb doctors, and/or private physicians. The last study reviewed IEC strategies and audio-visual materials that were used in the past 10 years to inform about FP, population, and AIDS. UNFPA conducted regional conferences to present research findings on the IEC study and to conduct strategic planning. Workshops reviewed findings on lessons learned. Participants from the public and private sectors presented recommendations for national programs. UNFPA has given financial support to IPPF programs in Guyana and Suriname. A needs assessment in the region identified reproductive health, advocacy, and adolescents as focus areas in the priority countries of Jamaica, Guyana, and Suriname.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 131995Abstract : A Bellagio Technical Working Group meeting sought to develop guidelines for post-abortion family planning services in order to break the cycle of repeated abortions. In the areas of service delivery, it was recommended that abortion providers establish links with family planning programs as well as offer some type of contraceptive service, whether supplies, counseling, or referral. To enhance the integration of family planning and abortion services, nongovernmental programs are urged to provide menstrual regulation and induced abortion to the fullest limits of local law. In addition, there are untapped opportunities for nongovernmental organizations to assist public sector family planning programs through the provision of supplies and training. Community-based distribution workers and pharmacists represent another means of directing women who have received an abortion to contraceptive services. Post-abortion family planning services that are individualized to personal risk factors and needs are more likely to be effective than those based solely on protocols defined by contraceptive method. Similarly, program success requires that women's perspectives are incorporated into the design of services. Family planning counselors should develop simple assessment mechanisms to determine the amount, level, and type of information a woman needs, based on her life-style, contraceptive history, and physical and psychological state. Wherever possible, post-abortion family planning care should be delivered in the context of decentralized but comprehensive reproductive health care.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : Se presentan los resultados preliminares de un proyecto de investigación de operaciones para evaluar los efectos de la integración del tratamiento de las complicaciones del aborto con los servicios y la información de planificación familiar postaborto en un hospital de enseñanza de nivel terciario en la provincia de Callao, Perú. Las fuentes principales de datos fueron las entrevistas con el personal y los pacientes, los registros clínicos y otros registros de hospital. La finalidad de las modificaciones en los servicios de postaborto era mejorar la calidad de la atención y reducir los costos, además de integrar los servicios de planificación familiar. Los servicios de postaborto fueron consolidados en una nueva zona construida para evitar que estuviesen por todo el hospital. Los trabajadores de salud recibieron capacitación en aspiración manual al vacío, relaciones interpersonales y orientación en planificación familiar. Los servicios se reorganizaron en un programa para pacientes ambulatorios. La comparación de 102 pacientes que fueron tratadas antes de la intervención y 102 que fueron tratadas después indicó que el legrado uterino instrumental había sido reemplazado casi completamente por la aspiración manual al vacío, que el número de exámenes pélvicos había disminuido y que la estadía hospitalaria promedio se había reducido de 33,3 a 6,4 horas. La percepción de dolor de las pacientes disminuyó y la satisfacción con los servicios aumentó. El porcentaje que usaba los servicios de planificación familiar después del aborto pasó de 31% a 64%. El costo de la atención disminuyó de US $119 a US$ 45 por paciente. Antes de la intervención, las pacientes pasaban alrededor del 10,5% de su tiempo con el personal hospitalario, mientras que después de la intervención el porcentaje aumentó a 50%. La información que se dio a las pacientes respecto a planificación familiar, diagnóstico médico y atención de seguimiento aumentó, mientras que las advertencias relativas a los signos de peligro disminuyeron.
Web site : http://www.popcouncil.orgAbstract : Preliminary results are presented of an operations research project to evaluate effects of integrating treatment of abortion complications with postabortal family planning information and services at a tertiary level teaching hospital in the province of Callao, Peru. Interviews with patients and staff, clinical records and other hospital registers were the main sources of data. The modifications in the postabortal services were intended to improve the quality of care and reduce costs, as well as integrating family planning services. The postabortal services were consolidated in a new area constructed for the purpose instead of being spread around the entire hospital. Health workers received training in manual vacuum aspiration, interpersonal relations, and family planning counseling. The services were reorganized into an outpatient program. Comparison of 102 patients treated before the intervention and 102 treated after indicated that instrumental uterine curettage had been almost completely replaced by manual vacuum aspiration, the number of pelvic examinations declined, and the average hospital stay was reduced from 33.3 to 6.4 hours. Patients perception of pain decreased and satisfaction with services increased. The proportion using family planning services after the abortion increased from 31% to 64%. The cost of care declined from US $119 to US $45 per patient. Prior to the intervention, patients spent about 10.5% of their time with hospital personnel, while after the intervention the proportion increased to 50%. The information given to patients concerning family planning, medical diagnosis, and follow-up care increased, while warnings about danger signs decreased.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 142998Abstract : Culminando el apoyo técnico y financiero que el Population Council brindó a dos grupos de trabajo en Perú y Bolivia a través de su Programa Regional de Género, Familia y Salud Reproductiva, el 29 y 30 de mayo de 1996 se celebró en La Paz un encuentro que reunió durante dos días a investigadores/as, funcionarios gubernamentales y representantes de organismos no gubernamentales, con el propósito de debatir sobre sus logros y desafíos. Las presentaciones y discusiones de esos dos días de trabajo se documentan en esta Memoria.
Notes : Español/espagnol/SpanishAbstract : En el Foro participó Martha Juárez, de GIRE, con un análisis del proceso de reforma que hizo posible modificar en agosto del 2002 el Código Penal del Distrito Federal para despenalizar el aborto en caso de violación y cuando el embarazo presente una amenaza a la salud de la mujer. El cd-rom incluye los textos de diversos documentos como instrumentos de Cladem, Profamilia, CRLP; se incluye el índice del contenido del disco en el ejemplar en papel. "La meta del Foro fue 'generar capacidad entre quienes trabajan para mejorar o incrementar el acceso al aborto, ya sea a través de la reforma de ley o de la ampliación del acceso y calidad de los servicios, compartiéndola con la Iniciativa de Johannesburgo, además de ser un componente clave del trabajo de Ipas en Centroamérica". "Este encuentro nos llevó a dar un paso más hacia la realización de una visión común: que las mujeres centroamericanas que enfrentan un embarazo no deseado tengan la opción de interrumpirlo de forma legal y sin restricciones, con acceso a servicios seguros y de alta calidad
Web site : http://www.gire.org.mx/Abstract : Intercambio de información que ofrece alternativas de solución a los principales problemas de salud que afectan a las mujeres
Notes : Español/espagnol/SpanishAbstract : Con el propósito de contribuir al proceso de discusión y consulta sobre el Anteproyecto de Ley para Reglamentar el Artículo 266 del Código Penal Boliviano, Católicas por el Derecho a Decidir presenta esta Memoria del evento realizado el 27 de septiembre de 2002 en las instalaciones del Colegio de Abogados de La Paz, en el marco de la Campaña 28 de Septiembre: Por el Derecho a Decidir. Al evento asistieron 400 personas del área jurídica de La Paz y El Alto, Senadores y Diputados de la República, miembros de la Corte Superior de Justicia, Jueces en Materia Penal y personal de los juzgados, representantes de la Brigada de Protección a la Familia, de la Coordinadora de Género del Gobierno Municipal de la ciudad de La Paz, organizaciones de la sociedad civil y estudiantes de Carreras universitarias de Derecho. El informe presenta las ponencias y debates, preguntas del público y respuestas de los y las panelistas.
Notes : Español/espagnol/SpanishAbstract : The idea of increasing men's participation in family planning has received periodic attention for the past 20 years, but there is no generally accepted understanding of what men's involvement actually means. This paper examines the gender implications of 'male involvement' for the staff and decision-makers of service delivery programmes, and the gender dynamics surrounding the use of contraceptives, particularly male-dependent methods. It discusses the importance of taking into account the interplay between men's and women's roles, rather than focusing on women's situation (or men's) alone, with the aim of increasing equality between women and men. Finally, it cautions against forms of 'male involvement' which result in men usurping what was formerly women's territory and thereby worsening existing male dominance.
Web site : http://www.rhmjournal.org.uk/Abstract : Notable changes have occurred in recent years in the conceptualization of sexuality and reproductive health. These two aspects of general health require frank and objective examination because of their repercussions on women, children, and adolescents, priority population sectors in the region of the Americas. Despite important advances in health in the region in recent decades, activities related to reproductive health still lack the coverage, variety, and organization required to respond to the needs of the population. Maternal mortality rates have declined slowly despite approval of the Regional Plan of Action. Maternal mortality rates of over 100/100,000 live births in 11 countries of the Americas are directly related to high rates of fertility and induced abortion and lack of access to prenatal care. Abortion is the principal cause of maternal deaths in eight countries and the second in three. Prevention of unwanted pregnancy and medical treatment of incomplete or complicated abortion are the most effective and least costly actions to reduce abortion mortality. But attempts to decriminalize abortion continue to provoke intense opposition. Policies related to maternal and child health must be analyzed in relation to rapid growth of the fertile-aged population, high rates of adolescent pregnancy, respect for individual rights including the right to healthy exercise of sexuality, gender equity, and the right to education of both sexes in the reproductive cycle and family life. The high risk of maternal morbidity and mortality is a clear indication of discrimination against many women. The Pan American Health Organization will continue to aid activities related to population, reproductive health, and fertility regulation as essential components of health programs.
Web site : http://cipa.snv.jussieu.fr/web_en/revues/references/rev39.htmlAbstract : Plantea de manera resumida los problemas más grandes y los retos mayores que afronta la salud reproductiva, también se propone la solución. Retomando la perspectiva de la Conferencia Internacional de Población y Desarrollo, Cairo 1995; la iniciativa de una Maternidad sin riesgo 1987 y la Conferencia Internacional sobre la mujer Beijing 1995; es un diagnóstico que identifica las áreas que requieren del esfuerzo y compromiso de gobiernos, así como de organizaciones internacionales.
Notes : Español/espagnol/SpanishAbstract : Salud y derechos sexuales y reproductivos - Adolescencia ; Maternidad sin riesgos ; Métodos anticonceptivos ; Anticoncepción post-coito o anticoncepción de emergencia ; Aborto inseguro ; Infecciones del aparato reproductor (ITR) y enfermedades de transmisión sexual (EIS) ; Otros temas de salud reproductiva ; Cáncer cervico-uterino ; Cáncer mamario.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Brazil launched sex education and contraception programs for teens through various methods, including peer counseling and group training, as early as the 1970s. While these programs achieved a great deal, Brazil in recent years has nonetheless witnessed an increase in unwanted teen pregnancy and illegal induced abortion. An estimated 4 million illegal induced abortions are conducted annually in Brazil, more than the country's 3.6 million annual births. An estimated one million induced abortions occur among teenagers annually, a figure which has tripled in two decades. The field of adolescent health education needs to close the awareness gap between teenagers and their parents who often do not know about the sexual activity of their children. Continuous education is needed not only to prevent unwanted pregnancy and abortion, but also sexually transmitted diseases including HIV/AIDS. As for AIDS, recent research identifies it as the major cause of death for women aged 22-35 years and the second major cause of death for men in the same age group. Brazil had 58,595 cumulative cases of AIDS in 1994, with unofficial estimates of up to 1% of the population of Sao Paulo State potentially HIV seropositive. The government and nongovernmental organizations have joined forces to combat AIDS, stressing education for attitudinal change.
Web site : http://www.joicfp.or.jp/Abstract : Cada año, según estimaciones recientes, 53 millones de embarazos terminan en un aborto provocado. Un tercio de esos abortos se practican sin garantías de seguridad, lo que da lugar a 50 000-100 000 defunciones al año, y todavía es mayor la cifra de mujeres con complicaciones que a largo plazo pueden tener consecuencias para su salud. En este informe de un Grupo Científico de la OMS se pasa revista a los métodos médicos de interrupción del embarazo en el primero y segundo trimestres, incluidos los estudios sobre los agentes que inducen el aborto, su modo de acción y su eficacia en comparación con los métodos quirúrgicos. Se examinan los factores que influyen en las complicaciones, en su prevención y en la aceptabilidad de métodos diferentes. Se formulan en el informe varias recomendaciones sobre el entorno asistencial necesario para el empleo de métodos médicos y en cuanto a la conveniencia de proseguir las investigaciones en el campo de la interrupción médica del embarazo.Contenido : 1. Introducción ; 2. Demografía del aborto ; 3. Mecanismos del aborto médico ; 4. Métodos abortivos aplicables hasta el 63° día de amenorrea ; 5. Métodos abortivos aplicables a las 9-14 semanas de gestación ; 6. Métodos abortivos aplicables después de las 14 semanas de gestación ; 7. Complicaciones del aborto y su prevención ; 8. Aceptabilidad del aborto médico ; 9. Adopción del aborto médico como prestación clínica regular ; Nota de agradecimiento ; Referencias
Notes : Español/espagnol/SpanishAbstract : In late January, the Mexican Supreme Court upheld a federal district law permitting women to obtain an abortion in cases of rape or "proven" instances of severe fetal deformity."There is still a long way to go," said Luisa Cabal, a CRLP staff attorney. "but the Supreme Court's decision to uphold the reform that makes Mexico's abortion law more flexible is a step in the right direction towards the recognition that women should have the legal right to choose."The court decision also reduced the maximum sentence for obtaining an illegal abortion from five years in prison to three. Abortion is illegal in all but a few cases in Mexico's 31 states and in Mexico City.
Web site : http://www.crlp.org/rfn_2002.htmlAbstract : This chapter on Mexico is part of a comprehensive examination of the laws and policies that affect the reproductive lives of women in nine Latin American and Caribbean countries. Each report begins with a page of statistical information on population, the economy, status of women, and reproductive health and a brief summary of the nation's recent history. The first main section describes the country's legal and political framework, including the structure of national and local governments and national and international sources of laws. The second section examines laws and policies regarding health and population. The objectives of national health policy and the financing, infrastructure, and regulation of health services and patients' rights are analyzed. Population policy, legislation affecting reproductive health, and government- provided family planning services are then examined. Discussions of contraception, abortion, and HIV/AIDS and sexually transmitted diseases examine relevant legislation and prevalence. The third major section assesses the social and juridical status of women as an influence on the exercise of their reproductive rights, including civil rights within marriage, socioeconomic rights, and the right to physical integrity. The characteristics of marital and family relations and women's educational level, access to economic resources and legal protection determine their possibilities of satisfying their reproductive health needs and rights to services. The final major section examines the rights of adolescents in the areas of reproductive health, marriage, sexual crimes against girls and young women, and sex education. Efforts to improve observation of the reproductive and other rights of adolescents are important for self-determination and health of women in general.
Web site : http://www.crlp.org/Abstract : Hace un recuento histórico de la lucha de las mujeres mexicanas por conseguir la despenalización del aborto
Notes : Español/espagnol/SpanishAbstract : Publisher Provided Annotation. Witnesses: Maria Sophia, assoc. prof., Dept. of Economics Business, Catholic Univ. of Amer.; Nirmal Bista, dir. gen., Family Planning Assoc. of Nepal, Kathmandu, Nepal; Kathy Cleaver, Dir. of Planning Information for the Secretariat for Pro-Life Activities, U.S. Conference of Catholic Bishops; Nicholas Eberstadt, scholar, Amer. Enterprise Institute; Susana Silva Galdos, pres., Movimiento Manuela Ramos, Lima, Peru; Alan Kreczko, Acting Assist. Sec., Bureau of Population, Refugees Migration, U.S. Dept. of State; Barbara Turner, Acting Assist. Administrator for Global Programs, U.S. Agency for Internat. Devt. (USAID); Aryeh Neier, pres., Open Society Institute; Daniel E. Pellegrom, pres., Pathfinder Internat., Watertown, MA.
Notes : Inglés/anglais/EnglishAbstract : Entrevistas con los y las participantes de la delegación de México en la Conferencia. Dan a conocer su punto de vista desde diferentes espacios, como son, gobierno, organizaciones no gubernamentales de mujeres y derechos humanos. Comentan que Pekin provocó que se hablara de las mujeres y se reflexionara sobre cómo hacer esfuerzos para que las mujeres tengan mejores oportunidades. Se refieren al debate sobre la posición del comité oficial mexicano con respecto al tema del aborto
Notes : Español/espagnol/SpanishAbstract : This news article reports on the ruling of Mexico's Supreme Court, allowing women who reside in Federal District of Mexico City to access abortion in the case of serious genetic malformations. The ruling confirms that the Legislative Assembly of the Federal District have the constitutionally-guaranteed power to establish the conditions under which abortion will be permitted, thereby asserting the validity of women's legal rights over those of the fetus in certain circumstances.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : The debate on abortion unleashed in July 1998 by remarks of Mexico's Secretary of Health has prompted dozens of individuals and institutions from all sectors to make their views known. The principal arguments have been that the secrecy in which abortion is practiced is damaging to public health and mental health in a society where between 850,000 and 1 million abortions and around 1000 maternal deaths from abortion occur annually. Considering that it is a grave problem experienced by millions of Mexicans, the scarcity of medical information and over-abundance of religious ideology are regrettable. The opposition of the Catholic hierarchy and allied groups to decriminalization, or even to consultation of the people, reveal fear that what surveys reveal is true: society is inclined to leave decisions about abortion to the woman and her partner. At least three indications are recognized as justifiable motives for abortion by a large number of people: rape, preserving the life of the mother, and congenital anomalies.
Web site : http://www.gire.org.mx/Abstract : In June 1991, the National Forum for Voluntary Motherhood and the Decriminalization of Abortion was convened in Tuxtla Gutierrez, Chiapas, Mexico. The forum culminated in the signing of a pact in which participants pledged to support the women of Chiapas in their efforts to win approval of legislation assuring the right to legal abortion. The action in Chiapas was viewed as the beginning of a national legislative process aimed at achieving juridical recognition of the sexual freedom of women. The participants planned to promote discussion in each community and state of existing abortion legislation and the proposed reforms to assure women the right to abortion. Space will be demanded in the mass media in order to inform the population. The movement will seek to develop a widespread local and national consensus on the right to voluntary maternity. Voluntary maternity implies recognition of the rights to women to make decisions regarding their own sexuality and fertility. It implies availability of sex education and contraception, as well as access to safe and legal abortions. Voluntary maternity implies elimination by society of morbidity and mortality due to causes associated with reproduction, and it implies generalized use of contraception and elimination of involuntary sterilization. Voluntary maternity requires that the state develop an ethic of protection of mothers and children, and that authoritarian demographic programs that do not recognize the humanity and autonomy of women be abandoned. Voluntary maternity requires protection by public institutions, and it requires that women and children have access to a decent standard of living. It requires as well that the daily care of children cease to be the exclusive responsibility of women and that it be shared by men. Women cannot be free as long as maternity is compulsory. It is proposed that the discussions and proposals made to local legislatures will eventually be brought before the national Congress in order that legislation be enacted to safeguard the right to voluntary maternity of all Mexican women.
Web site : http://www.geocities.com/catolicas/conciencia/www.catolicasporelderechoadecidir.orgAbstract : MEXICO CITY ; A law that would have made abortions for rape victims a crime was vetoed August 29 by the Guanajuato state governor after a nationwide flurry of outrage.The Guanajuato legislature, dominated by members of the conservative National Action Party who were emboldened by the victory of their candidate, Vincente Fox, as president of Mexico, voted in early August to make the law against abortion even stricter by removing the clause allowing it in cases of rape. The governor vetoed the bill after commissioning a public opinion poll that showed that most state residents opposed the change.Abortion, with a few exceptions, is generally illegal in Mexico. ; info from Washington Post, 8/30
Web site : http://www.offourbacks.orgAbstract : In general, midwifery practice does not include attending to women experiencing complications from unsafe abortion, despite its importance in the health and lives of millions of women around the world. This paper summarizes data collected from midwives from 41 different countries who attended the 25th Triennial Congress of the International Confederation of Midwives (ICM) in 1999, focusing on their experiences with and attitudes towards the provision of postabortion care (PAC) as well as barriers and facilitating factors for changes in PAC-related policies and practices within their countries. Midwives from developing countries, where complications from unsafe abortion present a serious public health problem, were cognizant of the need to authorize, train, and equip midwives in PAC, including uterine evacuation of incomplete abortion with manual vacuum aspiration (MVA). Changes in policy and practice are needed throughout the world so that women will have access to PAC services regardless of where they live. Ensuring that midwives are able to provide such services in the facilities where they work will help to reduce abortion-related morbidity and mortality. Entities such as ICM need to take an active role in promoting necessary changes.
Notes : Inglés/anglais/EnglishAbstract : In developing countries, midwives are the repositories of knowledge accumulated over centuries about pregnancy, childbirth, and abortion. However, they remain marginalized, lacking a relationship to the formal health sector or the technical skills that could improve their ability to manage high-risk deliveries. To upgrade the status of midwives in northeastern Brazil's Upper Sertao region, Grupo Curumin, a feminist organization created to promote health education and reproductive rights, has organized 6 Midwives Conferences in Pernambuco in the last 4 years. About 200 rural and urban midwives have participated. The discussions at these gatherings tend to focus on identity concerns. Although midwives are the only personnel available to assist deliveries in many of Brazil's rural areas, they are often blamed for infant mortality and neonatal tetanus. Many midwives believe that their clients would prefer a hospital delivery. Several organizations have emerged to help midwives cope with their isolation and marginalization. One such organization, the Network for Humanized Childbirth, unites nongovernmental organizations working to promote debate on obstetrical care in Brazil and recognition of the important contribution of midwives.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : This paper presents a prospective study of home administration and a one-treatment-visit regimen of mifepristone-misoprostol for medical abortion in Guadeloupe. The administration of this contraceptive method usually requires a standard 3-clinic visit regimen, which would sometimes lead to discontinuation of the abortion process. The study consisted of 92 medical abortion cases conducted over a 13-month period. The intervention involved a 1-day treatment visit with patients receiving 600 mg of mifepristone and instructions on ingesting 2 tablets (400 mcg) of misoprostol orally after 2 days and another 200 mcg misoprostol if bleeding had not occurred within 6-12 hours. A follow-up was conducted among these women after 10-15 days of initial clinic visit and contraceptive administration. The total success rate was 95.4% in comparison with those who received a 3-clinic visit regimen and the statistical result of a study conducted in the US. Several adverse effects have been associated with the administration of abortive methods, which include bleeding (19.6% in mifepristone users and 68.2% in misoprostol users) and vomiting. Strict monitoring of mifepristone and misoprostol distribution and patient follow-up was ensured by French legislators. The authors conclude that home administration of misoprostol must be made available to women in developing countries.
Web site : http://www.sciencedirect.com/science/journal/14700328Abstract : Miradas sobre el aborto es un libro que reúne más de 50 preguntas y respuestas sobre el aborto inducido en México. ¿Por qué abortan las mujeres? ¿Es peligroso el aborto? ¿Cuántos abortos se practican en México? ¿Qué dicen las religiones acerca del aborto? Éstas son algunas de las interrogantes a las que responde este libro con un lenguaje claro, sencillo y accesible. En Miradas sobre el aborto GIRE sostiene que "el tema no es 'aborto sí' o 'aborto no', sino quién decide sobre el aborto. Dado que es una decisión sumamente compleja y personal, ni el Estado, ni las Iglesias, ni los médicos pueden hacer nada más que ofrecer información. La decisión compete a la pareja, y si no hay acuerdo o la mujer está sola, a ella sola". Miradas sobre el aborto contiene información de fuentes legales, médicas, religiosas y de instituciones de salud, por lo que se trata de un libro imprescindible si se quiere conocer la problemática del aborto en México.
Web site : http://www.gire.org.mx/Abstract : Muestra la visión literaria, analítica, crítica, profunda de cinco mujeres que se atreven a abordar diversos temas para contribuir a la equidad entre géneros
Notes : Español/espagnol/SpanishAbstract : Ethnographic data were used to examine fertility control in 1993 among Aymara urban women in Bolivia. Data were gathered from in-depth interviews on family planning (FP) with 30 women, from similar interviews with eight men, from 38 other household interviews, and from FP service clients. Most of the Bolivian population is composed of members of the Aymara or Quechua indigenous groups. About 50% of total population is urban. Interview responses indicated that most women wanted to control their fertility so that they could improve their economic situation by selling items in the market. Cultural norms and beliefs were compatible with fertility control and women's work. Women were expected to control reproduction through rhythm or a form of abstinence. Barriers to fertility control included a lack of communication about sexual and contraceptive matters with friends, family, or spouses. This pattern of silence was handed down from their mothers. Almost 66% of the 30 women had never received information on menstruation or reproduction when growing up. The message was that sexuality was dangerous and shameful. Almost 33% engaged in a living arrangement with a sexual partner at the age of 14-16 years, and the remaining had done so by 17-20 years. Marriage occurred accidentally or by force (25%). Voluntary cohabitation occurred in about 50% of cases. After sexual contact occurred, parents strongly urged marriage. Women eventually learned about contraception through women's clubs, clinics, church groups, husbands, or friends. When fertility control failed, women resorted to extreme abstinence, abortion, infanticide, or modern methods. Modern methods were viewed as dangerous and with harmful side effects; modern medicine was viewed similarly. Contraceptive use could be associated with promiscuity. Women feared being touched by health personnel. Although abortion was illegal, women conveyed a desire to end an unwanted pregnancy or acted with systematic neglect to end an unwanted birth. Recommendations were made for providing culturally sensitive services which involved men.
Web site : http://www.popcouncil.org/publications/sfp/default.htmAbstract : A randomized trial was conducted including 287 pregnant women seeking elective abortion to compare the efficacy of misoprostol given 3, 4, or 5 days after methotrexate for abortion at 63 days or less gestation. Subjects received 50 mg/sq. m methotrexate intramuscularly and were randomly allocated to self-administer vaginally 800 mcg of misoprostol 3, 4, or 5 days after methotrexate administration. The misoprostol dose was repeated 48 and 96 hours later if the abortion did not occur. Outcome measures included successful abortion (complete abortion without requiring a surgical procedure) and side effects. 86 cases [93%; 95% confidence interval (CI), 85-97%] aborted in Group I; 90 cases (92%; 95% CI, 84-96%) aborted in Group II [relative risk (RR) = 1.09; RR 95% CI, 0.38-3.14]; and 89 cases (93%; 95% CI, 86-97%) aborted in Group III (RR = 0.97; RR 95% CI, 0.33-2.87). No significant statistical differences were obtained for the success rates when misoprostol was given days 3, 4, or 5 after methotrexate administration (p = 0.97) nor with any of the characteristics of the subjects. Complete abortion occurred in 265/287 patients (92%; 95% CI, 89-95%). 22 cases (8%; 95% CI, 5-11%) resulted in failure. Side effects for methotrexate were minimal, while for misoprostol they were moderate. This combination could be an alternative to surgical abortion or the use of antiprogestins and prostaglandins for medical abortion. (author's modified)
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?iss=3 vol=56 viewtype=issueAbstract : Misoprostol is being used widely by women throughout Latin America, often based on instructions passed along through friends, acquaintances or professionals who may have little information about safe and effective use. This paper presents the experience of a Latin American clinic working in a legally restrictive setting that offers misoprostol as one option to women seeking early pregnancy termination. Between February 2001 and June 2002, 3,225 women who attended the clinic chose to use misoprostol rather than vacuum aspiration. 89.9% returned for follow-up, of whom 76.4% had had a complete abortion within 72 hours, using one, two or three doses of 800 micrograms of misoprostol administered by the woman herself vaginally every 24 hours. The first 78 women who returned for follow-up at 72 hours responded to a questionnaire regarding their experiences. Satisfaction with the abortion process was high, despite some pain, chills, diarrhoea and/or nausea. Seventy-two of the 78 women said they would use misoprostol again if they needed to terminate another pregnancy and would recommend it to a friend. Having a clinic where staff are knowledgeable and experienced in misoprostol use is particularly important in settings where abortion is stigmatised, unsafe abortion common and access to safe services limited.
Web site : http://www.rhmjournal.org.ukAbstract : Misoprostol, a prostaglandin E1 (PGE1) analogue indicated for ulcer treatment, has been widely used as an abortifacient by women in Brazil, where abortion is legal only in cases of rape or incest, or to save the woman's life. Because misoprostol is an inefficient abortifacient, many women who use it have incomplete abortions and need uterine evacuation. The authors reviewed the records of women admitted to the main obstetric hospital of Fortaleza, capital of Ceara state, Brazil, between January 1990 and July 1992, for uterine evacuation after induced abortion. The number of incomplete abortions induced by misoprostol increased substantially during the first half of 1990, and declined thereafter. Of the 593 cases in 1991, 75% were related to misoprostol, 10% to the use of other specific drugs, and 6% to unspecified drugs. For the remaining 9%, the procedure used was not recorded: these included 3% in whom abortion had been induced by a clandestine abortionist. The number of uterine evacuations/month fell from 89 in August 1990 to 62 in July 1991, when sales of misoprostol in Ceara state were suspended. The fall continued after the sale of misoprostol ceases, to about 20 cases in December 1991: numbers remained around this level until June 1992, sustained by clandestine sales. The lack of access to contraception is the main reason for the large numbers of unplanned pregnancies and is a major public health issue for Brazilian women. The prohibition of abortion creates a void in which misuse of medicines in one extra complication, mainly because of the poor control of drug marketing. (author's)
Web site : http://www.thelancet.com/Abstract : The authors report on the determinants and consequences of induced abortion among 803 women admitted to hospital with abortion complications in Rio de Janeiro, Brazil, in 1991. 458 (57%) reported using misoprostol to induce abortion, 74% in the first 4 months of pregnancy. Doses of 200-16,800 mcg were reported, with a median of 800 mcg. 65% of the women took the drug orally, 29% used a combination of oral and vaginal routes, and 6% administered it intravaginally. Vaginal bleeding and uterine cramps were the most common reasons for seeking hospital care. Only 8% of women reported gastrointestinal side effects. Misoprostol induced vaginal bleeding within 12 hours of administration in 52% of the women, but 16% waited 10 days or more for onset of bleeding. 4% were admitted to hospital with complete abortion. The likelihood of bleeding starting within 12 hours increased with duration of gestation and it was greater when the drug was used both orally and intravaginally. A significant smaller proportion of women taking misoprostol than of those who induced abortion by catheter insertion presented signs of infection or physical injuries or required blood transfusion ( < 0.005). AMong 803 women interviewed at delivery as controls, 6% had taken misoprostol, but abortion had not ensued. Misoprostol has an important role as an abortifacient among the women studies. (author's)
Web site : http://www.thelancet.com/Abstract : The objective was to identify information and service delivery needs for obstetric/gynecologic uses of misoprostol in developing countries. The study included a survey of reproductive health providers in 23 countries and a qualitative study of misoprostol use in four developing countries. Researchers used purposive sampling methods for the survey and qualitative study and conducted a descriptive statistical analysis of survey data and computer-assisted text-based content analysis of qualitative data. In some developing countries, women frequently access misoprostol through pharmacies and self-medicate to induce early abortion. Some clinicians expressed concern about this use of misoprostol, but many stated that its availability had reduced serious complications resulting from unsafe abortions. Although misoprostol is routinely used for a range of off-label obstetric/gynecologic indications, evidence-based, up-to-date information about safety, effectiveness, and appropriate regimens is not widely available. This information is requested by providers, including pharmacists. Women need information and guidance about its use. (author's)
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : Misoprostol, a synthetic prostaglandin E1 analogue used to treat upper gastrointestinal ulceration, is available over the counter to Brazilians, who often use it as an abortifacient. However, it fails to induce abortion in about 80 percent of the women, and the pregnancies continue to term. Investigators compared the frequency of misoprostol use during the first trimester by mothers of infants with Mobius's syndrome (bilateral paralysis of the facial muscles) with use by mothers of infants with neural tube defects. Among the mothers of 96 infants with Mobius's syndrome, 47 (49 percent) had used misoprostol in the first trimester, versus only 3 (3 percent) of the mothers of the 96 infants with neural tube defects.The study suggests that misoprostol use during the first trimester of pregnancy is strongly associated with Mobius's syndrome in infants. (Journal Watch, Women's Health, Vol. 3 No. 8)
Web site : http://www.midwiferytoday.com/Abstract : The aim was to investigate the current clinical use of misoprostol for the treatment of a range of reproductive health (RH) indications by providers in Brazil, Jamaica, and the US. Using a `snowball' sampling technique, the authors surveyed 228 gynecologists and obstetricians in Brazil (n = 123), Jamaica (n = 52), and the US (n = 53). Providers use misoprostol for labor induction (46%), postpartum hemorrhage (8%), intrauterine fetal death (61%), cervical priming (21%), missed abortion (57%), and incomplete abortion (16%) as well as first and second trimester abortion induction (27% and 13%, respectively). There is a considerable variation in the regimens used; moreover, the regimens commonly used in clinical practice often differ from those recommended in the medical literature. While misoprostol is an appealing alternative for many RH indications in developing countries, the varied regimens and lack of registration raise critical medical and policy questions. (author's)
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : Studies have been conducted to examine the potential of misoprostol alone for early termination of pregnancy. These studies were done by Norman et al. (1991), Creinin and Vittinghoff (1994), Bugalho et al. (1996), Koopersmith and Mishell (1996), Carbonell et al. (two studies: 1997, 1998), and Jain et al. (1998). The designs, population sampling methods and regimens varied from study to study. Thus, comparison of results has been difficult. Overall, though, findings indicate that a misoprostol-alone regimen could be safe and effective as a method of medical abortion. This regimen could greatly improve access to safe medical abortion services for women in developing countries, which in turn would lead to a significant reduction in maternal mortality.
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?vol=59 viewtype=issue iss=4#S00107824990003Abstract : A study on the indiscriminate use of misoprostol (Cytotec) in Brazil as an abortifacient was carried out by a study group of the Federal University of Ceara, Brazil, in 1990-94. It was also in Ceara that the first case of congenital malformations in infants exposed to misoprostol in utero was detected. The FDA classifies the drug as a teratogenic substance, but it is also indicated for the prevention and treatment of gastric ulcers. In July 1992 the sale of misoprostol was suspended throughout the country and its sale dropped by 80% immediately after this court decision; however, its clandestine or irregular trade precipitated a renewed increase in the frequency of curettage. The efficacy of misoprostol for the treatment of gastric ulcers justifies its indication in preference to other drugs for the prevention of gastric erosion in risk patients treated with nonsteroidal anti-inflammatory agents, especially in elderly patients. For this reason it is common that misoprostol is prescribed by rheumatologists. Misoprostol is a synthetic analogue of prostaglandin E. It augments the uterine tone causing the softening and dilatation of the cervix for curettage. It is superior to other prostaglandins because of its effectiveness, ease of use, and low cost. If it is used under prudent medical supervision it can be an optimal abortifacient, but it may still fail to induce abortion in more than 10% of cases, necessitating other means for the evacuation of the uterus. Biolab-Searle produces this drug in Brazil, and its illegal trade should be controlled. Otherwise, the government and Biolab-Searle will be accountable for the births of children with malformations.
Web site : http://www.scielosp.org/scielo.php?script=sci_serial pid=0034-8910 lng=en nrm=isoAbstract : In Brazil between July, 1992, and February, 1993, 102 women, 16-49 years old, living in Fortaleza, capital of Cear State, who had used misoprostol to induce abortion were interviewed to examine their characteristics and experience. The largest proportion of women were 20-29 years old (57%), never married (46%), Catholic (81%), of the lowest social classes (77%), and had less than 8 years of education (58%). 57% did not use contraception. This induced abortion experience was the 1st for 65 women. 80% took 4 tablets of misoprostol (200 mcg each) ; 2 tablets orally and 2 tablets intravaginally. This pattern of misoprostol administration had a higher abortion rate than did the other routes (89% vs. 53% for oral route only and 60% for vaginal route only). Women at 9-12 weeks' gestation had the most successful abortion rate (95% vs. 57-87%). No pregnancy test was performed in most women (56%). At the time of misoprostol administration, 41% of the women had no more than 8 weeks of amenorrhea. 58% of women who reported abortion underwent curettage, either in a hospital (83.7%) or in private clinics (16.3%). 43 women were admitted to the hospital, with 95.3% undergoing curettage. Reported complications included infection (13%) and uterine perforation (4%). Rape, no stable partner, and poor economic conditions were the most common reasons for abortion. Even though 72% of the women favored legalization of abortion, 52% also favored banning misoprostol sales at pharmacies. More women in the next to the lowest social class than in the other social classes did not favor banning misoprostol sales (59% vs. 5-24%), however. Most women would not use misoprostol again and would not recommend it to a friend (66% and 53%, respectively). The opinions about abortion, misoprostol sales, and disapproval of misoprostol indicated that women did not consider misoprostol a concrete and safe method of abortion for Brazil.
Web site : http://www.arhp.org/healthcareproviders/onlinepublications/arhpjournal/journal.cfm?ID=300Abstract : El proyecto de difusión e información sobre embarazo no deseado y aborto riesgoso en Bolivia, al que pertenece esta publicación, formó parte del programa Regional de Salud Reproductiva del Population Council. En Bolivia comenzaron a funcionar una serie de iniciativas y proyectos en 1994. Mitos y Realidades es uno de los frutos de este trabajo. Presenta el tema del aborto desde diversas perspectivas, insertándolo en el ámbito de la salud sexual y reproductiva. Un panorama sucinto de la situación legal en el mundo, y en América Latina, permite contextualizar las características de la situación boliviana. Se concluye con una visión alternativa de la postura de la Iglesia Católica y de algunos de sus miembros. Un objetivo de la publicación es contribuir a la ampliación del debate. Conocer la magnitud real del problema, no sólo cuantitativa sino también cualitativamente, es una manera de comenzar a actuar.
Notes : Español/espagnol/SpanishAbstract : Aproximación a grupos de mujeres que por su nivel socio económico se consideran poco vulnerables a las enfermedades que definen la marginalidad materna, no se estudian y por tanto se desconoce esta dimensión de la morbilidad materna. Este estudio se realizó específicamente en mujeres profesionales que se desempeñan en 6 hospitales de Managua
Notes : Español/espagnol/SpanishAbstract : Aborda la problemática del aborto inducido e inseguro en México. La penalización del aborto ocasiona que miles de mujeres mueran, de ahí que estudios independientes como éste, evidencian que el aborto es un problema social de salud pública nacional. El texto está dividido en dos grandes partes. En la primera se aborda la política demográfica del gobierno, su origen en la ley general de Población y el Plan Nacional de Planificación Familiar. La segunda parte trata propiamente de la problemática del aborto como resultado de tres factores: la pobreza, la legislación y el sistema de salud. Por último presenta los indicadores epidemiológicos: la incidencia del aborto y la morbimortalidad
Notes : Español/espagnol/SpanishAbstract : The sister survival method applied to data from Bolivia's 1994 Demographic and Health Survey indicated that the estimated maternal mortality rate declined from 416/100,000 live births to 390/100,000 during 1989-94, but it still remains the highest rate in Latin America. Some 1000 mostly avoidable maternal deaths occur in Bolivia each year. The national averages obscure dramatic regional differences. The estimated maternal mortality rate during 1984-94 was 583/100,000 live births in rural areas, 282/100,000 in urban areas, 591/100,000 in the Altiplano, 286/100,000 in the Valle, and 166/100,000 in the lowlands. In the rural Altiplano, the rate reaches 929/100,000. The risk of dying during pregnancy, delivery, or the puerperium is estimated at 1 in 20,000 for a fertile-aged woman in developed countries and 1 in 45 for a Bolivian woman. Efforts to reduce maternal and child mortality in the past 5-year period showed better results for child mortality. Maternal mortality actually increased in the Altiplano and declined only slightly in the Valle. The social costs of maternal death include elevated mortality among orphaned newborns and children under age 5. Maternal deaths result from inadequate treatment of complications of pregnancy or induced abortion. Development of primary care has reduced infant mortality rates, but women with pregnancy complications require secondary-level care. Community cooperation is essential in developing programs to reduce maternal mortality.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 133728Abstract : A retrospective study was conducted of maternal mortality in the Maternal-Child Institute, a tertiary level teaching center attending low income patients in Bogota. In recent years the Maternal-Child Institute has become a referral center for high risk pregnancies from throughout Colombia. Records were examined of the 113 women who died during January 1985-December 1989 while under the obstetrical care of the Maternal-Child Institute. During that time there were 50,792 live births, resulting in a maternal mortality rate of 22.25/10,000 live births. The rate ranged from 16.98 in 1985 to 24.66 in 1987. 98 deaths (86.7%) resulted from direct causes, 8 (7.1%) from indirect causes, and 7 (6.2%) from nonmaternal causes. 41.6% of the deaths were due to sepsis, 36.7% to toxemia, and 11.2% to hemorrhage. Of the 47 cases of death due to infection, 35 followed abortions. Only 1 of the 4 women dying of puerperal infections delivered in the Maternal-Child Institute. In most cases more than 1 septic state was present. The most frequent were septic shock in 41 patients, myometritis in 39, generalized peritonitis in 10, septicemia in 6, tuboovarian abscess in 3, endometritis in 5, and acute endosalpingitis in 1. The 36 women dying of toxemia did not include any with histories of chronic hypertension. The 11 deaths from hemorrhage included 5 cases of postpartum atony and 3 of ectopic pregnancy. The 8 deaths from indirect maternal causes included 2 from pulmonary thromboembolism, 2 from cardiopathy, 1 from chronic viral hepatitis and hemorrhagic pancreatitis, 1 from medullar aplasia, 1 from primary pulmonary hypertension, and 1 from sickle cell crisis. Among the 7 deaths from nonmaternal causes was 1 from an anesthetic accident occurring during induction of anesthesia in a toxemia patient. Only 20% of the deaths occurred in women who were not referred by some other facility. 16 women were aged 14-19, 30 were 2024, 32 were 25-29, 17 were 30-34, and 11 were 35 or over. 34 deaths occurred in 1st pregnancies. The majority occurred at week 30 or later. 81.4% of the women had no prenatal care. 87.6% were considered a high risk on admission. 58.4% of the clinical records were considered good and 21.2% acceptable. Medical treatment was judged to have been good in 64.6%, average in 22.1%, and poor in 13.3%. Institutional care was judged poor in 38%, primarily because of the lack of an intensive care unit and an adequate blood bank.
Web site : http://scielo.sld.cu/scielo.php?script=sci_serial pid=0138-600X lng=es nrm=isoAbstract : Se revisaron 2,578 casos de muerte materna por todas las causas registrados por los Comités de Estudios en Mortalidad Materna del Instituto Mexicano del Seguro Social (IMSS) en el período 1992-2001 y se analizó su tendencia, sus principales causas y algunos factores asociados con la mortalidad por aborto, con el fin de obtener información para contribuir a conformar el panorama epidemiológico de este problema de salud entre la población amparada por la Institución. La tasa de mortalidad materna general descendió de 47.9 a 36.6 por 100,000 nacidos vivos y la específica por aborto de 3.9 a 2.5, en el lapso mencionado; 67.7% de las defunciones se debieron a preeclampsia-eclampsia, complicaciones hemorrágicas, aborto y sepsis puerperal. De las 178 muertes ocasionadas por complicaciones del aborto, 31 de ellas (17.4%) se debieron a casos de aborto provocado; la tasa específica de mortalidad más elevada (4.8 por 100,000 nacidos vivos) la tuvieron las mujeres de 35 años y mayores al embarazo, en tanto que la más baja la presentaron las adolescentes (2.1); 23.6% de las muertes por aborto tuvieron lugar en el primer embarazo y 46.6% de la tercera gestación en adelante. Se concluye que aunque la mortalidad materna ha disminuido significativamente en el IMSS, su tipo, causalidad y factores asociados no se han modificado. La información también sugiere una calidad insuficiente de la atención en las unidades médicas, lo que requiere de estudios dirigidos a identificar su origen y planear alternativas de solución.
Web site : http://www.medigraphic.com/espanol/e-htms/e-gaceta/em-gm.htmAbstract : Vital statistics are the most comprehensive source of information on maternal mortality in Mexico.... It is clear that maternal mortality has decreased throughout the twentieth century and will continue to do so. There are signs of a higher underestimation of mortality [due to] abortion. And there are regional differentials of maternal mortality.... Professional and/or institutional attention during childbirth has a great impact on maternal mortality decline. There are also socio-economic differentials by marital status, milieu, and schooling.... (EXCERPT) (SUMMARY IN ENG)
Web site : http://www.colmex.mx/centros/ceddu/revista/datgen.htmAbstract : These papers presented at a round table in October 1999 on maternal mortality and unsafe abortion in Peru were intended to promote discussion of issues regarding unsafe abortion in Peru. The first paper discusses abortion as a public health issue, provides data on the incidence of abortion and maternal mortality in South America and Peru, identifies technical innovations and improvements that should be made in the treatment of abortion complications, and discusses the ethical dilemmas involved in abortion legislation. The second paper argues that criminal law has little to contribute to reducing the number of abortions, and its use as the main deterrent of abortion is inappropriate. The need for a new ethics in reproductive rights and proposed components in the context of the advances in knowledge and control of reproduction over the past half century is the topic of the third paper. Two papers provide perspectives on abortion and women seeking abortion from an 18-year old university student and a health promoter in a low-income urban neighborhood. Statements and questions follow from representatives of women's organizations, Pathfinder International, and other organizations describing their experiences with abortion and its consequences. The work concludes with final statements of the participants and the six demands to the Peruvian government made by 67 organizations in September 1999 to reduce maternal mortality and unsafe abortion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159717Abstract : The quantification and classification of maternal mortality in women during the reproductive ages of 12-49 years was carried out in the Medellin metropolitan area of Colombia with a population of 2,343,614 in 1988. 28.7% of these were women in their reproductive ages. There were 33 cases and 112 controls. Death certificates yielded 47.2%; necropsy information, 41.5%; and review of clinical histories provided, 9.4% of maternal mortality. The rate of mortality was 15/10,000. 27.7% of these were attributable to violent causes, 6.7% to accidents, and 3.8% were because of maternal mortality. The violent mortality rate was 4.2/10,000 vs. a 4.2-10.1/10,000 homicide rate in the general population between 1980 and 1985. The general homicide rate rose from 3.5% in 1976 to 16.6% in 1985. The risk of death from homicide for women increased 5 times by the end of the 1980s. There were 7 deaths from firearms, 2 from traffic accidents, and 1 from fire out of 10 deaths of pregnant women dying from nonobstetrical causes. During the reproductive process, obstetrical causes accounted for 71.7% of deaths and 18.9% were attributable to nonobstetrical causes (trauma and violence). The maternal mortality rate reached 7.19/10,000 live births, more than twice the 1988 official rate. 33 maternal deaths occurred: 12.1% were indirect obstetrical deaths. Hypertension associated with pregnancy caused 39.4% equivalent to 27/100,000 live births. Infection accounted for 24.2% or 6.2/100,000 live births. There were 5 deaths caused by abortion and 3 from puerperal infections. Deaths related to abortion made up 23% of maternal mortality in 1984. Hemorrhage caused 12.2% of deaths or 8.1/100,000 live births. The availability of risks of maternal death ranged from 61.5% to 91%, especially risks of a socioeconomic character.
Web site : http://www.scielo.org.co/scielo.php?script=sci_serial pid=0034-7434 lng=pt nrm=isowww.fecolsog.org/ShowChannel.asp?ChannelId=300Abstract : Partly because of incomplete death registration, the true extent of maternal mortality in many developing countries is not known. Official statistics indicate a 1991 maternal mortality rate in Ecuador of 120/100,000 live births, one of the highest in Latin America but significantly lower than the 230 of 1970. In 1990 the reported maternal mortality rate exceeded 150/100,000 in 15 of Ecuador's 21 provinces and reached 390 in Zomora/Chinchipe. The national average using these figures was 168.09/100,000. Data from the 1994 Demographic and Health Survey (DHS) based on the indirect sister survival method yield estimates of 302/100,000 for 1981-87 and 159 for 1988-94. The highest rate of underregistration of maternal deaths probably occurred in deaths at home. During 1981-94, 53% of maternal deaths occurred in health facilities, 36% at home, 4% en route, and 7% elsewhere. During that same period, the maternal mortality rate was 250/100,000 in the sierra and 197 on the coast. In 1990, 29.4% of maternal deaths in Ecuador were caused by hemorrhage in pregnancy or delivery, 28.1% by other direct obstetric causes, 20.9% by toxemia, 9.5% by abortion, 8.5% by puerperal complications, and 3.6% by indirect obstetric causes. 306 maternal deaths were reported in 1990. Ecuador's total fertility rate fell from 6.86 during 1965-69 to 3.6 during 1989-94, but rural-urban differences persisted. In 1994, the DHS found that 56.8% of women in union used contraception, with the usual regional and educational differences. The Pan American Health Organization (PAHO) estimated on the basis of official data that 46.4% of pregnant women received prenatal care in 1991, but the 1994 DHS estimate was 74.7%. Estimates of the proportion of deliveries attended by professionals vary widely, from 26% in 1990 according to a PAHO document to 63.6% in 1994 according to DHS data. An estimated 1/3 of women received postpartum care.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 118541Abstract : La Dra. Ana Ma. Pizarro en Nicaragua, entrevista a mujeres de diversos sectores sociales acerca de la mortalidad materna; así como a profesionistas que aportan sus puntos de vista, o bien defienden los derechos reproductivos de la mujer y exponen que una de las causas que la provocan es el aborto clandestino, la toxemia y el trabajo que deben hacer las mujeres dentro y fuera del hogar. Esto hace evidente que la mujer se ha integrado a la participación económica de su entorno social. En consecuencia debe elegir cuántos hijos quiere y/o puede atender, educar y solventar aunque en mínima parte los gastos que esto ocasiona
Notes : Español/espagnol/SpanishAbstract : Elevado subregistro en datos oficiales ; Ineficiencia y falta de atención ; Aniconceptivos: demandas insatisfechas de las mujeres.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Abortion, has traditionally been a common cause of maternal mortality in Latin America and in Chile. At the present time maternal mortality has decreased, the number of abortions remains high in the country. For this reason, the purpose of this study is to analyze the abortion mortality in Chile from the epidemiological point of view, between 1985 and 2000. Results confirm the decrease in abortion mortality during this period, however abortion still causes maternal mortality in the country.
Web site : http://www.scielo.cl/scielo.php?script=sci_arttext pid=S0717-75262003000400007 lng=en nrm=isoAbstract : 50% of the reported deaths of women aged 10-48 that occurred from July 1 through December 41, 1986 in Sao Paulo Brazil were analyzed by examining death certificates, hospital medical records, and autopsy reports and by administering questionnaires to the families. The results were coded according to the International Classification of Diseases, 9th revision, 1975. 1023 cases were selected and 70 of these were excluded, leaving a total of 953 cases. There were 881 complete and 13 incomplete household interviews conducted as well as 871 medical interviews. 25 deaths 2.6% were attributable to basic maternal causes and another unreported 31 were added, raising the maternal death total to 56 (5.9%) and yielding a rate of 99.6 deaths/100,000 live births, a high figure compared to 10-30/100,000 in developed countries (7.9 in the US in 1985). There was a gradual decline in official figures from 1980 to 1985, since in 1962-64 the rate was 156/100.000. The most important causes were complications related to pregnancy (64.3%), complications of puerperium (17.9%), hypertension complicating pregnancy (14.3%), miscarriage and abortion (10.7 vs. 25% in 1974-75), and illegal abortion (7.1%). 95 deaths occurred within 1 year of the start of pregnancy, 56 of which were considered maternal deaths. If deaths that occurred after delivery 42 days, were ignored, the rate had to be corrected to 88.9/100,000 instead of 99.6/100,000. 57.1% of deaths were attributed to direct obstetrical causes, and 42.9% were ascribed to indirect causes. Official figures need to be multiplied by 2.2 to obtain real figures because of under reporting. More accuracy will be attained with the advancement of medical technology to differentiate deaths occurring after 42 days and those related to certain conditions which existed prior to conception.
Web site : http://www.scielosp.org/scielo.php?script=sci_serial pid=0034-8910 lng=en nrm=isoAbstract : The aim of this study is, first, to trace the epidemiological profile of maternal mortality in the State of Rio de Janeiro (Brazil) during the period from 1977 to 1987 and, second, to contribute to the planning of strategies for reducing maternal morbi-mortality in that context. With the purpose of identifying risk factors, the maternal mortality rate, its prospective trends, and its distribution according to age group, causes and location are compared to the same factors in other States of Brazil and other countries. In the State of Rio de Janeiro, the maternal mortality rate is 5.0 to 11.1 per 10,000 live births with a decreasing trend at present, despite having stabilized in the last few years. The main causes of death - hypertensive disease in pregnancy, haemorrhage and abortion - and the risk groups involved are identified and analysed. Within this framework, it is suggested that investments in the improvement of women's health services in general, health care during pregnancy and childbirth and puerperal care would represent not only a feasible but also a highly effective focus of action, depending solely on political decision by policy-makers.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0102-311X1992000400009 lng=en nrm=isoAbstract : Abortion is not only a major cause of obstetric hospitalization in poor countries, but it also represents the failure of the public health system to provide enough information about contraceptive methods and thus prevent pregnancies. In Brazil, the high utilization rates of health facilities due to abortions reflect the on-going difficulties with family planning and contraception. In addition, mortality resulting from abortions serves as an indicator of the quality of abortion procedures, an important point in a country where the practice is illegal and therefore done clandestinely. In this study, the authors analyzed the rates of mortality resulting from abortions among women 10-54 years old, including women who died from spontaneous and induced abortion, during 1980-95, for the various regions of the country. The information the authors used came from the mortality data bank of the public health system of the Ministry of Health. Population data were obtained from the Brazilian Institute for Geography and Statistics. The authors studied 2602 deaths, 15% of which were due to missed abortion, spontaneous abortion, or legally permitted induced abortion. The other 85% of the deaths were due to illegal induced abortions or to non-specified abortions. The mortality rates from abortion-related causes have steadily decreased in all the regions of Brazil, but this improvement has unevenly distributed in the country. The region with the smallest decrease in this rate (38% over 15 years) was the northeast. The age of women dying from abortions progressively declined over the period studied. (author's)
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S1020-49892000000300005 lng=en nrm=isoAbstract : There are many gaps in the knowledge of abortion-related mortality, including causes consequences and general levels. Indirect estimation techniques based on sibling interviews offer an addition to research based on death certificates, hospital records, autopsies, and selective surveys. Case-control studies of abortion morbidity is another useful approach. Multiple approaches help fill in the gaps. Commentary is provided on why people choose abortion, the mortality risks of abortion, adolescents and unwanted pregnancy, measuring maternal mortality due to abortion and a case-control study in Chile, which has a long history of abortion research. It is estimated that for the 10-22 million illegal abortions performed annually, 200,000 women die/year. 26-31 million women have relatively safe legal abortions. Women seek illegal abortions, which usually involve high-risk in order to avoid an unwanted pregnancy caused by 1) nonuse of contraception, which may in turn, be 2) contraceptive failure, or 3) inadequate use of a method. Late abortions are associated with the highest risk. Women with unwanted pregnancies choose to continue pregnancies due to weak motivation to terminate the pregnancy, poor knowledge of the termination options, religious principles that conflict with having an abortion, partner or relatives opposition to abortion, a delayed decision, the physician raising the issue but not following up on it, pregnancy termination was refused, a change of mind, acceptance of a marriage, and/or a decision to place the child up for adoption. From the piecemeal data available, it is known that the leading cause of death in countries with illegal abortions is maternal mortality due to abortion-related complications, most of which are avoidable as statistics from Sweden indicate. Mortality statistics are inaccurate, particularly for maternal-related causes, and considerable underreporting occurs in the case of abortion-related mortality. In many countries abortion is a form of fertility control. The most negative consequences occur in the case of adolescents with unwanted pregnancies. Maternal mortality statistics need improvement. In Chile, 57,368 incomplete abortions were recorded in hospital admissions in 1960 and hospital expenditures were over 1 million US dollars. Deliveries increased 1.8 times, while abortion complications increased 4.4 times primarily among married women. By 1987, mortality was reduced to .48/1000 reproductive age women from 2.99/1000 in 1960. The incidence of abortion in Chile is still reported to be high.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 074350Abstract : PURPOSE: to analyze maternal death cases that occurred at the "Hospital de Clínicas de Porto Alegre", a reference university hospital for high-risk pregnancies in the state of Rio Grande do Sul, Brazil. METHODS: we carried out a retrospective study of medical records of 10- to 49-year-old women who died at the hospital between 1980 and 1999. Deaths related to pregnancy and puerperium were analyzed independently of the kind and duration of pregnancy. The causes were classified into direct obstetric, indirect obstetric and nonobstetric, according to their association with pregnancy, delivery and puerperium disorders. RESULTS: a total of 81 patients with a mean age of 28.5 years were studied. The maternal mortality rate was 109 per 100,000 live births. Direct obstetric causes made up 61.7% of deaths. Indirect causes made up 23.5% of deaths. Nonobstetric causes made up 15.0% of the total. Among direct obstetric causes, arterial hypertension (18.5%), post-cesarean infection (16%), and septic abortion (12.3%) were the most prevalent. The main maternal mortality events among indirect obstetric causes were cardiopathy (8.6%), acute fatty liver disease (3.5%), and systemic lupus erythematosus (2.5%). Among the nonobstetric causes, malignant neoplasia (7.4%) and AIDS (3.7%) were the most important. CONCLUSIONS: the prevailing causes of maternal death have not changed in the last two decades. The main cause is still hypertension. There is an expressive number of deaths related to cesarean section and infections. The high prevalence of direct obstetric causes shows the low maternal mortality prevention capacity of our health care system.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0100-72032003000600008 lng=en nrm=isoAbstract : This is a collection of works on maternal mortality in Brazil. The papers are divided into sections concerning how to improve data quality, method of delivery and maternal health, the health care system, prevention of maternal mortality, and abortion and contraception. A section is devoted to the city of Botucatu. (ANNOTATION)
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND 8024604Abstract : The study of two birth cohorts in Pelotas, southern Brazil, in the years 1982 and 1993 allowed for a comparison of maternal characteristics, including biological, socioeconomic, demographic, and reproductive variables. All women living in urban Pelotas and giving birth in the city maternity hospitals were interviewed with a structural questionnaire. There were 6011 births in 1982 and 5304 in 1993. Women in the 1993 cohort were of a higher socioeconomic status (as measured by family income and years of schooling). They were also significantly taller and heavier than mothers giving birth in 1982. Mean parity did not differ for the two groups, but in 1993 there were fewer primiparae and more women with four or more children. The birth interval was also significantly greater in 1993; one possible reason (in addition to more frequent use of contraceptives) was an increase in the number of previous abortions observed in 1993 as compared to 1982. (author's)
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0102-311X1996000500004 lng=en nrm=isoAbstract : El problema del aborto se agudiza y aumenta cada día, en especial en el grupo de las adolescentes, las cuales no cuentan ni con la información, ni los medios para evitar un embarazo no deseado. Se realizó un análisis de 50 adolescentes para identificar los motivos que llevan a la joven a practicarse un aborto y las complicaciones que se derivan de este. Todas las jóvenes reclutadas tenían diagnóstico de aborto y la mayoría con complicaciones. La media de edad fue de 17 años, con uniones conyugales inestables, lo que genera gran inseguridad en ellas. Una gran parte de estas habían desertado del sistema escolar, previo al embarazo y vivían con sus padres en hogares con ingresos bajos. La tercera parte de estas mujeres desconocían su embarazo e igualmente no sabían que dificultades podían presentarse después de un aborto provocado. Las complicaciones que se presentaron con mayor frecuencia fueron: anemia, perforación uterina e infecciones. Luego del aborto, las jóvenes experimentaron sentimientos como culpabilidad, preocupación y ansiedad. En general los abortos fueron provocados, porque el embarazo fue accidental y no lo deseaban. Entre las personas que le hablaron sobre el aborto estuvieron amigas, parientes y educadores. Muchas de estas mujeres desconocían métodos para prevenir embarazos y otra gran porcentaje no había recibido información de educación sexual. Mencionaron conocer instituciones que podrían darle apoyo después de un aborto (Caja de Seguro Social, APLAFA, Centros de Salud, entre otras) para prevenir un nuevo embarazo. El principal medio para evitar embarazos en la adolescencia es la educación sexual.
Notes : Español/espagnol/SpanishAbstract : Analiza temas medulares de salud reproductiva en México, la situación actual de las mujeres ante sus riesgos y necesidades reproductivas. Incluye datos estadísticos y relaciona variables de salud reproductiva y salud pública, considera cuestiones de salud laboral y adicciones. Presentación ; El embarazo, el parto y el puerperio ; Sexualidad y fecundidad adolescente ; Drogas, alcohol y tabaco durante el ciclo reproductivo ; Incorporación de la mujer al trabajo 24 remunerado: repercusiones para su salud reproductiva ; La planificación familiar en México ; Prostitución en México ; El sida y la salud reproductiva ; Las enfermedades de trasmisión sexual como problema de salud pública: situación actual y prioridades de investigación ; Agresión y violencia contra el género femenino: un asunto de salud pública ; El aborto en México un fenomeno escondido en proceso de descubrimiento.
Notes : Español/espagnol/SpanishAbstract : Folleto que da a conocer los derechos de las mujeres para que vivan en condiciones más dignas. Retoma las experiencias y el conocimiento que se refieren a las violaciones a los derechos que con mayor frecuencia expresan las mujeres. Expresa lo que la ley establece para algunos problemas y delitos, así como las distintas instituciones a las que se pueden acudir
Notes : Español/espagnol/SpanishAbstract : Expone la ubicación que la iglesia tradicional le ha asignado a la mujer en el transcurso de la historia. Hace referencia a las diferentes vertientes dentro de la iglesia que han dado respuesta a la posición tradicional de la iglesia con respecto a la mujer. Entre las que se encuentra la teología de la liberación quien demanda la emancipación de la mujer en su participación
Notes : Español/espagnol/SpanishAbstract : El capítulo referido se basó en una consultoría realizada a solicitud de la Unidad de Análisis de Políticas Sociales en 1992. El libro constituye un testimonio de la voluntad gubernamental de diseñar e implementar políticas para las mujeres. El diagnóstico y las propuestas en materia de salud de las mujeres abordan temas de desigualdad (entre países de la región y áreas rurales y urbanas de Bolivia); mortalidad materna y la contribución del aborto realizado en condiciones inseguros; el alto índice de ocupación de camas ginecológicas por mujeres con complicaciones del aborto; roles de género y discriminación contra las mujeres; legislación inadecuada sobre el aborto inducido; y propuestas para políticas centradas en la disminución de la mortalidad materna.
Notes : Español/espagnol/SpanishAbstract : Información actualizada relacionada con el SIDA. Contiene una breve reseña histórica del origen, desarrollo y primeras formas de contagio. Proporciona datos estadísticos de su expansión a nivel internacional en el período 1980 1990. Los temas que aborda son, VIH y métodos anticonceptivos, riesgo de cáncer de cuello de útero, VIH y el embarazo, VIH en las cárceles, situación y consecuencias sicosociales en la mujer con SIDA
Notes : Español/espagnol/SpanishAbstract : Los contenidos de este manual ilustrado se basan en entrevistas con mujeres internadas por aborto incompleto y con personal hospitalario. Las entrevistas fueron realizadas por Ipas en 1993 para el estudio "Necesidad de Información sobre el Aborto". El manual, dirigido tanto al personal de salud como a las mujeres usuarias, se enmarcó en la Política Nacional de Salud contenida en el Plan Vida que buscaba iniciar un proceso de reducción de la mortalidad materna, perinatal y del menor, a través del diálogo con la sociedad, para lograr la atención oportuna y de calidad para las mujeres que la requieran.
Notes : Español/espagnol/SpanishAbstract : El estudio aborda la incorporación de la situación de la mujer o de la perspectiva de género a partir de la IV Conferencia Mundial de la Mujer en el ámbito sociodemográfico, se hace mención de los adelantos, fortalezas, problemas y debilidades existentes
Notes : Español/espagnol/SpanishAbstract : El estudio aborda la incorporación de la situación de la mujer o de la perspectiva de género a partir de la IV Conferencia Mundial de la Mujer en el ámbito sociodemográfico, se hace mención de los adelantos, fortalezas, problemas y debilidades existentes
Notes : Español/espagnol/SpanishAbstract : Este informe es un suplemento de actualización del trabajo "Mujeres del mundo: leyes y políticas que afectan sus vidas reproductivas; América Latina y el Caribe" que fue realizado por CRLP y DEMUS en 1997 y que tenía como objetivo de recopilar y analizar las leyes y políticas que afectan la vida reproductiva de la mujeres para reconocer e identificar las maneras a través de las cuales controlan su capacidad reproductiva y determinan su posición jurídica, económica y social en nueve países de la región latinoamericana. Este suplemento al informe original examina las reformas legales y políticas relacionadas con los derechos reproductivos impulsadas en los distintos países desde 1997; asimismo se incluyen datos de estudios recientes que miden el impacto de estas reformas o estadísticas sobre los diferentes temas estudiados. Se presenta un panorama de las reformas de las leyes y políticas que se refieren, de manera específica, a los temas de salud reproductiva de las mujeres, así como también a los derechos de las mujeres de manera más general. Incluye: Introducción ; Agentina ; Marco legal y político ; Salud y derechos reproductivos ; Legislación y políticas sobre salud ; Población, salud reproductiva y planificación familiar ; Anticoncepción ; Aborto ; VIH/SIDA y otras infecciones transmisibles sexualmente (ITS) ; Situación jurídica de la mujer ; Derechos socioeconómicos ; Derecho a la integridad física ; Adolescentes ; Bolivia ; Marco legal y político ; Salud y derechos reproductivos ; Legislación y políticas sobre salud ; Población, salud reproductiva y planificación familiar ; Anticoncepción ; Aborto ; VIH/SIDA y otras infecciones transmisibles sexualmente (ITS) ; Situación jurídica de la mujer ; Derechos socioeconómicos ; Derecho a la integridad física ; Adolescentes ; Brasil ; Marco legal y político ; Salud y derechos reproductivos ; Legislación y políticas sobre salud ; Población, salud reproductiva y planificación familiar ; Anticoncepción ; Aborto ; VIH/SIDA y otras infecciones transmisibles sexualmente (ITS) ; Situación jurídica de la mujer ; Derechos civiles dentro del matrimonio ; Derechos socioeconómicos ; Derecho a la integridad física ; Adolescentes ; Colombia ; Marco legal y político ; Salud y derechos reproductivos ; Legislación y políticas sobre salud ; Población, salud reproductiva y planificación familiar ; Anticoncepción ; Aborto ; VIH/SIDA y otras infecciones transmisibles sexualmente (ITS) ; Situación jurídica de la mujer ; Derechos socioeconómicos ; Derecho a la integridad física ; Adolescentes ; El Salvador ; Marco legal y político ; Salud y derechos reproductivos ; Legislación y políticas sobre salud ; Población, salud reproductiva y planificación familiar ; Anticoncepción ; Aborto ; VIH/SIDA y otras infecciones transmisibles sexualmente (ITS) ; Situación jurídica de la mujer ; Adolescentes ; Guatemala ; Marco legal y político ; Salud y derechos reproductivos ; Legislación y políticas sobre salud ; Población, salud reproductiva y planificació familiar ; Anticoncepción ; VIH/SIDA y otras infecciones transmisibles sexualmente (ITS) ; Situación jurídica de la mujer ; Derechos civiles dentro del matrimonio ; Derechos socioeconómicos ; Derecho a la integridad física ; Adolescentes ; Jamaica ; Marco legal y político ; Salud y derechos reproductivos ; Legislación y políticas sobre salud ; Población, salud reproductiva y planificación familiar ; Anticoncepción ; Aborto ; VIH/SIDA y otras infecciones transmisibles sexualmente (ITS) ; Situación jurídica de la mujer ; Derechos socioeconómicos ; Derecho a la integridad física ; Adolescentes ; México ; Marco legal y político ; Salud y derechos reproductivos ; Legislación y políticas sobre salud ; Población, salud reproductiva y planificación familiar ; Anticoncepción ; Aborto ; VIH/SIDA y otras infecciones transmisibles sexualmente (ITS) ; Situación jurídica de la mujer ; Derechos civiles dentro del matrimonio ; Derechos socioeconómicos ; Derecho a la integridad física ; Adolescentes ; Peru ; Marco legal y político ; Salud y derechos reproductivos ; Legislación y políticas sobre salud ; Población, salud reproductiva y planificación familiar ; Anticoncepción ; Aborto ; VIH/SIDA y otras infecciones transmisibles sexualmente (ITS) ; Situación jurídica de la mujer ; Derechos civiles dentro del matrimonio ; Derechos socioeconómicos ; Derecho a la integridad física ; Adolescentes ; Cconclusiones ; Marco legal y político ; Salud y derechos reproductivos ; Legislación y políticas sobre salud ; Población, salud 73 reproductiva y planificación familiar ; Anticoncepción ; Aborto ; VIH/SIDA y otras infecciones transmisibles sexualmente (ITS) ; Situación jurídica de la mujer ; Derechos civiles dentro del matrimonio ; Derecho a la integridad física ; Adolescentes.
Web site : http://www.crlp.org/Abstract : This compilation of principal social, economic, and legal indicators depicting the status of women in Honduras presents data for 1988-96 along with commentary from a gender perspective. Topics covered include structure and dynamics of the female population, household composition, morbidity and mortality, family planning, abortion, violence against women, educational status and illiteracy, employment, poverty, political participation, and legislation affecting women's rights.
Web site : http://www.derechosdelamujer.orgAbstract : El propósito de este trabajo es repensar el binomio mujer - madre desde una óptica analítica no naturalizada. Para ello se le da la voz a las mujeres que han "elegido" voluntariamente no ser madres, a fin de conocer los procesos que las llevaron a tomar esta elección, así como las experiencias y presiones sociales a las que han estado sujetas por no cumplir con el destino materno asignado teleológicamente a sus vidas. Destaca la necesidad de contextualizar el momento histórico bajo el cual fue posible que las mujeres pudieran tener acceso a este derecho reproductivo, que ha sido un eje de lucha del movimiento feminista, al exigir la autonomía de controlar sus cuerpos para decidir libremente la maternidad. Plantea, asimismo, que la maternidad es un tema complejo, que no puede ser reducido solamente a lo cultural o, en su defecto, a lo biol6gico, si no que se entreteje con el nivel del inconsciente y por tanto del deseo.
Web site : http://www.ciesas.edu.mxAbstract : SIPAM comparte la experiencia adquirida al trabajar con mujeres en la prevención y detección de virus del VIH/SIDA
Notes : Español/espagnol/SpanishAbstract : O tema do aborto é capaz de reverter expectativas de eleições políticas, de criar constrangimentos entre nações, de provocar rompimentos entre entidades e instituições, fazendo com que o aborto, ora seja considerado uma questão religiosa, ora de direitos fundamentais, e muitas vezes de política nacional. E é a partir desse quadro pouco definido sobre a inserção social do aborto - se como um tema de saúde pública, de direitos humanos, de liberdades de crença ou de política partidária - que a mídia impressa nacional o resgata.
Web site : http://www.anis.org.br/serie/artigos/sa20(dinizdamasceno)midiaaborto.pdfAbstract : Based on the symbolic interactionist approach, we aimed to verify the meanings attributed to induced abortion by women who adopted such behavior as well as to analyze the impact of the experience on their self-image. The results point out the contradiction in women's discourse when they evaluate the experience, and the emotional negative reactions they had developed: remorse/guilty conscience, regret, feeling of grief, and mainly guilt, which, according to their accounts, they will carry for the rest of their lives.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0104-11692000000600008 lng=en nrm=isoAbstract : Unsafe abortion and associated morbidity and mortality in women are completely avoidable. This paper reports on an analysis of the association between legal grounds for abortion in national laws and unsafe abortion, drawing on an unpublished study and using estimates of the incidence of and mortality from unsafe abortion using information from the sources used to estimate the incidence of unsafe abortion and associated mortality in 2000. Although legal grounds alone may not reflect the way in which the law is applied, nor the quality of services offered, a clear pattern was found in more than 160 countries indicating that where legislation allows abortion on broad indications, there is a lower incidence of unsafe abortion and much lower mortality from unsafe abortions, as compared to legislation that greatly restricts abortion. The data also show that most abortions become safe mainly or only where women's reasons for abortion, and the legal grounds for abortion coincide. This is a compelling public health argument for making abortion legal on the broadest possible grounds. A wide range of actions have formed part of national campaigns for safe, legal abortion over the past century, covering law reform, provision of safe services, ensuring quality of care, training for providers and information and support for women. Safe abortion is an essential health service for women, as essential for sexual and reproductive health as safe contraception, and safe pregnancy and delivery care. In spite of sometimes powerful opposition and terrible setbacks, the public health imperative is gaining ground in many parts of the globe.
Web site : http://www.rhmjournal.org.ukAbstract : Este artículo resume los hallazgos de una investigación cualitativa realizada en cuatro hospitales de la ciudad de La Paz en 1993. El estudio tuvo como base un convenio suscrito entre Ipas y la Dirección Nacional de Atención a las Personas del Ministerio de Previsión Social y Salud Pública, para la elaboración de material informativo destinado a mujeres internadas con aborto incompleto y al personal de salud que las atiende. El artículo se enfoca en momentos y dimensiones descritas como especialmente problemáticas para las mujeres entrevistadas en las salas de ginecología: la censura moral y amenaza de una denuncia legal; el castigo económico; la falta de información sobre su estado y los procedimientos de tratamiento postaborto; la arbitrariedad en las prácticas del personal, influidas por valores personales; y la necesidad de orientación para evitar otro embarazo no deseado y aborto inseguro.
Notes : Español/espagnol/SpanishAbstract : This section includes an interview with Marta Marfa Blandon and Lorna Norori, Nicaraguan psychologists and members of Nicaragua's Red de Mujeres contra la Violencia (Network ofWomen Against Violence). Marta Marfa and Lorna participated directly in the resolution of Rosita's case, which is emblematic of the struggle for the defense of women's human rights, the right to reproductive choice and the right to corporal and psychological integrity. We also include information about the recent consolidation of the Mesa Feminista sobre Aborto (Feminist Working Group on Abortion) in Chile. In this country, women are absolutely prohibited from accessing legal abortions even when their lives or health is endangered. A bill currently before the Chilean Senate would toughen this already restrictive law in direct opposition to Chilean public opinion. Despite the stigmatization of abortion, a high percentage of both women and men in Chile support women's right to reproductive choice. (excerpt)
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : El objetivo general es definir el nivel de conocimientos sobre sexualidad e identificar las actitudes y prácticas asociados al comportamiento sexual de riesgo en los escolares adolescentes del 3º y 4º grados de educación secundaria en dos colegios estatales mixtos diurnos, Lima-Norte, Perú, en 1995. El diseño fue descriptivo transversal y se aplicó una encuesta anónima a una muestra de 525 escolares adolescentes. Aunque el nivel de conocimientos es bajo en el 45 % de los caos, la autopercepción del conocimiento sobre sexualidad es elevado. Hablan más sobre sexualidad con pares del mismo sexo, con la madre (sobre todo las mujeres)y con el padre (especialmente los varones). Pese a que el grado de instrucción de los padres fue secundaria incompleta a superior en la mayoría, el lugar donde obtienen información sobre los temas de sexualidad es el colegio. Las actitudes con respecto a la sexualidad son generalmente positivas, pero a veces contradictorias, sobre todo en los varones como, por ejemplo, les es "difícil acostumbrarse a usar condón", pero "se cuidarían al tener Relación sexual" y les "sería imposible negarse a tener Relación sexual", pero "pueden controlar su deseo sexual". La mediana de edad de la primera eyaculación y de la primera regla es de 13 años. El 27 % ha tenido relaciones coitales. La mediana de edad del primer coito para varones fue de 13 años y de 14 para las mujeres. El 76 % usaría la píldora, pero sólo el 27 % usaría condón; la razón principal de no uso del condón es que "no se siente igual placer" y "son dañinos para la salud" . La razón de abortos es de 67/1000 escolares sexualmente activos. El comportamiento sexual de riesgo definido como "no uso del condón" es alto y está asociado de manera no significativa a: "sexo", "beber licor", "usar drogas", "edad al primer coito", "nivel de conocimientos sobre sexualidad" y en forma significativa a "fumar cigarrillos".
Notes : Español/espagnol/SpanishAbstract : In countries where abortion is illegal, a range of approximate levels of induced abortion can be calculated from data on the number of women hospitalized for treatment of abortion complications, after correcting for underreporting and misreporting and adjusting to eliminate spontaneous abortions. An estimated 550,000 women are hospitalized each year as a result of complications from induced abortion in Brazil, Chile, Colombia, the Dominican Republic, Mexico, and Peru. About 2.8 million abortions are estimated to occur in these countries annually when women not hospitalized as a result of induced abortion are taken into account. If the situation in the six countries is assumed to be typical of the entire region, then about 800,000 women are probably hospitalized because of complications of induced abortion in Latin America in a given year, and an estimated 4 million abortions take place. The abortion rate most likely ranges from 23/1000 women aged 15-49 in Mexico to 52/1000 in Peru, and the absolute number ranges from 82,000 in the Dominican Republic to 1.4 million in Brazil. From 17% of pregnancies in Mexico to 35% in Chile are estimated to end in induced abortion. (author's)
Web site : http://www.guttmacher.org/Abstract : The Center for Reproductive Law and Policy reports on the recent amendment of the Constitution to recognize life from the moment of conception. Researcher Soledad Varela discovered that the Catholic Church in El Salvador had been actively engaged in manipulative tactics to sway an already conservative legislature into passing the extreme laws. Although some legislators were in favor of this amendment, some believe that the reform was wrong and that therapeutic abortions and terminations of pregnancies resulting from rape should not be penalized. Restrictive abortion laws did not stop abortions from occurring; in fact, the UN estimated that 35% of all pregnancies in Chile end in illegal abortions. With the new restrictions, mothers are abandoning unwanted newborns. Illegal practitioners have become harder to trace. Nevertheless, others seem to be successful at evading the law. The wealthy have the right to choose and still avail themselves of legal, more liberal abortion laws from other countries.
Web site : http://www.crlp.org/rfn_2000.htmlAbstract : Del 17 al 21 de julio 2002, la Campaña 28 de Septiembre (Bolivia) "Por la Despenalización del Aborto en América Latina y el Caribe" se reunió en la ciudad de Cochabamba en su Asamblea General con todos los Comités Departamentales que la conforman. La reunión tuvo un carácter reflexivo y de análisis sobre los nuevos tiempos y debates que confrontan los derechos sexuales y los derechos reproductivos y, en este marco, la problemática del aborto. La memoria del evento busca promover y proponer debates amplios, en el marco del reconocimiento de que sin los derechos de las mujeres no hay derechos humanos; y que dentro de estos derechos, los sexuales y reproductivos son los más humanos. El documento incluye las ponencias presentadas en la Reunión Nacional, sus Resoluciones y Compromisos.
Notes : Español/espagnol/SpanishAbstract : Contenido: La salud como derecho humano ; La reforma de salud y las mujeres dominicanas ; IPAS : aborto inseguro, amenaza para la salud de las mujeres ; Chile : parlamentos de mujeres por la Reforma de Salud ; Solidaridad : llamados a la acción.
Web site : http://www.gire.org.mx/Abstract : Dedicatoria ; Reconocimiento ; Introducción ; Saber es poder ; Perspectiva internacional ; Sistemas de salud y política de la mujer ; Cómo organizarnos para lograr un cambio ; Introducción a los recursos de salud de la mujer disponibles por computadora ; Cuidando nuestra salud ; La salud y los métodos integrales de curación ; Imagen corporal ; Los alimentos ; Mujeres en movimiento ; La salud mental ; El alcohol, las drogas que lateran el estado de ánimo y el consumo de tabaco ; La violencia en contra de la mujer ; La salud ambiental y ocupacional ; Envejeciendo: las mujeres y el paso del tiempo ; Relaciones y la sexualidad ; La sexualidad ; Hacia una mutualidad ; Relaciones amorosas entre mujeres ; La salud y los derechos reproductivos ; Entendiendo nuestros cuerpos: anatomía y fisiología de la sexualidad y la reproducción ; Los anticonceptivos ; Las enfermedades transmitidas por vía sexual ; El SIDA, el virus de 127 inmunodeficiencia humano (VIH) y las mujeres ; Si piensas que estás embarazada: información, recursos y alternativas ; El aborto ; Nuevas tecnologías reproductivas ; Enfermedades comunes y no comunes ; La maternidad ; El ambarazo ; El parto ; El post-parto ; La infertilidad y la pérdida del feto ; Recursos ; Indice.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : The conditions that impede an objective debate about the appropriate legal status of abortion in Mexico and specific prerequisites for change are analyzed. The idealization of motherhood and the imposition of private religious beliefs of legislators into the affairs of a secular state are major impediments to relaxation of sanctions against abortion. Excerpts from other texts and new material include a feminist critique of myths about motherhood and an analysis of the strategy of the Vatican in Mexico. An article follows on the process of conversion of Minority into majority opinion, including discussion of the value of minority opinions, the stages of conversion, and the relationship between conversion and identity. Secular morality and theological morality are contrasted in the following section, with particular attention to the debate about when human life begins. Chapters follow on the incidence and complications of abortion in Mexico and the characteristics of women seeking abortions, and on the legal status of abortion throughout the world. An ethical posture toward abortion appropriate for a secular state is suggested, and the question of who should make abortion decisions is discussed. The final chapter explores issues of reproductive responsibility and quality of life.
Web site : http://www.gire.org.mx/Abstract : Expone el contexto del problema de justicia social y salud pública que representa el aborto inducido en el país. Presenta un diagnóstico urgente a atender sobre todo en el aspecto político para fortalecer la posibilidad de su despenalización. Con datos y cifras actualizadas se demuestra la necesidad de abordar y actuar sobre esta problemática considerada de salud pública. Los argumentos para la despenalización se basan en los costos en salud y vidas. Contiene los argumentos jurídicos, el debate ético y científico y por último los mitos y desmistificaciones
Notes : Español/espagnol/SpanishAbstract : Apertura de la reunión ; Documentos técnicos ; VlH/SIDA: una perspectiva multidimensional / Dr. Mario Bronfman y Maestra en Sociología Cristina Herrera ; Embarazo no deseado: impacto sobre la salud y la sociedad en América latina y el Caribe / Dra. Ana Langer y Dr. Henry Espinoza ; La violencia contra la mujer: un problema de equidad de género / Dra. Claudia García Moreno ; Conclusiones ; Palabras de cierre
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : El artículo trata algunos cambios mundiales en la normatividad jurídica y la discusi6n ético-política respecto a la interrupción del embarazo. Se muestra el conflicto enfrentado con la jerarquía de la Iglesia cat6lica, y se ejemplifica con los casos de países de tradici6n católica como Irlanda, España y Francia. Además, se plantea el avance progresista en la materia con la aceptación del aborto con el medicamento RU 486 Y en las resoluciones jurídicas que anteponen la calidad de vida a cualquier otra consideraci6n. También se enseña el retroceso que se ha dado en Estados Unidos, bajo la administraci6n conservadora de los republicanos. Asimismo, se informa sobre las recientes reformas (2000-2004) en la ciudad de México. Todo ello acompañado de una reflexi6n sobre qué esta en juego en la decisión del aborto. Si cada innovación tecnológica relativa a la procreaci6n y cada fallo jurídico o reforma legislativa causan agitaciones, es porque tocan algo nodal: concepciones sobre la vida, lo humano, lo ético, lo privado. Definir una posición ante el aborto agudiza conflictos religiosos y políticos, y remite a revisar los conceptos y creencias que tenemos, no únicamente acerca de la procreación y su interrupción, sino por encima de todo, acerca de la libertad.
Web site : http://www.ciesas.edu.mxAbstract : In Brazil, Sister Ivone Gebara, a Catholic nun, wants the government to legalize abortion to prevent thousands of women from dying from illegal abortions. In fact, illegal abortions are responsible for 20% of deaths of female adolescents and more than 10% of maternal deaths every year. In 1991, Brazilian hospitals treated almost 400,000 women for complications of illegal abortions. Illegal abortions are the 10th leading reason for hospital admissions. 1-3 million women undergo illegal abortions each year in Brazil. The nun sees the legalization of abortion as a means to reduce violence against life. Her call for legalization of abortion has resulted in wider discussion of abortion within the church. Abortion is allowed only if the pregnant women was raped or her life is in danger. In case of rape, she must seek permission to undergo abortion from a judge. Staff at the only hospital allowed by law to perform abortions have performed only 40 abortions in 3 years. Women use knitting needles, sticks, and over-the-counter drugs to induce abortion. Many women use the synthetic prostaglandin misoprostol, because it causes uterine contractions. Misoprostol does not always succeed, however. The coordinator of obstetric nursing at the Sao Paulo School of Medicine reports congenital malformations of the hands and feet of infants whose mothers used misoprostol to induce abortion. Both women who have an abortion and those who help to bring on an abortion may be put in prison for up to 3 years. A former health secretary of the State of Sao Paulo says that the health system puts women low on their priority list. Two senators, a Social Democrat and a member of the Community party, put off bills in congress calling for abortion to be legalized. Less than 25% of their colleagues, who tend to be male, agree with them. Almost 50% of the Social Democrats do not want abortion legalized.
Web site : http://bmj.comAbstract : Introducción 1. Algunos conceptos de los que partimos 2. Metodología del estudio 3. Las mujeres entrevistadas 4. Los relatos de las mujeres 5. Vivencias de las mujeres ; Los métodos utilizados ; Las razones para interrumpir el embarazo ; La falta de control y el desconocimiento ; La soledad ; Otros sentimientos ; Sexualidad ; Puntos de vista ; Penalización ; Propuestas ; 6. Resumen y conclusiones ; Anexo ; Bibliografía
Web site : http://www.derechosdelamujer.org/html/PUBLICACIONES/Nunca%20antes%20lo%20habia...pdfAbstract : For some adolescents, pregnancy means happiness and fullfillment. However, for most of them, it means a sad moment, characterized by fear and despair, as this is an unplanned situation and the abortion seems the only alternative. This retrospective study aimed at finding out the epidemiological profile of the adolescents admitted at the Clériston Andrade General Hospital, in Feira de Santana, Bahia, that were submitted to a curettage from January 1995 to December 1997. The results showed the need for educative programs in order to prevent unplanned pregnancies.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0104-11692001000200006 lng=en nrm=isoAbstract : Há um que de deprimente na estatística mundial: 60 milhões de abortos provocados ao ano. Em nome da paz, esse genocídio cruel precisa acabar. Este livro contribui para essa mudança, discutindo os argumentos científicos contra o aborto. Ao mergulhar nas origens da vida planetária, busca o significado da própria vida e resgata, com o conhecimento dos primórdios, os Direitos Inalienáveis do Embrião-Persona
Notes : Portugués/portugais/PortugueseAbstract : In the inaugural issue of the Revista Estudos Feministas (Feminist Studies Magazine) in 1992, I wrote an article desiring to briefly take stock about the abortion discrimination in Brazil. In that article, written almost six years ago, I try to recover the proposals presented about this issue in the 1970s and 1980s by both the feminist movement and the National Congress. In summary, the crucial point of the debate at that time was three-fold: did we need to fight for total abortion discrimination; did we need to fight for regulatory discrimination; or did we need to fight for the enlargement of legal leniency of the Penal Code? For the feminists, those three questions didn't present any incoherence. It was only a question of choosing the most efficient strategy for voluntary pregnancy interruption to be accepted by the Brazilian government as a licit behavior. This is beyond what was already permitted by law in cases of danger to the mother's life or pregnancy resulting from a rape. (excerpt)
Web site : http://www.cfh.ufsc.br/~refAbstract : Objetivo: avaliar, numa populaçäo brasileira, a possível associação entre história de violência sexual e algumas das queixas ginecológicas referidas com maior freqüência pelas mulheres. Métodos: análise secundária de dados de um estudo do tipo transversal retrospectivo em que foram entrevistadas, em seus domicílios, 1.838 mulheres com 15 a 49 anos de idade, residentes em Campinas e Sumaré, no Estado de São Paulo. Utilizou-se um questionário estruturado e pré-testado, que permitiu caracterizar a história de violência sexual das mulheres, a existência de disfunçöes sexuais e a presença de sintomas ginecológicos no ano anterior a entrevista. As diferenças estatísticas foram avaliadas com o teste X². Resultados: pouco mais de um terço (38,1 por cento) das mulheres não relatou história de violência sexual; 54,8 por cento referiram que, alguma vez, tiveram relações sexuais contra sua vontade, sem terem sido forçadas a isto, embora 23 por cento mencionaram algum tipo de constrangimento; 7,1 relataram já terem sido forçadas a manter relações. Verificou-se associação estatística entre história de violência sexual e a referência a queixas ginecológicas e a disfunçöes sexuais. Conclusões: evidenciou-se que até formas menos agressivas de imposição da vontade masculina na vida sexual do casal associaram-se a uma maior prevalência das queixas ginecológicas mais freqüentes. O ginecologista deve, portanto, ter em conta este fator etiológico, excepcionalmente considerado no presente momento (AU).
Web site : http://www.scielo.br/scielo.php?script=sci_serial pid=0100-7203 lng=en nrm=isoAbstract : Crime ou direito, autor dádiva ou pecado. entretanto Aqui, a discussão sobre ginette paris o aborto livro ultrapassa o imediato e ganha Sacramento do Aborto, O dimensões históricas e arquetípicas. O autor defende uma espiritualidade mais flexível para discutir a prática constante escritor na história da autor humanidade
Notes : Español/espagnol/SpanishAbstract : En 1999, Paulina quedo embarazada a los treces años, como consecuencia de un violación. Paulina decidió abortar... pero funcionarios públicos lograron, con base en engaños de, que se desistiera. Axial le impusieron que nunca decidió: ser une madre adolescente a consecuencia de la violación que sufrió. En el ano 2000, el Grupo de Información en Reproducción Elegida (GIRE) publico la primera parte de esta historia: Paulina en el nombre de la ley. En el 2004, aun quedan muchas cuentas pendientes, por eso hubo que escribir Paulina cinco anos después. Este numero incluye información de los hechos mas relevantes los últimos anos en torno a la vida de Paulina y a " su caso ", que se ha convertido en emblemático porque evidencia las limitaciones en materia políticas publicas que garanticen el acceso al aborte a las victimas de violación.
Notes : Español/espagnol/SpanishAbstract : Contenido Indice, Prólogo, Cómo se escribió este documento, Introducción ; Capítulo ILa Declaración del Milenio ; Capítulo IILa lucha contra la pobreza y el hambre ; Capítulo IIILa educación como eje del desarrollo humano ; Capítulo IVAutonomía de las mujeres e igualdad de género ; Capítulo VEl derecho a la salud y los objetivos de desarrollo del Milenio ; Capítulo VIGarantizar la sostenibilidad del medio ambiente ; Capítulo VIIEl financiamiento de los objetivos y la asistencia internacional para el desarrollo ; Capítulo VIIIHacia el logro de los objetivos de desarrollo del Milenio en América Latina y el Caribe ; Anexo estadístico, Bibliografía, Abreviaturas y siglas En septiembre del 2000, los Jefes de Estado y de Gobierno de 147 países y 42 ministros y jefes de delegación se reunieron en la Asamblea General de las Naciones Unidas para emprender la tarea de determinar cómo mancomunar sus voluntades y su compromiso de realizar un esfuerzo conjunto para revitalizar la cooperación internacional destinada a los países menos desarrollados y, en especial, a combatir decisivamente la pobreza extrema. En esa oportunidad, se identificaron objetivos que apuntan a la lucha contra la pobreza y el hambre, la reversión del deterioro ambiental, el mejoramiento de la educación y la salud, y la promoción de la igualdad entre los sexos, entre otros. Además, quedó de manifiesto que, dado que la falta de desarrollo es un problema que atañe y preocupa al mundo todo y no solo a los países menos desarrollados, el establecimiento de una alianza que enriquezca y revitalice la cooperación internacional, haciéndola más adecuada y efectiva, debía ser uno, no el menos importante, de los ocho objetivos seleccionados. Así quedaron estructurados los objetivos de desarrollo del Milenio. Los objetivos tienen un fuerte sustento en la visión integral derivada de los acuerdos suscritos en las cumbres mundiales de las Naciones Unidas celebradas en la década de 1990 y forman parte de la Declaración del Milenio, de alcance aun más amplio, en la que se propone, entre otros temas importantes, el desarrollo de consensos en torno a temas de fundamental importancia como la paz, la seguridad y el desarme, los derechos humanos, la democracia y el buen gobierno y el fortalecimiento de las Naciones Unidas. Los objetivos fueron establecidos con la mayor claridad posible y se acordaron, asimismo, metas cuantificadas, en las que se indica el nivel que debían alcanzar en 2015 las principales variables económicas y sociales que reflejan los objetivos aprobados. También se convino en examinar periódicamente los adelantos logrados, tratando de evitar así que todo el esfuerzo se desvanezca con el paso del tiempo. Hemos llegado a uno de los hitos de ese necesario examen, que la Asamblea General de las Naciones Unidas prevé celebrar en septiembre del 2005. Para facilitar su labor, el Secretario General de las Naciones Unidas presentó el 21 de marzo de este año un informe titulado "Un concepto más amplio de la libertad: desarrollo, seguridad, y derechos humanos". En dicho informe, tras recordar los problemas que enfrenta la deseada construcción de un futuro común para todos los pueblos del orbe, el Secretario General señala que "...debemos contemplar los objetivos de desarrollo del Milenio como parte de un programa de desarrollo aún más amplio. A pesar que han sido objeto de numerosas actividades de seguimiento tanto dentro como fuera de las Naciones Unidas, es obvio que los objetivos no representan por sí mismos un programa de desarrollo completo. No abarcan directamente algunas cuestiones más generales que se trataron en las conferencias del decenio de los noventa, ni abordan las necesidades particulares de los países en desarrollo de ingresos medios ni las cuestiones de la desigualdad creciente ...". Los países también recibirán, para su consideración, el informe que el Proyecto del Milenio presentó al Secretario General. Además de ambos informes, los representantes de América Latina y el Caribe tendrán a su disposición un panorama más detallado de la situación regional, en la que se consideran sus especificidades. Esto les permitirá participar en las discusiones que tendrán lugar en la próxima Asamblea General con mayor información, lo que les facilitará la tarea de velar por que los puntos de vista de nuestros países estén adecuadamente considerados. Ese panorama es el que estamos presentando aquí. El mencionado no es el único propósito de este informe, pero es sin duda el más inmediato. Para conseguirlo se han aunado los esfuerzos de todos los organismos internacionales que tienen presencia en la región. A la Secretaría de la CEPAL le ha cabido la honrosa tarea de coordinar esos esfuerzos. Se responde así a la reconocida conveniencia de contar con una visión sistémica e integrada, elaborada por todos los organismos. En las páginas siguientes describiremos cómo se elaboró este informe y cuáles fueron los resultados de esa labor, lo que permitirá a los lectores familiarizarse con el método empleado para la identificación y cuantificación del progreso logrado por nuestra región, y también los desafíos que aún nos quedan por delante. En este texto también se destacan las diferencias entre los países en la consecución de los objetivos y, en todos los casos posibles, se examinan las diferencias en la evolución de distintos segmentos de la población -clasificados en función del género, la etnia, el grupo etario, el lugar de residencia y el nivel de ingresos-, lo que ayuda a comprender en qué áreas se requieren redoblados esfuerzos para que el progreso llegue a todos. A esto se suma un análisis integrado de los factores macroeconómicos, incluidos los fiscales, en su relación con el objetivo de combatir la pobreza. Los organismos del sistema de las Naciones Unidas que participamos en la elaboración del presente documento lo consideramos un texto valioso para las autoridades nacionales y para todos los representantes de la cooperación internacional, pero también para la sociedad civil y las organizaciones no gubernamentales. En general, creemos que este informe será de interés para todos los que están comprometidos con el aumento del bienestar de nuestros pueblos, a quienes la Declaración del Milenio no solo prometió revitalizar la cooperación internacional sino también les dio la esperanza de vencer definitivamente la pobreza extrema y lograr un mundo más justo y seguro.
Web site : http://www.eclac.cl/cgi-bin/getProd.asp?xml=/publicaciones/xml/1/21541/P21541.xml xsl=/tpl/p9f.xsl base=/tpl/top-bottom.xslAbstract : Este libro resulta del análisis del monitoreo de la prensa brasileña de diciembre de 1996 a junio de 2000, realizada por la Comissão de Cidadania e Reprodução (CCR). La publicación, con prefacio de Elza Berquó, Jacqueline Pitanguy y Silvia Pimentel, consta de seis capítulos cuyos títulos expresan las temáticas abordadas: Incluye: PREFACIO / Elza Berquo, Jacqueline Pitanguy, Silvia Pimentel ; CAPITULO 1 - Precursores ou retardatarios? / Laura Greenhalgh ; CAPITULO 2 ; Bioética e os temas de fronteira das biociencias no "Olhar sobre a Midia" / Fatima Oliveira ; Bioética, um humanismo de novo tipo ; A funcao social do jornalismo cientifico nas biociencias ; Ética e informaçao jornalistica escrita ; Os megaprojetos da genética humana ; Quem tem medo de Dolly? ; Nao se faz mais bebes de proveta como antigamente ; Anencefalos, doadores potenciais ideais? ; Ser normal e um conceito cultural e subjetivo! ; Enfim ; Nao enxergar pode resultar em posturas contra a ética ; Referencias bibliograficas ; CAPITULO 3 ; A AIDS na midia: da "cura" ao mercado / Jane Galvao ; 1996: O ano da "cura" ; 1997: Novos temas aparecem na pauta ; 1998: Um ano de transicao ; 1999: Os limites da prevencao ; 2000: Tecnologia e pobreza ; 2001: O mercado da AIDS ; Consideracoes finais ; Agradecimentos ; Referencias bibliograficas ; CAPITULO 4 ; Quando o assunto e cultura sexual: um "olhar sobre a midia" / Luis Felipe Rios ; Cultura sexual a brasileira ; Convite a imprensa ; O sexual em discurso ; Quando o sexo e lugar de vitimizaçao: agravos sexuais: assedio sexual, pedofilia, abuso e violencia sexuais ; Assedio ; Pedofilia ; Violencia, abuso e mutilacao ; Respondendo a violencia ; Homossexualidade: um passo a frente com o debate sobre direitos sexuais ; Direitos sexuais: um balanço ; Para alem da violencia: olhares futuros ; Agradecimentos ; Referencias bibliograficas ; CAPITULO 5 ; Aborto: mais polemicas a vista! / Magaly Pazello e Sonia Correa ; Os argumentos em jogo ; Desequilibrio entre as fontes de informacao ; No horizonte a / Gag Rule ; Carta da Guanabara ; Referencias bibliograficas ; CAPITULO 6 ; A reproducao humana na pauta dos jornais brasileiros (1996-2000) / Maria Teresa Citeli ; Saude reprodutiva e sexualidade nos jornais diarios: um olhar sobre a midia ; A pauta sobre reproduçao humana ; Politicas publicas e contracepcao na pauta dos jornais ; Esterilizaçao: os servicos de saude e a midia ; Mortalidade materna: outra lacuna ; Os jornalistas e suas fontes de informaçao ; Legitimidade e imunidade ; A midia integrada a rede de produçao cientifica ; Referencias bibliograficas
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : In Mexico City the Christian Women's Collective's open letter to the Catholic Church is a response to the Catholic bishops' threats of excommunication of lawmakers in Chiapas State, Mexico, who may have approved a bill legalizing abortion. The bishops maintain that God is a just and merciful God who loves women and suffers with them. The Collective cannot ignore the 2 million women, 1.72 million of whom are Catholics, who undergo illegal abortions annually in Mexico. They tend to be poor and in a union and to have large families. The Collective does not advocate abortion, but recognized that almost all women who have had an abortion were not at all happy to do so. Instead they suffer depression, solitude, shame, and pain. In addition to the moral punishment, these women are at high risk of dying (150,000-200,000 women die annually from illegal abortions). Economic circumstances, health problems, rape, and abandonment threaten their lives, so abortion is a last resort. The Collective maintains that the Catholic Church must understand that God empathized with women's pain, and in sending Jesus, has become one with humanity. The Church must seriously consider this sorrowful and very complex situation and reflect on the circumstances leading to abortion rather than condemn it. It must realize that by choosing abortion women want to avoid harm in those cases where pregnancy could cause death, avoid injustice when rape caused the pregnancy, or avoid giving birth to an infant that society or family cannot sustain. The present adverse and unjust situation contributing to unwanted pregnancy and illegal abortion is a social sin. The Catholic Church needs to build a new pastoral program with women at its center emphasizing sexuality, maternity, and contraception. Indeed, confronting the true social, moral, and political causes of abortion, and avoiding punishment, incarceration, or excommunication will resolve the issue.
Web site : http://www.catholicsforchoice.org/conscience/archives/default.aspAbstract : Esta investigação visou analisar os discursos de rapazes de estratos populares urbanos envolvidos no fenômeno da gravidez adolescente, verificando se as diferentes atitudes em resposta à gravidez seriam expressivas de padrões culturais tradicionais e/ou emergentes na sociedade chilena. Através de duas entrevistas e das discussões com seis grupos de jovens com 17 a 24 anos da Região Metropolitana de Santiago do Chile, ficou claro que, frente à gravidez da parceira, para o rapaz as respostas incluem fuga, pressão por aborto, união ou casamento e paternidade solteira. Esta última, prescindindo da união do casal, em face do padrão recorrente de resposta masculina pela evasão, constitui uma opção emergente, ainda em processo de legitimação social e cultural.
Notes : Portugués/portugais/PortugueseAbstract : Little is known about the opinion of Brazilian women on induced abortion. One objective of a study carried out in the region of Campinas, Sao Paulo State, was to learn whether women agreed as to specific circumstances under which hospitals should provide abortions. A total of 1838 women of childbearing age who had been pregnant at least once were interviewed. Single women and those who had had at least one induced abortion were the ones who most agreed that hospitals should perform abortions under the circumstances presented. The circumstances most accepted were rape, the woman's life being at risk, and fetal malformation. A smaller percentage of women were in favor of abortion when the reasons affected the woman but could not be observed in a direct and objective way by others. (author's modified) (summaries in ENG, POR)
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0102-311X1994000300012 lng=en nrm=isOAbstract : A questionnaire-based study was carried out in the city of Rio Grande, Brazil, during January and February 1995, enlisting 1456 women of reproductive age (15-49 years) to obtain information about demographic, socioeconomic, and reproductive variables and seek their opinions about the issue of legalization of abortion. Approximately 15% were adolescents (15-19 years of age), 60% were aged 20-39, and the rest were 40 years old or older. Approximately 20% of them had already undergone at least 1 abortion. 25% of these interventions were done by using misoprostol. 30% of the women were in favor of legalizing abortion in any situation. The main reason cited was the lack of necessary finances to guarantee an acceptable quality of life for the child (53%); 17% agreed that legalization would reduce the incidence of clandestine abortions and consequently maternal morbidity and mortality. Among women who opposed the legalization, 26% said abortion should not be used for contraception; 20% considered it a crime. Only 20% of the low-income family women concurred with the legalization of abortion, whereas 41% of those did whose family income was 6 times the minimum monthly earnings. Only 13% among the illiterate group of women approved legalization versus 50% of the women who had 12 or more years of education (p < 0.001). A multivariate analysis indicated that the opinion in favor of legalization was 2.1 times higher among women aged 45 years or older in comparison to women aged 15-19 years. The odds ratio and relative risk of such opinion among women with 9 or more years of education was approximately 5 times higher than among women without any schooling. The odds ratio of favoring legalization of abortion among women who had deliberately interrupted their pregnancy was 3.3.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89101997000700004 lng=en nrm=isoAbstract : El aborto es la interrupción de un embarazo antes de que el feto sea viable, es decir, que pueda vivir fuera del vientre materno. Esta es una práctica que en los últimos años se ha generalizado en el país, sobretodo entre el grupo de las adolescentes, debido a que no cuentan con las condiciones necesarias para hacer frente a la maternidad. Este estudio, de tipo descriptivo, detalló el nivel de información con que contaba y la opinión que tenía un grupo de 36 estudiantes graduandas de un colegio secundario del interior de la República en torno al aborto. Estas jóvenes estaban entre los 17 y 18 años; un 92% mantenían Relación sexual, no hubo datos sobre si utilizaban anticonceptivos. Manifestaron no haber tenido un aborto (100%); la gran mayoría de estas no se sentían preparadas para afrontar la responsabilidad de ser madre, aunque si se presentara un embarazo afrontarían la responsabilidad del mismo (97%), sólo 3% recurriría al aborto. Los padres serían los primeros a los cuales acudirían por ayuda y orientación en caso de un embarazo. Este grupo de jóvenes considera que aquellas adolescentes que se practican un aborto lo hacen por no perder su libertad (47%), no aceptan la responsabilidad de un embarazo (33%) o porque no cuentan con los recursos económicos para mantener a un bebé (31%). Manifestaron que los medios de comunicación sí ejercen una poderosa influencia sobre la conducta sexual de los adolescentes (67%) lo que influyen en el inicio de Relación sexual sin conocer las consecuencias de estas. La educación sexual sería la principal fuente de ayuda para evitar que una adolescente se embarazará y tuviera que recurrir a un aborto. Esta educación podría proporcionarse a través de charlas en los colegios (86%), orientación a los padres de familia sobre cómo abordar el tema de la sexualidad con sus hijos (83%) y por medio de ayudas audiovisuales (películas , videos) (17%).
Notes : Español/espagnol/SpanishAbstract : No government can survive without consulting the opinion of the governed. Even dictators cannot be completely ignorant of the needs and sentiments of the population. This truth applies as well in intimate aspects of life related to conscience and morality. Mexican federal and local legislators lack means of consulting the citizenry. Only a few localities have the type of procedures to determine the will of the electorate used in nations of long democratic tradition. Abortion and other matters of conscience should be subjected to referendum. At present, referenda are impracticable in Mexico. Reflecting the situation in secular society, the Catholic Church hierarchy lacks means of consulting that would at least temper the authoritarian condemnation by the Pope of contraception and birth control and the obsessive opposition to condoms, the best HIV preventive. It is difficult to gauge the true weight of the pope s influence in Mexico, but many lawmakers and authorities consider it definitive. The Church hierarchy neither consults the faithful nor listens to those within the Church who recommend modification of doctrines regarding reproduction. Surveys reveal that Catholic men and women use contraception, and women have obtained abortions without considering themselves outside the religious community. Legislators and officials should know what people really think, and citizens should be provided with information to enable them to form their own opinions.
Web site : http://www.gire.org.mx/Abstract : El presente estudio tuvo como objetivo conocer las ideas y opiniones de un grupo de jóvenes universitarios acerca del aborto y si sus percepciones personales favorecen o no a este fenómeno. La investigación fue de tipo descriptivo y exploratorio, en la que se exploraron variables como: datos sociodemográficos, circunstancias en que se comprende el aborto, opinión acerca de la situación del aborto en general, área de la mujer y derechos. El instrumento utilizado fue una encuesta que abarcó las áreas de interés Se realizó un análisis estadístico entre variables e items para inferir sobre los diferentes factores que influyen en la opinión del tema del aborto. Se escogió una muestra representativa en base al sexo de la población estudiantil de la universidad; se obtuvo el 10% del total de la población. Los resultados indicaron que el 52% de los entrevistados eran mujeres y 48% son hombres. La muestra de estudiante respondió que comprendían el aborto en circunstancias como violación, incesto,cuando el niño tiene posibilidades de nacer minúsvalido y cuando la vida de la madre corre peligro. No justifican el aborto en circunstancias económicas, cuando la mujer no desea más hijos, o porque la mujer es soltera. Estos estudiantes no conocían la situación legal del aborto en Panamá: el 46% esta en contra de la legalización del aborto, 37% a favor y el 15% no está seguro. El 61% de los encuestados opina que la penalización del aborto no impide que se practique; 60% piensa que la legalización impediría que se practicaran abortos en condiciones de riesgo y otro 61% piensa que si se legalizara el aborto se evitaría la muerte de muchas mujeres. El 63% de los estudiantes considera que el aborto es una decisión moral; otro 79% manifestó que la decisión de abortar no sólo corresponde a la mujer, sino también el hombre debe tener poder de decisión sobre el aborto. La opinión de la iglesia debe ser tomada en cuenta (62%), aunque un 47% de los estudiantes encuestados afirma que su opinión respecto al aborto está basada en creencias religiosas. En cuanto a la percepción del aborto tenemos que 63% considera al aborto una práctica inmoral y el 77% lo percibe como un crimen comparable al homicidio. El 70% de los entrevistados considera que el aborto no es un método de control de la natalidad; otro 45% no lo ven como una alternativa a un embarazo no deseado y 80% no lo considera una solución al problema de la superpoblación. Un 58% de los estudiantes conoce a alguien que ha abortado. El 67% respondió que no le recomendaría a nadie que abortara y recomiendan más bien la adopción como alternativa preferible al aborto. El 54% de la muestra del estudio considera que las instituciones de salud públicas no deberían realizar abortos, y un 80% alega que las mujeres de bajos recursos son las más afectadas con abortos clandestinos. El 93% de la población considera que la educación sexual desde la niñez ayudaría a prevenir el problema del aborto.
Notes : Español/espagnol/SpanishAbstract : The safety and effectiveness of oral methotrexate and vaginal misoprostol for early abortion were evaluated in a prospective study of 300 women who presented to the Cuidad de la Habana (Havana, Cuba) for termination of a pregnancy of a gestational age of 63 days or less. All women were given 50 mg of methotrexate at study entry and then were randomly allocated to receive 800 mcg of misoprostol either 3, 4, or 5 days later. If abortion did not occur, misoprostol was readministered 48 and 96 hours later. Complete abortion occurred in 273 women (91%); the success rate was 72% (216 cases) after just one dose of misoprostol. There were no significant differences in abortion rates based on the day on which misoprostol was administered. Vaginal bleeding lasted an average of 7.1 +or- 3.8 days, spotting continued for 4.1 +or- 2.5 days, and total bleeding persisted for 11.2 +or- 4.1 days. Side effects for methotrexate included nausea (9.7%), vomiting (6.7%), dizziness (10.3%), fatigue (6.3%), headache (5.3%), and chills (5.3%). For misoprostol, side effects included nausea (23.0%), vomiting (25.3%), diarrhea (51.7%), dizziness (18.3%), headache (18.0%), chills (60.0%), and pelvic pain (97.3%). All signs and symptoms were of low intensity and short duration, however. These results suggest that combined use of methotrexate and misoprostol represents a feasible alternative to the intramuscular use of methotrexate or of antiprogestins and prostaglandin for medical abortion. The efficacy and safety of this new regimen are very close to those of RU-486, but the cost is considerably less.
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?vol=57 viewtype=issue iss=2#S001078249800004Abstract : The objective of this study was to compare the oral and vaginal administration of misoprostol for cervical priming before surgical abortion up to 63 days' gestation. A total of 900 pregnant women, with ages ranging from 18 to 42 years, who asked for pregnancy termination, were included in this study. Women were randomly allocated to one of the following groups: oral administration of 400 mg misoprostol, 8 h before aspiration; and vaginal self-administration of 400 µg misoprostol, 4 h before aspiration. During admission, all subjects were checked on a 15-min basis. The preoperative cervical dilatation achieved was the main outcome assessed. The cervix was dilated (Hegar = 8) in 348 (78%) subjects from the oral treatment group and in 391 (87%) women from the vaginal treatment group; this difference was statistically significant (p = 0.0004). The mean dilatation achieved in the oral treatment group was 8.1 mm (SD 1.6 mm) and it was 8.5 mm (SD 1.5 mm) in the vaginal treatment group; this difference was statistically significant (p = 0.0001). The frequencies of side-effects such as nausea, vomiting, diarrhea and chills reported by women from the vaginal misoprostol group were 10, 8, 18 and 4 times lower, respectively, than those reported by subjects from the oral misoprostol group. In conclusion, vaginal self-administration of misoprostol was the best administration route, as it obtained the same or greater priming effectiveness of the cervix in half the time with a much lower frequency of side-effects. (author's)El objetivo de este estudio fue comparar la administración oral y vaginal del misoprostol para la maduración cervical antes del aborto quirúrgico hasta los 63 días de gestación. En el presente estudio se incluyeron 900 embarazadas, de 18 a 42 años de edad, que habían solicitado la interrupción de sus embarazos. Las embarazadas se asignaron aleatoriamente a uno de los siguientes grupos: administración oral de 400 mg de misoprostol, 8 horas antes de la aspiración; y auto administración de 400 µg de misoprostol por vía vaginal, 4 horas antes de la aspiración. Se controló a todas las embarazadas al ingresar durante 15 minutos. El principal resultado que se evaluó fue la dilatación cervical prequirúrgica lograda. Se observó una diferencia estadísticamente significativa (p = 0.0004)en la dilatación del cuello uterino (Hegar = 8): en 348 (78%) embarazadas del grupo de tratamiento por vía oral y en 391 (87%) embarazadas del grupo de tratamiento por vía vaginal. También se registró una diferencia estadísticamente significativa en la dilatación media lograda en el tratamiento por vía oral que fue de 8,1 mm (desviación estándar 1,6 mm) y de 8,5 mm (desviación estándar 1,5 mm) en el grupo de tratamiento por vía vaginal. Las frecuencias de los efectos secundarios como náuseas, vómitos, diarrea y escalofríos informados por las embarazadas del grupo de misoprostol por vía vaginal fueron 10, 8, 18 y 4 veces menores, respectivamente, que las informadas por las embarazadas del grupo de misoprostol por vía oral. En conclusión, la auto administración de misoprostol por vía vaginal fue la mejor vía de administración, ya que obtuvo la misma eficacia o mayor en cuanto a la maduración del cuello uterino en la mitad del tiempo con una frecuencia mucho menor de efectos secundarios. (del autor)
Web site : http://www.tandf.co.uk/journals/titles/13625187.aspAbstract : OBJECTIVE:To compare the safety and effectiveness of vaginal with oral misoprostol for induction of labor.METHODS:A total of 107 women with clinical indication for induction were randomly assigned to receive oral or vaginal misoprostol. Doses of 100 [mu]g of oral or 25 [mu]g of vaginal misoprostol were given every 3-4 hours. If cervical ripening or active labor did not occur, repeated doses of oral (100-200 [mu]g) or vaginal (25-50 [mu]g) were given until labor was established.RESULTS:Fifty-nine women received oral misoprostol, and 48 received vaginal administration. Delivery time was similar for the vaginal and oral arms (1074 +/- 488 minutes versus 930 +/- 454 minutes, P = .11). Parity was significantly different (P = .04) for the vaginal and oral groups. The cesarean delivery rate was similar for the vaginal and oral arms (17% versus 15%, P = .72). The number of medication administrations was consistent between groups. Birth weight was not different for patients in the control and treatment groups (vaginal 3281 +/- 507 g versus oral 3359 +/- 541 g, P = .44). Chorioamnionitis and tachysystole were comparable for the oral and vaginal groups. There was no statistical difference in neonatal outcomes. Similar proportions of infants were admitted to the well baby nursery and intermediate care nursery.CONCLUSION:These findings indicate that, in a closely supervised hospital setting with adequate monitoring, oral misoprostol has the potential to induce labor as safely and effectively as its vaginal analogue.
Web site : http://www.sciencedirect.com/science/journal/00297844Abstract : For over 25 years, the Oriéntame Foundation in Bogotá, Colombia, has been providing reproductive health services to women, regardless of their socio-economic or marital status, race, age or religious affiliation. Oriéntame started by focusing primarily on unwanted pregnancy and treatment for incomplete abortion, which has contributed to the reduction of maternal mortality in Bogotá. Oriéntame now provides comprehensive sexual and reproductive health services, including sexual health education, Pap smears, gynaecological problems, STIs and sexual violence, with a continuing emphasis on unwanted pregnancy, treatment for incomplete abortion and post-abortion care. The women that come to Oriéntame, some 18,000 per year in recent years, are from all socio-economic levels, and are increasingly more informed. The services are regularly re-evaluated so as to accommodate their changing needs. There is a sliding scale of fees, so that the 40% of women patients with higher incomes subsidise the 60% with lower incomes; this also allows the clinics to be self-supporting. Services are offered in an atmosphere of respect for women and their decisions, with professional staff who are trained to take care of both the medical and emotional needs of each woman. Since 1992, Oriéntame has also been doing outreach to the slum areas of Bogotá, providing education and information, to contribute to the empowerment of the poorest inhabitants of the city.
Web site : http://www.rhmjournal.org.ukAbstract : This chapter of a book about abortion legislation in El Salvador gives the country's political, social and economic background. It notes that El Salvador is the smallest, most densely populated country in the region. The Salvadoran population is 94% mestizo, 5% indigenous and 1% White. In terms of politics, it is noted that although there have been political achievements such as Peace Accords and a number of peaceful changes of government, there has been no significant change in the country's overall situation. Moreover, it is emphasized that a change in the Roman Catholic Church's role as a protector of social justice and human rights in the mid-1990s influenced the stance of both the Church and the government with regard to social issues that affect women in particular. Furthermore, not only is El Salvador one of the poorest countries in the region, but it is also one of the most violent countries in Latin America. Successive governments have failed to acknowledge the true magnitude of crime and violence, and have forgotten their share of responsibility for this on-going and increasingly serious problem.
Web site : http://www.crlp.org/Abstract : Data were analyzed for the year 1988 at the Maternity Hospital Therezinha de Jesus (Juiz de Fora, Brazil) with the objective being to compare them with data collected previously at the same institution by Guerra et al. and to study other perinatal patterns not previously studied. 3404 hospital charts were analyzed. Weight, height, and cephalic perimeter of term newborns were measured, as well as the stillbirth index, incidence of abortions, and malformations. The mean weights and heights of the male newborn babies (3286 g and 48.7 cm, respectively) are significantly greater than those of the female babies (3066 g and 47.9 cm, respectively), but are not statistically different from the data obtained by Guerra et al. and are, apparently, within normal parameters. The mortality index decreased 58% since 1975 and this was probably due to better prenatal care. The abortion rate was 14.39%. The high incidence of congenital club feet observed (2.05%) deserves a specific study addressing the possible causes, such as environmental and/or genetic. (author's modified) (summaries in POR, ENG)
Web site : http://www.cnpq.brAbstract : The International Population Conference on Population and Development was held in Cairo with the participation of 3500 people and more than 5000 nongovernmental organizations. The most important findings were the recognition of the problem of women's reproductive health; the need for empowerment of women; and the need for facilitating access to family planning information and service to avoid premature, too close, too late, and too many pregnancies. In 1990 there were approximately half a million maternal deaths related to pregnancy, delivery, and abortion. About 70,000 women are estimated to die as a result of illegal abortions and thousands survive with lesions and various complications. Every year 53 million induced abortions occur worldwide: almost 1 for every 3 births. On the global level 1 out of every 400 women who undergo high risk abortion die, i.e., between 100,000 and 200,000 women a year. The Action Plan of the conference resolved that the recourse to abortion should be reduced by means of more widespread and better access to family planning services. In the Dominican Republic a proposed study about the problem of abortion would have the objective of preventing abortion, focusing attention on maternal health, and designing a national policy that would help women and couples to make well-informed decisions about contraceptives and about the prevention of abortion. This means the provision of contraceptive services with easy access to all persons who require them.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 115799Abstract : This article relates the case of two young girls who became pregnant as a result of rape and their efforts to exercise their rights to terminate the pregnancy. The first victim was a 12-year-old girl from Bolivia and the second was Paulina, a 13-year-old resident of Baja California, Mexico. Though abortion is illegal in both countries, in the case of rape the procedure is "unpunishable" in Bolivia and legal in Mexico. Despite these laws, the girls, their families and their advocates contend repeatedly with local government and Catholic Church officials on the issue. Only the first victim successfully exercised her right to terminate her pregnancy through the efforts of her family and the decision of Penal Judge Luis Ledezma. This paper also highlights the need for reforms in the abortion law in both countries.
Web site : http://www.catholicsforchoice.org/conscience/archives/default.aspAbstract : Presentations and proceedings from the November 1994 Latin American and Caribbean Abortion Research Meeting have been published. Nearly 100 participants from more than 20 countries attended the meeting, which focused on new trends in research.For more information, contact: Universidad Externado de Colombia, Apdo. Aereo 034141, Bogota, Colombia.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Peru has high incidences of illegal abortion and maternal mortality. 60% of pregnancies are undesired and terminate in unwanted birth or abortion. Maternal deaths, unsafe abortions, abortion complications, and unwanted pregnancies reveal the precarious state of women's reproductive rights in Peru. In the past few decades, the right of women to make fertility decisions has been affirmed and the possibility of regarding sexuality as a value in itself has arisen. Contraception has been a fundamental factor in the liberation of women and their incorporation into public life. The process of deciding freely about fertility does not occur in a vacuum, but is related to the level of power a woman can exercise over other aspects of life. Empowerment of women is a basic condition for exercise of reproductive rights. It has been suggested that abortion and women seeking abortion should not be condemned; rather, the society that does not permit human living conditions for women and their children should be condemned as an abortion-encouraging society. A proposed feminist ethics of reproductive rights would recognize the capacity of women to make their own decisions and the intrinsic values of sexuality and of maternity. It is imperative to fight for abortion rights. Quality care for abortion complications and legal modifications to permit abortion in cases of rape or congenital malformation or to save the mother's life are immediate priorities. The number of unwanted pregnancies should be reduced drastically through provision of information, health services, contraception, and economic and emotional support, especially for adolescents.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159734Abstract : The hypothesis that a restriction of family planning services will be associated with an increased incidence of abortion was investigated in a survey carried out in Asuncion, Paraguay, in 1985. In 1979, the Government of Paraguay abruptly eliminated all support for family planning services at Ministry of Health clinics ; a measure that affected at least half of all contraceptive acceptors and forced them to turn to pharmacies for contraceptive supplies. The survey, which samples 10% of the registered private pharmacies in Asuncion, used the sale of pseudo- abortifacients as a measure of induced abortion. Also interviewed were 56 contraceptive purchasers and 51 purchasers of injectables contraceptives intended for use as abortifacients who were recruited at the participating pharmacies. The results indicated that low-income women were 5 times more likely than their higher income counterparts to purchase pseudo-abortifacients. In addition, unmarried women were 3 times more likely to purchase progestogen injections to induce a missed menstrual period than married women. Almost 70% of abortifacient purchasers reported that they had attempted to self-abort on previous occasions. The pharmacists stated that up to 50 women a week requested medication for pregnancy termination and were in agreement that this practice had increased substantially following the government's withdrawal of support for contraception. The pharmacists expressed concern about the nonavailability of counseling from trained family planning personnel and indicated that some pharmacy staff knowingly exploit women by injecting them with unsafe preparations or drugs that cannot induce abortion. The administration of ineffective pseudo-abortifacients can delay the decision to seek an illegal abortion or result in life-threatening incomplete abortion.
Web site : http://www.cambridge.org/uk/journals/journal_catalogue.asp?historylinks=ALPHA mnemonic=JBSAbstract : Introducción ; Algunas consideraciones históricas acerca de la relación Iglesia-Estado ; Iglesia Católica y movimiento de mujeres: algunas consideraciones doctrinarias ; Conclusiones ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : A pesar de las consecuencias que el aborto en condiciones de riesgo trae a la salud, y de los argumentos sobre derechos y discriminación a favor de hacer el aborto seguro y legal, los elaboradores internacionales de políticas, responsables de cuestiones relacionadas con la población y la planificación familiar, optaron por no tratar el problema del aborto directamente hasta la Conferencia Internacional sobre Población y Desarrollo (CIPD) celebrada en El Cairo en 1994. En ese encuentro, con representación de casi todos los países del mundo, por primera vez se llegó a un consenso mediante el cual se reconoció que el aborto en condiciones de riesgo es un problema de salud pública que todo gobierno tiene la responsabilidad de tratar. El reconocimiento formal de este problema en el Párrafo 8.25 del Programa de Acción de la CIPD finalmente dio a muchos de los gobiernos, agencias donantes y organizaciones no gubernamentales el empuje oficial que necesitaban para empezar a tratar este asunto tan sensible relacionado con la salud pública, la salud de la mujer y los derechos humanos. Esta publicación examina el progreso en esta materia desde El Cairo, con recuadros y ejemplos ilustrativos de diversos países del mundo incluyendo Bolivia y otras naciones latinoamericanas.
Notes : Español/espagnol/SpanishAbstract : The term fertility control, with its connotation of demographic policy to limit the number of births in a country, has been replaced practically everywhere by the term responsible parenthood. Irresponsible parenthood might be defined as bringing into the world a child who is unwanted. The irresponsibility does not stem from the wealth or poverty, number of children, marital status, or other condition of the parents, but from not preventing the unwanted pregnancy. In a recent study of 2500 pregnant women attending a prenatal clinic, 22% stated that the pregnancy was a disaster for them, 33% were happy about it, and 44% stated they would have preferred to wait. 19% of births in Ecuador are to women under 20, and 58% of such births are extramarital. The number of abortions is unknown, but estimates from different sources suggest that one abortion occurs for each two births, or around 135,000 abortions per year. It may be estimated that each year, of the 270,000 births, 60,000 are unwanted, 120,000 are inopportunely timed, and 51,300 are to adolescent parents. The reasons for the large number of unwanted or badly timed births are undoubtedly complex. A form of sex education is needed that will promote development of sexual responsibility and not just transfer technical information. The program should stress the importance of the couple in procreation.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 102146Abstract : El embarazo adolescente en Chile: una maternidad en la adolescencia -cuestión de mujeres o inequidades de género- fundamentalmente mujeres de pobres- o las razones de la segmentación social y cultural ; El embarazo adolescente profundiza inequidades en las relaciones de género ; La fuga de la paternidad y la negación del origen del embarazo ; El aborto como otro modo de no hacer la paternidad ; La interpretacion inmediata de la experiencia del aborto ; La reinterpretación actual de la experiencia ; El sentido de la experiencia vivida ; El sentido biográfico actual ; Paternidad si, emparejamiento no: la paternidad en solteria ; La paternidad juvenil: una experiencia biográfica que trasgrede el orden social como un medio para integrarse en él ; Perdida de pareja y riesgo de perdida del hijo ; Un aprendizaje dificil: una posición de orden .
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Statistics on induced abortion incidence in Brazil are considered highly deficient. The randomized response technique (RRT) improves estimates of induced abortion by allowing women to furnish accurate information indirectly, maintaining privacy. Use of the RRT indicates that around 80% of women with induced abortions refuse to admit their experience when questioned directly. The present study explored induced abortion-related behavior among two samples of women 15-49 years from a subdistrict of Sao Paulo (Vila Madalena) as a function of demographic factors. In the first sample (n = 996), the incidence of induced abortion in the year preceding the survey (1987) was estimated through use of the RRT. In the second (n = 1004), the same information was sought through a conventional approach. A total of 275 induced abortions were reported. Analysis of variance indicated single women, women 15-19 years of age, those who have not had live births, those who have a number of children below the expected ideal, users of contraception (especially inefficient methods), and women who do not have any moral resistance to the practice of abortion are most likely to resort to induced abortion. The multivariate model identified a woman's beliefs as to the moral acceptability of abortion ; a factor that derives from the broader cultural context ; as the variable with the highest predictive value. Overall, these findings indicate a clear need for development of birth control methods that meet the needs of young women at the beginning of their reproductive lives since these women comprise the majority of abortion seekers.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89101998000100002 lng=en nrm=isoAbstract : In 1987, a researchers used the randomized response technique and the conventional approach to investigate the incidence of induced abortions in 1986 among 2000 women, 15-49 years old, living in the upscale subdistrict of Vila Madalena in Sao Paulo, Brazil. (Abortion is illegal in Brazil, except to save the life of the mother or in cases of rape.) Their mean incomes were 7-9.8 times higher than the minimum wage. fertility among 40-44 year old women was 2.4 children. Overall fertility was 1.3 (2.1 for nonsingle women). 80% of women who experienced an induced abortion did not admit having an abortion when questioned directly. Single women had the second lowest abortion rate (95.8/1000 vs. 173.1 for widows and 447.4 for separated or divorced women) and lowest pregnancy rate (23.9% vs. 79.7% for women in a consensual union) but the highest rate of abortion/pregnancy (22.2% vs. 17.9% for separated or divorced women and 3.8 for married women). These findings indicated that women in unstable relationships tended to experience unwanted pregnancies. Overall, as family size increased, the induced abortion rate decreased (16.5% for parity 1, 6.8% for parity 2, and 1.3% for parity = or > 4). Yet, women who had more children than desired family size tended to resort to abortion. Nulliparous women (13.4% of all women) had a high rate of pregnancies ending in induced abortion (54.9%), while they had a very low rate of abortions (91.7/1000). Thus, in nulliparous women, the likelihood of a pregnancy being terminated is great. The greater the resistance to accepting induced abortion, the smaller the frequency of induced abortions. Nevertheless, induced abortion was a principal means of regulating fertility. 15-19 year old women had the highest rate of abortions/total pregnancies (23.1%). Women who used contraceptives, particularly ineffective ones, had a higher abortion rate than nonusers 917.2% vs. 6.1%). These results showed that removal of abortion restrictions would allow more abortions to occur. Brazil should liberalize the abortion law to grant women their reproduction rights as well as to contain mass sterilization practices occurring in Brazil.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 084789Abstract : En 1999, Paulina quedo embarazada a los treces años, como consecuencia de un violación. Paulina decidió abortar... pero funcionarios públicos lograron, con base en engaños de, que se desistiera. Axial le impusieron que nunca decidió: ser une madre adolescente a consecuencia de la violación que sufrió. En el ano 2000, el Grupo de Información en Reproducción Elegida (GIRE) publico la primera parte de esta historia: Paulina en el nombre de la ley. En el 2004, aun quedan muchas cuentas pendientes, por eso hubo que escribir Paulina cinco anos después. Este numero incluye información de los hechos mas relevantes los últimos anos en torno a la vida de Paulina y a " su caso ", que se ha convertido en emblemático porque evidencia las limitaciones en materia políticas publicas que garanticen el acceso al aborte a las victimas de violación.
Notes : Español/espagnol/SpanishAbstract : El presente folleto narra el proceso emocional y penal por el cual tuvo que pasar Paulina, una niña de 13 años de edad que fue violada y a quien las autoridades le negaron el derecho de abortar
Web site : http://www.gire.org.mx/Abstract : En 1999, Paulina quedo embarazada a los treces años, como consecuencia de un violación. Paulina decidió abortar... pero funcionarios públicos lograron, con base en engaños de, que se desistiera. Axial le impusieron que nunca decidió: ser une madre adolescente a consecuencia de la violación que sufrió. En el ano 2000, el Grupo de Información en Reproducción Elegida (GIRE) publico la primera parte de esta historia: Paulina en el nombre de la ley. En el 2004, aun quedan muchas cuentas pendientes, por eso hubo que escribir Paulina cinco anos después. Este numero incluye información de los hechos mas relevantes los últimos anos en torno a la vida de Paulina y a " su caso ", que se ha convertido en emblemático porque evidencia las limitaciones en materia políticas publicas que garanticen el acceso al aborte a las victimas de violación.
Web site : http://www.gire.org.mx/Abstract : In July of 1999, 13-year-old Paulina del Carmen Ramírez Jacinto was raped in front of family members by a man who broke into her home to rob them. As a result, Paulina became pregnant. She and her mother requested an abortion to which they had the legal right, as dictated by Mexican law in all 31 states and the Federal District for victims of rape. Unfortunately, the justice officials and health authorities of Baja California, where the crime was committed, impeded Paulina from terminating the pregnancy. They put their religious beliefs before the legal obligations that come with their positions as public servants. This document offers basic information to people interested in the defense of human rights and reproductive and sexual rights. It is hoped that justice may be served in the case of Paulina and that this may be the last story of its kind.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 152982Abstract : This Law amends the Penal Code of the Cayman Islands (Act No. 12 of 1975) to provide the following: "i) that no person shall be guilty of the offence of either attempting to procure the miscarriage of a woman or of killing an unborn child unless it is proved that either act was not done in good faith for the purpose of preserving the life of the mother only; and ii) that an authorized registered Health Practitioner shall not be guilty of the offence of either attempting to procure a miscarriage of a woman or of killing an unborn child if prior written certification is given by two such registered Health Practitioners, (one being an obstetrician or a gynaecolgist) that either act is necessary for the purpose of preserving the life of the mother.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 085075Abstract : Several chapters of Peru's revised penal code relating to abortion, family relationships, and sex crimes are presented in this document. Chapter 2 of book 2 regarding abortion establishes sentences for women causing or obtaining abortion, health professionals or others practicing abortion, and individuals who cause unintended abortions through violent actions. Abortions practiced by physicians with the woman's consent to save the life of the mother or avoid grave harm are not punishable. Shorter sentences are specified for abortions in cases of rape outside of marriage reported to the police, or of medically diagnosed probability of grave physical or mental deformity. Chapter 1, title 3, on crimes against the family, establishes sanctions for persons knowingly entering into bigamous marriages or officiating at them. Chapter 2 of title 3, on crimes against civil status, establishes sanctions for persons altering vital records, pretending pregnancy or substituting one child for another to give false filiation or alter or hide filiation. Chapter 3 specifies sanctions for removing a child or inducing a child to leave the parents or other responsible parties. Chapter 4 establishes sanctions for persons not fulfilling their responsibilities of providing food and for men who abandon women they have impregnated. Chapter 9 establishes sentences for rape under different conditions, including rape of a minor. Article 179 of chapter 10 specifies sanctions for persons promoting the prostitution of another person under different conditions or profiting from the exercise of prostitution. Sanctions are also specified for participation in international transport of prostitutes. Article 442 of title 2 in book 3 establishes sanctions of community service or fines for abuse of a spouse in which no lesions occur.
Notes : Español/espagnol/Spanish, nbsp;085265Abstract : 405 lower class women aged 12-44 in the Delegacion Miguel Hidalgo, Mexico City, were interviewed in their homes in an effort to identify patterns in their perceptions of reproductive risk factors. The women were interviewed in late 1989 with a largely precoded questionnaire containing items described in the literature as risk factors for pregnancy, low birth weight, and birth defects. 7.9% of the respondents were 12-15 years old, 17.3% were 16-20, 37.0% were 21-30, 24.4% were 31-40, and 13.3% were 41-44. 24.9% were single, 59.5% were married, and 12.0% were in free union. 7.9% had no education, 33.8% had primary, 33.8% secondary, 20.9% preparatory, and 3.5% professional educations. Among the 300 women who had children, 23.6% had 1, 48.9% had 2-3, and 28.3% had 4 or more. 22.7% had histories of abortion, 1.3% of stillbirths, 15.7% of premature labor, 11.3% of low birth weight infants, 4.7% of neonatal deaths, and 5.0% of infant death. 62.2% perceived the risk of pregnancy at 17 years or younger, 78.8% the risk of pregnancy at age 35 or over, 70.6% the risk of a 5th or higher order pregnancy, and 55.1% the risk of a birth interval of less than 2 years. The majority perceived smoking, drinking alcohol, untreated pathologies during pregnancy, and inadequate nutrition to be risk factors. 27.7% identified a history of low birth weight infants and 61.0% birth intervals of 1 year or less as risk factors for low birth weight. 60.5% recognized family history of birth defects, 80.2% maternal age of 35 or over, and 84.4% rubella during pregnancy as risk factors for congenital malformations. The influence of sociodemographic and obstetric variables on perception of risks was inconsistent and no linear correlations were detected. Health educators should recognize differences in levels of knowledge and behavior in the target population when the educational program is designed.
Web site : http://scielo-mx.bvs.br/scielo.php?pid=0300-9041 script=sci_serialAbstract : Estudio cualitativo de un modelo integral de atención del aborto no complicado y servicios de anticoncepción. Informa sobre la técnica de aspiración manual endouterina que fue comparada en costos, efectividad y eficiencia con la técnica clásica del legrado instrumental para la limpieza uterina. Estos resultados significan una valiosa información para la reorganización del servicio de atención del aborto incompleto no complicado
Notes : Español/espagnol/SpanishAbstract : With the objective of determining the ideas of a group of adolescents on some issues as beginning of the sexual life pregnancy and abortion, the filling of self-applied questionnaires by 399 nine-graders of both sexes from 4 previously selected junior high schools located in "Plaza de la Revolución" municipality was supervised. It can be seen that 72.5% of male teenagers and 90.3% of female teenagers believed that the right moment for starting their sexual life is when both members of the couple wish so and they know very well each other. 67.7% of boys and 78.1% of girls are aware of the health risks for a girl who gets pregnant in her teens whereas 63.3% of males and 78.1% of females consider that abortion is a health risk. It may be concluded that there are significant differences between the ideas of male teenagers and those of the female teenagers regarding the best moment for beginning their sexual life, and early pregnancy and abortion risks. The family has been the main responsible for providing a differentiated education and communication by gender. (author's)
Web site : http://scielo.sld.cu/scielo.php?script=sci_arttext pid=S0864-34662001000100007 lng=es nrm=isoAbstract : La situación de la mujer en Panáma.
Web site : http://www.unifem.org.mxAbstract : This study aimed to describe the socioeconomic and psychosocial characteristics of a sample of teenage mothers classified according to marital status and age group. A sample of 1,228 adolescent mothers was interviewed in the immediate post-partum, selected from public and private hospitals in the City of Rio de Janeiro, Brazil. The chi-square test ( 2) was used to verify the hypothesis of homogeneity of proportions. Comparing the groups, we found that single and younger adolescents were at increased risk of unwanted pregnancy, less family support, and more abortions. Fathers of the infants also tended to be adolescents and unemployed. Adherence to prenatal care was influenced by the adolescent's marital status. The results showed that the most disadvantaged socioeconomic and psychosocial conditions were found among single and younger adolescents.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X2004000700012 lng=en nrm=isoAbstract : A study to identify the sociodemographic characteristics associated with induced abortion of the first pregnancy utilized data from a survey conducted in the Havana district of Diez de Octubre from 1991 through mid-1992. 659 women whose first pregnancies ended in induced abortion and 869 whose first pregnancies were carried to term formed the two study groups. The sociodemographic characteristics of the two groups differed significantly except for race. Nearly 60% who aborted the first pregnancy were under 20 years old and only 6% were 25 or over. 44% who carried the pregnancy to term were under 20 and 15% were 25 or over. 56% who aborted were single, while 70% who carried to term were married. 60% who aborted were not employed, but 64.5% who carried to term were employed. Women 20-24 years old had 2.1 times higher risk of aborting the first pregnancy and those younger than 20 had 3.3 times higher risk than women 25 and older; the relationship was statistically significant. Single women were at 9.5 times greater risk and women in union at 2.3 times greater risk of abortion than were married women. It was concluded that age under 25 and especially under 20 years and being single or in union rather than married were risk factors for abortion.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0036-36341998000300007 lng=en nrm=isoAbstract : In 1986-1987, death records had incomplete data on causes of death and factors linked to adverse pregnancy outcomes and health outcomes and underestimated perinatal deaths, so the Jamaica Perinatal Mortality and Morbidity Survey was done to fill these gaps. In September-October 1986, the Registrar General's Department had registered most of the 10,482 (94.2%) ...... births, 12.8% of fetal deaths, and 9% of neonatal deaths. 430 perinatal deaths occurred in these 2 months (41/1000 total births). In September 1986 through august 1987, 2069 (38/1000) perinatal deaths occurred. Intrapartum problems caused 44% of perinatal deaths and included asphyxia (61% of deaths of mature infants), antepartum fetal death (29%), and prematurity (19%). Mothers in parishes with hospitals with an obstetrician, an anesthetist, a pediatrician, and resident junior staff were much less likely to experience infant asphyxial deaths than those without these staff. Other intrapartum problem risk factors were antepartum hemorrhage, maternal syphilis, high blood pressure, eclampsia, gestational diabetes, previous fetal death, abortion, and lack of prenatal care. Social factors were overcrowding, poor local amenities, and low maternal educational status. In the 12-month period, 62 maternal deaths (11.5/10,000 live births) occurred. Causes of maternal death included hypertension (19 cases), hemorrhage (15), infection (11), sickle cell disease (5), and fortuitous causes (2). Miscellaneous causes accounted for 6 cases and were rheumatic heart disease, thyrotoxicosis/thrombocytopenia, diabetes mellitus, hepatitis, and suicide. Mothers older than 30 years were more likely to die (p = .0001), especially from hemorrhage and causes other than hypertension, infection, and hemorrhage. Hospitals without specialist facilities had higher rates of maternal death from all causes and death from hypertension and hemorrhage than did other hospitals (p < .0001). Protocols for less well-equipped hospitals to better manage obstetric emergencies, adequate transport of referrals, improved maternal education, and more available family planning services would further reduce perinatal and maternal deaths.
Notes : Inglés/anglais/EnglishAbstract : En este trabajo se analiza la situación legal del acceso al aborto en El Salvador, país que tiene una de las legislaciones más restrictivas del mundo, según la cual la interrupción del embarazo no se permite ni siquiera para salvar la vida de la madre. Incluye capítulos que analizan el contexto general del país y la situación de la mujer en particular, y hace un recuento de las modificaciones que ha experimentado la legislación sobre el aborto en El Salvador. También se presentan capítulos referidos a los procesos por aborto, la violación a los derechos de las mujeres como resultado de la legislación punitiva y los derechos humanos internacionales vulnerados. Incluye un capítulo con recomendaciones.
Web site : http://bookstore.reproductiverights.org/perseguidas.htmlAbstract : OBJECTIVE: To analyze the perspective on induced abortion of men of a university community living in legal or consensual wedlock. - METHODS: A descriptive cross-sectional study was carried out and 361 members of different categories of an university were interviewed. Chi-square test was used to assess the association between dependent and independent variables. - RESULTS: Fifth-three percent of the participants acknowledged that women have the right to end pregnancy. Men were more favorable to abortion when there is a risk to woman's life (85%); rape-related pregnancy (80%); and fetal anomalies (75%). Higher schooling of both men and their partners and the interviewees' position (teacher/student) were associated to a positive attitude towards abortion. - CONCLUSIONS: Men tended to be more prone to abortion in legally and/or socially accepted instances. Better education of both men and their partners was relevant to determine their attitude towards abortion.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89102002000300003 lng=en nrm=isoAbstract : Catholics do not follow official Roman Catholic teachings on matters of sexuality and reproduction, including the position that contraception , even for married couples, is always evil, and that direct abortion , even to save a woman's life, is always immoral. Less well known is the extent of the Church's involvement in policy-making on these same issues. For example, it has forced the closing of in vitro fertilization (IVF) services from Poland to Uruguay. As the Church has never declared any of the dominant views, over time, regarding when a fetus becomes a person as a doctrine or dogma, there is no theological justification for the absolute condemnation of abortion. Neither is there a theory on "just abortion" similar to the "just war" that allows killing under certain circumstances. The enormous gap between the Church's positions and the views of worshippers has led Catholics to shape a workable and honorable sexual and reproductive ethic of their own. The Church could make a positive contribution if it chose to accompany people on this quest rather than to raise roadblocks.
Web site : http://www.scielo.br/scielo.php?script=sci_arttext pid=S0102-311X1998000500024 lng=en nrm=isoAbstract : This chapter on Peru is part of a comprehensive examination of the laws and policies that affect the reproductive lives of women in nine Latin American and Caribbean countries. Each report begins with a page of statistical information on population, the economy, status of women, and reproductive health and a brief summary of the nation's recent history. The first main section describes the country's legal and political framework, including the structure of national and local governments and national and international sources of laws. The second section examines laws and policies regarding health and population. The objectives of national health policy and the financing, infrastructure, and regulation of health services and patients' rights are analyzed. Population policy, legislation affecting reproductive health, and government-provided family planning services are then examined. Discussions of contraception, abortion, and HIV/AIDS and sexually transmitted diseases examine relevant legislation and prevalence. The third major section assesses the social and juridical status of women as an influence on the exercise of their reproductive rights, including civil rights within marriage, socioeconomic rights, and the right to physical integrity. The characteristics of marital and family relations and women's educational level, access to economic resources and legal protection determine their possibilities of satisfying their reproductive health needs and rights to services. The final major section examines the rights of adolescents in the areas of reproductive health, marriage, sexual crimes against girls and young women, and sex education. Efforts to improve observation of the reproductive and other rights of adolescents are important for self-determination and health of women in general.
Web site : http://www.crlp.org/Abstract : Women's advocates say Health Minister Fernando Carbone and Prime Minister Luis Solari are pushing their conservative Roman Catholic philosophy by promoting motherhood and cutting off free contraceptives and birth-control information to the poor. The government denies the accusations - and points to its efforts to make pregnancy safer - but the critics are not convinced. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 182378Abstract : The average number of children per woman in Peru declined from 7 to 3.5 between 1960-65 and 1990-95, but the 1991 Demographic and Health Survey indicates that ideal family size was 2.7. Significant socioeconomic and regional fertility differentials persist. Despite the desire for smaller families, 59% of reproductive-age women use no contraceptive method. The most widely used method in Peru is rhythm. Around 34% of women 15-44 years old, some 2 million women, can be considered insufficiently protected against risks of unwanted pregnancy. The 1991 survey found that 1/3 of women using contraceptive methods had experienced failure of their method, with proportions ranging from 32% for rhythm to 1.2% for IUD. Abortion is illegal in Peru, as in most of Latin America, but is known to be widespread. The recurring public debates about abortion are hampered by lack of reliable data. The Alan Guttmacher Institute (AGI) estimate for Peru was based on data from the 1991 Demographic and Health Survey, official hospital discharge statistics, and a survey of 197 professionals and nonprofessionals. The AGI study reveals that a wide variety of techniques are used to induce abortion. There are the safe, modern methods, such as vacuum aspiration or dilatation and curettage, but the most common methods include inserting a probe or catheter, sometimes pouring toxic fluids into the uterus. Women also insert metal objects into the uterus or herbal suppositories into the vagina. They jump, fall, exercise violently, and take injections. 84% of rural women and 64% of poor urban women attempt to induce the abortion themselves or seek the aid of untrained midwives. 95% of wealthier urban women are attended by health professionals. An estimated 1 in 5 illegal abortions in Peru result in hospitalization. Applying this ratio to the estimated 54,230 hospitalizations for induced abortion in 1989 results in an estimate of 271,150 induced abortions in that year, equivalent to 43% of live births.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 111742Abstract : Peru's population multiplied from 6.2 million in 1940 to 17.2 million in 1981 and is expected to reach almost 28 million inhabitants by 2000. The annual growth rate slowed down from 2.9% in the 1960s to 2.6 in the 1970s. While mortality was declining rapidly during the 1940s and the 1950s, the total fertility rate (TFR) remained high at around 6.9 children/woman. In 1981, the TFR was estimated at 5.2, and two-thirds of the inhabitants were urban. Demographic projections predict a population of 22.3 million by 1990 with a TFR of 4.49 and 27.9 million by 2000 with a TFR of 3.1. Rural to urban migration became massive, and the capital grew from 645,000 resident to over 1.8 million in the second half of the 20th century. In 1964, the first governmental institution on population studies was founded. The 1972, the third national census counted a population over 13.5 million, an increase of over 3.5 million since 1961. The first National Development plan of 1975-78 included explicit population goals. After 1978, development plans included more population programs. Also, training activities on population problems were offered to civil servants with the participation of the National Population Council and the Associacion Multidisciplinaria de Investigacion y Docencia en Población. The National Law on Population was passed in 1985 dealing with the family: education in population, social communication, health and population, and national development, and population distribution. Specific contraceptive methods were not addressed, but sterilization and abortion were prohibited. A 1980 study of abortion-related complications among patients of health facilities estimated an incidence of 137 abortions/1000 live births. Increased motivation for a smaller family and the slow pace of efficient family planning services could raise the incidence of abortion, an issue demanding careful consideration which was avoided in the law owing to the opposition of the conservative parliamentary commission.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 080206Abstract : Peruvian health officials chose mock the annual celebration of International Women's Health Day in Peru this May by taking steps to severely restrict women's reproductive choices and personal freedoms. The first action -a policy approved by the former Minister of Health Fernando Carbone on May 27- regulates the structure and roles of state- and district-level health departments. Among other things, these regulations require women to register their pregnancies "from the moment of conception." The second action involves draft legislation released by the Ministryof Health (Moll) May 29 and intended to replace Peru's existing General Health Law.2 To become law, this bill must be approved by the Congressional Health Committee and then passed by the Peruvian Congress. The bill seeks to limit reproductive rights in a variety of ways, including by conferring legal rights on fertilized eggs from the too merit of conception. (excerpt)
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Peruvian law allows abortion for therapeutic reasons, yet a Peruvian women diagnosed with an anencephalic baby at 14 weeks of pregnancy was forced to carry it to term and breastfeed it until its inevitable death four days later. The Centre for Reproductive Rights (CRR), Latin American and Caribbean Committee for the Defence of Women's Rights and Counselling Centre for the Defence of Women's Rights filed a complaint on the woman's behalf to the UN Human Rights Committee, asking for recognition that Peruvian public health officials failed to comply with their own laws, and for compensation from the government. (1)(1.) Centre for Reproductive Rights. UN Human Rights Committee petitioned with reproductive right case (Peru). Press release, 26 November 2002.
Web site : http://www.rhmjournal.org.ukAbstract : Background: Access to legal abortion services are virtually unavailable in Mexico. Previous research has documented that women seek abortifacients at pharmacies in Latin America, in particular the widely available prostaglandin misoprostol. Objectives: To learn more about abortion seekers and abortifacient prescription, specifically for misoprostol (sold under the brand name Cytotec) at pharmacies in Mexico City. Methods: Employees at a representative random sample of 103 Mexico City pharmacies were interviewed using a standardized questionnaire. Mystery clients were later sent to the same pharmacies to better ascertain actual prescribing practices and counseling. Findings: A total of 97 pharmacies participated, a response rate of 94.2%. Among interviewees, 60.8% receive abortifacient requests, on average 1.7 requests per week. Abortifacient-seekers had a mean estimated age of 22.2 years and were most frequently women. Nearly three-quarters of the sample (74.3%) had heard of misoprostol, though only 22.9% of the sample identified it as an abortifacient. Over half (59.8%) of the pharmacies surveyed sell Cytotec, and 46.6% claimed to require a prescription. Knowledge about dosage and side effects was low; ongoing fieldwork with mystery clients will help to elucidate more about actual prescribing practices and information provision. Conclusions: Abortifacient provision is common in Mexico City pharmacies although knowledge about the medications appears to be relatively low among pharmacy workers. Education efforts may improve outcomes. Learning Objectives: At the conclusion of the session, the participant will be able to: 1. Describe the prevalence of abortifacient requests at pharmacies in Mexico City. 2. Evaluate abortifacient knowledge and prescribing practices. Learning Objectives: At the conclusion of the session, the participant will be able to Describe the prevalence of abortifacient requests at pharmacies in Mexico City ; Evaluate abortifacient knowledge and prescribing practices
Notes : Inglés/anglais/EnglishAbstract : In most states of Mexico, induced abortion is illegal except in cases of rape or when the pregnancy would jeopardize the woman's life. This qualitative study assesses the knowledge, attitudes, and practices of pharmacists and herb vendors in the state of Mexico City regarding abortion and contraceptives. The study sample was chosen randomly from the total number of pharmacies and markets identified through a census and by direct physical observation in three Mexico City districts. Findings indicate that pharmacy workers and market herb vendors fulfill the role of a medical provider, except that their knowledge is inadequate for such responsibility. Almost equal percentages of pharmacy workers (62.6%) and herb vendors (64.3%) said that there are methods that will induce an abortion. The medication most prescribed by the pharmacy workers was metrigen (56.3%). Other substances included quinine, benzoginestril, lutoginestril, prostigmine, syntocinon, and clagluquina. Market herb vendors more commonly mentioned two herbs as having abortive properties, zoapatle (Montanoa tomentosa) and ruda (Ruta graveolens. The study also showed that a provider's negative opinion of women who abort did not have any significant impact on provision of abortive methods. From the findings, recommendations are presented for policy changes, training programs, and further research.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : AbstractTo examine physicians' knowledge and attitudes in regard to medication abortion, we conducted focus-group discussions with general practice physicians and obstetrician-gynecologists in Honduras, Mexico, Nicaragua and Puerto Rico. Physicians were familiar with the practice of several types of medication and surgical abortion methods. Medication abortion with misoprostol is most common among women of higher socioeconomic status and is prescribed by physicians, pharmacists or self-administered. Conflicting opinions regarding safety, efficacy, cost, potential for self-medication and acceptability emerged; some participants expressed hope that medical abortion would reduce the risks associated with unsafe abortion, while others contended that drug distribution and self-medication without proper counseling could be problematic. Participants noted a lack of reliable sources of information for both providers and women, and expressed interest in strategic dissemination of information
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?iss=2 vol=70 viewtype=issueAbstract : Annotation: Examines family planning debate in light of both political interests expressed at the national level and women's concerns expressed at individual level. Provides limited statistics on abortion, contraceptive use, infanticide, abandonment, and family planning.
Notes : Español/espagnol/SpanishAbstract : As questões do planejamento familiar e do aborto são temas centrais na discussão dos direitos sexuais e dos direitos reprodutivos. Essas questões são objeto de legislações específicas, de políticas públicas e de programas de saúde que, de algum modo, vêm sendo implementados no Brasil sobretudo a partir da segunda metade dos anos 80. A discussão tem o movimento feminista e a Igreja Católica como seus principais atores políticos e sociais e teve na Conferência Internacional de População e Desenvolvimento e na Conferência Mundial sobre a Mulher importantes recomendações, retratadas em suas respectivas plataformas de ação. Objetivo, neste trabalho, focalizar historicamente a discussão política, principalmente a parlamentar, além da legislação, das políticas públicas e dos programas referentes ao tema no país, enfatizando dos anos 90 aos dias de hoje.
Web site : http://www.abep.nepo.unicamp.br/site_eventos_abep/PDF/ABEP2004_527.pdfAbstract : As questões do planejamento familiar e do aborto são temas centrais na discussão dos direitos sexuais e dos direitos reprodutivos. Essas questões são objeto de legislações específicas, de políticas públicas e de programas de saúde que, de algum modo, vêm sendo implementados no Brasil sobretudo a partir da segunda metade dos anos 80. A discussão tem o movimento feminista e a Igreja Católica como seus principais atores políticos e sociais e teve na Conferência Internacional de População e Desenvolvimento e na Conferência Mundial sobre a Mulher importantes recomendações, retratadas em suas respectivas plataformas de ação. Objetivo, neste trabalho, focalizar historicamente a discussão política, principalmente a parlamentar,além da legislação, das políticas públicas e dos programas referentes ao tema no país, enfatizando dos anos 90 aos dias de hoje.
Web site : http://www.abep.nepo.unicamp.br/site_eventos_abep/PDF/ABEP2004_527.pdfAbstract : El documento reune las ponencias, comentarios y conclusiones de los participantes en los Talleres-debate sectoriales (11 al 15 de marzo de 1991) y el Seminario-debate general (19 de julio de 1991) sobre Planificación Familiar, que fueron organizados y auspiciados por la Unidad de Política de Población del Ministerio de Planeamiento y Coordinación y UNFPA-Bolivia. En torno al tema central de planificación familiar se discutieron asuntos como salud reproductiva, control natal, educación sexual, mortalidad materna, aborto, paternidad responsable, rol del Estado, ONGs, Iglesia, Políticas de Salud y de Población. Hay un Anexo sobre la fundación del primer Comité de Defensa de los Derechos Reproductivos.
Notes : Español/espagnol/SpanishAbstract : En 1990, Bolivia era el país latinoamericano cuya población contaba con el menor acceso a información y servicios de planificación familiar. En este libro, la Secretaría Técnica del Consejo Nacional de Población (CONAPO) examinó las razones detrás de este hecho e invitó al lector a participar en el debate en torno a este tema de creciente interés nacional. Para iniciar el debate, se destacan tres hechos que forman la base de la conciencia nacional sobre una política estatal de población: la baja densidad demográfica de lo que se ha llamado el "país despoblado"; las altas tasas de mortalidad, especialmente infantil; y las campañas antinatalistas denunciadas en las décadas del '60 y '70 que alertaron al país sobre el peligro de la intervención extranjera en este campo. El libro se basa en la revisión de datos sociodemográficos de fuentes secundarias, archivos de hemeroteca, y entrevistas con personajes representativos de diversos sectores sociales.
Notes : Español/espagnol/SpanishAbstract : Vatican on preparations for the International Conference on Population and Development to be held in Cairo in September 1994. It argues for the need to distinguish between the pastoral works of the Holy See, which are its mission, and attempts to exert political influence through moral authority. The Vatican has sought to influence the workings of successive World Population Conferences beginning in 1974, when it stated that "...any policy favoring contraception, sterilization, or abortion is a loss of respect for the dignity of the life of each married person and should be clearly excluded". In a March 1994 meeting with the president of the UN Population and Development Fund, the Pope severely criticized the draft of the final document for the Cairo Conference. During the meeting, the Pope stated that "...contraception is immoral, voluntary sterilization is unacceptable, and population policies should not be formulated in terms of the rights of women." The Vatican objected to implicit or explicit approval of abortion, to the concept of reproductive rights, and to implications that family planning and contraception are synonymous terms, because that would not distinguish natural family planning. The Vatican called upon delegations especially of "Catholic" countries such as those of Latin America to revise their positions or to remove their signatures from the draft document, and to join a block attempting to dictate ethical norms, irrespective of the beliefs of the rest of the world. In this attempt it used procedures that failed to respect the minimal norms of diplomatic ethics, using moral manipulations. This intervention of the Vatican into the internal affairs of other states is impermissible, since the Vatican is the only observer with a voice and vote capable of exercising this type of influence. The Vatican is a society of celibate men without families, which has succeeded in appropriating for itself the right of interpreting the relationships and destinies of families according to its own definitions. Several Latin American countries have pledged their support to the Vatican positions and have acted as spokesmen. Other Latin American countries have maintained their positions and withstood pressures. It is necessary to provide support to delegations and to take measures to reinforce their commitment to respect reproductive and sexual rights and the needs of women and children in Latin America.
Notes : Español/espagnol/Spanish, nbsp;12288163Abstract : Resumen o contenido: Introducción ; Empoderamiento de las mujeres y ejercicio de los derechos sexuales y reproductivos ; Los derechos sexuales y reproductivos: los mas humanos de todos los derechos ; Brechas entre las mujeres en el ejercicio de los derechos sexuales y reproductivos ; Persistencia de la violencia de género hacia las niñas y las mujeres: golpe a la vigencia de los derechos humanos ; Pobreza e inequidades sociales y de género en la salud sexual y reproductiva ; Factores influyentes en la reproducción intergeneracional de las inequidades de género y la pobreza ; Elevado número de embarazos no deseados ; Embarazo en adolescentes: un problema de género ; Elevada mortalidad materna y morbilidad ; El aborto no es un problema solo de las mujeres ; Acceso a los métodos anticonceptivos ; Incremento relativo de contagio de SIDA en las mujeres ; Recomendaciones para la acción ;
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : During a sharing session which took place at a conference sponsored by the Philippine Institute for Social Studies and Action in 1991, Peruvian Victoria Villanueva and US citizen Margaret Ann Schuller discussed their work. Schuller reported on her upcoming book entitled "Freedom from Violence: Women's Strategies Around the World." In addition to proposing a definition of violence against women, the book will include 12 case studies from Malaysia, Bolivia, Mexico, India, Pakistan, Thailand, Sri Lanka, Brazil, Zimbabwe, Chile, Africa, and Alaska describing how national organizations of women are dealing with the problem. An important advance is the development of a framework to look at the connection which exists between violence and health issues. Villanueva described the work of the Movimiento Manuela Ramos, which was organized informally to deal with reproductive rights and abortion and has since expanded to parent groups of women who defend legal and medical cases as paid paralegals. Manuela Ramos uses popular media, traditional drama, and even state television to publicize its issues. Manuela Ramos has accomplished important work on rape, unsafe abortion, and maternal mortality, but most importantly, the women involved with the organization have had the opportunity to develop their self-esteem.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 095534Abstract : Emergency contraception (EC) has great potential to decrease the incidence and resulting consequences of unwanted pregnancy, including unsafe abortion. We conducted this study to understand EC practices in Latin America and the Caribbean (LAC). We contacted 43 International Planned Parenthood Federation affiliates in LAC to interview them about EC availability. We collected family planning norms and researched registered EC products in LAC. We searched English- and Spanish-language sources to compile EC literature reviews. Thirty-seven affiliates (86%) responded to the survey, and 62% offer EC. Central and South American affiliates are more likely to offer EC than are Caribbean affiliates. Of those offering EC, 96% offer cut-up packets of oral contraceptives, whereas six affiliates offer dedicated products. Of those not offering EC, 79% believe it constitutes abortion. EC availability and support for the method appear to be increasing in LAC, and clearer distinctions between EC and abortion in medical and policy guidelines should increase acceptance further. (author's)
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?iss=2 vol=65 viewtype=issueAbstract : Globally, abortion continues to be a very controversial issue; many and diverse points of view about it are argued in public debates. This paper provides case studies where social science research, conducted on the issue of induced abortion, has resulted in major impact for policy utilization. Moreover, it provides new light on what the reality of abortion means under different social, legal, and political contexts. It is noted that barriers to conducting research on induced abortion are many and range from institutional hostility to women's refusal to answer questions concerning the issue. However, findings obtained by the case studies indicate that induced abortion is not restricted to adolescents facing unwanted pregnancy but occurs equally within marriage to limit family size. It is also clear that induced abortion exists both in contexts where family planning programs are strong as well as where they are weak or nonexistent. In other contexts, where contraceptive choices are limited, abortion forms part of fertility regulation strategies that include a mix of traditional and modern methods, often used ineffectively. Unsafe clandestine abortions are more likely to be sought by poorer, less-educated women, and also by adolescents. The studies dealing with providers' perspectives point to the cost in both human and financial resources of treating abortion complications that drain hospital budgets unnecessarily.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : In Mexico, recent political events have drawn increased public attention to the subject of abortion. In 2000, using a national probability sample, we surveyed 3,000 Mexicans aged 15-65 about their knowledge and opinions on abortion. Forty-five per cent knew that abortion was sometimes legal in their state, and 79% felt that abortion should be legal in some circumstances. A majority of participants believed that abortion should be legal when a woman's life is at risk (82%), a woman's health is in danger (76%), pregnancy results from rape (64%) or there is a risk of fetal impairment (53%). Far fewer respondents supported legal abortion when a woman is a minor (21%), for economic reasons (17%), when a woman is single (11%) or because of contraceptive failure (11%). In spite of the influence of the Church, most Mexican Catholics believed the Church and legislators' personal religious beliefs should not factor into abortion legislation, and most supported provision of abortions in public health services in cases when abortion is legal. To improve safe, legal abortion access in Mexico, efforts should focus on increasing public knowledge of legal abortion, decreasing the Church's political influence on abortion legislation, reducing the social stigma associated with sexuality and abortion, and training health care providers to offer safe, legal abortions.
Web site : http://www.rhmjournal.org.ukAbstract : The Policymakers Chartbook on World Population Issues provides statistical charts by region or country on world population trends and projections, family planning (FP) programs, birth control technology, FP and family welfare, population impact on poverty, population impact on the environment, and trends in donor support. A few brief statements accompany each chart. Specific charts on population details population growth from the year 0-2050, annual world population growth rates from 1900-95, relative change in population in developing countries from 1950-2020, annual population increments by region in 1991, largest annual population increments in 1991 in 25 countries which accounts for 80% of growth (India, China, Pakistan, Nigeria, Indonesia, Brazil, Bangladesh, former USSR, US, Mexico, Iran, Philippines, Egypt, Ethiopia, Vietnam, Turkey. Zaire, South Africa, Tanzania, Kenya, Myanmar, Thailand, Sudan, Algeria, and Colombia), world population by region in 1990 and 2025, income/capita compared to population growth rates and doubling times for 17 countries, alternate population projections in 1990-2025 (India, Nigeria, and Mexico), and growth of 13 selected large cities. Charts on organized FP include the time span for fertility reduction for 7 selected countries, average family size declines in Latin America and Africa and Asia, the percentage of childbearing married women who desired stoppage or postponement of childbearing, changes in key indicators of FP, developing countries by type of population policy (none but subsidize FP, no support for FP or restrictions on contraception, or supportive FP policies), FP expenditures by donors and developing country governments and foreign aid donors, and comparison of current with projected FP expenditures for the year 2000. Effective contraceptive usage, failure rates, annual maternal deaths from contraceptive use and unintended pregnancy in low income developing countries by age group, abortion law type (restrictive, moderate) by country and region, private sector costs of condoms and oral contraceptives and female contraceptive sterilization for selective countries charts are also included. Other charts are available on infant and maternal mortality for selected countries and family size, educational attainment, and wealth accumulation for Thailand. Poverty alleviation charts include world grain production, age group and dependency burden, labor force, and gross national product/capita. Environment maps reveal population pressure on tropical forests, and land degradation at risk, and charts show estimated water supply and greenhouse gas emission. Donors are listed by country.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 075699Abstract : This paper describes the existing legislation on abortion and reviews the political process that led to the Penal Code and constitutional reforms that criminalized induced abortion in El Salvador. It also examines the positions and actions of the various groups that pushed for reform in the Salvadoran Legislative Assembly, and of the groups that were against the continued criminalization of abortion. These groups include the Salvadoran government, legislators, the media, Catholic Church, right-wing Catholic groups, and women's movements. A comparison between the 1973 Penal Code and the existing Penal Code is also presented in this article. Moreover, reactions to the reforms on the part of various players in the medical profession, the judicial and legislative branches and a number of organizations operating in El Salvador are examined.
Web site : http://www.crlp.org/Abstract : Surveys conducted in Mexico by GIRE in 1992, 1994, and 1995 reveal that over 80% of the national population believes only a woman or a woman and her partner should make abortion decisions. Neither the government, the Church, nor physicians should intervene. Public opinion and the documented social and public health consequences of illegal abortion demonstrate the obsolescence of laws penalizing abortion. Mexico does not have a direct means of converting the opinions of the population into votes and laws. In place of referendums, committees of specialists have been convened; they are limited in number and ability to represent diverse groups, and oriented above all to the losses and gains of political and parliamentary disputes. The electoral reform of 1995-96 was a good example of the question under debate getting lost in partisan maneuvering. The Federal District and four states have initiated development of the referendum process, but the procedures have been too cumbersome and the results disappointing. In the current day, opinions are often formed not by following a rational process, but by bombardment with advertising appealing to irrational emotions. The democratic effects of referendum should be furthered by guaranteeing fair and exhaustive exposure of all points of view before the vote is held. GIRE recommends that a referendum on decriminalization of abortion should be preceded by a period of at least two years for public debate and reflection, and that the Federal Electoral Institute should organize the debate and the referendum.
Web site : http://www.gire.org.mx/Abstract : Young people comprise a significant portion of the world's population. Their fertility will dictate the future population size of the world. Population education stresses the development of problem-solving, communication, and Decision making skills to avoid unwanted pregnancies, abortion, abandoned babies, child abuse, and early marriage and pregnancy. Population education and communication programs targeted to youth, however, are relatively new. This paper presents an overview of the Johns Hopkins University Center for Communication Programs's mass media programs, particularly youth-oriented popular entertainment programs. The author explains how effective population education programs involve social structures such as home, school, and social clubs which influence the attitudes, values, and behavior of young people and involve parents, teachers, and religious leaders. The programs are in the Ivory Coast, Nigeria, the Philippines, Yemen, Indonesia, Egypt, Mexico, Latin America, Ecuador, Peru, and Madagascar.
Notes : Inglés/anglais/EnglishAbstract : This report singles out 10 countries whose progress or lack of progress towards providing universal access to family planning and lowering fertility levels will help determine whether world population will stabilize at about 10 billion (up from the current 5 billion) or whether it will continue to grow beyond that figure. 5 countries are recognized for their achievements on family planning ; India, Thailand, Colombia, Morocco, and Kenya. The success of these countries shows that population growth can be curbed without having to await major social and economic transformations. For example, in India, strong local leadership has succeeded in reducing the average number of children born to a woman from 5.3 in 1980 to 3.9 in 1991. In Thailand, creative marketing and public/private cooperation has led to a 600% increase in contraceptive use. The 5 countries singled out for their lack of progress (or backsliding) on family planning issues include the US, the Philippines, Saudi Arabia, Malawi, and Haiti. These countries share the common feature of possessing failed political leadership on family planning. Since 1980, the US has abandoned its global leadership on population issues, has exported an anti-abortion ideology worldwide, and has challenged women's reproductive rights. In the Philippines, religious opposition has undermined government support for family planning. Saudi Arabia has pursued a pronatalist policy and has kept women out of the work force. Malawi's authoritarian ruler has failed to support family planning, even though the country has one of the world's highest population growth rates. And in Haiti, which has the highest fertility rate in the Western Hemisphere, government corruption, political turmoil, and poverty have stunted any progress on family planning.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - 071002Abstract : Plantea las contradicciones inherentes a las políticas de población desde el enfoque de una demógrafa feminista comprometida con la defensa de los derechos reproductivos como parte de la dignidad del ser humano. Explica el desarrollo histórico de concepto de "derechos humanos" y su identificación con los derechos reproductivos; las políticas del feminismo y el control de la natalidad como movimientos sociales; propone una agenda para políticas públicas acordes con la defensa de estos derechos y del derecho de las mujeres a la salud
Notes : Español/espagnol/SpanishAbstract : Esta publicación se refiere al desarrollo de este foro de mujeres centroamericanas que se fijaron como objetivo del encuentro ampliar la visión sobre la situación del aborto en la agenda sociopolítica de Centroamérica, partiendo de la construcción de un diagnóstico retrospectivo, y , asimismo, brindar apoyo a la construcción de estrategias para abordar el tema en el escenario de cada país. Como anexos, se incluyen marcos de análisis, mapeos de actores claves, análisis de audiencia, correspondiente a los países centroamericanos representados.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : ¿no es inmoral para la sociedad obligar a las mujeres a parir hijos para que luego mueran por hambre o desnutrición?¿No es inmoral permitir que mueran mujeres por abortos inseguros, siendo un procedimiento médico relativamente sencillo y poco peligroso?¿No es inmoral permitir y alentar a las mujeres que lleven a término su embarazo para que luego entreguen sus hijos en "adopción" trayendo consigo dolores y traumas mayores tanto para las mujeres como para las hijas o hijos que tardan en comprender que el abandono de su madre biológica, fue el acto más generoso y amoroso de su vida?¿Por qué siendo Colombia un país que reconoce la separación entre las Iglesias y el Estado, sigue haciendo sus normas y diseñando sus políticas de acuerdo con las enseñanzas y presión de la jerarquía conservadora de esta Iglesia que pretende ser hegemónica en el país? Como católicas feministas defendemos la vida, como un precioso don, pero no creemos que se pueda restringir esa protección solo al futuro Ser, o seguir culpando a las mujeres que abortan. Tener una legislación que despenalice y legalice el acceso al aborto, no obliga a nadie a interrumpir embarazos, pero si obliga al Estado a que incorpore y mantenga servicios de calidad, que no ponga en riesgo la vida y la salud de mujeres y niñas que se ven afectadas por dicha situación...
Web site : http://www.despenalizaciondelaborto.org.co/data/documentos/200510211618460.AudienciaCDD.pdfAbstract : El Senado uruguayo rechazó el proyecto de ley de Defensa de la Salud Reproductiva. Ello significa que el Estado seguirá sin hacerse cargo implementar políticas que podrían reducir la necesidad de abortar de las uruguayas, que el aborto seguirá siendo un delito siempre... y que los abortos seguirán practicándose como hasta el presente. Sin embargo todavía hay condiciones y tiempo para que algo importante cambie.
Web site : http://www.bitacora.com.uyAbstract : The concept of reproductive health refers to phenomena related to biological reproduction and includes not only health problems related to reproduction itself, but those related to the exercise of sexuality and the prevention of undesired pregnancy. Reproductive health problems of the Mexican population include maternal and neonatal morbidity and mortality, adolescent pregnancy, abortion, AIDS and other sexually transmitted diseases, and the negative consequences of some reproductive technologies. Most research in the area has been conducted from a biomedical or epidemiologic perspective, although there has been significant demographic research on fertility and family planning. Qualitative studies of the subjective processes and interpersonal relations including sexuality that underlie many reproductive health problems are increasing. But systematic studies of reproductive health issues from the social science perspective are lacking, and researchers in the field are few. Various social and cultural processes influencing reproductive health have been identified, but their mechanics are poorly understood. Important influences of this type include conditions of social inequality, differential access to health and family planning services, gender relations including domestic and sexual violence, and the design of population and health policies and functioning of the corresponding services. Laws and their application, development strategies, and changes in social spending and labor markets also have effects on reproductive health. Social scientists must become more involved in revealing the links between these phenomena and reproductive health, in order that reproductive health problems may be more effectively controlled.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 102623Abstract : Comenta sobre la posición de los médicos ante la aceptación o no del aborto ya que se enfrentan a valores profesionales y morales conflictivos.
Notes : Español/espagnol/SpanishAbstract : Improving postabortion care can reduce the negative impact of unsafe abortion. Of the 53 million estimated induced abortions occurring annually about two out of five involve unsafe procedures. About one abortion occurs for every three births annually. 96% of abortions in Africa and 85% of abortions in Latin America are unsafe. About 100,000 to 200,000 women die every year from unsafe abortion, or 1 out of 400 women. Family planning is unavailable to over 120 million women in developing countries who desire contraception. Past moral and political controversies divert attention away from death and injury. The international community can take the opportunity to change affairs by adopting a women's health initiative globally. Improvements are needed in quality of care and accessibility of emergency treatment services. Emergency treatment services are usually only available at the tertiary level of care in urban areas. Poor transportation systems limit access. Access is also impaired by women's attitudes toward treatment centers. Availability of services needs to increased through decentralized centers. Clear protocols and comprehensive, systematic training must be accomplished in tandem with improvements in quality. Provision of technology such as manual vacuum aspiration is cost effective and an easy way to improve quality in primary care or outpatient settings. Unsafe abortion is a byproduct of the failure to provide adequate family planning for prevention of unwanted pregnancy. The obstacles, that interfere with provision of family planning to abortion users, should be removed. These obstacles include providers' lack of understanding of women's needs and motivations, separation between abortion and family planning services, misinformation about contraception following abortion, lack of acknowledgement about unsafe abortion, and women's low status. National and international policies also interfere with provision of contraception. Complete reproductive health care is a necessity for improvement in maternal health and mortality.
Web site : http://www.ipas.org/english/publications/advances.aspAbstract : The high incidence of abortion in Brazil and the increased use of misoprostol among women having clandestine/unsafe abortions has led to an interest in evaluating whether there is an association between the use of misoprostol and the incidence of septic complications post-abortion. To test this association, a retrospective cohort study was conducted with 1840 women treated postabortion at the Instituto Materno-Infantil de Pernambuco (IMIP) between 1988 and 1992. Incidence of infection (4.2%) was lower in women stating they had used misoprostol than in those stating that the abortion was not induced (7.9%) and twelve times lower than in women stating that they had used other methods (49.4%). These results suggest that misoprostol is a safe, inexpensive method for inducing abortion, and leads to fewer complications and consequently shorter hospital stays. Misoprostol should be considered a viable option in situations where induction of abortion is legal or medically indicated. (author's)
Web site : http://www.ingentaconnect.com/content/klu/advaAbstract : Third World women with complications from an illegally induced abortion tend to postpone seeking medical treatment, because of both a lack of knowledge about the signs of infection or hemorrhage and a fear of moral and legal sanctions. At admission, hospital policies require that women be questioned repeatedly until they acknowledge whether their symptoms are a result of induced or spontaneous abortion. In Bolivia, women hospitalized for abortion-related complications also face financial sanctions. They are charged 450 Bs (US$105) for dilatation and curettage); social security coverage is denied as is eligibility for sliding scale fees based on ability to pay. Interviews with 12 patients and 14 staff members at 4 Bolivian hospitals revealed substantial variation in the postabortion care women receive. Care seemed to be more dependent on the personal ethics of staff members than definite policies. In general, however, these women did not receive the moral support needed to help them overcome their feelings of ambivalence, guilt, and depression. Rather, a double standard prevails, where women alone bear responsibility for the pregnancy and then are blamed for seeking termination under illegal conditions.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 096781Abstract : This yearmarked the five-year Review of the 1994 Intemational Conference on Population and Development in Cairo. This review allowed a refocusing of effort within the broader context of the Cairo Programme of Action. It revealed progress in some areas, but also some serious gaps. The international community has not provided effective leadership on some of the toughest health problems, norhave national governments taken on sensitive issues. The review indicated that governments must find ways to promote sexual and reproductive health within health sector reform and work more effectively with NGOs. It also highlighted the need to use existing knowledge to tackle the epidemic ofHIV/AIDS, young people's sexual and reproductive health problems, maternal mortality and morbidity, and unsafe abortion. Work on these issues requires leadership and coordination at national level, along with well coordinated international support for governments willing to take on these controversial topics. ICPD+5 will only have been worthwhile if the recommendations are sufficiently resourced and supported by action in a range of social sectors.
Web site : http://www.rhmjournal.org.uk/Abstract : The needs and life situations of female adolescents seeking postabortion care (PAC) and contraceptive counseling vary greatly depending on their age, marital status, and the circumstances of their pregnancies. For all young women who have had an abortion, making postabortion contraceptive services available is critical for preventing repeat abortions. Few adolescent-specific PAC programs exist anywhere in the world. Two of the first such programs in Kenya and Brazil are described and PAC recommendations are included.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 171545Abstract : Adolescents who choose abortion are more likely than adult women to delay seeking services once they know they are pregnant. They also are more likely to resort to unskilled providers and dangerous methods. When complications result from an abortion, adolescents tend to delay seeking treatment and, consequently, often present at health facilities with serious and life-threatening complications. What is the experience of young women who have abortions and then seek treatment for complications? What happens in cultures where unmarried young women face social, familial, and educational ostracism for being pregnant; where teens often are physically too immature to carry a pregnancy to term and give birth safely without significant clinical intervention; where they are uneducated, and unable to afford a child; where abortion is legally restricted and socially unacceptable? What kind of treatment do young women seeking postabortion care (PAC) services receive from health care providers, and what care and information do they need? And once adolescents have received PAC services, do they know how to prevent unwanted pregnancies in the future? There is still much to learn about how best to provide PAC services to adolescents. To this end, EngenderHealth conducted studies in the Dominican Republic and Malawi in 2002 and 2003, respectively, to determine how hospitals can better meet adolescents' needs for PAC. (excerpt)
Web site : http://www.engenderhealth.org/res/offc/pac/adolescent/pdf/pac_adol_report.pdfAbstract : This chapter highlights the nine postabortion care operations research studies conducted in Latin America funded under the Latin America and the Caribbean Operations Research and Technical Assistance in Family Planning and Reproductive Health III. Most of the studies that were reviewed address the themes of Clinical Practices; Information versus Counseling; Post-abortion Contraception; and Costs and Sustainability. The section on clinical practices refers to the protocols and procedures followed when treating incomplete abortion arising from spontaneous or unsafely induced abortion. The information versus counseling section examines whether providers identify and appropriately inform them about their diagnosis, treatment, and proper care after leaving the facility. For post-abortion contraception, the section outlines the ways in which a patient's reproductive needs and intentions are addressed. A summary of findings regarding the costs and sustainability of providing emergency services for incomplete abortion is presented. Such reviews are based on information from published and unpublished reports, although when feasible, study investigators were contacted for supplemental information.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 141507Abstract : Unsafe abortion contributes significantly to maternal mortality and morbidity in Latin America. Postabortion care (PAC) using preferred technologies and a woman-centred approach to treat the complications of unsafe abortion can save women's lives and improve their reproductive health, as well as reduce costs to health systems. This article reviews results from 10 major PAC operations research projects conducted in public sector hospitals in seven Latin American countries, completed and published between 1991 and 2002. The studies show that following relatively modest interventions, the majority of eligible patients were being treated with manual vacuum aspiration (MVA), a method preferred for safety and other reasons over the method conventionally used in the region, sharp curettage (SC). A number of studies showed improvements in contraceptive counselling and services when these were integrated with clinical treatment of abortion complications, resulting in substantial increases in contraceptive acceptance. Finally, data from several studies showed that, in most settings, reorganizing services by moving treatment out of the operating theatre and reclassifying treatment as an ambulatory care procedure substantially reduced the resources used for PAC, as well as the cost and average length of women's stay in the hospital. These studies suggest that comprehensive PAC can and should be available to all women in Latin America. Such efforts should be coupled with work to improve primary prevention, including better contraceptive services to prevent unwanted pregnancy and safe, legal abortion services to reduce the number of clandestine and unsafe abortions.
Web site : http://heapol.oxfordjournals.org/cgi/content/abstract/20/3/158Abstract : This document presents a global update on postabortion care (PAC) programs, which is a summary of the workshop proceedings on issues in the establishment of PAC services in low-resource settings. The PAC programs, which were initially implemented and designed in 1993, include emergency treatment of complications of spontaneous and unsafely induced abortion, provision of postabortion family planning, and other reproductive health services. Conclusions gathered at the meeting include: the need to build a common framework for PAC, a strategic plan on PAC services, better coordination of PAC programs, and collaboration on common advocacy strategies that emphasize the missions, country leaders, other donors and PAC programs. Several steps have been identified as the key elements of a comprehensive approach to PAC services involving the organization of services, communication, providers, policy and management. Various steps were emphasized as critical in the development of PAC program such as the development of common strategic approach, sharing of lessons learned, focus on fewer countries, address on sustainability and measurement of impact, increase success awareness, mobilization of human and financial resources, clarification of PAC roles and leadership, and collaboration with other donors.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 146800Abstract : Among the most neglected reproductive health care patients are women who have experienced complications from incomplete abortion. The medical care that is provided for these women are generally poor, with an unacceptable quality of communication and standards between health care providers and patients, as well as inappropriate referrals to family planning services following treatment. It was only recently that postabortion care became a priority in women's reproductive health programs. This book features a study that focus on how to reduce the number of death and morbidity associated with unsafe abortion. It describes operation research studies on postabortion care conducted in Africa, Latin America, and the Middle East. Chapter 2 presents the effect of husband involvement on postabortion recovery of patients and contraceptive use in Egypt, while chapter 3 reports on the association between incomplete abortion treatment and family planning services in Kenya. Chapters 4 and 5 present the service quality and contraceptive acceptance improvement in Bolivia and Mexico. Chapters 6-10 present a cost estimation of postabortion services in Mexico and Egypt, the role of midwives in a comprehensive postabortion care in Ghana, the roles of traditional midwives and postabortion care services in Mexico, and the ethical issues in postabortion care research.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 147353Abstract : The Association for Voluntary Surgical Contraception (AVSC) investigated the linkages between induced abortion and family planning services in a qualitative research project conducted in Colombia, India, and Turkey. Study methodologies included interviews with abortion and family planning service providers, record review, observation, and discussions with policy-makers. In general, abortion and family planning services were entirely separate. Although postabortion clients clearly wanted to avoid another unwanted pregnancy, they generally failed to receive family planning information and services. Abortion providers tended not to view contraceptive provision as their responsibility and, in many cases, had negative attitudes toward abortion patients. Services for abortion and family planning often were not available on the same day or in the same location. In some areas in India, where abortion patients were provided with contraception (IUD and sterilization), its provision was coerced as a condition for abortion. AVSC is working to raise awareness of the need to integrate service links between abortion and family planning programs.
Web site : http://www.affection.org/sante/asvc/www.igc.apc.org/avsc/site/Abstract : An informal study was conducted in order to reveal 1) whether family planning (FP) information and services are offered to women who receive abortions, 2) how provider attitudes and program design affect postabortion services, and 3) whether women are being pressured to accept specific methods in exchange for receiving a safe abortion. Profiles of the provision of FP and abortion services were developed for India, Turkey, and a country in South America (anonymous because abortion is illegal) through observation of client-provider interactions, discussions with providers and other knowledgeable sources, and reviews of records and written protocols. The factors which were found to specifically affect postabortion provision of FP services included service delivery and administrative structures; service standards and training in contraceptive technology; service delivery factors such as comfort at the site, continuity of care, timing of services, and integration of services; provider attitudes toward their clients, their own responsibility, timing, and financial considerations; and client factors such as orientation to services, misinformation, and attitudes towards sex and abortion. It is concluded that whereas the high incidence of abortion in the world signals a failure of health care systems to respond to women's reproductive health needs, the inadequacy of postabortion contraception services represents a double failure. It is recommended that providers, policy-makers, and funding agencies 1) learn what abortion clients need, want, and experience; 2) improve provider attitudes and knowledge; 3) overcome institutional barriers by integrating FP services with abortion services or, if this is not possible, by strengthening referral systems; and 4) improve service quality.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 108966Abstract : This report includes summaries of 22 interviews with health policymakers, family planning program managers, nongovernmental organizations, and women's health advocates in Ecuador, Honduras, and Mexico. The interviews provide country specific summaries of perceptions and suggestions regarding existing postpartum and postabortion programs and family planning (PPP/FP), barriers to improved services, and training and research opportunities. The aim is to provide information that would help in establishing new or expanding existing PPP/FP. It is not a service delivery guide. It does not describe the needs of postpartum women. Each section contains a country summary followed by interviews that may overlap in content. Charts detail the organization of services. The interviews were obtained by telephone in the Fall of 1996. An annotated bibliography reviews key articles in the literature on PPP/FP. The interviews reveal that the limited success of PPP/FP is due to lack of institutional or official support and poor integration of these programs into existing maternal and child health services. Other constraints are cultural barriers to FP, provider attitudes toward women seeking PPP/FP, a lack of adequately trained staff and updated service delivery guidelines, legal barriers, and limited client-centered services. PPP/FP is limited by inadequate facilities, equipment, and supplies. Information confirms the recommendations of the 1990 International Conference on Postpartum Contraception in Mexico and the 1993 International Workshop on Postpartum and Postabortion Family Planning in Quito, Ecuador.
Notes : Inglés/anglais/EnglishAbstract : This report includes summaries of 22 interviews with health policymakers, family planning program managers, nongovernmental organizations, and women's health advocates in Ecuador, Honduras, and Mexico. The interviews provide country specific summaries of perceptions and suggestions regarding existing postpartum and postabortion programs and family planning (PPP/FP), barriers to improved services, and training and research opportunities. The aim is to provide information that would help in establishing new or expanding existing PPP/FP. It is not a service delivery guide. It does not describe the needs of postpartum women. Each section contains a country summary followed by interviews that may overlap in content. Charts detail the organization of services. The interviews were obtained by telephone in the Fall of 1996. An annotated bibliography reviews key articles in the literature on PPP/FP. The interviews reveal that the limited success of PPP/FP is due to lack of institutional or official support and poor integration of these programs into existing maternal and child health services. Other constraints are cultural barriers to FP, provider attitudes toward women seeking PPP/FP, a lack of adequately trained staff and updated service delivery guidelines, legal barriers, and limited client-centered services. PPP/FP is limited by inadequate facilities, equipment, and supplies. Information confirms the recommendations of the 1990 International Conference on Postpartum Contraception in Mexico and the 1993 International Workshop on Postpartum and Postabortion Family Planning in Quito, Ecuador.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 139655Abstract : O capítulo I, "Aborto e infanticídio: práticas muito antigas"- O capítulo II, "Amores e dores, brigas e intrigas de Zulmas, Marizas, Florências...: processos judiciais" - O terceiro capítulo, "Aborto e infanticídio nos códigos penais e nos processos judiciais: a pedagogia de condutas femininas" - O capítulo quarto , "Um outro olhar sobre o corpo e práticas femininas: medicalização do aborto e infanticídio na cidade de Florianópolis" - O capítulo V, "O infanticídio na imprensa de Florianópolis.." O capítulo VI, "Mulheres, memórias e experiências..." - O capítulo VII, "A repercussão das disputas legislativas: a legislação sobre o aborto na imprensa", - VIII, "A prática do aborto sobre falas autorizadas: seus usos e abusos na mídia impressa brasileira", - O capítulo IX, "Corpos femininos em debate: aborto e infanticídio na imprensa de Florianópolis, uma história de controle e normatização", - o capítulo X, "Uma história de notícias: o debate sobre o aborto em jornais e revistas" - o capítulo XI, "Com a palavra, os leitores...", - O capítulo XII, "Em silêncio... as mulheres que decidam
Notes : Español/espagnol/SpanishAbstract : This prospective study investigated predictors of repeat pregnancies by 12 months after the delivery of a first child and their outcomes in inner-city adolescent mothers. The sample included four groups: those who had therapeutic abortions, miscarriages, full-term deliveries, and no repeat pregnancy. The therapeutic abortion group had more pregnancies before their first delivery (41%) than did full term (20%) and no repeat (15%), p less than .01. More delayed grade placement was found in therapeutic abortion -1.6 years (1.3) and full term -1.8 years (.9) than in no repeat pregnancy -.6 years (1.1), p less .001. Reading achievement scores were higher in no repeat 86.3 (17.1) than in full term 75.0 (16.5), p less than .05. School attendance was higher in no repeat (65%) than in therapeutic abortion (35%) and full-term (24%) p less than .01 groups. Depressive symptoms at baseline were higher among therapeutic aborters 18.9 (9.9) than among full term 10.2 (8.2) and no repeat pregnancy groups 12.2 (6.2). Logistic regression analyses identified delayed grade placement as the most important predictor of pregnancy outcome.PIP: The purpose of this prospective study of 120 black and Puerto Rican adolescent mothers recruited from an urban adolescent health center was 1) to identify multiple predictors of repeat pregnancies and their outcomes, and 2) to assess the relative contribution of these predictors to repeat pregnancies. Variables include demographic factors, frequency of sexual activity, contraceptive method used, occurrence of pregnancies before the first delivery, educational attainment, and levels of depressive symptoms by 3 weeks postpartum. Pregnancy outcomes included mothers who terminated their pregnancy, who delivered a live birth, and who had a miscarriage; data were available 12 months postpartum. The mean age was 17.13 years. 52% were black and 44% were Puerto Rican and of low socioeconomic status. Reliability of self-reports was 95%. 60.3% had no repeat pregnancy and 39.6% became pregnant during the 1-year followup, of which 15.3% had a therapeutic abortion, 6.3% miscarried, and 18.1% carried to term. There were no significant differences in the characteristics of the repeat and nonrepeat pregnancy groups. The procedure involved interviews at 2-4 weeks (time 1), 6-7 months (time 2), and 12-13 months (time 3). Measures for delayed grade placement, reading achievement, career aspirations and socioeconomic status of the family, and school attendance are described. Multivariate analysis, univariate analyses, and Duncan multiple range tests were conducted as well as logistic regression model construction. The significant predictors of pregnancy outcome (repeat pregnancy) were having 2 or more previous pregnancies. The abortion group was twice as likely to have had a pregnancy before the birth of the first child (41%) than the full-term (20%) and the no-repeat groups (15%). There were no differences in frequency of sexual activity or contraceptive method used. In the no-repeat and miscarriage groups, grade placement was less delayed. In the no-repeat group, reading achievement scores were higher than in the full-term group. There were no differences in career aspirations. 65% of the no-repeat group were attending school at time 2 while only 35% of the therapeutic and 24% of the full-term groups were attending school. Depressive scores were significantly higher for the abortion group. Delayed grade placement was the only predictor independently associated with the increased log odds of repeat pregnancy.
Notes : Inglés/anglais/English, nbsp;1577961Abstract : Métodos ; Marco local mexicano ; Grupos focales ; Resultados ; Conocimiento y uso ; Atributos preferidos ; Efectos secundarios ; Métodos de barrera ; Métodos masculinos ; Problemas de distribución de servicios ; Información erronea ; El aborto ; Sexualidad ; Análisis ; Referencias.
Web site : http://www.guttmacher.org/Abstract : Recent studies conducted by the World Health Organization's Special Program of Research, Development, and Research Training in Human Reproduction reveal high rates of unwanted pregnancy and illegal abortion in selected developing countries. In a Colombian study, 30% of women undergoing illegal abortion could not explain why they became pregnant, 40% believed that a woman bears sole responsibility for contraception, and almost 50% did not know when the likelihood for conception was greatest. In a study of pharmacists and herb vendors in Mexico, only 35% of those in the former group and none of those in the latter group could describe the mechanism of action of modern contraceptives, despite the fact that they were frequently consulted about pregnancy prevention. 25% of abortion seekers in a Cuban study had used no contraceptive method and the abortion ratio was highest (2 for every live birth) among women under 20 years old. The majority of the unwanted pregnancies occurring to contraceptive users involves use of an IUD that is not appropriate for young, nulliparous women. Finally, a study conducted in Tanzania found that a third of illegal abortions involved women under 17 years of age. 90% of whom had no knowledge of a family planning method.
Notes : Inglés/anglais/EnglishAbstract : Every year, more than 1 million adolescents become pregnant in the US, of which half bear their children to become adolescent mothers. Most of these young women are unmarried. Pregnancy among adolescents is an important problem in most developing countries. In Brazil's public hospitals, 15-25% of the mothers delivering babies are adolescents, mainly aged 15-19 years. The phenomenon in Brazil appears numerically stable for people 15-19 years old, with a trend of increase among people under age 15. Most pregnancies are unwanted, and involve medical, psychological, and social consequences. Those consequences of pregnancy are described, followed by consideration of the causes of unwanted pregnancy and gender issues. The disadvantages of teen pregnancy are more marked for multipara adolescents. The main immediate consequences of unwanted pregnancy are induced abortion, lack of prenatal care, personal and family disruption, and adoption and abandonment. Intervention policies are suggested to reduce the incidence of pregnancy during adolescence through sex education programs, services for the special care of adolescents, access to orientation and contraceptive methods, and support for the pregnancies to be carried until term.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : 1 Introducción, 2 La teoría, 3 Metodología utilizada, 4 Conocimientos científicos y legos, 4.1 Momentos fértiles y embarazo, 4.2 Aborto, métodos anticonceptivos y sus mecanismos de acción, 5 Fuentes de información e indicación de métodos anticonceptivos, 6 La comunicación en el proceso de toma de decisiones, 7 Conclusiones, 8 Para mejores servicios de salud reproductiva y sexualidad
Notes : Español/espagnol/SpanishAbstract : 23,000 maternal deaths per year in Latin America and the Caribbean reflects clearly the critical situation in this part of the world. Although we do not know exactly how many women die every year from pregnancy and childbirth, it is clear that the majority of these women are from low socioeconomic backgrounds, live in remote places and have a low level of education. Hemorrhages, infections and hypertension induced by pregnancy are the most common causes of maternal mortality. These pathologies can in many cases be prevented if there is a will for a positive change that involves different sectors related with health. The role of the scientific societies, and the role of the International Federation of Gynecology and Obstetrics through the "Save the Mothers" Project are of extreme importance, assuming a chief role and compromise that can help in the right way to be able to revert this situation. (author's)
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : The Robert H. Ebert Program on critical issues in reproductive health and population was established by the Population Council in 1988 to study important problems in reproductive health and their impact on women. Projects currently are under development in Mexico, Brazil, and Peru in the context of this program in the area of unwanted pregnancy and the consequences of unsafe abortions. A Working Group on Induced Abortion was formed in Lima in 1992 to promote exchange of ideas and mutual assistance among individuals and organizations working in this area and to encourage debate that would reach decision makers.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 094097Abstract : En el marco de la Campaña 28 de Septiembre, "Día por la Despenalización del Aborto en América Latina y el Caribe", llamada en Bolivia "Por el Derecho a Decidir", Católicas por el Derecho a Decidir (CDD-Bolivia) auspició el Seminario de presentación del Anteproyecto de Ley para Reglamentar el Aborto Impune, que se realizó en el auditorio del Colegio Médico Departamental de La Paz, el 5 de junio de 2001. El objetivo de CDD-Bolivia es abrir espacios de discusión sobre la necesidad de reglamentar el Artículo 266 del Código penal Boliviano (Aborto Impune) que no sanciona el aborto en casos de embarazo por violación, rapto no seguido de matrimonio, estupro o incesto, y cuando la vida de la madre está en peligro. El informe presenta las ponencias y debates, preguntas del público y respuestas de los y las panelistas.
Notes : Español/espagnol/SpanishAbstract : In countries such as Brazil, where abortion is prohibited, a range of drugs are used to induce menstruation. The present study investigated the prevalence and clinical correlates of unsuccessful use of drugs given to pregnant women to start menstrual flow. Enrolled were 6102 pregnant women at gestational weeks 21-28 presenting to the prenatal clinics of the Brazilian National Health Care System in 1991-95. 874 women (14.4%) responded affirmatively to the question, "In order to know if you were pregnant, did you take any medication to induce menstrual flow?" The frequency varied from 6-22% among the seven cities included in the study. The most commonly used drugs were herbal teas (41%), estrogens and/or progestogens (30%), and misoprostol (16%). Significant independent predictors of such medication use included unplanned pregnancy (odds ratio (OR), 4.3), low educational attainment (OR, 3.3), absence of husband or male partner (OR, 1.8), 1 or more living children (OR, 1.5), previous induced abortion (OR, 1.4), and current use of oral contraception (OR, 1.4). Herbal tea and misoprostol use were more strongly associated with unplanned pregnancy than medroxyprogesterone acetate; however, most drug use reported for menstrual induction appeared to be intended to avoid a possible pregnancy. Of concern is the effect of these medications and herbs on fetuses in cases where an abortion attempt is unsuccessful.
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?vol=57 viewtype=issue iss=2#S001078249800004Abstract : It is estimated that 90-95% of the nearly 30,000 maternal deaths each year in Latin America are preventable with available knowledge and technology. The majority of women who die during pregnancy, delivery, or the postpartum period are of lower social status and/or live in rural areas with limited access to health services. The disadvantaged position of women in society, exemplified by their restricted access to education, training, and employment opportunities, and their double work day in and outside of their home, is an important aspect of maternal mortality that must be addressed if programs to reduce maternal mortality are to achieve maximum impact. Although maternal mortality rates have declined in some countries of the region, they continue to be very high in most countries of Latin America. In 1987, the maternal mortality rates for Paraguay, Peru, and Bolivia were 270,303, and 80/100,000 live births, compared with just 4 in Canada. Differences in maternal mortality rates in countries at different levels of development suggest that availability of resources and the quality of accessibility of services to different population sectors are important factors. There is usually a direct correspondence between adequate prenatal care and attention during delivery and low maternal mortality rates. Knowledge of maternal risk factors of various kinds and implementation of programs to control or eliminate them can be useful tools in preventing maternal deaths. The most frequent direct obstetrical causes of maternal death in developing countries are induced abortion, hemorrhage, infection, obstructed delivery, and eclampsia. Maternal death often is the final result of poor reproductive health and wasting processes produced by decades of malnutrition, fatigue, and poverty. An estimated 5 million abortions occur in Latin America each year, with risks depending on such variables as the method used and the skill of the practitioner, the gestational age, the health of the woman, and the availability and quality of medical care. Although the causes of maternal mortality are multiple, they are generally concentrated in a few of greatest frequency, which facilitates planning basic control strategies. Only when the multiple causes of maternal mortality ; medical, biological, economic, and cultural ; are combined as a group can significant declines in maternal mortality be expected. Maternal mortality is an important indicator of the accessibility, coverage, and quality of health services, and also of social development and the position of women in society. General strategies should include improving the basic level of health of the population. Specific strategies should include sex and reproductive education for the general population, use of the risk focus for women, organization of health services according to levels of care, improved training of health personnel, and provision of supplies for care during pregnancy and delivery.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 077660Abstract : The object is to study reproductive health care governmental programs and the preventive practices that women from the City of Buenos Aires (CBA). Reproductive health care is defined as care during pregnancy, childbirth, postpartum, contraception, cervical and breast cancer, post-menopausal disorders such as osteoporosis, and sexually transmitted infections including HIV/AIDS. In the first section Health Care Programs related to reproductive health care prevention are described, as well as in depth interviews to persons responsible for CBA Programs. The results of a quantitative telephone survey that questioned women aged 15 to 69, living in CBA, about their reproductive and preventive practices, are examined in the second part.
Web site : http://maestria.rec.uba.ar/revistas/Seis/principal6.htmmaestria.rec.uba.arAbstract : En este documento se proporciona información general que puede ser de utilidad en dichas gestiones. Contiene datos básicos y declaraciones clave de la comunidad médica y de organismos de las Naciones Unidas sobre las medidas que pueden prevenir las muertes derivadas del aborto en condiciones de riesgo. Dichas medidas incluyen: o promover los derechos de la mujer, así como su salud y condición; o garantizar acceso a la anticoncepción; o prestar servicios de aborto seguro, incluida la consejería; o implantar sistemas de referencia; o despenalizar el aborto y liberalizar las leyes restrictivas.
Web site : http://www.ipas.org/publications/es/MEDADV_S02_es.pdfAbstract : The main objective of this study is to test the hypothesis that by improving family planning services, and by focusing them on women identified as having a high risk of induced abortion, it is possible to achieve a significant reduction in abortion rates in areas known for their high abortion incidence. Samples were selected and interviewed from three low-income area of northern Santiago: 1613 women in Pincoya, 1620 in Cortijo, and 1674 in Quinta Bella. Data collected were analyzed using multivariate analysis. Overall, this study demonstrated that increasing the prevalence of contraceptive use among women identified as having a high abortion risk does reduce its incidence. More personalized family planning services, in association with risk detection, can succeed in lowering abortion. The population who received the benefit of the full intervention and who subsequently increased their use of effective contraception showed the clearest decline in abortion rates. An effective intervention of improved family planning services with personalized inputs, directed at women with high risk of abortion, can be successful in lowering abortion incidence in populations of low socioeconomic status, especially in contexts where abortion is illegal.
Notes : Español/espagnol/SpanishAbstract : The continued illegality of induced abortion in Latin America has led to substantial, preventable maternal mortality and morbidity. The first strategy for preventing unsafe clandestine abortion is to reduce the incidence of unwanted pregnancy through measures such as improved access to effective contraception, post-abortion family planning counseling, health education campaigns aimed at promoting condom use among young people, involvement of men in family planning decision making, biomedical research on safer and more effective male and female contraceptive methods, and empowering women to demand the use of condoms or avoid unwanted intercourse. The second strategy is to reduce abortion-related mortality and morbidity through more effective clinical management of incomplete illegal abortions, introduction of menstrual regulation services, formation of women's solidarity groups aimed at discouraging the practice of self-induced abortion, and, ultimately, abortion legalization.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 107639Abstract : The main objective of this study is to test the hypothesis that by improving family planning services, and by focusing them on women identified as having a high risk of induced abortion, it is possible to achieve a significant reduction in abortion rates in areas known for their high abortion incidence. Samples were selected and interviewed from three low-income area of northern Santiago: 1613 women in Pincoya, 1620 in Cortijo, and 1674 in Quinta Bella. Data collected were analyzed using multivariate analysis. Overall, this study demonstrated that increasing the prevalence of contraceptive use among women identified as having a high abortion risk does reduce its incidence. More personalized family planning services, in association with risk detection, can succeed in lowering abortion. The population who received the benefit of the full intervention and who subsequently increased their use of effective contraception showed the clearest decline in abortion rates. An effective intervention of improved family planning services with personalized inputs, directed at women with high risk of abortion, can be successful in lowering abortion incidence in populations of low socioeconomic status, especially in contexts where abortion is illegal.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : Cuba has been able to achieve some things that few Western countries have been able to achieve: equal access to health services for the entire population and equity in health status. After the 1959 revolution, community organizations conducted a census to obtain baseline demographic and epidemiologic data about the population, a literacy campaign, and sanitary and immunization campaigns. Polyclinics provided various social, environmental, and community health services free of charge. They were geographically distributed. Cuba instituted its neighborhood/home clinic model in 1984, a holistic, family, and neighborhood approach to comprehensive health care of the community. The family physician and nurse live in the neighborhood. Health education and health promotion are central to this model. The physicians and nurses are expected to conduct research and to present their findings at congresses or in journals. Cuba's infant mortality rate is not much higher than that of the US (1993, 9.4 vs. 8.3). Major causes of death in Cuba match those in developed countries, mainly heart disease and cancer. More than 95% of pregnant women attend their first prenatal visit during the first trimester. They receive prenatal care monthly unless they have a high-risk pregnancy when they receive prenatal care once a week. Infants receive well-baby care once a month. Sex education is available to everyone. All primary care facilities provide contraception. Nevertheless, the induced abortion rate is high, which concerns the government and health providers. Key effects of the economic hardship Cuba faces caused by the fall of the Soviet Union include food rationing, emigration, increased use of traditional herbs, lack of exchange of professional literature between the US and Cuba, and lack of enough paper to continue publications of medical and nursing journals. Cuba has prioritized health and education over economic development.
Web site : http://www.tandf.co.uk/journals/titles/07399332.aspAbstract : The First Meeting of Investigators on Induced Abortion in Latin America and the Caribbean, held in Bogota in November 1994, was attended by 135 researchers, legislators, and institutional observers from 22 nations. 60 works were presented in seven sessions covering abortion incidence; abortion determinants and associated factors; abortion services and practice; hospital care and costs of abortion; the impact of abortion; social concepts and social movements; and methodologic aspects. A summary of abortion law in the region and presentations on ethicoreligious aspects and on the effects of legalization on administration of abortion services were also included. At the close of the meeting, the participants divided into five working groups to prepare conclusions and recommendations concerning incidence and legislation; adolescence, undesired pregnancy, and abortion; hospital care and abortion costs; contraception and abortion; and maternal mortality and abortion. In addition to the recommendations formulated by the five working groups, recommendations were made for a research agenda and for a political agenda, and the attending legislators outlined a series of recommendations addressed to the Latin American Parliament. The conclusions and recommendations of the different groups are described in this document.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 108153Abstract : PIP: As part of the observance of the Day for Decriminalization of Abortion in Latin America and the Caribbean, a meeting of 50 journalists representing 18 countries was held in Mexico City from September 5 to 8. The journalists discussed consequences in their countries of the illegality of abortion, and agreed that it is the most serious reproductive health problem in the region. The journalists were not necessarily active in women inverted question marks organizations working for legal abortion, but they had all demonstrated sensitivity to the problem. The meeting demonstrated the utility of mass media in the formation of a culture of respect for reproductive and sexual rights. The example of the decriminalization vote in Guyana, which was obtained by a nonpartisan vote in Congress with full citizen support, shows what can be achieved with organization, opportunity, and hard work.
Web site : http://www.gire.org.mx/Abstract : Síntesis del análisis y elaboración del diagnóstico de la realidad sociopolítica y la situación de los derechos sexuales y reproductivos en América Latina que realizaron periodistas y ONG's del continente. Este evento contempla la articulación de los derechos reproductivos con los medios de comunicación electrónicos
Notes : Español/espagnol/SpanishAbstract : Introduction : Democracy, dictatorship and gender rights ; Three normative models of gender and the state ; Military rule, civil code modernization, and women's property rights ; Completing the agenda : democratic transitions and family equality ; The family, the Church, and the state in the struggle to legalize divorce ; Policy legacies and policy stalemate in the abortion debate ; A disaggregated approach to gender ; Feminist lobbying around the new Brazilian civil code ; Divorce deliberations in the Chilean Constitutional Commission.
Notes : Inglés/anglais/EnglishAbstract : Primera parte - Problemas sensibles y estrategias metodológicas: a proposito de la investigación sobre aborto inducido/ Lucero Zamudio y Norma Rubiano - Introducción ; 1. El problema de la representatividad y el diseño de la muestra estadística para la recolección de la información cuantitativa ; 1.1. Población de muestreo ; 1.2. Marco de muestreo ; 1.3. Tamaño de la muestra ; 1.4. Distribución de la muestra ; 1.5. Método de muestreo ; 1.6. Selección de la muestra ; 1.6.1. En ciudades estratificadas ; 1.6.2. En ciudades no estratificadas ; 1.7. Selección de la muestra de campo ; 1.8. Procedimiento de expansión ; 1.9. Cálculo de errores de muestreo ; 2. El problema de la significación social y el diseño de la muestra intencionada para la recolección de la información cualitativa ; 3. El problema de la confiabilidad y el diseño de los instrumentos y estrategias de recolección de la información ; 4. Los instrumentos de recolecci6n y el tipo de información ; 4.1. El cuestionario de autodiligenciamiento secreto y consignación reservada ; 4.2. La historia de vida ; 4.3. El relato temático ; 5. La organización del trabajo de campo y los instrumentos de control y seguimiento ; 5.1. Recolección de información cuantitativa ; 5.1.1. Selección y entrenamiento de recolectores ; 5.1.2. Mecanismos de supervisión ; 5.1.3. Duración neta del diligenciamiento ; 6.1. El calculo demedidas y la perspectiva temporal ; 6.1.1. Medidas longitudinales ; 6.1.2. Medidas de momento. Observación en un mismo ano calendario ; 6.1.3. Otras medidas ; 6.1.4. Indicadores obtenidos a partir del cuestionario del diligenciamiento secreto y consignación reservada ; 6.2. El análisis de399 contenido y la captación de sentido ; 6.2.1. La historia de vida ; 6.2.2. El relato temático ; 6.3. El problema del procesamiento de la información cualitativa - Bibliografía. Segunda parte ; El aborto, el debate publico y la prensa nacional. aproximaciones o metodológicas / Mara Viveros ; 1. ¿Por qué se seleccionó el análisis de la prensa nacional para abordar el tema del aborto? ; 2. Definición del corpus del análisis y creación del archivo físico de noticias ; 3. Análisis de contenido ; 3.1 Tipos de variables y categorías ; 3.1.1. Variables de identificación y presentación ; 3.1.2. Variables analíticas ; 4. Constituci6n de la base de datos ; Bibliografía - Tercera parte ; Género, decisiones ajenas y sentimientos propios: apuntes metodológicos sobre el uso de la entrevista en la investigación social / Hernando Salcedo Fidalgo - - Presentación ; 1. La entrevista, el enfoque biográfico, las ciencias sociales y la salud ; 2. Las dificultades metodológicas: una vía hacia múltiples reflexiones ; 2.1. Cierta idea de muestreo ; 2.2. La captación de casos ; 2.3. La indagación de la vida sexual ; 2.4. Las demandas ; 3. El meollo del análisis discursivo ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : The National Report on Population prepared by Bolivia for the 1994 World Population Conference in Cairo called attention to the economic and social problems of the general Bolivian population. Despite scarcity of data, it is known that the status of the Indian population of Bolivia is relatively disadvantaged. Many indigenous peoples in the lowland area and in the rural highlands lack medical services and basic health infrastructure. Health professionals are not trained in ethnocultural aspects of care, and little respect or recognition is given to indigenous traditions of health care. High illiteracy rates attest to the marginal status of indigenous groups. Bilingual education is limited, and curricula are not geared to the special needs of indigenous groups. Despite their strong identification with the land, many indigenous groups lack secure title to their ancestral territories. Invasions or alienation of lands encourage migration, placing the population at risk of cultural disintegration. Indigenous populations with nomadic ways are in danger of extinction as they fail to encounter free lands. Invasion of indigenous territories by impoverished nonindigenous groups threatens ecological balance. Many indigenous groups, especially the smaller ones, are vulnerable to pressures from outside and are in need of assistance tailored to their special needs. All cooperative interventions with indigenous groups must respect their identity and traditions. The UN Population Fund has provided technical and financial assistance to Bolivia since 1972 to reduce maternal and child morbidity and mortality, adolescent pregnancy, and abortion, to improve knowledge and attitudes related to reproductive health, and to improve the conditions of women.
Notes : Español/espagnol/SpanishAbstract : En los últimos años en el distrito de Santiago, provincia de Veraguas en la República de Panamá, se ha registrado una serie de problemas sociales, entre los cuales está el aborto, situación ésta que afecta directa e indirectamente la salud de la mujer, e inclusive provocarle la muerte, cuando el procedimiento se realiza sin la intervención de personal profesional o con recursos inadecuados. Este fue un estudio analítico - descriptivo que trató de conocer las causales del aborto, definir las consecuencias de este en la salud de la mujer y señalar las posibles soluciones a este flagelo. Se estudiaron 6 casos en adolescentes menores de 20 años. De estos, 67% fueron abortos clandestinos, definido así por las complicaciones presentados en este (hemorragia, infecciones, hinchazón) y otro 33% se definió como aborto por accidentes (caída, golpe, esfuerzo físico excesivo). Entre las causales para provocarse el aborto estuvieron: temor a confesarle a los padres el embarazo (50%), por problemas socioeconómicos (33%) y otros como falta de apoyo de la pareja y el deseo de terminar la escuela (17%). La institución de salud en donde se realizó el estudio, coordina programas educativos de salud, para los jóvenes de todas las edades. Los programas incluyen charlas, conferencias y simposios, ofrecidos por un personal especializado. Además, se brinda charlas y capacitaciones a los padres de familia , para que desde su hogar sirvan de agentes multiplicadores y refuercen conductas sexuales responsables. Con la planificación familiar, la orientación de los padres y de los docentes , podría minimizarse la práctica del aborto que atenta contra la vida de la mujer y del niño que lleva dentro.
Notes : Español/espagnol/SpanishAbstract : The legislative and judicial aspects of abortion have been relatively neglected in Bolivia, where the Napoleonic Code remained in effect until recently. A commission meeting in 1960 to consider revision of abortion laws unfortunately limited its composition to lawyers, with no participation of physicians or practitioners of the other relevant disciplines. Abortion law should be evaluated in the light of recent findings in genetics, as well as of data from studies of the psychosocial problems of children born after their mothers were denied legal abortions. In cases in which chromosomal anomalies give the fetus no chance for normal development, abortion should be permitted for eugenic reasons in order to avoid criminal abortions. Therapeutic abortion, necessary to save the life of the mother, perhaps requires no further justification. A permanent commission should be formed including representatives of the medical and legal fields to advise on abortion legislation in Bolivia.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 104151Abstract : Abortion has continued to be a medico-social problem in both developed and developing countries despite the availability of contraceptive methods and the diffusion of sex education and messages on responsible parenthood. Various factors identified as having a negative influence on contraceptive usage are also negative influences on efforts to prevent abortion. Myths and superstitions regarding sexuality, some religious beliefs, irrational fears and opposition, false modesty, masculine prejudices, ignorance of female anatomy and physiology, female dependence, and some cultural beliefs may impede acceptance of contraception, leading to unwanted pregnancy and abortion. Bolivia, one of the poorest countries of Latin America, has one of the highest birth rates. Almost half of the estimated maternal mortality rate of 48/1000 live births is related to abortion. The average Bolivian woman has 5 children although the majority desire only 3. A survey of Bolivian women hospitalized with abortion complications revealed that almost half did not use contraception because of lack of knowledge. Respect for reproductive rights demands knowledge of family planning and abortion, topics that are controversial but of great interest for the quality of life and health of the Bolivian population. Induced abortion has historically been the last desperate resort for couples lacking access to contraception, but abortion is psychologically traumatic for the woman. Health professionals must be aware that unconscious motivations may affect use of family planning. Abortion may be a form of self-punishment in single women or it may signify aggression against a husband considered inadequate to assume the paternal role.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 104150Abstract : Although abortion is illegal in Colombia and condemned by the Catholic Church to which most of the population adheres, the actual number of abortions is believed to surpass half a million annually. This work analyzes the religious conflict of women who choose abortion despite the moral sanctions of the church. The first chapter presents statistical results of recent research on attitudes toward and incidence of abortion in Colombia. The second chapter examines past and present legal dispositions regarding abortion in Colombia and the influence of Catholic moral teachings on legislation. The next chapters examine Catholic doctrine concerning sexuality, women, and procreation, and the evolution of Catholic doctrine on the theme of abortion. The chapters identify the theological basis of doctrine in these areas through analysis and commentary on writings from the early church to the present. An attempt is then made to define the religious problem of women who abort and of the persons attending them. The results of three surveys are presented. In the first, 151 priests responded anonymously to a questionnaire concerning their treatment of abortion in confession in relation to the official position of the church and their personal views of church doctrine regarding abortion. The other two surveys sought the views of women working in two nongovernmental organizations that attend women with incomplete abortions, and of the women themselves. The objectives of the surveys were to determine whether the workers and women knew and understood church doctrine concerning abortion and the penalties for violating church doctrine, whether they perceived their actions as sinful, and if so how they reconciled their actions with church teachings. The final chapter examines the writings of some contemporary Catholic theologians whose views differ from official church doctrine. The writings are interpreted in the light of recent medical research and propositions in the field of bioethics.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103225Abstract : A survey of Colombian priests, abortion practitioners, and women undergoing treatment for abortion complications concerning their perceptions of religious aspects of abortion is presented in the context of the history of Church teachings on abortion. The work begins with a review of data on the incidence of induced abortion in Colombia. The point is made that nearly all abortions and abortion practitioners in Colombia are Catholic. A chapter follows on the legal and juridical status of abortion in Colombia. The philosophical postulates underlying the criminalization of abortion and the influence of Catholic teachings are examined. The traditional teachings of the Church are then examined on three fundamental themes that affect the thoughts, feelings, and actions of Catholic women: perceptions of sexuality, of women, and of procreation. Precise knowledge of these elements of Catholic doctrine and of the theological principles on which they are based is of great usefulness for understanding the religious problem of women who abort. The evolution of Catholic doctrine on the theme of abortion from the Old Testament to the current day is examined through analysis of texts, with particular attention to the theological position of the Church concerning whether or not certainty exists that a human person with full human rights exists during the process of gestation. 151 priests were surveyed on their treatment of abortion during the confession. 56 abortion practitioners and over 1200 women being treated for abortion complications were surveyed concerning their perceptions of religion and their motives for seeking abortions despite church teachings. The final section presents proposals by respected moral theologians for a new Catholic moral perspective on abortion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 137485Abstract : El objetivo de este estudio fue identificar los procesos sociales relacionados con el maltrato médico hacia las mujeres que llegan a los hospitales con complicaciones de un aborto. Para ello se llevó a cabo un estudio cualitativo en servicios públicos de salud en una entidad federativa de la república mexicana, en 2004. Se realizaron 31 entrevistas en profundidad a médicos varones vinculados con la atención de procesos reproductivos. Se indagó en torno a las percepciones y prácticas respecto al aborto y a las mujeres que demandan atención por complicaciones de un aborto.
Web site : http://www.isciii.es/htdocs/redes/investen/LibroPonenciasCualitativa.pdfAbstract : This article discusses the roles of social workers, psychologists, nurses, and physicians concerning abortion and their participation in assisting legal abortion in Brazil for women victims of sexual violence. The working hypothesis was that many health professionals might oppose such programs on the grounds that they involve interruption of pregnancy. This qualitative study interviewed 12 health professionals and two program managers in the State of Paraíba and the Federal District (Brasilia). The health professionals' representations of abortion ranged from a moralist and religious concept to the promotion of women's rights and autonomy. The health professionals faced obvious challenges in dealing with the abortion issue. Their experience in treating women had fostered changes in values and a reinterpretation of the meaning of their own practice. (author's)
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0102-311X2003000800021 lng=en nrm=isoAbstract : El Plan Estratégico de Salud de Lucha contra la Pobreza para el período 1997 - 2002 es el principal instrumento de política del sector. El Programa Nacional de Salud Sexual y Reproductiva, conducida por la Unidad Nacional de Atención a la Mujer y el Niño, es el principal instrumento de política y orientación programática del sector para enfrentar la situación de la salud sexual y reproductiva de adolescentes, mujeres y varones adultos del país. El Programa es el marco de los Subprogramas de Salud Materna y Merinatal, Atención Integral a la Mujer no Gestante y la Planificación Familiar, Prevención y Control del Cáncer Ginecológico, Promoción de la Participación Masculina en actividades de Salud Sexual y Reproductiva, Atención Integral a la Salud de los Adolescentes, y Control de las ETS/SIDA.
Notes : Español/espagnol/SpanishAbstract : Iniciativa mundial de tres años para promover el acceso a la atención del aborto seguro. El programa se centra en 10 países en desarrollo en África, Asia y América Latina.
Web site : http://www.ipas.orgAbstract : Introducción General / Mónica Gogna ; Estudios de caso: programas de salud reproductiva para adolescentes en Buenos Aires, Argentina / María Alicia Gutiérrez, Mónica Gogna y Mariana Romero ; Estudio de casos: programas de salud reproductiva para adolescentes en México, D.F. / Claudio Stern y Diana Reartes ; Estudo de caso: programas de saúde reproductiva para adolescentes em Sao Paulo, Brasil / Maria Coleta Oliveira, Margareth Arilha, Estela Maria G.P. da Cunha y Jucilene Leite da Rocha
Web site : http://www.cedes.org/informacion/ci/catalogos/index.htmlwww.cedes.orgAbstract : Este documento de trabajo presenta los resultados de un estudio en la ciudad de México que se realizó en el marco de una programa de investigación multicéntrico, cuyo objetivo fue conocer los principales políticas y programas públicos en el campo de la atención a la salud reproductiva de las y los adolescentes en las tres ciudades más grandes de América Latina: Buenos Aires, México y San Pablo. Se presenta el contexto socioeconómico, demográfico y epidemiológico de la población adolescente del Distrito Federal de México y se hace un recuento del sistema de salud en ese país y de los antecedentes de los actuales servicios de salud reproductiva para adolescentes. Se incluye una caracterización de los servicios, pertenecientes al primer y segundo nivel de atención, donde se realizó el trabajo de campo y se aborda la perspectiva de los proveedores de servicios respecto de los principales problemas de salud reproductiva de las y los adolescentes, y el punto de vista de los adolescentes en relación con los servicios ofrecidos. Incluye: Introducción ; Contexto socioeconómico, demográfico y epidemiológico de la población adolescente en el Distrito Federal ; Situación general: población, desigualdad y pobreza ; Escolaridad, actividad económica y desempleo 130 ; Sexualidad, nupcialidad, fecundidad y anticoncepción ; Perfil epidemiológico ; El contexto de atención a la salud del adolescente ; El sistema de salud en México ; Antecedentes de la atención a la salud reproductiva de los adolescentes ; Programas seleccionados para el estudio ; Análisis de los documentos de los programas seleccionados ; Obstáculos y facilitadores en la formulación e implementación de los programas ; La influencia de la COnferencia de El Cairo ; Descripción del trabajo de campo ; Caracterización de los servicios ; En Buen Plan ; Programa Educativo para Adolescentes (PREA) ; La salud de los adolescentes a partir de perspectivas de los proveedores ; La perspectiva general de los proveedores de servicios ; Autorización paterna ; Anticoncepción ; Embarazo ; Sexualidad ; Violencia ; Drogas, alcoholismo y otras adicciones ; Aborto ; La salud a partir de la perspectiva de las y los usuarias/os ; La vinculación con el servicio ; Motivos de asistencia ; Principales problemas de salud ; Satisfacción con la consulta ; Privacidad y confiabilidad ; Actividades de información, educación y comunicación ; Consideraciones finales ; La influencia de la Conferencia de El Cairo ; Comparación entre lo que se dice y lo que se hace ; Recomendaciones ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Induced abortion remains a relatively uncharted research topic in medical demography, social science, and to a lesser extent, in epidemiology. Up to 20% of the 500,000 maternal deaths which occur annually throughout the world, however, may be a consequence of complications of unsafe abortion procedures. The UNDP/UNFPA/WHO/World Bank Special Program of Research, Development, and Research Training in Human Reproduction started a number of studies in 1989 in developing countries on the determinants and consequences of induced abortion. The program's research has produced a wealth of data, with many countries taking important steps to change abortion policy in the interest of improving reproductive health. For example, a study in Mauritius of women hospitalized for abortion revealed that 20% of them had not been using a method of contraception when they became pregnant; a motion was subsequently tabled in the National Assembly to decriminalize abortion. Another study in Chile showed the incidence of induced abortions to be generally under-reported by women and that interventions based upon sound policy can reduce their incidence and improve reproductive health.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 099577Abstract : This document presents the final report of the INOPAL project which aimed to strengthen the postpartum and postabortion family planning program in Hospital Escuela, Infant Maternal Wing, in Honduras. The specific objectives of the project were: 1) restart female postpartum and interval voluntary surgical sterilizations (AQV) services; 2) determine the needs of the department in order to organize the family planning and outpatient clinic services; and 3) develop and try out a model of family planning hospital services and outpatient clinics that will respond to the needs of users. Specific activities undertaken were hiring and training of personnel, management of equipment and instrumentation, provision of educational material, and other arrangements. To measure the impact of the implemented strategies, periodic analysis were carried out through service statistics and interviews. Results presented reflect the service statistics for AQV procedures and IUD insertions; family planning educational activities; characteristics of postpartum patients, prenatal attention received by patients; and information received on family planning. Data during pre-intervention and final evaluation are presented. Conclusions and recommendations drawn from the evaluation are also presented.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 142877Abstract : Nearly 200 million women become pregnant around the world each year. The United Nations estimates that one-third of these pregnancies are unintended and unwanted.1 Of these, many result in the death of the mother. How many women would be alive today if contraceptives and family planning services had been available to prevent these pregnancies? Thanks to a grant from the David and Lucile Packard Foundation, the Global Health Council has compiled a statistical analysis designed to detail the cost in women's lives and health as a result of unintended pregnancy. At the 1994 International Conference on Population and Development (ICPD) in Cairo, 179 nations pledged to improve the health of the world's women. How well has the world done in meeting this commitment? While the goal of this analysis is to provide an accurate metric for assessing the consequences of unintended pregnancy, it should not be forgotten that every statistic included represents the life of a woman or girl, a wife, a mother, a daughter or a sister. These statistics, and the lives they represent, shed light on a hidden and intransigent epidemic of premature death and disability that plays itself out in thousands of communities every minute of every day. The women, whose lives are represented in the analysis detailed in this report, and whose stories appear throughout this document, were victims of a twofold tragedy: they wanted to avoid pregnancy and they wanted to live. It is a somber reflection of the world's priorities that they were unable to do either.
Web site : http://www.globalhealth.org/assets/publications/PromisesToKeep2.pdfwww.globalhealth.org/assets/publications/PromisesToKeep.docAbstract : Quadro de projetos sobre o tema aborto acompanhados pelo CFEMEA que estão tramitando no Congresso Nacional
Web site : http://www.cfemea.org.br/pdf/proposicoesabortocn.pdfAbstract : Objetivos de la propuesta ; Mediciones a nivel macro y micro de la cobertura de los servicios ; Cobertura de los servicios ; Conceptos básicos sobre calidad de atención ; Evaluación de la calidad ; Elementos e indicadores de calidad en planificación familiar ; Aspectos metodológicos ; Indice de calidad ; Bibliografía ; Anexo.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This work presents analyses and proposals prepared by women's groups to protect the needs of women in Mexico City's new penal code. Five priority themes are discussed: victim's rights, domestic and sexual violence, rights of minors, abortion and the right to health, and discrimination.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 168154Abstract : A survey of 240 randomly selected female students (average age, 19.9 years) at the State University of Campinas in Sao Paulo, Brazil, provided comprehensive information about the physical, psychological, and psychosexual dimensions of adolescence. Over half reported negative feelings or indifference to body changes associated with puberty and 54% stated they did not receive information on sexual development from their parents. The average age at menarche was 12.3 years. 79% reported persistent menstruation-related discomfort (e.g., cramps, moodiness). Virginity until marriage was considered essential by 14%; to 42%, it made no difference in the context of a loving relationship. 44% of female students had experienced intercourse; the average age at initiation of sexual relations was 17.6 years. 78% stated the idea of having a child was fundamental or agreeable. 84% of sexually active students were using contraception (including unreliable methods such as rhythm). Although 65% viewed abortion as a theoretically acceptable option, only 8% indicated they would make this choice and just 6% had had an abortion. 6% of students considered themselves at risk of AIDS. Most students characterized their relationship with their parents as good, yet they preferred to talk to friends or siblings about sexual matters. Although these students appear to have satisfactorily negotiated most of the developmental tasks of adolescence, there was some evidence of failure to resolve independence-dependence conflicts.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 125830Abstract : A random sample of 268 male freshmen of mean age 19.6 years at the State University of Campinas in the state of Sao Paulo, Brazil, responded to a questionnaire in 1990 on aspects of their sexuality from the beginning of their adolescence. Topics such as physical changes, first ejaculation, masturbation, homosexual manifestations, and sexual practices were investigated, as well as present attitudes toward virginity, intercourse, birth control, abortion, and AIDS prevention. The quality of their relationships with parents was also surveyed. The sample comprised 31% of the entering students for that year. 32% were living with their parents. Most respondents reported satisfactory development in most areas of their sexuality, as well as a good relationship with their parents. However, they found it very difficult to discuss sex within their family circles. 32% were still virgins at the end of their freshman year. 28% and 20% had homosexual manifestations during childhood/early adolescence and currently, respectively, including fantasies, attraction to men/boys, physical contact with men/boys, and sexual intercourse with men/boys. 38% of the sexually active men reported taking no measures to prevent pregnancy and HIV transmission.
Web site : http://www.findarticles.com/p/articles/mi_m2248/is_n118_v30/ai_17150121Abstract : Although the Second National Abortion Survey Gallup found that 88% of Mexicans believe abortion should be a woman's choice and 77% think the decriminalization of abortion would substantially reduce maternal mortality, abortion in Mexico remains governed by a 1931 criminal code. The survey was initiated by the Information and Reproductive Choice Group to provide information for the 1994 national debate on abortion. Supporters of legal abortion note that poor women resort to unsafe pregnancy terminations without regard to the criminal status of abortion. According to Patricia Mercado, co-founder of the Reproductive Choice Group, "You can be against abortion, but still allow it to be decriminalized. In other words, criminalization does not prevent women from having abortions, it only makes then have then in bad conditions. The idea is that women should be able to decide freely without risking problems of health and social justice." Despite public support for abortion legalization, survey results indicate widespread fear about acknowledging the existence of clandestine abortion. An estimated 1-2 million illegal abortions occur each year in Mexico, yet only 26% of survey respondents would admit to knowing a woman who had undergone illegal abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 096764Abstract : This article focuses on the Mexico City policy which US President George W. Bush has reimposed through a memorandum on January 22, 2001. As noted, Mexico City policy is a set of restrictions on overseas family planning programs, named so for the UN conference at which the Reagan administration announced the policy
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 170579Abstract : Annotation. Examines the work of the resolute women of the Puerto Rican independence movement. The first woman mayor of San Juan, Felisa Rincon, discusses problems of delinquency and crime within the culture, and how women are contributing to a solution. Feminism and women's rights in the areas of divorce, abortion and employment are examined, along with racism experienced by Puerto Ricans in the US.
Notes : Inglés/anglais/EnglishAbstract : The purpose of this report is to present an overview of results from the Puerto Rico Reproductive Health Survey (PRRHS), 1995-96. The PRRHS was carried out from November 1995 to July 1996, and is the eighth survey of women of reproductive age conducted in Puerto Rico." Information is provided on sample characteristics, characteristics of respondents, knowledge and use of contraceptive methods, maternal and child health, health care, and young adults.
Notes : Inglés/anglais/EnglishAbstract : This MotherCare working paper is concerned with summarizing the results of an in-depth study of 230 women's reproductive health knowledge, beliefs, and practices in urban and periurban areas of Cochabamba, Bolivia, in 1991. Also included are the recommendations for future MotherCare interventions which were discussed in a subsequent conference. The study objectives were to describe the population's perceptions of and behavior toward the formal health care systems and provide useful information for future intervention strategies to improve maternal and neonatal health. The analysis was conducted individually, by reproductive stage, and as a whole in order to provide an explanation for the way in which the Quechua-Aymara or ethnic groups understand the physiology of the human body and reproduction and to compare it with the biomedical model of the formal health system. The report includes sections on: study methodology, ethnophysiological model, and findings by stage of the reproductive cycle (pregnancy childbirth, birth of the placenta, the immediate postpartum period, newborn care, breast feeding, family planning, abortion, traditional birth attendants (TBAs) and other findings, and recommendations for project interventions. Appendices include a chart of the beliefs and practices of the Quechua-Aymara women during various stage of the reproductive cycle with emphasis on time and space, and strategy materials and the questionnaire. The sample population included users and nonusers of health services and TBAs. The findings were that the Quechua-Aymara woman is healthy when her important body parts are located and moving correctly according to warm or cold elements, and when she is well nourished and strong with an abundance of blood. A measure of health is whether she delivers her children without problems. In a home birth the infant receives little attention following the delivery; anise tea is given and breast feeding is delayed several days. Husbands assisted during childbirth. TBAs sometimes helped. Practices such as the use of oxytocin were not always beneficial. Family planning is accepted along with induced abortion. Barriers to use of services among nonusers were the perceived mistreatment of women, care that interfered with their modesty and ethnophysiology, lack of information given at clinic visits, and costs of services in time and money. 7 problems among the population practices or conditions in the health sector were targeted for intervention.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 073192Abstract : Neste artigo, analisarei os argumentos utilizados por médicos, advogados, promotores e juízes para justificar a moralidade ou a imoralidade do aborto seletivo, tendo por estudo-de-caso o primeiro pedido de alvará do Distrito Federal.
Web site : http://www.anis.org.br/serie/artigos/sa27(diniz)abortoseletivo.pdfAbstract : Este libro reúne artículos sobre el tema de la salud reproductiva producidos en Brasil. La publicación fue concebida como una demostración del esfuerzo conjunto de la academia, los servicios y los movimientos sociales en la lucha por la salud. Se presentan los siguientes trabajos: · O movimiento nacional e internacional de saúde e direitos reprodutivos, Jacqueline Pitanguy. · Saúde reprodutiva, gênero e sexualidade: legitimação e novas interrogações, Sonia Corrêa. · Família, sexualidade e reprodução no direito brasileiro, Leila Linhares Barsted. · A medicalização do corpo femenino, Elizabeth Meloni Vieira. · Corpo e conhecimiento ná saúde sexual: uma visão sociológica, Karen Griffin.· tendências de fecundidade brasileira no século XX: uma visão regional, Ana Camarano, Herton Ellery Araújo e Isabella Gomes Carneiro. · Ainda a questão da esterilzação femenina no Brasil, Elza Berquó. · Laqueadura túbaria: situação nacional, internacional e efeitos colaterais, Aurelio Molina. · Métodos de barreira controlados pela mulher, Suzana Kalckmann. · Aborto provocado: a dimensão do problema e a transformação da prática, Sarah Hawker Costa. · Padrões e tendências em saúde reprodutiva no Brasil: bases para uma análise epidemiológica, Estela Leão de Aquino, Thália Velho Barreto de Araújo y Lilian Fátima Barbosa Marinho. · A mortalidade materna no Brasil no período de 1980 a 1993, Kátia Silveira da Silva, Eleonora D´Orsi, Catherine Lowndes y Ana Vaz Reis. · Incidência e mortalidade por câncer em mulheres adultas no Brasil, Sergio Koifman y Rosalina Jorge Koifman. · Doenças sexualmente transmissíveis na mulher, Catherine Lowndes. · AIDS e saúde reprodutiva: novos desafíos, Regina Helena Simões Barbosa. · Direito à saúde ou medicalização da mulher? Implicações para avaliação dos serviços de saúde para mulheres, Lynn Silver. · Desenvolvimento e implantação do PAISM no Brasil, Ana María Costa. · Violência de gênero, saúde reprodutiva e serviços, Ana Pires Lucas D´Oliveira y Lilia Blima Schraiber. · Ações de contracepção e assisteência ao parto: a experiência do Rio de Janeiro, Diana do Prado Valladares. · A atenção integral e a caixa de Pandora: notas sobre a experiência do Coletivo Feminista Sexualidade e Saúde, Simone Grilo Diniz. · Condições da saúde de funcionários de Banco Estatal: aspectos ligados à reprodução, Dóra Chor, María de Jesus Mendes da Fonseca, Milena Piraccini Duchiade, Célia Regina de Andrade y KaizôIwakami Beltrão.· O recorte racial/étnico e a saúde reprodutiva: mulheres negras, Fátima Oliveira. 174 · O drama da mulher no mundo do rabalho: o ser o estar, Eleonora Menicucci de Oliveira.· Homens, saúde reprodutiva e gênero: o desafio da inclusão, Margareth Arilha.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Raped at the age of 14, Paulina Remirez Jacinta became pregnant by her rapist and wanted to have an abortion. Her mother, Maria Elena Jacinta, wanted the same thing. However, they decided against these plans after senior officials very openly and forcefully frightened them. This case has become a cause among feminist groups and some leading intellectuals in Mexico, where abortion in outlawed, with few exceptions. Abortion is shunned by the medical community and condemned by the Catholic Church. Normally, abortion is practiced as an underground activity, where up to half a million women terminate their pregnancies each year. The office of the Baja California human rights prosecutor, an independent agency, ruled in March 2000 that Paulina's rights had been violated by the failure of the government to carry out the abortion. The United States, with clinics where an abortion could have been carried out more routinely, is only a few miles from the Jacinta f amily home. However, Mrs Jacinta, did not have the money to do so. Paulina was finally permitted to have the abortion, but it was held up for a week by a physician who refused to perform it. There was extensive counseling that went on for awhile, and finally, an official again granted her permission to have the abortion. However, a doctor then informed Paulina's mother that the procedure could leave her sterile or she could hemorrhage to death. Paulina's mother then decided herself to cancel the abortion because, realizing how everyone else felt about it, she couldn't be sure doctors wouldn't botch the procedure on purpose.
Notes : Inglés/anglais/EnglishAbstract : This document, which is also available in Arabic, Chinese, French, Russian, and Spanish, is a preliminary version of the report from the conference held in Cairo. It includes the text of resolutions adopted by the conference, which consists primarily of the program of action agreed upon during the conference, together with a number of administrative details. (ANNOTATION)
Notes : Francés/français/French, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND 803021Abstract : Data are presented on maternal mortality in the Mexican Institute of Social Security (IMSS) system. World Health Organization recommendations for the definition and measurement of maternal mortality were followed. Death certificates were used to estimate mortality levels, data on the number of live births were used to calculate death rates, and reports of the Study Committees on Maternal Mortality were used to analyze causes of death. Maternal mortality rates declined during the 1980s from 59.9/100,000 live births in 1982-84 to 42.4 in 1987-89, a reduction of 29%. The overall maternal mortality rate in Mexico was estimated at 65/100,000 in 1986. The declining maternal mortality rate, in the context of deteriorating living conditions of the population, appears to be due primarily to the effect of greater coverage of prenatal care, prevention of pregnancies, and a greater relative number of pregnancies at younger ages. Maternal mortality in 1982-84 formed a J-shaped curve in which mortality of younger mothers was higher than that of mothers in intermediate age groups but not as high as that of mothers in the oldest groups. The J-shaped curve was no longer observed in 1987-89, probably because of application of the risk focus in obstetric services and the reproductive risk focus in family planning services. The 5 principal causes of maternal deaths, according to the Study Committees on Maternal Mortality, were toxemia, hemorrhages of pregnancy or delivery, puerperal sepsis, abortion complications, and other complications in the puerperium. These causes accounted for almost 80% of maternal deaths in 1984-86. The decline in the maternal mortality rate does not appear to be associated with reduction in any of the 5 main causes of death except abortion. Greater availability of family planning services contributed to a reduction in the rate of complications of abortion attended by IMSS facilities from 13.7 to 8.0 per 1000 fertile-aged women during the 1980's. Improved prenatal care and attention before, during, and immediately after delivery are urgently needed in order to improve maternal mortality rates even more. Also required are improved training of health personnel and education of the population in detection of reproductive risk so that high risk populations can be counseled and obstetrical risk recognized in time to seek help
Web site : http://www.ejournal.unam.mx/demos/demos_index.htmlAbstract : Muestra la polémica actual frente al aborto en México a través de los escritos de los principales representantes de la investigación y de las distintas corrientes de opinión; abarca las cuestiones bioéticas, sociales, legales y médicas entre otras
Notes : Español/espagnol/SpanishAbstract : In Latin America, where restrictive laws limit women's access to safe abortion services, misoprostol is being used to induce abortions, often without correct information on dosage or regimens. This study in an unnamed Latin American country aimed to identify appropriate channels through which instructions on misoprostol use could be disseminated to women. In-depth interviews were carried out with physicians, pharmacy staff, women who had had safe abortions and women from the community, as well as focus group discussions with advocates of safe abortion. Participants considered physicians to be the most appropriate source of information and for ensuring confidentiality for both women and provider. Participants considered midwives, pharmacists and women's groups as appropriate referral points, but not providers of information. Legal restrictions and professional risk were the primary reasons why pharmacists rejected this role, though many are selling misoprostol. There was a general lack of information about misoprostol for medical abortion among both health professionals and women. Accurate information about misoprostol use for a wide range of gynaecologic and obstetric purposes, including induced abortion, could be incorporated into training and educational materials for physicians, midwives and other appropriate mid-level providers, as well as pharmacists. Without these alternative information channels, access to information would be severely restricted, especially in rural areas.
Web site : http://www.rhmjournal.org.uk/Abstract : This study identifies and quantifies risk factors for hospitalization arising from termination of pregnancy and abortion in the population served by the maternity unit of the Instituto Materno-Infantil de Pernambuco, Recife, Brazil. A total of 230 women admitted subsequent to complications following pregnancy loss (case group) and 920 women admitted to the labor ward for normal delivery (control group) from August 1994 to June 1995 were included in the study. All the patients answered a standard questionnaire, which included questions on the demographic characteristics and pregnancy history of the mothers. For each potential risk factor considered the odd ratio and its respective 95% confidence interval (CI) were calculated. The results revealed that among all potential causes studied, those that showed significant association with pregnancy termination or abortion were: being single; absence of emotional support from partner; being a working woman; literacy up to 4th year of school; failure of contraceptive method used; and experience of previous pregnancies, children and abortions. From these findings, it is evident that the solution for lowering maternal mortality and morbidity rates from complications of termination of pregnancy is the easy access to family planning in the rural areas of Brazil.
Web site : http://tropej.oupjournals.org/Abstract : This study examined abortion motivation among women. Analysis was based on published findings from 27 countries, an analysis of 3 countries, and representative surveys from 52 countries. Popline, Medline, and Population Index databases, bibliographies, and unpublished sources were also used. Women's desire to postpone or stop childbearing ranged from 39% in the Central African Republic to 89% in Japan. In 23 countries, women chose abortion for many reasons. In 4 developing Asian countries and 3 developed countries, women commonly desired a postponement or stop to childbearing. In 10 out of 20 countries, 50% of women gave birth timing and family size control reasons for abortion. A second key reason was poverty and economic concerns. Being young and unmarried was a key reason in some countries. Risk to maternal health was less important in Latin America and developed countries. African women tended to report socioeconomic reasons, followed by postponement or limiting of births. Asian women favored family size control reasons. Latin American women chose socioeconomic and relationship reasons. Developed countries favored family size control and timing reasons. In 10 countries, education was not associated, age was moderately associated, and marital status was associated with reasons. Married women tended to give socioeconomic and family size control reasons. Unmarried women cited socioeconomic factors and youth or parental objections. In the US, abortion reasons were similar to reasons for stopping childbearing. Research affirms that improved contraceptive practice is an important way to reduce abortion.
Web site : http://www.agi-usa.org/pubs/journals/2411798.htmlAbstract : In this interview, a women's health activist working in Brazil identified the 1984 national policy that created the Integrated Program of Health Assistance to Women (PAISM) as the catalyst for women's health programs in the country. Effective implementation of PAISM has been hampered, however, because of political factors such as the inequitable distribution of funds, a lack of accountability, and allocation of funds to curative rather than preventative services. PAISM covers services such as sex education and counseling, prenatal care, most forms of contraception, and cancer screening. Abortion is illegal except in cases of rape or of danger to the mother's life due to the influence of the Roman Catholic Church. However, efforts to increase availability of legal abortions have begun as a first step towards liberalizing the abortion law. Also, some prominent physicians have announced that they have performed abortions in cases when fetal life would not be viable. This has provoked the media to conduct a public opinion poll that indicated that 62% of the population does not support the current restrictions to abortion. Feminists have stayed out of this controversy and simply point to the cost burden on the public health system that has to treat women suffering morbidity associated with illegal abortion. Women's health groups believe that improving the educational status of women will be vital to empowering Brazilian women to regulate their fertility and demand their rights.
Web site : http://journals.cambridge.orgAbstract : Context: Legal abortion rates vary widely among countries with nonrestrictive laws. Data on trends in legal induced abortion may provide insight for policymakers into factors that influence rates of legal induced abortion and the levels of abortion that might be achievable in their own countries and in other parts of the world.Methods: Numbers of legal induced abortions were estimated for 54 countries from official statistics or other national data. Abortion rates per 1,000 women aged 15-44 were calculated for the years 1975 through 1996.Results: The most striking recent trend is a sharp decline in abortion incidence in Eastern and Central Europe and the successor states to the Soviet Union. For example, rates fell by 28-47% in the four former Soviet states with reasonably complete data (Belarus, Estonia, Kazakhstan and Latvia), and by 18-65% in six states with less-complete reporting. Similar patterns were seen in such nations as Bulgaria, Hungary and the Czech and Slovak Republics. Rates have also declined in several other developed countries. Since 1975 the abortion rate in such countries as Denmark, Finland, Italy and Japan has dropped by 40-50%. In only a few developed countries (among them Canada, New Zealand and Scotland)have abortion rates shown an increase over time. In the few developing countries with reliable data, some (China, South Korea, Tunisia and Turkey) have experienced a declining abortion rate. while others (such as Cuba and Vietnam) have seen increases in levels of abortion.Conclusions: In developed countries with high abortion rates, use of abortion is likely to fall rapidly when a range of contraceptive methods become widely available and effectively used. Legalization of abortion and access to abortion services do not lead to increased reliance on abortion for fertility control in the long term; in developed countries with these conditions, the predominant trend in abortion rates has been downward.
Web site : http://www.agi-usa.org/pubs/journals/2504499.pdfAbstract : The desire for fertility control, changes in the role of women, the secularization of society, and more open attitudes about sexuality are some of the factors which led to the liberalization of abortion laws and services in countries around the world. The author hypothesized that since these underlying factors are stable or increasing in importance, the worldwide trend toward liberalization should be continuing. He therefore examined all changes which took effect from January 1988 - February 1993 in the abortion laws and regulations of countries with populations of one million or more. Data were gathered from all available sources, including newspapers, newsletters, and published articles. Satisfying the hypothesis, results show the overall movement to be still in the direction of liberalization, although restrictions have been increased in a few countries; five countries made major liberalizing changes in their laws, while only one imposed major restrictions.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 099534Abstract : Partiendo de un controvertido caso de reproducción asistida,ampliamente discutido en Francia, el artículo examina los efectos sociales producidos al desplazarel locus de la concepción del cuerpo femenino al laboratorio. Se sugiere que esas prácticasmédicas conducen a una redistribución de responsabilidades y de poder en decisiones queconciernen a embriones entre los tres principales protagonistas de la red que los abarca: la mujer,su pareja y el cuerpo médico. Al examinar esos reordenamientos se toman, como punto dereferencia y de contraste, las disposiciones legales francesas relativas al aborto.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Se presentan algunos argumentos que utiliza Provida para condenar al aborto, extraídos de notas periodísticas y de un par de libros
Web site : http://www.gire.org.mx/Abstract : To determine if Chile achieved the objective of reducing maternal mortality by 50% between 1990 and 2000, in line with the provisions of the Regional Plan of Action for the Reduction of Maternal Mortality in the Americas, which the governments of the Americas approved in 1990 at the 23rd Pan American Sanitary Conference. METHODS: A descriptive, observational study was designed, making it possible to analyze the trend in maternal mortality in Chile from 1990 through 2000. The variables that were evaluated were the maternal mortality ratio, the causes of death, and the age of the mothers who died. The causes of death were classified according to the ninth revision of the International Classification of Diseases (ICD-9), and the raw data were obtained from the yearbooks of the National Institute of Statistics of Chile. The changes in the variables were estimated according to the percentage of cumulative change, and trends were analyzed with the Pearson correlation coefficient. RESULTS: The study found a 60.3% reduction in maternal mortality from 1990 to 2000. The lowest maternal mortality ratio, 18.7 per 100 000 live births, occurred in the year 2000. The five leading causes of maternal mortality were hypertension, miscarriage, other current conditions in the mother, puerperal sepsis, and postpartum hemorrhage. There was a significant downward trend in maternal mortality due to hypertension (r = 0.712; P = 0.014), abortion (r = 0.810; P = 0.003), and puerperal sepsis (r = 0.718; P = 0.013), but there were no statistically significant changes in mortality from other current conditions in the mother or from postpartum hemorrhage. The highest level of maternal mortality was found in women who were 40 years of age or older (100.2/100 000 live births), and the lowest level was in adolescents 15 to 19 years old (18.7/100 000 live births). CONCLUSIONS: Chile achieved the objective of the Regional Plan of Action for the Reduction of Maternal Mortality in the Americas, with a decrease of more than 50% in maternal mortality in the 19902000 period. That reduction is due mainly to the decline in maternal mortality from hypertension, abortion, and puerperal sepsis.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S1020-49892004000500007 lng=en nrm=isoAbstract : El mal estado de salud, la desnutrición, la falta de cuidado contribuyen al fallecimiento de mujeres entre 15 y 49 años durante el embarazo y el parto. La mayor parte de esos fallecimientos se podrían evitar si se adoptaran medidas preventivas y se proporcionara una asistencia adecuada. La declaración se basa en las lecciones aprendidas y en los conocimientos adquiridos por los países de todo el mundo en su empeño por reducir y evitar la mortalidad materna y neonatal.
Notes : Español/espagnol/SpanishAbstract : Reseña los cambios que se han evidenciado en programas de desarrollo de salud, los cuales habían tenido una perspectiva reducida para abordar los aspectos de salud y la reproducción humana. Como respuesta se ha incorporado recientemente el concepto de salud reproductiva, en base a la definición de salud de la Organización Mundial de la Salud (OMS). Este concepto implica tener una vida sexual satisfactoria y libre
Notes : Español/espagnol/SpanishAbstract : Muestra por qué las mujeres recurren al aborto inducido, aborda la situación legal en el mundo, y que es un problema de salud pública. Al respecto los principios morales, éticos y religiosos coartan la libertad de las mujeres para decidir sobre su cuerpo
Web site : http://www.crlp.org/Abstract : mapa interactivo
Web site : http://hrw.org/photos/2005/argentina0605/Abstract : Women's reproductive rights emerged as a human rights key political social policy issue in very recent times. In this study, women's reproductive rights are indicated by legal abortion right marriage divorce rights. The latter is an additive measure of four variables: personal rights to interracial, interreligious, or civil marriages; personal rights for equality of sexes during marriage for divorce proceedings; maternity leave benefits; singulate mean age at marriage. We found substantial regional variations among sub-Saharan Africa, Asia /Pacific, Latin America, the Middle East. Policy implications are discussed to improve women's reproductive rights in developing countries.
Notes : Inglés/anglais/EnglishAbstract : Introducción y antecedentes ; Regulación de la fecundidad después del parto ; Fisiología del postparto ; Fisiología del puerperio ; Fisiología de la lactancia ; Amenorrea del postparto ; Fisiología de la amenorrea de la lactación ; Anticoncepción postparto y postaborto ; Anticoncepción en el postparto ; Modalidades de anticoncepción postparto ; Opciones anticonceptivas en el postparto o postaborto ; Los diferentes métodos ; Actuación delpersonal de salud ; Modelo de un programa de anticoncepción postparto o postaborto ; Modelo de organización de un programa de regulación de la fecundidad.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : National and regional estimates of the incidence of induced abortion in Brazil, Colombia, and Mexico from the late 1970s to the early 1990s indicate a clear rise in the abortion rate in Brazil and increases in the abortion ratio in all three countries. Crosssectional analysis showed no significant correlation between the abortion rate and contraceptive use, except in Mexico in the early 1990s, where a strong positive association was observed. Longitudinally, the abortion rate increased as contraceptive use increased in most regions of Brazil and Mexico throughout the study period, and in parts of Colombia until the mid-1980s. In Colombia and the most urban region of Mexico, the abortion rate declined as contraceptive use stabilized or increased. The abortion ratio was positively associated with contraceptive use over time in nearly every region of each country. The role of abortion in fertility decline was greatest in Brazil, where the general fertility rate would have been nearly 13% higher in the early 1990s if the abortion ratio had not increased from its level in the late 1970s. Abortion tended to have a greater impact on fertility in regions where contraceptive use was low. Overall, contraceptive use appears to have been a more important determinant of fertility than abortion, but abortion has played an important subsidiary role in determining fertility levels and trends in these countries. (author's)
Web site : http://www.guttmacher.org/pubs/journals/2300497.htmlAbstract : CONTEXT: The relationship between levels of contraceptive use and the incidence of induced abortion continues to provoke heated discussion, with some observers arguing that use of abortion decreases as contraceptive prevalence rises and others claiming that increased use of family planning methods causes abortion incidence to rise. METHODS: Abortion trends are examined in countries with reliable data on abortion and with contraceptive prevalence information from two points in time showing increases in contraceptive use. The role of changes in fertility in mediating the relationship between abortion and contraception is also explored. RESULTS: In seven countries-Kazakhstan, Kyrgyz Republic, Uzbekistan, Bulgaria, Turkey, Tunisia and Switzerland- abortion incidence declined as prevalence of modern contraceptive use rose. In six others-Cuba, Denmark, Netherlands, the United States, Singapore and the Republic of Korea-levels of abortion and contraceptive use rose simultaneously. In all six of these countries, however, overall levels of fertility were falling during the period studied. After fertility levels stabilized in several of the countries that had shown simultaneous rises in contraception and abortion, contraceptive use continued to increase and abortion rates fell. The most clear-cut example of this trend is the Republic of Korea. CONCLUSIONS: Rising contraceptive use results in reduced abortion incidence in settings where fertility itself is constant. The parallel rise in abortion and contraception in some countries occurred because increased contraceptive use alone was unable to meet the growing need for fertility regulation in situations where fertility was falling rapidly. (author's)
Web site : http://www.agi-usa.org/pubs/journals/2900603.html.Abstract : Examines the diversity of expression of religious belief and practice in relation to the current social situation and to the state; includes indigenous religions, Roman Catholicism, and Protestantism; Latin America, with some focus on Mexico; 10 articles. Topics include religious ritual and festival, syncretism, conversion, ascetism, peasant religious movements for social change, views on abortion, and the National Catholic Confederation of Labor in Mexico.
Notes : Español/espagnol/SpanishAbstract : Expone la realidad chilena ante el aborto y según el modelo de salud familiar, además plantea una serie de hipótesis de los orígenes de las representaciones sociales del aborto.
Notes : Español/espagnol/SpanishAbstract : El parlamento y el debate sobre el aborto en Brasil / María Isabel Baltar da Rocha ; 1979, un año crítico en la historia del debate sobre el aborto en Colombia / Mara Viveros ; Desde el movimiento feminista hacia el sistemapolítico : estrategias y representaciones de los actores que participan en el debate sobre el aborto en la prensa Mexicana 1974-1990 / María Luisa Tarrés Barraza ; Opinión de las mujeres sobre las circunstancias en que deberían tener derecho a abortar / Anibal Faúndes, Ellen Hardy, María José Duarte Osis ; Actitudes, representación social y variables psicosociales relacionadas con el aborto y la contracepción : una integración de investigaciones / Caridad Teresita García ; [Pt. 2] El aborto en Arménia : un estudio de casos / Mónica María Alzate ; Resultado de tres encuestas nacionales de opinión sobre aborto, México 1991-1993 / Sussan Pick de Weiss, Marta Givaudan y Gillian Fawcett ; En busca de un objetivo compartido : del feminismo a la sociedad, la lucha por legalizar el aborto en México / Marta Lamas ; Una aproximación al aborto inducido en el eje cafetero / Rosalba del Socorro Sánchez ; Aportes de la psicología y el género al problema del aborto inducido / María Raguz ; El personal de salud ante el aborto : valores y contraindicaciones / María del Carme Elú ; Imaginarios, representaciones e identidades masculinas sobre el aborto inducido / Hernando Salcedo Fidalgo.
Notes : Español/espagnol/SpanishAbstract : Introducción ; Aspectos demográficos y políticas públicas ; La mirada antropológica ; Cuerpo, sexualidad y género: categorías analíticas y conceptos explicativos ; El contexto cultural de la pobreza ; Masculinidad, sexualidad y salud sexual y reproductiva en el contexto de pobreza ; El lugar de la sexualidad en la construcción de la masculinidad/virilidad ; La relación entre las representaciones y prácticas sobre anticoncepción y aborto y la construcción de masculinidad/virilidad ; A modo de conclusión ; Bibliografía.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Introducción ; Material y métodos ; Resultados de las discusiones de grupos focales ; Resultados de las encuestas ; Discusion ; Conclusiones ; Addenda.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Los trabajos recopilados en este libro reflejan investigaciones recientes realizadas con el apoyo del Programa Especial de Investigación, Desarrollo y Entrenamiento en Investigación en Reproducción Humana de la Organización Mundial de la Salud en siete países de América latina y el Caribe sobre temas de salud reproductiva. Bajo esta denominación se incluyen temas como sexualidad, embarazo, anticoncepción, aborto, infertilidad, maternidad, lactancia, enfermedades de transmisión sexual y SIDA, entre otros. Se reúnen los siguientes artículos: · "Los dichos y los hechos: formación de la familia y anticoncepción en mujeres pobres del conurbano de Buenos Aires", Elsa López. · "Fecundidad y condiciones socioeconómicas: el caso del Paraguay rural", Ramón Fogel.· "Los hombres mexicanos frente a la vasectomía", Martha Givaudan, Susan Pick y Carmen Fuertes. · "Anticoncepción y aborto en Cuba", Luisa Alvarez Vásquez y María Teresa Martínez. · "El aborto inducido en Colombia", Lucero Zamudio Cárdenas.· "Concepciones legas de salud y enfermedad: el SIDA según pobladores de un barrio pobre del Gran Buenos Aires", Edith Pantelides, Mónica Gogna y Silvina Ramos. "Esterilización femenina y prevención de las enfermedades de transmisión sexual y el SIDA", Wilza Vieira Villela y Regina Barbosa. "Modificación de concepciones y conductas de riesgo sexual en el imaginario y las costumbres", Graciela Sikos. "Fortalezas y debilidades en la cultura de tres poblaciones guatemaltecas ante el peligro del SIDA", Alfredo Méndez Domínguez. "La salud reproductiva de las adolescentes frente al espejo: discursos y comportamientos de madres e hijas", Rosa Geldstein, Graciela Infesta Domínguez y Nena Delpino. "Adolescentes de la ciudad de Buenos Aires: su paso hacia la vida sexual adulta", Silvia Necchi, Marta Schufer y José Méndez Ribas. "Implicaciones para políticas y programas de salud", Sarah Bott.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Library of Congress Summary. Papers presented at various seminars held during 1995-1996. Annotation. A comparative study of fertility declines occurring in India and Brazil. It consists of 11 papers by well-known scholars from various disciplines, among them demographers, anthropologists, and economists.
Notes : Inglés/anglais/EnglishAbstract : In August 1996, approximately 3000 unclaimed frozen human pre-embryos were destroyed by fertility clinics in the UK. While the Vatican, which opposes in vitro fertilization and the freezing of embryos, denounced the event and called for women to volunteer to "adopt an embryo," the Catholic primate for England and Wales said that the pre-embryos should be allowed to die and be disposed of with dignity. Another international controversy occurred when an English woman who was 16 weeks pregnant with twins decided to abort one of them because she considered herself too poor to rear both children. While Roman Catholic clerics blamed the state for financing abortions rather than providing sufficient assistance to poor mothers, anti-abortion groups raised US $70,000 to persuade the woman not to undergo the abortion, but the abortion had already taken place. A Peruvian program to provide incentives to poor women who undergo sterilization has also drawn the ire of the Roman Catholic Church, which denounced the program for violating freedom. The program has been criticized on the same grounds by the president of the Peruvian Medical Association, who supports contraception.
Notes : Inglés/anglais/English, nbsp;117797Abstract : Reproductive health programs should adopt an approach based on human rights at the levels of clinical management as well as national policy, especially those programs responsible for abortion and post-abortion care. Resource-poor women face greater maternal mortality and morbidity, suffer continuous risk because of a lack of access to adequate reproductive health services, and are likelier than more affluent women to resort to unsafe, inaccessible, and/or unaffordable abortion services. The public health and medical communities are highly effective when providing safe abortion procedures and treatment in the event of complications. Efforts must be continued to develop strategies to prevent unwanted pregnancies, unsafe abortions, and abortion-related deaths; to treat abortion complications; to broaden the types of medical and health professionals who are allowed to perform abortions; and to enhance training for abortion providers.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : The policy approaches taken by each Latin American state in each of the facets of reproductive sexual health, eg, abortion, family planning, human immunodeficiency virus, are not homogeneous. Each state faces different pressures has different actors in its executive, administrative, judicial branches dealing with reproductive sexual health. As the medical field has changed during the last 20-30 years (eg, the feminization of the medical profession), so have the states' different health policies changed. The communications media have also impacted the field of reproductive sexual health. The impacts of these institutional dimensions on the health field need further investigation debate. 20 References. M. Pflum.
Notes : Inglés/anglais/EnglishAbstract : On December 17, armed criminal investigative forces acting under the direction of Colombia's secretary and deputy secretary of health, brutally raided the main clinic of the Orientame reproductive health care federation in Bogota, Colombia. Allegedly responding to charges that the clinic was providing abortions, investigators entered the clinic without warning, brandishing automatic weapons. Once inside, they threatened and physically assaulted patients and clinic staff, destroyed office equipment, broke down doors, and ordered the clinic to close. Since its founding in 1977, Orientame has become Colombia's second largest non-governmental family planning organization. The federation, consisting of three clinics, provides a full range of obstetric, gynecological, and information services, including family planning counseling, cancer screening, treatment for sexually transmitted diseases, prenatal care, adoption placement and counseling, and treatment of incomplete abortion. Serving approximately 250,000 women in its 17 years of operation, Orientame has a sliding fee scale and often waives costs for women who are unable to pay. Were Orientame to close its doors permanently, women facing complications from unsafe abortions but unable to pay private doctors would be forced to go to public hospitals and risk arrest. Despite the country's prohibition of abortions not necessary to save a woman's life, an estimated 288,400 Colombian women underwent abortions in 1989; 57,680 were hospitalized for complications from unsafe or incomplete procedures. (full text)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 102278Abstract : Investigations of reproductive health within Latinos living in the United States suggest that sexual behaviors and contraception use practices vary by ethnicity and between foreign- and US-born adolescents. This article compares high-risk sexual behaviors and reproductive health among foreign-born Latinas, US-born Latinas, and US-born non-Latinas aged 15-24 years. We recruited 361 females from reproductive health clinics in the San Francisco Bay Area of California between 1995 and 1998; these women completed an interview that assessed sexual risk behaviors and history of pregnancy, abortion, and sexually transmitted infections. Current chlamydial and gonococcal infections were detected through biological testing. Among participants aged 15-18 years, US-born Latinas were more likely to have been pregnant (odds ratio [OR] comparing US-born Latinas and US-born non-Latinas = 3.9, 95% confidence interval [CI] 1.3, 11.4), whereas among respondents aged 19-24 years, foreign-born Latinas were more likely to have been pregnant than US-born Latinas (OR = 11.3, 95% CI 1.0, 130.8) and US-born non-Latinas (OR = 64.2, 95% CI 9.9, 416.3). US-born Latinas were most likely to have had an abortion (OR comparing US-born Latinas and US-born non-Latinas = 2.0, 95% CI 0.9, 4.7). They were also most likely to have chlamydial infection at study enrollment (8.2% prevalence compared to 2.2% and 1.0%for foreign-born Latinas and US-born non-Latinas, respectively; P =.009). Reproductive health differences between foreign and US-born females and within the US-born population warrant further examination and highlight the need for targeted prevention.
Notes : Inglés/anglais/English, nbsp;11796809Abstract : The health and social, psychological, and economic well-being of adolescent girls below the age of 17 are likely to be disadvantaged by pregnancy and childbirth. Although there is a worldwide trend toward higher age of marriage, there is also a worldwide trend toward an increase in adolescent sexual relations prior to marriage. Sexual relations in adolescence, particularly in developing countries, are likely to take place without the use of modern contraceptives or protection against sexually transmitted diseases, including the human immunodeficiency virus. By the year 2000 more than 85%, or over two billion, of the world's people below the age of 20 will live in developing countries. In addition, there are 40 million street children in Latin America, 25-30 million in Asia, and 10 million in Africa. For census or survey purposes unions can be considered to be a) legal marriage, whether civil, religious or customary; and b) common-law marriage, consensual union and cohabitation. The legal minimum age of marriage is often different for males and females. More than 50 countries allow marriage at 16 or below, with parental consent. A much higher proportion of adolescents marry in Sub-Saharan Africa and southern and western Asia; this is less true for eastern Asia, the Caribbean region, and many countries in Latin America. In 11 Sub-Saharan countries surveyed, rates of contraceptive use varied from 1% to 7% among unmarried sexually-active adolescents aged 15-19, and from 1% to 6% for those who were married. In 13 of 14 developing Asian countries surveyed, below 10% of adolescents under age 18 had ever used a modern contraceptive. In Latin America and the Caribbean, in 8 of the 11 countries surveyed the proportion was below 10%. In most of the developing world, abortion is highly restrictive, but even in countries where it is legal, screening procedures, parental consent, and its cost will deter adolescents from safe abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 098472Abstract : This book contains the final report of the National Research Council's Panel on Reproductive Health in Developing Countries, which was organized in the aftermath of the 1994 International Conference on Population and Development to examine the degree of reproductive health problems in developing countries, assess the costs and effectiveness of interventions, and recommend programmatic and research priorities. The framework adopted by the panel holds that every sex act should be free from coercion and infection, every pregnancy should be intended, and every birth should be healthy. The panel, thus, concentrated on the causes, consequences, and remedies of health problems that are linked programmatically. The book opens with an extensive summary that is followed, in chapter 1, by an introduction. The framework is fleshed out in the next four chapters. Chapter 2 covers healthy sexuality through a discussion of the cultural context of sexuality, sexual violence, female genital mutilation, and policy and program implications. Chapter 3 considers infection-free sex and reproduction in light of the determinants and consequences of reproductive tract infections as well as interventions to prevent and treat these infections. The fourth chapter discusses intended births in terms of defining and measuring intended fertility, the consequences of unwanted pregnancies and births, the role of family planning and abortion services, and technical problems with measurements of fertility intentions and abortion. Chapter 5 looks at healthy pregnancy and childbearing through a consideration of maternal and infant death and disability and lessons for saving lives. The final two chapters link the interventions with a discussion of program design and delivery (chapter 6) and costs, financing, and prioritizing (chapter 7).
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 129399Abstract : In 1974, Mexico responded to a population growth rate of 3.4% by including family planning (FP) as a constitutional right and establishing a new population law and population program which sought to reduce fertility levels as well as maternal-child mortality. By 1994, Mexico's growth rate was reduced to 1.8 and maternal-child mortality had declined. Reproductive health (RH) was made a priority issue for the National Development Plan for 1995-2000 and applies a gender perspective to FP, the needs of adolescents, safe motherhood, women's health, sexually transmitted diseases, male responsibility, and infertility management. The quality and accessibility of FP programs were strengthened through an intensive program of training in logistics to improve contraceptive distribution and introduce methods such as no-scalpel vasectomy, monthly injectables, IUDs, and subdermal implants. The mass media is being used to promote the concept of RH, and specific initiatives target adolescents, promote safe motherhood, promote breast feeding, provide screening for birth defects, seek to improve access to and quality of prenatal care, help diabetic women plan pregnancies and contraception, create a network of laboratories for cervical and breast cancer screening, provide information and services for peri- and postmenopausal women, and continue RH research. The Latin American region is characterized by large variation in health status among countries, limited epidemiological data, early entry into reproductive life, mortality due to HIV/AIDS and illegal abortion, and low levels of contraceptive use among young people. A network of collaborating institutions has conducted 250 RH research projects during the past 20 years, and a South-South Partnership has been formed to implement the Programme of Action of the 1994 International Conference on Population and Development.
Web site : http://www.ingentaconnect.com/content/klu/advaAbstract : This case study focuses on the implementation in Brazil of the ICPD [International Conference on Population and Development] recommendations on reproductive health and rights.... The study covers various actions included in the reproductive health agenda: prenatal care, obstetrical assistance, gynecological cancer; prevention of STDs and HIV/AIDS; incomplete abortion care and access to abortion services, as permitted by law; and contraception assistance. The study emphasizes abortion-related issues and contraception assistance... (EXCERPT)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND RH96135Abstract : Aborda la necesidad de contemplar los derechos reproductivos como derechos humanos y luchar por su legalización en las Leyes Internacionales. Ofrece información sobre aborto, anticonceptivos, adolescentes, consentimiento del esposo y elección informada, esterilización y enfermedades de transmisión sexual. Presenta el marco legal en los niveles de la política y la comunidad, actualizándonos en cuanto a las polémicas más recientes sobre el tema
Notes : Inglés/anglais/EnglishAbstract : In the Dominican Republic, pregnancy termination is illegal under any condition, even when a woman's life is at risk. According to a 1994 estimate, one woman in 30 had had an abortion. The annual number of abortions for that year was 82,500, which translates to 43.7 women per 1000. In 1992, 16,500 women obtained hospital treatment for abortion complications. In the last 15 years, some Dominican women's organizations have tried to change legal restrictions on induced abortion. Due to internal and external factors, however, advocacy efforts have failed and the issue of abortion has become a quixotic struggle. (author's)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 156748Abstract : Este informe fue producido por la División de Población del Departamento de Aspectos Económicos y Sociales de la Secretaría de las Naciones Unidas y presenta información actualizada al año 2002 sobre aspectos seleccionados de derechos reproductivos y salud reproductiva, cubriendo los siguientes temas: entrada en la vida reproductiva; comportamiento reproductivo; planificación familiar; aborto; mortalidad y morbilidad materna; infecciones de transmisión sexual; VIH/sida; y derechos reproductivos. El informe también contiene un anexo con cuadros estadísticos que brindan información específica sobre derechos reproductivos y salud reproductiva. Incluye: Preface ; Sources, methods and classifications ; Explanatory notes ; Overview ; Introduction ; Entry into reproductive life ; Menarche ; Marriage ; Sexual activity before marriage ; Conclusions ; Reproductive behaviour ; Average family size: levels and trends in fertility ; Adolescent childbearing ; Women's education and reproductive behaviour ; Initiation of childbearing and duration of the childbearing span ; Implementation of reproductive aspirations ; Infertility: prevalence and underlying causes ; Reproductive risk factors and matemal health ; Contraception ; Government policy regarding provision of modern contraceptive methods ; Levels of contraceptive use ; Recent trends in contraceptive use ; Types of contraception employed ; Fertility desires and the unmet need for contraception ; Current contraceptive use and need in different population groups ; Users' perceptions of contraceptive methods and experience with methods ; Abortion ; Data on abortion ; Major dimensions of abortion law ; Abortion laws: grounds for permitting abortion ; Global analysis ; Regional perspective ; Maternal mortality and morbidity ; Definition and classification ; Measures of maternal mortality ; Measurement of maternal deaths ; Levels of maternal mortality ; Causes of maternal deaths and related morbidities ; Interventions to reduce maternal mortality and morbidity ; Relationship between maternal and neonatal mortality ; Conclusion ; Sexually transmitted diseases, including human immunodeficiency virus/acquired inodeficiency syndrome (HIV/AIDS) ; Magnitude of the problem ; Impact ; Responses: some success stories ; Sexually transmitted diseases, HIV/AIDS and reproductive health ; Some key issues ; Priority interventions and actions ; Research and development needs ; Reproductive rights ; Definitions ; Foundation of reproductive rights ; Key issues with respect to reproductive health and reproductive rights ; Implementation ; Population information, education and communication ; Aims of information, education and communication programmes ; Activities ; Issues ; Strategies and policies ; Priority areas.
Notes : Inglés/anglais/English, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : The 1994 International Conference on Population and Development (ICPD) is part of an ongoing political process that is overseeing a shift in the population paradigm from a demographic to a human rights perspective. Since the 1970s in Brazil, women's advocates have framed reproductive and sexual health in terms of citizenship rights, and the 1988 constitution recognizes some reproductive rights and the state's responsibility in providing the means of exercising these rights. Because they had also been building international coalitions and networks since the early 1990s, women were fully able to assume a leading political role at the ICPD. The agreements of the ICPD, thus, responded to women's proposals for a new, broader conceptualization of human rights. Now, the momentum leading up to the ICPD is over, resources are scarce, and the political forces that opposed the ICPD agreements have regained with power. This was manifest in Brazil when efforts to make states comply with the federal regulation of provision of abortion services in cases where the mother's life is at risk or of rape were circumvented by a carefully timed visit by the Roman Catholic Pope. In this case, the fact that no ground was lost was important because sometimes the struggle to maintain a position changes the ground even if it fails to advance the cause. While gaps remain between what has been gained in principle and in reality, it is important to avoid undervaluing the importance of the limits and possibilities inherent in legislative achievements. The next priority is to rebuild a coalition of women to face the challenges inherent in efforts to close the gap between ideology and reality.
Web site : http://www.ingentaconnect.com/content/pal/dev/2001/00000044/00000003Abstract : The author's ten years of research experience in the English-speaking Caribbean leads her to believe that men and boys in the region hold women responsible for preventing pregnancy. Men perceive themselves as free and in control, while women see themselves as burdened. These differing perceptions are due to fundamental differences in status and power between the sexes where terms of relationships are dictated by men. The Minister of Health in Guyana, finding high rates of out-of-clinic abortions in which many women risk their lives, introduced a bill in parliament to legalize abortion. The initiative, however, was supported by neither her party nor the usual opposition. All but a few of the women in parliament opposed the bill. The author notes the need for more women to become aware of and fight for their general reproductive rights. She also condemns the medical experimentation upon low-income women in developing countries. A feminist agenda is described in closing.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 095132Abstract : The author describes how the struggle for women's reproductive rights in Nicaragua progressed under both the Sandinista government and the more conservative government that replaced it in 1990. She notes that Nicaraguan women have experienced high maternal mortality from illegal abortion, and describes the efforts and achievements of women's groups to reduce such mortality through campaigns for effective birth control education and for legalized abortion. (ANNOTATION)
Web site : http://www.feministstudies.org/Abstract : The Helms Amendment to the Foreign Assistance Act and to the Mexico City Policy severely restrict the provision of safe abortion services, counselling or referral for women in the United States and in programs in developing countries that are funded by the US government. This paper cites excerpts from Bangladesh, Brazil, Nigeria, and Chile after the Webster decision in 1989 highlighting the fact that when abortion services are available and safe in the US, such a service and policy provides moral support to women around the world. Work must begin to provide American women with a complete range of reproductive freedoms including: 1) the right to choose abortion; 2) the right to choose a preferred method of contraception; and 3) and the right to decide whether to have sex and with whom.
Notes : Inglés/anglais/EnglishAbstract : This is a draft report presented for submission to the Chilean Commission on Human Rights in July 1992. The report provided background summaries on the following topics: the importance of reproductive rights to women, international acceptance of reproductive rights, and family planning during the 17-year Chilean military dictatorship 1973-90). The body of the report is devoted to a discussion of reproductive rights under the military regime: the destruction and reorganization of the national health system, the changes in family planning policy, and the impact of the dictatorship's policies on family planning services, abortion law and practice, sterilization, and sex education. Reproductive rights are protected under the International Convention on the Elimination of All Forms of Discrimination Against Women, and reproductive choice is linked with women's ability to exercise their human rights. Under the military regime of Pinochet family planning services were withdrawn and threats were made against women with abortion complications. These actions and the resulting maternal mortality of many women are viewed as violations of human rights that should be included along with the violent deaths of thousands that were documented by human rights organizations. The military regime's policies had the greatest impact on young women. Education about contraception and sexuality ceased to exist for young women. There was less access to physical means to control fertility and to information about contraception. The Pinochet government asserted that contraceptive knowledge and services prevented couples from making free decisions about reproduction. However, the number of unwanted pregnancies and abortions remained stable during the years of military rule. It is argued that the prevention of information and services interfered with childbearing decisions and was an attack on women's right to decide freely and responsibly about the number and spacing of children.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 110332Abstract : In Guatemala, where women exert little control over their reproductive lives, maternity is a risky undertaking. As a study a few years ago indicates, over 1/2 of all births are attended by untrained personnel. This situation is compounded by the health and socioeconomic conditions faced by Guatemalan women, who rarely receive the daily minimum caloric requirement. According to an epidemiological study in Guatemala City, 44% of pregnant women suffered from at least one parasite. These women were generally less educated, lived in worse sanitary conditions, and had a lower nutritional status than uninfected women. Between 1980-87, the overall maternal mortality rate in Guatemala was 110/100,000 live births, compared to a rate of 9/100,000 in the US. Many of these maternal deaths result from diseases and complications arising in the perinatal period, usually epileptic seizures, bleeding, premature labor, abortion, and postpartum infections. In addition to the women who die from pregnancy complications, many more are left permanently disabled. Complications such as infections and bleeding often result from illegal abortions, usually performed in unsanitary conditions by inexperienced individuals. Abortion rate estimates range from 4%-18% of all pregnancies. Guatemala bans abortion, except in a few life threatening conditions, when approval must be obtained from a committee and a physician. In reality, only women who can afford a private physician can secure approval for an abortion. While a 1985 WHO report argued that family planning is the first step in preventing illegal abortions and reducing maternal mortality, the growing anti-abortion movement in Guatemala has also begun to threaten support for family planning.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 072734Abstract : The purpose of this study of 3385 women hospitalized for abortion services in developing countries was to 1) establish the effect of counseling on the incidence of repeat pregnancy and abortion; 2) establish the effect of contraceptive acceptance and use on the incidence of repeat pregnancy and abortion; 3) study the effect of postabortion counseling on contraceptive acceptance and use; 4) document their sociodemographic characteristics, reproductive history, and knowledge and use of contraceptive methods; and 5) study the immediate complications of abortion. The study was conducted between late 1987 and August 1990 in Nairobi, Kenya (17.7% of the women); Harare, Zimbabwe (32.9%); Lusaka, Zambia (13.8%); Mexico City, Mexico (9.9%); Lagos, Nigeria (18,4%); and Jos, Nigeria (7,3%). All women who presented with abortion, whether spontaneous or induced, were randomly assigned to either a noncounseled control group or a postabortion counseled study group, using computer-generated random numbers. Counseling was a one-time event, and the counseling protocol was not standardized among centers. Both groups of women were given 3 follow-up appointments over the next year, and 60% were followed-up. 17% of the women were adolescents, 36% were single, and most were literate. Most women (78%) had had 1 or more pregnancies prior to the index abortion, while 35% had experienced 1 or more abortions. The index pregnancy was unwanted in two-thirds of the cases; up to 41% admitted that the index abortion had been induced. 25% of all women and 13% of the teenagers were using contraception prior to the index abortion, and use was shown to be dependent upon the level of contraceptive knowledge. During follow-up, 63% of all women and 59% of the teenagers were found to have accepted and used a method, and 57% used the method for at least 6 months. Increased acceptance was associated with age (older women) and education (well-educated). Counseling did not increase the overall acceptance of family planning (FP). Within the 1-year follow-up, 333 pregnancies (16.5% pregnancy rate) and 66 abortions (20.9%) were recorded. Counseling was associated with a significant overall reduction in the risk of repeat pregnancy (11.7% among the counseled women, 21.5% among the noncounseled group); however, among those women who got pregnant, counseling did not exert any direct protective effect against repeat abortion, but did lead to a significantly longer median interval between abortion and repeat pregnancy (9.4 months for counseled women vs. 6.8 months for the noncounseled). The author concluded that improved abortion-care facilities are needed; improved FP knowledge and services are needed; counseling may not influence FP acceptance in locations where overall acceptance rates are already high; contraceptive use is associated with significant reduction of repeat pregnancies; and counseling does not directly reduce the incidence of repeat abortion, but it indirectly lowers the need by reducing the number of unwanted repeat pregnancies (the author attributes this apparent paradox to the strong motivation for abortion among those women with unwanted pregnancy). Based upon these results, the author recommended the provision of postabortion FP services; further research to standardize and test appropriate counseling packages; studies to document the effect of more intensive counseling; and provision of follow-up services for women who are identified as being at high risk for repeat pregnancy and/or abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 101357Abstract : The study of abortion behavior, especially its determinants and consequences, requires the utilization of exploratory research methods, often innovating or combining techniques derived from a variety of disciplines. This paper stresses the social and psychological dimensions of induced abortions, wherein, research designs are firmly anchored in the methodology of the social sciences. These research designs include quantitative, qualitative, and provider studies. Of the qualitative studies, anthropological techniques such as direct observation, in-depth interviewing utilizing interview guides, focus group discussion and subject focused one-on-one discussions are particularly well-suited to pursue difficult questions such as those that arise in abortion research. The studies that utilized quantitative approaches as their central technique for data collection are divided into hospital-based surveys, follow-up studies, community surveys, special group surveys, and national surveys. A final category, "provider studies," is another example of the mix approach. It requires separate discussion because of the special problems in first identifying and then interviewing abortion providers in countries where abortion is illegal. Overall, the increasing problem of teenage pregnancy requires further study, particularly when abortion is used to terminate unwanted pregnancies in contexts where the practice is unsafe. It is suggested that in the field of abortion research, assessment of different methodologies, alone or in combination, is essential to improve the validity and quality of data upon which findings are built.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : En esta publicación el Programa Especial de Investigación, Desarrollo y Capacitación en Investigación en Reproducción Humana (HRP) de la Organización Mundial de la Salud presenta un informe de los hallazgos en investigación sobre diferentes temas entre 2000 y 2001. Se incluyen los siguientes capítulos: planificación familiar - expandiendo las opciones, haciendo al embarazo más seguro, prevención de infecciones en el tracto reproductivo, prevención del aborto inseguro, explorando la salud reproductiva de los adolescentes, cooperación con países. Incluye: Family planning expanding the choices ; Making pregnancy safer ; Preventng reproductive tract infections ; Preventing unsafe abortion ; Exploring adolescent reproductive health ; Cooperating with countries ; Financial overview for the biennium 2000-2001.
Notes : Inglés/anglais/English, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Cuando hablo sobre sexualidad me uso a mi misma como ejemplo': consejería en sexualidad y planificación familiar en Colombia" ('When I talk about sexuality, I use myself as an example': sexuality counseling and family planning in Colombia), por Bonnie Shepard. · "Mejorando la atención pos-aborto en un hospital público en México" (Improving postabortion care in a public hospital in México), por Ana Langer, Angela Heimburger, Cecilia García-Barrios y Beverly Winikoff. Encarando la violencia de género en un programa de salud sexual y reproductiva en Venezuela" (Addressing gender violence in a reproductive and sexual health program in Venezuela) , por Alexandra Guedes, Lynne Stevens, Judith Helzner y Susana Medina. · "Riesgo sexual, infecciones de transmisión sexual y opciones anticonceptivas: empoderando a las mujeres con información y elección en México" (Sexual risk, sexually transmitted infections, and contraceptive options: empowering women in México with information and choice), por Cristiana Coggins y Angela Heimburger. · "Cómo una asociación de planificación familiar transformó su abordaje en salud sexual: colaborando con comunidades en Belice" (How a family planning association turned its approach to sexual health on its head: collaborating with communities in Belice), por Lucella Campbell y Mervin Lambey. · " 'Seamos ciudadanas, no pacientes': grupos de mujeres en Perú hacen valer su derecho a atención de salud reproductiva de alta calidad" ('Let´s be citizens, not patients!': women's groups in Peru assert their right to high-quality reproductive health care), por Bonnie Shepard. · "Investigación acción para aumentar la elección reproductiva en un municipio de Brasil: el proyecto Santa 376 Barbara" (Action research to enhance reproductive choice in a Brazilian municipality: tha Santa Barbara project) , por Margarita Díaz, Ruth Simmons, Juan Díaz, Francisco Cabral, Debora Bossemeyer, Maria Yolanda Makuch y Laura Girón. · "ReproSalud: el feminismo se encuentra con USAID en Perú" (ReproSalud: feminism meets USAID in Peru), por Debbie Rogow y Susan Wood.
Notes : Inglés/anglais/English, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Abortion is the second leading cause of maternal mortality in Colombia. The underregistration rate for maternal death is estimated at 50%, and that for abortion is probably higher still. Women in Colombia die from abortion because it is illegal and clandestine. Unwanted pregnancy is the major factor leading to abortion mortality. While unwanted pregnancy and abortion are difficult to avoid completely, abortion mortality has largely disappeared where abortion is legal. Abortion is not likely to be legalized in Colombia in the foreseeable future. Although abortion is a polarizing issue, in reality no one is in favor of abortion, even women resorting to it to terminate unwanted or inopportune pregnancies. Despite numerous studies and advances in the efficacy and availability of contraceptive methods, abortion continues to be very frequent. A study of abortion morbidity and mortality carried out in 15 hospitals by the Colombian Federation of Obstetrics and Gynecology found 4263 abortions and 21 resulting deaths, corresponding to a mortality rate of 493/100,000 abortions. 42% of the women admitted for abortion stated they wanted no more children, and 63% were not using a contraceptive method, but only 37% received family planning services in the hospitals. Just as abortion mortality is largely avoidable, the huge economic burden of treating abortion complications is also largely avoidable. Although knowledge of contraceptives is nearly universal, their correct and continuous use is much less well distributed. Obstetricians and gynecologists should reflect on their own attitudes toward abortion, and should contribute to finding a solution to the problem through concrete actions in their clinical practice, teaching, and influence over legislation.
Web site : http://www.scielo.org.co/scielo.php?script=sci_serial pid=0034-7434 lng=pt nrm=isowww.fecolsog.org/ShowChannel.asp?ChannelId=300Abstract : Worldwide, approximately 300,000 people have AIDS, and there are 50-100 infections for each case. Responsible sexual behavior is crucial for prevention, since sexual transmission is the principal route of contracting AIDS. The major causes of maternal mortality in the 15-39 year age group in Latin America are complications from induced abortion which is also responsible for 40% of global maternal mortality, i.e., 200,000 women die because of induced abortion complications out of 500,000 women who succumb to pregnancy- and birth-related caused annually. In the 1980s 38% of deaths in Chile were related to abortion of women who died in reproductive age. In developing countries almost 50% of hospital admissions occur because of abortion sequelae. Infant mortality is higher in <20-year old mothers giving birth compared with the 20-29 age group. 40,000 children are born/year in Chile to mothers <20. In 1980 these births made up 16.7% of all births. 45% of births of mothers <20 are illegitimate. These young mothers are often unprepared for the parental role: 80% of children hospitalized for malnutrition were children of adolescent mothers according to a survey. The Catholic Church's view opposing contraceptives and sexuality outside of marriage conflicts with contemporary opinion backed by mass media favoring sexuality as leading to personal enrichment and advocating contraception. More than 60% of boys and more than 30% of girls start sexual relations <20. Young people do not use contraceptives because of misinformation, difficulty in getting appropriate information, and male machismo. AIDS prevention mandate sex education stressing responsible sexuality with abstinence, condom use, and monogamy.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 075955Abstract : Estadísticas del Centro de Ayuda para la Mujer del número de mujeres que han convecido de no abortar
Web site : http://www.gire.org.mx/Abstract : Equity in access to effective, safe, timely and women-centered abortion related services is a public health priority. Measurement of progress requires efforts to assess PAC services at a national level. This kind of information is largely non-existent in most developing world countries. This paper presents results from a national "rapid assessment" designed to evaluate quantity, quality and geographic distribution of public postabortion care (PAC) services in Peru. To determine PAC service availability, study investigators collected data from 30 of the 33 MOH Administrative Health Units in Peru. In a subsequent convenience sample of 31 individual facilities, researchers assessed overall service quality, using a simple checklist format. Results showed that 26,934 postabortion patients were treated in 206 MOH facilities during year 2000, primarily in health centers. This estimate is 339 % higher than the last annual (1997) PAC patient caseload captured by the existing MOH information system. The majority of facilities offering PAC attended one or fewer patients a month. Services were unequally distributed, with PAC services unavailable in 46% of all provinces. Manual vacuum aspiration for uterine evacuation was available in 16% of 206 facilities surveyed and was utilized for over one-half of PAC patients. Thirty-four percent of PAC patients received a contraceptive method prior to leaving the health care facility. Average patient fee for treatment was US $ 22 (rage: from $6 to $100) per case. The study findings underscore current problems in PAC services and justify for allocation of increased resources to improve access and quality. Learning Objectives: At the conclusion of the session the participant will be able to: Describe a broad picture of PAC services in Peru; Identify gaps in PAC access and quality that need to be improved to scaling up PAC services
Notes : Inglés/anglais/EnglishAbstract : Este reporte es una versión abreviada de las memorias y resultados de la Conferencia Desarmando la Crítica: El Cairo, cinco años después. Con la finalidad de que sea una ayuda para ejecutar las tareas del programa de acción a nivel regional, nacional e internacional
Notes : Español/espagnol/SpanishAbstract : In an attempt to rethink explanations of change in Brazilian fertility I discuss two "demographic truths" that systematically appear, are widely disseminated for public consumption. The first truth, that fertility decline began in the mid-1960s its future will be an irreversible decline, homogenization, stability, is problematic since deliberate control has occurred since the beginning of the 20th century, it varies widely by cohort, race, geographical region. Although the mid-1960s may have been an important turning point toward the generalization acceleration of the process of decline, it does not represent its onset. Also the complexity of factors interactions form different regional experiences, trends do not support the hypothesis of homogenization the irreversibility of fertility decline. Regarding the second "demographic truth," that fertility decline is mostly explained by a series of "unanticipated results" of the action of institutional actors "unintended consequences" of public policies, I argue that it lacks sufficient attention to history takes a narrow view of what constitutes population policy. Rather, I find the "medicalization of social relations" to be the common thread that captures the complexity of the interactions between medicine, the family, the Brazilian state, fertility behavior. Through this complex interaction, an interesting set of elements emerges pointing toward a profile of a policy affecting population reproduction that goes beyond contemporary neo-Malthusian conceptions or measures aimed to control population growth. 91 References. Adapted from the source document
Notes : Inglés/anglais/EnglishAbstract : Prólogo: Proteger los derechos humanos de los niños, niñas y adolescentes supone diseñar políticas y programas sociales a partir de información de calidad. Por ello, el UNICEF presenta la siguiente investigación, que arroja luz sobre una zona novedosa en los estudios sobre sexualidad adolescente. El estudio de Rosa N.Geldstein y Edith A. Pantelides presenta nuevas preguntas frente a la evidencia de que más de 105.000 adolescentes dan a luz anualmente en la Argentina, y que casi el 14% de las muertes maternas registradas en el país corresponde a niñas de entre 10 y 19 años de edad. En el análisis de los datos recogidos en este trabajo, se manifiesta que tanto las condiciones materiales de vida de las jóvenes como las imágenes que de sí mismas y de sus congéneres tienen las mujeres son decisivas a la hora de exponerse o no a conductas de riesgo reproductivo. La construcción cultural de las relaciones de género define territorios sociales y culturales que asignan espacios, responsabilidades, actividades y recursos diferenciales para hombres y mujeres. En la medida que las mujeres y los varones incorporan sin cuestionamientos algunas imágenes tradicionales sobre lo que significa pertenecer a uno u otro género en una sociedad determinada, no son pocas las fronteras que se imponen a sí mismos y también a otras personas. Sin embargo, el problema no radica tanto en estas diferencias como en aquel momento preciso en que las diferencias legítimas que existen entre las personas constituyen bases de desigualdad en el ejercicio de los derechos humanos. En el terreno de la sexualidad, esta investigación muestra que en muchos casos no es la falta de conocimiento o información la que impide a las jóvenes una conducta de autocuidado y prevención, sino el pudor y la convicción de que una mujer no puede poner condiciones en la negociación de las relaciones sexuales. Allí donde dos personas tienen responsabilidad respecto de la vida y su mutuo cuidado, la total decisión sobre el uso de medios de protección de enfermedades de transmisión sexual y embarazos no deseados recae sobre una de ellas debido a la fuerza con que se inscriben las imágenes de género en nuestras vidas. Pero esto no sucede con igual intensidad en mujeres de distintas clases sociales. Por el contrario, esta investigación comprueba que la superposición de la condición de género y de clase tiene efectos negativos en el desarrollo de las capacidades de decisión de las jóvenes más pobres. Entre ellas, se observan mayores dificultades para desarrollar capacidades de decisión -incluso en aspectos relacionados con el propio cuerpo- cuando el acceso a la información y las posibilidades de desarrollo personal y social también son dificultosos. Esta investigación procura que las diferencias encontradas entre los tres segmentos poblacionales caracterizados (adolescentes de clase baja, que la investigación divide en dos grupos denominados marginadas e integradas, y adolescentes de clase media alta) puedan leerse como desafíos para superar las desigualdades encontradas y no como el destino inexorable que deberán afrontar las mujeres más pobres debido a la convergencia de clase y género. Con este propósito, políticas que promuevan la participación de las mujeres adolescentes en igualdad de condiciones que los varones se vuelven tan centrales como aquellas políticas orientadas a ofrecer servicios de salud e información de calidad para los y las adolescentes. Esta participación de la mujer joven debe comprenderse como el fortalecimiento de la autonomía mediante la apropiación de su cuerpo y la extensión de las fronteras del espacio que habita, la valoración de su voz, de sus decisiones y de su capacidad de autocuidado, particularmente entre aquellas jóvenes de los sectores más pobres de la sociedad. Pensar los derechos humanos bajo el prisma de su integralidad e interdependencia traza uno de los mayores desafíos para las políticas públicas. En la vida de las personas y en las relaciones sociales e institucionales que establecen, se superponen de múltiples maneras el acceso a servicios satisfactorios con la capacidad de la gente para solicitarlos. Y frecuentemente esta última dimensión, que requiere de una preparación específica de capacidades para el ejercicio de derechos, queda postergada. Consideraciones de este tipo son las que concluyen en la necesaria articulación de los derechos civiles y políticos con los derechos económicos, sociales y culturales. El estudio que se presenta en este Cuaderno del UNICEF permite deducir, una vez más, lo altamente relacionados que están unos y otros derechos durante la adolescencia. Eleonor Faur
Web site : http://www.unicef.org/argentina/spanish/ar_insumos_Riesgoreproductivoadolescencia.pdfAbstract : The full text includes discussion of women's health issues in Argentina, including health systems and economic policies
Web site : http://www.wedo.org/library.aspx?ResourceID=20www.wedo.org/files/risksrightsreforms.docAbstract : 75% of Chile's population follows the teachings of the Roman Catholic Church. Women in Chile, however, are increasingly abandoning official church teachings on childbearing and sexual and marital ethics. They are making their own reproductive choices, regarding contraception as a socially legitimate need, often with clergy support. Evidence of this behavior may be seen in Chile's low 2.6 child per woman rate of total fertility, comparable to those of Uruguay and Cuba as the lowest in Latin America. Chilean women's attitude contrasts sharply with the Catholic fundamentalism in Chile's laws. For example, divorce is illegal, pregnant teens have only recently been allowed in the classroom, and even abortion for medical reasons was banned in 1989. Wary of taking on the Church, the current government of Chile has done little since 1990 to reform its family and population policies after 17 years of military dictatorship under General Augusto Pinochet. Church authorities who defended human rights during the military regime have now focused upon restricting reproductive rights. The author discusses Church disapproval of family planning, dissent within the Church, contraceptive imperialism, the morality crusade, the conservative nature of family law in Chile, changes and reversals with regard to abortion, machismo and marianismo, and the need for the Catholic Church to adopt a more realistic approach to reproductive choice and health.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 106846Abstract : As a non-invasive means of early abortion, RU-486 has the potential to increase women's reproductive options; at the same time, the "abortion pill" has stimulated debate about the ethics and safety of new medical technologies. When combined with a prostaglandin (PG), the success rate for RU-486 is 96% for pregnancies of up to 9 weeks' gestation. In France, over 120,000 women have used RU-486/PG to terminate pregnancy, and this regimen is now used in about 25% of abortions. Clinical trials of RU-486 are underway in Cuba, China, India, Singapore, and Zambia. The Program for Appropriate Technology has identified four considerations for introducing RU-486 to developing countries: whether abortion or menstrual regulation is legal; whether women find the method acceptable and can comply with the multiple visit treatment regimen; whether the health infrastructure can support safe method use, including prevention of misuse and provision of appropriate medical backup personnel and facilities; and whether the cost of the regimen is affordable to individuals and/or programs ; conditions unlikely to be met in most such countries. Ideal would be development of a medical abortifacient that is single dose and the lowest possible dose of each drug, provokes miscarriage within a more predictable time frame with less acute and prolonged bleeding, is safe and effective beyond two months, has minimal side effects, and maximizes short-term safety and minimizes long-term effects. Technological advances are being undermined, however, by political and religious attacks on the method. Even some feminists have expressed concerns about potential long-term effects of RU-486 use.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Routine follow-up visits after abortion are intended to confirm that the abortion is complete and to diagnose and treatcomplications. Many clinicians also take advantage of the follow-up visit to provide general reproductive health care: discussing contraceptive plans and providing family planning services; diagnosing sexually transmitted infections; performing a Pap test or discussing abnormal Pap results. We reviewed the evidence related to the routine postabortion follow- up visit. Other than mifepristone medical abortion performed at 50 days of gestation or later and methotrexate medical abortion, we found little evidence that mandatory follow-up visits typically detect conditions that women themselves could not be taught to recognize. In addition, the natural history of the most severe complications after abortion- infection and unrecognized ectopic pregnancy-have time courses inconsistent with the usual timing of the follow-up visit. Costs associated with this visit can be great. These include travel expenses, lost wages, child-care expenses, privacy and emotional burdens for women, and scheduling disruptions and the related opportunity costs caused by "no-shows" for the provider. Follow-up appointments should be schedule for those women likely to benefit from a physical examination. For the remainder of women, simple instructions and advice about detecting complications, possibly coupled with telephone follow-up, might suffice. Although arguably valuable in their own right, counseling, family planning services, or sexually transmitted infection diagnosis and treatment should not be so inflexibly bundled with postabortion care. Protocols that require in-person follow-up after abortion may not make the best use of a women's time or abilities, or of the medical system. (author's)
Web site : http://www.sciencedirect.com/science/journal/00297844Abstract : En junio de 1999, en la Sesión Especial de Asamblea General de las Naciones Unidas se revisó y evaluó el progreso realizado hacia la implementación del Programa de Acción de la Conferencia Internacional sobre Población y Desarrollo realizada en el Cairo en 1994. Los gobiernos del mundo reconocieron nuevamente al aborto inseguro como uno de los principales temas de salud pública, y se comprometieron a reducir la necesidad de abortos a través de la expansión y el mejoramiento de los servicios de planificación familiar. También acordaron que en circunstancias donde el aborto es legal, los sistemas de salud deberán capacitar y equipar a los proveedores de los servicios de salud y deberán tomar otras medidas para asegurar que el aborto sea seguro y accesible; y que se deberán tomar medidas adicionales para salvaguardar la salud de las mujeres. Esta guía técnica y política surge de una consulta técnica a expertos del mundo en los campos de la medicina, ciencias sociales, leyes, ética, provisión de servicios e información, y políticas de salud. Está dirigida a una amplia gama de profesionales de la salud y otros, dentro y fuera de los gobiernos, que estén trabajando para reducir la mortalidad y la morbilidad materna. Provee un revisión comprensiva de muchas de las acciones que pueden ser tomadas para asegurar el acceso a servicios de aborto de buena calidad cuando esto sea legal.
Notes : Inglés/anglais/English, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This report contains background information for Safe Motherhood efforts in Latin American and the Caribbean. After a brief introduction, chapter 1 deals with the following topics: 1) national and regional levels and trends in maternal mortality; 2) the causes of death structure of maternal mortality; 3) demographic factors contributing to maternal mortality (conditions of fertility, maternal age, age at first marriage or union, age patterns of childbearing, the contribution of maternal deaths to overall mortality among reproductive-age women, parity, and birth intervals); and 4) morbidity and reproduction (sexually transmitted diseases, infertility, other health impairments, nutrition, and the infirmities associated with burden of work). Chapter 2 looks at the consequences of marriage and fertility patterns through a consideration of marital forms, the relationship of marital forms with STDs, the reproductive life cycle, and adolescent childbearing. Chapter 3 discusses ways to achieve and maintain the well-being of women, such as overcoming the effects of adverse health conditions through provision of information, community participation, increasing access to and quality of maternal care, improving nutrition, and empowering women; preventing high-risk and unwanted pregnancy; family planning (FP); enhancing women's education; and improving the environment. Chapter 4 describes the cultural constraints that contribute to maternal mortality and morbidity, including machismo, the sheltered female role, son preference, the impact of illegal abortion, the distinctive culture of the elite, delivery of health care, and harmful cultural practices surrounding child birth. Chapter 5 considers resource mobilization (human and financial, institutionalization and community participation, and maximizing returns from investments in FP and maternal health care). The final chapter presents recommendations to enhance safe motherhood by improving education, FP, family life education, female nutrition, women's status, and the delivery of maternal health care. Safe Motherhood recommendations forwarded by UN agencies are also summarized.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 116651Abstract : This article examines the impact of discourses on maternal mortality, including issues pertaining to induced abortion, health policies and services for women. In the 1987 International Conference on Safe Motherhood held in Nairobi, a goal was set to halve the number of maternal deaths in developing countries by the year 2000. Subsequently, efforts were made by the Bolivian government to rapidly reduce maternal mortality rates, at least one third of which result from the complications of unsafe abortions. Public debates increasingly centered on women's health and experiences have touched on the issue of abortion, however, opposition from conservative forces within the Bolivian government influenced by the Catholic hierarchy has curtailed such endeavors in 1996. Moralists addressed the government, as well as the general public, labeling abortion as criminal and anti-life. This scenario provides evidence that discourses, which condemn abortion, have material effects on women's bodies and lives. Hence, there should be recognition and consolidation of the advances brought about by the Safe Motherhood Initiatives and a revitalizing of these initiatives with new concepts and fresh objectives.
Web site : http://www.rhmjournal.org.uk/Abstract : This paper is based on the article published in 1997 in Reproductive Health Matters 5(9):10-19, with the same title. However, this re-edition in the book Safe Motherhood Initiatives: Critical Issues incorporates a Postscript written in 1999 to update the discussion on abortion discourse and practice in Bolivia. The Postscript includes sections on the new official language of "treatment of haemorrages" (to replace "postabortion care"; forward and backward steps in implementation of the Cairo agenda; a documented case of unsafe abortion, with the woman at risk being taken from one service to another in search of treatment to save her life; and the first legal abortion in Bolivia, on August 10th 1998, for a 14-year-old girl who had been raped by her father.
Notes : Inglés/anglais/EnglishAbstract : Ten years ago, in 1987, the International Conference on Safe Motherhood was held in Nairobi. As a result of this event, greater attention has been given to the previously 'unseen tragedy' of maternal mortality and its significance as a development indicator. A goal was set to halve the number of maternal deaths in developing countries by the year 2000. In Bolivia, the past decade has seen considerable developments in reproductive health policies and services, including a number of programmes designed to reduce maternal mortality, at least one third of which result from the complications of unsafe abortions. However, due to opposition from conservative forces within the Bolivian government influenced by the Catholic hierarchy, efforts to reduce deaths from unsafe abortion took a step backwards in 1996. This paper shows that discourses which condemn abortion have material effects on women's bodies and lives. It argues that the advances brought about by Safe Motherhood initiatives should be recognised and consolidated, and calls for these inititiatives to be revitalised with new concepts and fresh objectives, which construct women's diverse identities and needs as women and not only as mothers.
Web site : http://www.rhmjournal.org.ukAbstract : Between 2,000 and 5,000 Mexican women die each year from infections or other complications after illegal abortions performed by doctors in cities and by midwives and herbalists in the countryside, women's groups estimate. They say that more than two million Mexican women terminate their pregnancies each year."Most of the women who die are poor," says Marta Lamas, president of the Elective Reproduction Information Group, which is pressing for the legalization of abortion in the pre-dominantly Roman Catholic country.
Notes : Inglés/anglais/EnglishAbstract : A multi-center comparative study of medical compared to surgical abortion confirmed that medical abortion can be safe, effective, and acceptable in developing countries. A total of 1373 women from medical centers in China, Cuba, and India with pregnancies of 56 days' gestation or less were given the choice of surgical abortion or 600 mg of mifepristone followed after 48 hours by 400 mcg of misoprostol. Since the majority selected medical abortion, researchers in China and Cuba assigned some of these women to the surgical group to equalize the size of the two groups. The surgical abortion failure rates in China, Cuba, and India were 0.4%, 4%, and 0%, respectively, while the failure rates for medical abortion were 8.6%, 16.0%, and 5.2%, respectively. In all sites, both medical failures (an adverse effect resulting in a medically indicated surgical intervention) and acceptability failures (failure to complete the entire regimen) contributed substantially to the gross failure rates for medical abortion. Medical abortion failure rates increased with gestational age. Although cramping, nausea, and vomiting were more frequent among women in the medical abortion group and bleeding was heavier, general assessments of well-being reported at exit interviews did not differ between the two treatment groups at any site. Regardless of abortion method, the majority of women were either satisfied or highly satisfied with the procedure. In all countries, a higher number of medical than surgical abortion patients indicated they would opt again for the same procedure. Neither the bleeding pattern nor the higher failure rate associated with medical abortion justify withholding this option from women in developing countries.
Web site : http://www.ajog.org/scripts/om.dll/serve?action=searchDB searchDBfor=iss id=job971762 target=Abstract : Family planning programs became available on a small scale in Chile in 1938. In 1962 the Director General of the National Health Service created an advisory committee of obstetricians and public health workers to study the desirability of expanding family planning programs. The committee was supported by National Health Service resources and the IPPF through its local affiliate, the Chilean Association for Family Protection, which began functioning in 1964. Control of illegal abortion and reducing maternal morbidity and mortality were principal objectives of the program. By the early 1960s, Chile's abortion rate was estimated at 32.0/1000 fertile-aged women, and 19.7/100 live births, but the true occurrence was believed to be higher. In 1964, 20% of beds in the maternity services were devoted to abortion complications, which accounted for 8% of hospital discharges. In 1965, the maternal mortality rate from abortion was 9.9/10,000 live births, while overall maternal mortality amounted to 27.9/10,000. A 1965 resolution sanctioned the new National Policy of Fertility Regulation, which had the stated objectives of controlling illegal abortion, reducing infant mortality, and promoting family welfare and responsible parenthood. Priority in obtaining family planning services was to be given to women hospitalized for abortion complications and grand multiparas with socioeconomic problems and serious pathologies. The number of women covered by the service increased from 57,000 in 1965 to 560,424 in 1987. High quality family planning education was offered to clients, and a comprehensive research program was undertaken that benefited from the assistance of the Population Council, Ford and Rockefeller Foundations, USAID, and other bilateral organizations. 2 large projects to extend maternal-child health and family planning coverage at the primary level and in rural areas were successfully carried out in 1973-76 and 1978-81, with the assistance of the UNFPA, UNICEF, and the Latin American Demographic Center. As a result of the newly available family planning services, the maternal mortality rate declined from 27.9/10,000 in 1965 to 13.1 in 1975 and 4.8 in 1987. Rates of maternal mortality from abortion declined from 9.9/10,000 in 1965 to 4.8 in 1975 and 1.7 in 1987. The estimated prevalence of abortion declined from 28.0 hospital discharges/1000 fertile-aged women in 1965 to 11.3 in 1984. The variation was, however, less marked among adolescents. The infant mortality rate fell from 95.4/1000 in 1965 to 18.5 in 1987, with almost 30% of the decline attributed to family planning. The crude birth rate fell from 36.3/1000 to 22.3 and the population growth rate declined from 2.5% to 1.7/year between 1965-87. The total fertility rate fell from 4.7 in 1960 to 2.4 in 1987.
Web site : http://www.scielo.cl/scielo.php?pid=0034-9887 script=sci_serialAbstract : Resumen ; Introducción ; Evaluación del cambio ; El contexto más amplio ; Políticas que apoyan la salud reproductiva ; Mejoras en los servicios de salud reproductiva ; Factores que apoyan u obstaculizan el cambio ; Recursos dedicados a la salud reproductiva ; Con vistas al porvenir ; Apéndice 1: participantes en el proyecto ; Apéndice 2: resúmenes de los estudios de caso: Brasil, India, Marruecos, Uganda
Web site : http://www.prb.org/Abstract : Analiza el rol que juegan los hombres en relación con la planificación familiar en Santa Lucía; el aborto como elección anticonceptiva en Guyana y la experiencia de mujeres adolescentes de Jamaica en cuanto a salud reproductiva. Presenta el contexto histórico de cada país con el fin de entender sus composiciones demográficas y antecedentes culturales. Presenta los resultados de las encuestas del trabajo de campo realizado, datos estadísticos sobre población y comenta las políticas de población en cada caso
Notes : Español/espagnol/SpanishAbstract : El presente trabajo tiene como propósito brindar un panorama actualizado de los aportes científicos de las Ciencias Sociales y de la Salud al conocimiento de la Salud Reproductiva de los Adolescentes argentinos. La búsqueda de referencias bibliográficas se acotó al período 1990-1998, e incluye documentos que enfocados sobre población adolescente, desde una perspectiva que puede encuadrarse en el área de Salud Reproductiva. El análisis del material permitió brindar un panorama de cómo se ha producido el conocimiento y de cuáles son los puntos de llegada, los vacíos y los nudos problemáticos que se desprenden de lo realizado hasta el momento.
Web site : http://www.cedes.org.ar/Publicaciones/Ndoc_c/ndoc_c4.pdfAbstract : These two volumes present a selection of the scientific studies that have been undertaken in Cuba on the subject of reproductive health. The first volume contains sections on reproductive rights, sexuality, fertility and infertility, and maternal and child health. The second volume has sections on family planning and contraception, abortion, AIDS, and other aspects of maternal health. (ANNOTATION)
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND RH86141Abstract : Este informe presenta las conclusiones de un estudio exploratorio realizado en las áreas rurales pobres de tres provincias norteñas de la Argentina (Misiones, Salta y Santiago del Estero). Estas provincias fueron seleccionadas debido a que tienen grandes concentraciones de población rural, particularmente pequeños productores (minifundistas), con altas tasas de pobreza y un bajo desempeño en términos de indicadores de salud y necesidades básicas. El estudio abarcó una muestra aleatoria de trescientos hogares de mujeres en edad reproductiva con un hijo como mínimo. Se realizaron también grupos focales y entrevistas en profundidad con informantes clave para validar los datos cuantitativos y a fin de explorar temas tales como los roles de género, la violencia doméstica, el aborto y la anticoncepción. El estudio se propuso realizar una contribución para la mejor comprensión de los problemas relacionados con la salud reproductiva, la calidad de la vida y la pobreza rural -primordialmente en lo que respecta a cómo afectan a las mujeres- y brindar recomendaciones sobre políticas destinadas a abordar estrategias de alivio de la pobreza rural y problemas de salud reproductiva. En el estudio también se exploraron las percepciones y conductas masculinas relacionadas con la salud reproductiva.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : El espacio de los derechos en el campo de la reproducción /Juan Guillermo Figueroa y Blanca Margarita Aguilar Ganado ; Argumentos e inquietudes. La oposición a la legalización del aborto / Frances Kissling ; Factores psicosociales y conducta sexual riesgosa para el SIDA en mujeres rurales involucradas en la migración México-Estados Unidos / V. Nelly Salgado de Snyder y Ma. de Jesus Dlaz Perez ; Declaración de principios éticos sobre derechos reproductivos.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Este informe presenta los resultados de la Encuesta Nacional de Salud Reproductiva y Migración de 1999-2000 (ESR-99), llevada a cabo por el Programa Centroamericano de Población (PCP) de la Escuela de Estadística de la Universidad de Costa Rica, con la colaboración del Instituto de Investigaciones en Salud (INISA). Esta encuesta continúa un tradición de estudios similares efectuados en Costa Rica a intervalos de aproximadamente 5 años, que ha permitido dar seguimiento a la situación de este país en lo referente a la fecundidad y planificación familiar en las últimas tres décadas. Esta encuesta, a diferencia de las anteriores, recoge además información sobre la inmigración de nicaragüenses a Costa Rica, que permitió estimar con precisión el volumen de la migración nicaragüense y analizar la situación de la salud reproductiva y el uso de los servicios de salud en esta población migrante. Incluye: Introducción ; Diseño del estudio ; Población de estudio ; Muestra general ; Muestra complementaria ; Resultados del trabajo de campo ; Salud y características reproductivas de mujeres residentes en Costa Rica 1999 ; Características de las mujeres en edad fértil y sus hogares ; Características de las entrevistadas ; Características de los hogares donde viven las mujeres en edad fértil ; Salud de la mujer y del niño ; Salud de la mujer en edad fértil ; Tabaquismo ; Prevención de cáncer de útero ; Prevención de cáncer mama ; Vacunación antitetánica ; Consulta médica ; Prevalencia de patologías específicas ; Salud materna y del niño menor de cinco años ; Control Prenatal ; Niños prematuros ; Niños con bajo peso al nacer ; Atención del parto ; Lactancia materna ; Inmunizaciones ; Morbilidad del niño ; Diarrea ; Fiebre/tos ; Atención médica del niño enfermo ; Nacimientos no reconocidos por el padre ; Planificación familiar ; Conocimiento de métodos y fuentes ; Aprendizaje y difusión de la planificación familiar ; Uso pasado de la planificación familiar ; Prevalencia anticonceptiva ; Planificación familiar entre las mujeres no unidas ; Proveedores de los métodos anticonceptivos ; Acceso a los servicios de planificación familiar ; Preferencias de fecundidad ; Antecedentes ; Fecundidad no deseada ; Deseo de un nuevo hijo y espaciamiento ; Concordancia en los deseos de la pareja ; Número deseado de hijos ; Antecedentes en Costa Rica ; Objetivos ; Metodología ; Variables a analizar ; Metodología de análisis ; Resultados ; Tendencias entre 1992 y 1999 ; ¿Qué se asocia con el comportamiento de las preferencias de fecundidad, en 1999? ; Discusión y conclusiones ; Nupcialidad, práctica sexual y fecundidad ; El estado conyugal ; Preferencias Anticonceptivas ; Percepción acerca del Aborto ; Percepción de la mujer costarricense respecto a la posición de la iglesia, el gobierno y la enseñanza de la educación sexual a los jóvenes ; La unión libre ; Práctica sexual ; Otros aspectos importantes de la práctica sexual ; Comportamiento premarital ; La primera relación sexual ; Disolución de la primera unión y uniones sucesivas ; Edad de la primera Unión ; Fecundidad Conyugal ; Migrantes nicaragüenses en Costa Rica 2000: volumen, características y salud reproductiva ; Número y características de los inmigrantes nicaragüenses en Costa Rica ; Fecundidad de las nicaragüenses ; Estimación del total de nicaragüenses ; Características de los nicaragüenses: Distribución por sexo, edad y nivel de educación ; Características de los hogares en los que viven los nicaragüenses ; Anexo: Método de estimación del total de inmigrantes nicaragüenses en Costa Rica ; A.I: Estimación de las MEF ; A.2: Estimación de la población total ; A.3: Estimación de la fecundidad relativa con regresión múltiple de Poisson ; A 4: Resultados ; Salud y uso de los servicios: una comparación entre costarricenses e inmigrantes nicaragüenses ; Características de las entrevistadas ; Salud y uso de servicios ; Tabaquismo ; Prevención del cáncer de útero ; Prevención del cáncer mamario ; Vacunación antitetánica ; Consulta médica en el último año ; Lugar de la última consulta ; Prevalencia de patologías específicas ; 72 Prevalencia anticonceptiva ; Proveedor de los métodos modernos ; Salud y uso de los servicios de madres y niños menores de cinco años ; Mujeres con último hijo nacido vivo menor de cinco años ; Control prenatal adecuado ; Niños prematuros ; Bajo peso al nacer ; Parto por cesárea ; Atención profesional del parto ; Lactancia materna ; Salud y uso de los servicios en niños menores de cinco años ; Inmunizaciones ; Morbilidad ; Diarrea ; Fiebre/tos ; Atención médica del niño enfermo ; Niños con padre desconocido ; Referencias ; Apéndice: cuestionario de encuesta
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Desarrollo humano y salud reproductiva ; Población y desarrollo ; El contexto histórico de la Conferencia Internacional sobre Población y Desarrollo de El Cairo ; Nuevos Paradigmas del Desarrollo ; La cotidianeidad como espacio de decisiones en salud reproductiva ; Variaciones en torno al desarrollo humano sostenible ; Algunas reflexiones sobre la interpretación social de la participación masculina en los procesos de salud reproductiva ; La masculinidad y el rol masculino en la salud sexual ; Cambios en fecundidad y anticoncepción ; Cambio social y la transición de la fecundidad en América Latina: Una exploración Teórica ; Necesidades y demanda de planificación familiar ; Politicas de población en salud reproductiva ; Salud reproductiva y planificación familiar ; Implicancias de la Conferencia Internacional sobre Población y Desarrollo de El Cairo en las Politicas de población ; Evaluación de programas de población y de Salud Reproductiva (SR) ; ETS, Sida y Mortalidad materna en las Americas ; Mortalidad materna, tendencias en la prevención ; Aborto inducido y morbimortalidad por aborto inducido: los retos culturales y políticos de la prevención ; La prevención ETS/SIDA: Una mirada sociológica ; Situación del SIDA en el Perú ; Ética en salud reproductiva ; Un apunte sobre ética y derechos reproductivos ; - Adolescentes, sexualidad y salud reproductiva ; La sexualidad de los adolescentes y los jóvenes Linçmeños contemporáneos ; Adolescentes y sexualidad ; Servicios para adolescentes.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : The outcome of the International Conference on Population and Development held in Cairo in 1994 had important implications for the development of future programs. Since the end of the 1950s family planning programs have been characterized by an emphasis on contraception, measuring effectiveness by means of continuation rates and new acceptors. In the 1970s it became clear that family planning also had to be associated with maternal-infant health. The 1984 conference in Mexico revealed the importance of the condition of women as relating to problems of fertility, morbidity, mortality, and family formation. The central topic of the Cairo conference was that the right to health includes reproductive health. The Program of Action had a section on reproductive rights and reproductive health from a social perspective. This also means the right to information, services, and family planning methods. The conference accepted five actions relating to family planning, maternal health, abortion (in Peru there were 271,150 abortions out of 905,400 pregnancies in 1989), infections of the reproductive tract including AIDS, and infertility caused by tuberculosis and STDs. Actions outside the health sector relate to problems of the population and health with socioeconomic development and improvement of the status of women and equality with men. Other objectives deal with the elimination of all discrimination against girls, the participation of women in the programs, access to education, and the elimination of poverty.
Notes : Español/espagnol/Spanish, nbsp;115697Abstract : Mensaje de la editora ; Al hablar de la sexualidad se promueve la salud sexual ; Capacitación de los proveedores para hablar acerca del sexo ; Las circunstancias de la vida influyen en las decisiones ; Estereotipos ponen en peligro la salud sexual ; Mensajes contradictorios ponen a las jóvenes en una situación de riesgo ; Programas para los jóvenes cuestionan estereotipos ; Cuando la pareja dialoga, disminuye el riesgo ; Dialogue: instrumento que promueve las conversaciones francas ; Algunas veces el uso de métodos tradicionales se relaciona con la comunicación ; Asesoramiento a las parejas facilita revelar el estado relativo al VIH ; Más uso de anticoncepción menos abortos ; Servicios de alta calidad mantienen bajas las tasas de aborto ; ¿una cultura de aborto?.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Reproducción, familia y género: decisiones en torno a la fecundidad y al trabajo / Elsa López y Liliana Findling ; Un estudio comparativo del comportamiento reproductivo de mujeres de alta y baja paridez / María Cristina Ventura ; Uso de métodos anticonceptivos entre las mujeres pobres del Conurbano Bonaerense / Andrea Federico ; El estudio de la participación del varón en la salud reproductiva: notas para la discusión / Graciela Infesta Domínguez y Hernán M. Manzelli ; Legislaciones sobre aborto: un análisis comparado / Mario Pecheny ; Póliticas de población en la década de 1930-1940 en la Argentina. Un análisis preliminar / Susana Novick ; Mortalidad por suicidio en la Ciudad de Buenos Aires. Su magnitud y características. Transformaciones en el período 1980-1995 / Victoria Mazzeo ; Utilización y gasto en servicios de salud según educación, clase social e ingreso, en el área metropolitana de Buenos Aires / Jorge Raúl Jorrat, Elida Marconi, Mercedes Méndez, Alonso e Inés Moreno ; La desregulación de las obras sociales: una mirada sobre la reforma desde los actores involucrados / Liliana Findling ; Nuevo perfil sindical, mercado y salud. El 231 caso de la obra social de los trabajadores de las empresas de electricidad (O.S.T.E.E.) / Stella Maris Cabral ; La voz del estado y la voz del mercado. Diferencias y algunas semejanzas entre las campañas de promoción de la salud y promoción del consumo / Ricardo Martínez Mazzola ; Los modelos político-comunicativos del sida y el cólera en la Argentina 1991-1993 / Mónica Petracci, Luis A. Quevedo y Ariana Vacchieri ; Identidades y complejo vih/sida / Graciela Biagini ; El hospital público y el complejo vih/sida / Marita Sánchez y Raquel Ayala Torales ; Percepciones de los jefes de guardia de un hospital metropolitano acerca de su trabajo / Ana Lía Kornblit ; La salud reproductiva en las representaciones y prácticas de los servicios públicos de salud / Susana Checa y Cristina Erbano ; Los jóvenes y el riesgo / Ana María Mendes Diz ; Jóvenes, instituciones y malestar personal acerca de la producción social de problemas biopsicológicos en adolescentes que reciben tratamiento hospitalario / Daniel R Padilla ; El suicidio juvenil en la Argentina / Pablo D. Bonaldi
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This work describes ethnographic and other evidence that lower class women in southern Brazil believe that the fertile period is simultaneous with or closely related to the menstrual period. Ethnographic reports from both rural and urban areas in southern Brazil, materials on the folklore of the area, and findings of an ongoing study of four lower class neighborhoods served by community health services indicate that nearly all lower class adults of both sexes believe that conception is possible if not most likely during the menstrual period. Menstrual blood is not viewed as actually a part of women, but as a fluid which remains in the uterus after fertilization or otherwise as something dirty that must be eliminated. The cultural model of the female body includes notions of opening to allow elimination of the menstrual fluid, closing after its departure, and states of wetness and heat. Numerous informants reported cases in which women became pregnant while using IUDs or in the interval between 21-day packets of oral contraceptive (OC) pills. The fact that OCs reduce the menstrual flow is viewed as problematic, because blood that should be eliminated is apparently retained. The IUD, which causes long menstrual periods and intermenstrual bleeding, is also viewed with suspicion since it appears impossible to prevent pregnancy when there is actually greater flow. Irregular and incorrect use of OCs and very limited acceptance of IUDs may be factors in the growing demand for female sterilization and in the very high rates of illegal abortion.
Web site : http://www.colmex.mx/centros/ceddu/revista/datgen.htmAbstract : Con motivo de la celebración de diez años de la RedeSaúde, la Rede Nacional Feminista de Saúde e Direitos Reprodutivos presenta una serie de dossier temáticos. Se trata de documentos que son al mismo tiempo técnicos y políticos, y que abordan cuestiones centrales de la salud de las mujeres y de derechos reproductivos. Publicados originalmente entre 1998 y 2001, estos dossier fueron actualizados y fueron reunidos en esta colección. Incluye los siguientes trabajos: Prefacio/ Maria Isabel Baltar da Rocha, Maria Jose de Oliveira Araujo e Maria Betania Avila ; Mortalidade Materna/ Ana Cristina d'Andretta Tanaka ; Aborto Inseguro/ Sara Sorrentino ; Mulher e Aids/ Wilz.a Villela ; Violencia contra a Mulher/ Monica Fontana e Simone Ferreira dos Santos - Menopausa/ Rina Nissim e Maria Jose de Oliveira Araujo ; Bioética e as Mulheres/ Fatima Oliveira e Joaquim Antonio Cesar Mota.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Introduçao ; Conferencia de abertura do Seminario "Saude reprodutiva na AMérica Latina e no Caribe" ; O brasil e as recomendaçoes do Plano de Açao do Cairo / Elza Berquo ; Revisitando o campo tematico saude reprodutiva ; Desde el control de la natalidad hacia la salud sexual y reproductiva: la evolución de un concepto a nivel internacional / José Barzelatto ; De la reproducción social a la salud reproductiva / Carlos Welti ; Análisis ético del entorno de los servicios de salud en el ámbito de la reproducción / Juan Guillermo Figueroa Perea ; Maternidad segura, aborto inseguro: impacto de los discursos en las políticas y en los servicios / Susanna Rance ; Estado, sociedade e direitos reprodutivos ; Derechos sexuales y reproductivos, Estado y sociedad / María Isabel Matamala ; Sexualidade e reproduçao: Estado y sociedade / Leila de Andrade Linhares Barsted ; Hacia nuevas formas de relación entre la sociedad civil y el Estado: la experiencia de Mujeres Autoconvocadas para Decidir en Libertad (Argentina) / María Alicia Gutiérrez; Mónica Gogna: Silvian Ramos ; Questoes de saude reprodutiva ; Rol masculino y disminución de la fecundidad: el caso cubano / Juan Carlos Alfonso Fraga; Mayda Alvarez Suarez ; Varones adolescentes: los significados de la paternidad en la transición hacia los roles adultos / Graciela Infesta Domínguez ; Una espada de doble filo: la salud reproductiva y la violencia doméstica contra la mujer / Juan Carlos Ramírez Rodríguez; Patricia Noemi Vargas Becerra ; Esterilizaçao feminina no Nordeste brasileiro: uma decisao voluntaria? / Maria Gabriela Hita; Maria das Graças da Silva ; Saude reprodutiva em países da América Latina e do Caribe ; La salud reproductiva en Ecuador: realidad y desafíos / Clementina González Espinosa ; Derechos reproductivos y salud reproductiva: la experiencia cubana / Raúl Hernández Castellón ; Maternidad sin riesgos o los riesgos de la maternidad en Costa Rica / Mayra Achío; Ileana Quirós ; Anticoncepción, patrones reproductivos y salud de las mujeres en la Argentina: precisiones, contrastes y problemas / Elsa López ; El empleo de la esterilización como método contraceptivo en una zona del Pacífico Colombiano / Rodolfo Heredia Benítez.
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : A primeira parte apresenta um panorama da saúde sexual e reprodutiva no Brasil nas últimas décadas: o regime demográfico, os movimentos de saúde e direito reprodutivo, e políticas de saúde pública. A segunda discute aspectos conceituais, relaçoes de género, corpo e sexualidade, ética e qualidade de atençao saúde. A última parte traz textos sobre temas atuais como cesárea, aleitamento, género e violéncia, sexualidade, doenças sexualmente transmissíveis, cáncer uterino e climatério.
Notes : Español/espagnol/SpanishAbstract : Unsafe abortion is a public health problem in Central America. Guatemala has one of the highest maternal mortality rates in the Americas. In response, International Planned Parenthood Federation, Western Hemisphere Region developed a project to train hospital staff to provide post-abortion care and family planning counseling. (author's)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 178674Abstract : The monthly distribution of conceptions among adolescents and the proportion of adolescent pregnancies that are voluntarily terminated by induced abortion by month of conception are the objects of this study. Additionally, seasonal variations in the timing of initiation of prenatal care services by adolescents are investigated. Vital records files of single live births, fetal deaths, and induced terminations of pregnancy to residents in the State of South Carolina, 1979-86, were aggregated to estimate conceptions. There was a significant difference between adolescents and adults in the monthly distribution of conceptions. The peak month of adolescent conceptions coincided with the end of the school year. Pregnancies of adolescents occurring at this time further demonstrated later access of prenatal care services than conceptions occurring at other times of the year, most notably during the school term. These findings suggest that there is considerable opportunity for improving the availability of reproductive health care services for adolescents. The results specifically suggest the potential benefit of increasing adolescent pregnancy prevention efforts prior to high-risk events and increasing the availability of and access to health care and counseling services to adolescents during the school recess months of the summer.
Web site : http://www.publichealthreports.org/Abstract : This summary provides key background information for the design and development of a contraceptive social marketing (CSM) project in Venezuela. The country situation is described by providing a map; graphs illustrating population growth, age structure, total fertility rate, and infant mortality rate; the demographic characteristics of the population; the social situation; and leading economic indicators and factors. The population/family planning (FP) environment is then described in terms of the national population policy and goals, the legal and regulatory environment, the media, other international donor agencies and nongovernmental organizations active in the field of population, and the commercial contraceptive market. Available data are then presented on contraceptive usage by methods, the most available methods in the country, discontinuation, abortion, maternal age, needs, desired family size, and contraceptive awareness. The summary lists the following implications for project design from the point of view of the consumer: 1) the most recent data (1977) indicated an unmet need for FP, but more recent data must be obtained to access current demand; 2) more data are needed on the benefits and barriers to oral contraceptive and condom use; 3) data are needed on current use rates, sources of supply, and knowledge of correct use of oral contraceptives (OCs); 4) a significant target population exists for OCs and condoms; 5) marketing strategies should influence women to use modern contraceptives instead of abortion to limit family size. Project implications resulting from the market situation are that 1) despite the fact that commercial distribution networks within urban centers (83% of the population) are well-developed, contraceptives are not widely available at the retail level and are expensive; 2) obstacles to the commercial contraceptive industry exist at the importer, retailer, and consumer levels; and 3) most homes have radios and televisions, but all advertising must be government-approved, and the government has never approved contraceptive advertising. Appended to this document are charts showing 1) fertility rates by region, 2) urban and rural population growth, 3) an analysis of the urban population, 4) the incidence of abortion among current contraceptive users, 5) an analysis of the female population of reproductive age, 6) the age breakdown of women who desire no more children, 7) the contraceptive method used by women who desire no more children, and 8) desired family size.
Notes : Inglés/anglais/EnglishAbstract : Presenta las memorias de las jornadas feministas con el fin de contribuir a la discusión del V encuentro feminista. Discute el feminismo desde la utopía hasta las estrategias concretas prácticas en el marco político y de los partidos. Analiza el movimiento social de mujeres, problemas que enfrenta (como el financiamiento), los espacios mixtos, la relación gobierno/iglesia. Incluye experiencias concretas de América Latina
Notes : Español/espagnol/SpanishAbstract : La salud de las mujeres en la Argentina: precisiones, preguntas y problemas / López, E. ; Características reproductivas y riesgo asociado a la maternidad en una muestra de 650 mujeres provenientes de diferentes estratos sociales / Butinof, M; Reyna, L. y Sabulsky, J. ; Hacia la construcción de una tipología de los comportamientos reproductivos de mujeres pobres urbanas / Ventura, M.C. ; Mujeres pobres del conurbano bonaerense: conexiones entre dinámica del hogar y prácticas anticonceptivas / López, E. y Findling, L. ; Duendes, sexualidad y mujeres / Lorca, N.R. ; Fecundidad y masculinidad: algunos dilemas subjetivos en la construcción de género de los varones / Villa, A.M. ; Sexo e contracepçao em grupos evangélicos e católicos. Notas de uma pesquisa / Campos M.,M. das D. ; Sexualidad, género y prevención de las enfermedades de transmisión sexual / Gogna, M.; Pantelides, E.A y Ramos, S. ; El centro Cecilia Grierson: una experiencia piloto para la promoción de los derechos reproductivos / Zurutuza, C. ; Los derechos reproductivos en la Argentina / Lubertino, M.J. ; Abordaje interdisciplinario en la era de la tecnología reproductiva humana / Willner, R.; Coco, R. y Arribere R. ; Opiniones y percepciones sobre salud reproductiva: el caso de las secretarías regionales de salud en Bolivia / ; García Pimentel, F. ; Comportamientos de unión y salud reproductiva de la población femenina de 15-19 años en Argentina / Añaños, M.C. ; Embarazo adolescente: investigación sobre aspectos biopsicosociales / Calandra, N.; Vázquez, S.; Berner; E.; Corral, A. y Bianculli, C. ; Estilo de vida, imágenes de género y proyecto de vida en adolescentes embarazadas / Climent, G.l. y Arias, D.B. ; Percepción del riesgo y conductas preventivas en relación con el embarazo y el SIDA en jóvenes escolarizados / Kornblit, A. L. y Méndes Diz, A. M. ; Tipología de adolescentes escolarizados de la ciudad de Buenos Aires según sus conductas en la iniciación sexual / Schufer, M.; Necchi, S.; Méndez Ribas, J. M. y Muiños, R. ; Salud reproductiva y sexualidad: una visión desde la perspectiva del varón adolescente / Infesta D., G. ; Incidencia de la información en los modos de comportamiento del equipo de salud frente al SIDA / Etchegoyen, G.; Ascóniga, M.; Legarralde, M.; González A., S. y Candreva, A. ; Representaciones médicas sobre VIH-SIDA: del "riesgo" a la vulnerabilidad / Wallace, S. ; Uso y gestión de los servicios de salud pública en la atención del embarazo y la regulación de la fecundidad / Checa, S. ; Médicos y legos: Convergencias y divergencias respecto del aborto / Zubieta, N. ; El debate sobre la despenalización del aborto: androcentrismo y consenso informado / Lista, C.A.
Notes : Español/espagnol/Spanish, nbsp;255221Abstract : Because of American preoccupation with abortion, worldwide reproductive health issues in 1991 received scant attention, despite many important changes. With the fall of Communism, Eastern European governments struggle in the legislatures and the courts to regulate abortion, particularly Poland, Czechoslovakia, Hungary, and the newly unified Federal Republic of Germany. Two international tribunals ruled narrowly on the restrictive Irish abortion law and international treaties ratified by Ireland protecting freedom of speech, leaving the Irish law intact. Spain's Supreme Court relaxed restrictions on abortion and for the 1st time allowed abortions for social reasons. Frances' highest administrative court ruled that the French government exceeded its authority in ordering the distribution of RU 497 (mifepristone), but ruled that French abortion law, allowing abortions in the 1st 10 weeks in "situations of distress," did not violate international treaties guaranteeing the "right to life." England approved use of RU 486 under English abortion law, with medical restrictions. The Canadian Supreme Court agreed to review a province's legislation that had the effect of limiting access to abortions via medical and hospital regulations. The Islamic, developing countries of Pakistan and the Sudan replaced colonial laws with more liberal abortion rules tailored to Islamic law. Pakistan decriminalized early abortions when given to provide (undefined) "necessary treatment" the Sudan allows abortions during the 1st 90 days. Peru reduced the penalties for some abortions. In Latin America, only Cuba allows abortions on request in early pregnancy. Iran, China, and the former USSR tightened and encouraged compliance with their family planning regulations. Fear of AIDS prompted several countries to tighten condom regulations. Artificial insemination, embryo research and surrogate motherhood also received attention.
Web site : http://www.guttmacher.org/Abstract : Even a few decades ago, it was considered normal and even desirable in Latin America for young women to become pregnant before they were 20 ; provided they were married; while young men were expected to become sexually active as soon as they entered adolescence, without much concern about potential risks or with whom they did so ; as long as it was a woman. This view is now changing. There seems to be a general consensus that 'education' is necessary to prevent adolescent pregnancy, abortion, sexually transmitted infection/HIV and sexual abuse. Attempts to reach agreement as to what kind of education and where, and how and when to provide it often fail, however, because of the conflicting views of sexuality upon which they are based. This article discusses conflicting concepts of sexuality and describes the theory of critical pedagogy followed by Alternative Sex Education (AVESA), a Venezuelan nongovernmental organization whose work focuses on sexuality, problems of sexuality and alternative sex education. It describes AVESA's practical experience in training youth promoters and running an on-going youth education program in sexual and reproductive health. AVESA advocates on educational alternative that builds self-awareness and a critical understanding of social reality. The authors encourage individuals to engage with their own history and circumstances in order to be able to experience their sexuality in a full, responsible, pleasurable and just manner. (author's)
Web site : http://www.rhmjournal.org.ukAbstract : This study estimated the proportion of incomplete abortions that are induced in hospital-based settings in Tanzania. A cross-sectional questionnaire study was conducted in two phases at three hospitals in Tanzania. Phase 1 included 302 patients with a diagnosis of incomplete abortion, and phase 2 included 823 such patients. In phase 1, in which cases were classified by clinical criteria and information from the patient, 3.9-16.1% of the cases were classified as induced abortion. In phase 2, in which the structured interview was changed to an empathetic dialogue and previously used clinical criteria were omitted, 30.9-60.0% of the cases were classified as induced abortion. An empathetic dialogue improves the quality of data collected among women with induced abortion. (author's)
Web site : http://www.ajph.org/cgi/content/abstract/90/7/1141Abstract : Silvina Ramos ; Mónica Gogna ; Mariana Romero/La salud reproductiva en la Argentina: dimensiones epidemiológicas y socio-demográficas ; Marcela V. Rodríguez/La situación legal de los derechos reproductivos y sexuales en Argentina ; María Cristina García/Políticas económicas y modelo de salud ; Martha I. Rosenberg/Las mujeres como sujetos...De las elecciones reproductivas, las condiciones de las mismas y los derechos que garantizan la libertad para tomarlas ; Marta Vassallo/Derechos reproductivos: un desafío a la dinámica partidaria ; María Alicia Gutiérrez/"Parirás con dolor": aborto, derechos sexuales y reproductivos en la cosmovisión eclesiástica ; Zulema Palma/El aborto y los derechos sexuales desde el movimiento de mujeres en 305 el contexto de la Argentina democrática ; Susana Checa/La salud reproductiva en la perspectiva de los profesionales de la salud ; Claudia Laudano/Cuando el aborto está en los medios
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : La Sociedad Boliviana de Obstetricia y Ginecología (SBOG), fundada el 20 de octubre de 1947 en la ciudad de La Paz, dedicó el primer número de su revista científica oficial, Gineceo, a la Memoria del Seminario-Taller Internacional sobre Aborto Impune realizado en La Paz los días 4 y 5 de octubre de 2005. La publicación contiene las memorias, conclusiones y recomendaciones del evento multidisciplinario. El nacimiento de la revista marca el compromiso de la SBOG con la defensa de los derechos sexuales y reproductivos de la mujer boliviana, en pro de un mundo más equitativo y libre de discriminación.
Notes : Español/espagnol/SpanishAbstract : Seminario sobre Maternidad ; Taller de Salud Reproductiva. Morbilidad por Causas obstétricas: el caso de abortos inducidos hospitalizados ; Factores de riesgo en la salud materno infantil en el proceso de embarazo parto y puerperio ; Seminario Cuerpo y Sexualidad en la Adolescencia
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : The September 28 Latin America and Caribbean Campaign for the Decriminalization of Abortion widened its base of support in a meeting of focal points and networks in Rio de Janiero, Brazil in December 2001. Prior to the meeting, the Campaign Coordination organized an inter-continental meeting for women from Latin America, the Caribbean, North America, Asia and Africa entitled "Aborto en América Latina y el Caribe, derechos de las mujeres frente a la conyuntura mundial" (Abortion in Latin America and the Caribbean: Women's Rights and the Global Panorama). Representatives from 27 countries and eight regional networks attended the meeting's three panel presentations on the political, legal, cultural, and communications aspects of abortion. The format of the meeting provided an opportunity for the exchange of experiences among participants and served as a precursor to the December meeting of focal points and networks. Moreover, the December meeting aimed to define campaign strategies for the upcoming years. Three areas of action were discussed: communications; legal frameworks (national and international laws and instruments; and the existing global context. Finally, the Centro de la Mujer Peruana "Flora Tristan" was elected as the coordinating organization for the September 28 Campaign for the 2002-04 period.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Presenta datos estadísticos de los servicios en establecimientos particulares de atención a la salud
Notes : Español/espagnol/SpanishAbstract : Calidad de atención en mujeres con aborto en la IX Región Servici de Salud de la Araucanía, Chile / Ricardo Celis ... [et al.] ; La experiencia de los servicios alternativos de salud en relación con el aborto / Ana María Pizarro ; Manejo ambulatorio del aborto como estrategia para aumentar la cobertura y reducir los costos / Luis Alberto Tavara Orozco ; Investigación cualitativa : la salud reproductiva y el papel que juega el embarazo no deseado / Elizabeth de Bocaletti ; Aborto en adolescentes con Ru/486 / Evelio Cabezas, Mario García, Elina Guzmán.
Notes : Español/espagnol/SpanishAbstract : Uma pesquisa que comprova como os serviços de aborto garantidos por lei ainda são vistos sob o prisma da ilegalidade. Esse foi o trabalho coordenado pela psicóloga Rosângela Aparecida Talib, doutoranda em Ciências da Religião, membro da organização não-governamental Católicas pelo Direito de Decidir (CDD) - entidade de caráter ecumênico que trabalha para a mudança nos padrões culturais e religiosos a partir do respeito à diversidade, a liberdade e a justiça. O dossiê Serviços de Aborto Legal em Hospitais Públicos Brasileiros (1989-2004) foi organizado a partir do projeto de CDD que visa sensibilizar os profissionais de saúde que atuam nos hospitais que oferecem o serviço de aborto legal no país sobre as questões ético-religiosas que envolvem a interrupção da gravidez. Em prática desde 2000 pela Ong, foram verificados no decorrer da realização do prometo dados e informações até então desconhecidos do Ministério da Saúde, da Federação Brasileira das Associações de Ginecologia e Obstetrícia (Febrasgo), de Ong's e de estudiosos do assunto. Com os dados colhidos, durante 2004 novas informações foram levantadas para a sistematização do dossiê, que mostra como influências e conceitos católicos trazem conseqüências danosas para a vida de mulheres, alteram o trabalho realizado pelos profissionais de saúde e impedem o acesso, principalmente das menos favorecidas, a políticas públicas relacionadas ao aborto. No Brasil, o Código Penal de 1940, ainda vigente, só não pune os casos de aborto praticados por médicos em duas situações: se não há outro meio para salvar a vida da gestante ou caso a gravidez seja resultado de estupro. Apesar disso, durante cinco décadas as mulheres que se enquadravam nesses casos não dispuseram de atendimento público gratuito, pois o serviço só começou a ser implantado em 1989. Para estudar as políticas de atendimento nos casos de aborto legal foram pesquisados 56 hospitais públicos estaduais, municipais e universitários em 24 unidades da federação a partir de julho de 2004. Os dados, registrados até dezembro de 2004, foram coletados por telefone, visitas, e-mails e faxs e foi preciso superar a falta de registros sistematizados, a dificuldade de acesso aos responsáveis pelas equipes e a relutância dos profissionais em repassar as informações. De acordo com o levantamento, 37 instituições afirmaram prestar atendimento aos casos de aborto previsto por lei. Deste número, 78% disseram ter realizado de 0 a 30 serviços. Ainda segundo a pesquisa, apenas dois hospitais localizados na cidade de São Paulo (Região Sudeste) registraram mais de 270 atendimentos. Em cinco unidades da federação, localizadas em três diferentes regiões do país, as mulheres não dispõem de serviços de aborto legal: Roraima, Amapá e Tocantins (Norte), Piauí (Nordeste) e Mato Grosso do Sul (Centro-Oeste). Em dois outros Estados, Ceará e Goiás, apesar de existirem equipes treinadas, os serviços nunca foram usados. No total, a pesquisa revela que 1.266 interrupções de gravidez foram realizadas pelos serviços legais de aborto. De 1989 até 2002, foram registrados 845 procedimentos.Nos anos seguintes, 2003 e 2004, foi verificada certa estabilidade: 161 e 171, respectivamente. Foi possível observar ainda que 70% dos atendimentos foram realizados na Região Sudeste, que recebe encaminhamentos de todas as regiões do país. "É fácil perceber que os discursos alarmistas produzidos pelos setores conservadores, principalmente a Igreja Católica, afirmando que a disponibilidade destes serviços provocaria uma avalanche de mulheres burlando a lei (presumivelmente mentindo) para provocar abortamentos está longe de ser confirmado", explica Rosângela Aparecida Talib, autora da pesquisa. Outra questão chave é a exigência do Boletim de Ocorrência (BO) Policial para a realização do procedimento cirúrgico. De acordo com os dados levantados, 70% das instituições ainda exigem o documento, que desde a primeira Norma Técnica para prevenção e tratamento dos agravos resultantes da violência sexual contra mulheres e adolescentes (1999), do Ministério da Saúde - revista e atualizada em 2005 -, não é tida como um elemento que impeça a realização do aborto em casos de estupro, mas sim como um procedimento que registre a violência sofrida. Nesse contexto, é relevante citar ainda que no início de setembro de 2005 o Ministério da Saúde concedeu a liberação do BO nos casos de estupro, medida que vai na contramão da determinação do Conselho Federal de Medicina, que exige o documento. A pesquisa também constatou que muitos hospitais exigem o laudo do IML, exigência esta desnecessária para o atendimento. Também ficou claro que percentuais consideráveis de médicos desconhecem a legislação e as técnicas para realização do aborto legal. Foi constatado ainda que grande parte dos profissionais de saúde se recusa a prestar atendimento com base em preconceitos, medo de se expor a ameaças (internas e externas), acusações, ofensas, risco de discriminação e receio de processos judiciais. O trabalho ainda aponta as estratégias logísticas e discursivas em defesa da ordem tradicional mantida pela Igreja Católica: ações para barrar o acesso a contraceptivos ou ao aborto, agindo em casos e localidades específicas nas quais encontram receptividade de prestadores e gestores de serviço, pressão aos integrantes dos poderes executivo, legislativo e judiciário e formação de discurso religioso para questionar a veracidade das políticas públicas em curso. Segundo as informações levantadas, especial atenção, apoio e acompanhamento merecem ser oferecidos aos profissionais atuantes nos Estados do Rio de Janeiro e Mato Grosso do Sul, nos quais a ofensiva conservadora da Igreja Católica tem interferido na implantação de serviços e Normas do Ministério da Saúde, na assistência a anticoncepção e até no cumprimento de alvarás judiciais. "A condição de ilegalidade, associada à de grave transgressão religiosa, não restringe a prática do aborto, justamente porque estas restrições não alteram as condições básicas que antecedem uma gravidez indesejada. No entanto, essa condenação tem conseqüências desastrosas, tanto no plano da economia e das políticas públicas, quanto na vida das mulheres, em termos de saúde física e psíquica, de exercício da autonomia e da cidadania", finaliza a autorada pesquisa.
Notes : Portugués/portugais/PortugueseAbstract : In March 1993, a symposium to prepare for the 1994 International Conference on Population and Development was held in Mexico City for representatives of international organizations conducting contraceptive research, international and national funding agencies, and women's nongovernmental organizations. The participants endorsed an 11-point declaration giving priority to contraceptive methods which protect against sexually transmitted diseases and stressing the need for access to safe abortion. It was noted that research should identify methods appropriate for different people at different stages of their lives, and funding levels should be increased. Among the participants were Paul Van Look Mahmoud Fathalla, and Jose Barzelatto, all of whom are influential in determining research trends in contraception and reproductive technologies and are interested in incorporating women's views into their work. When interviewed for this article, Van Look, of the World Health Organization, noted that the symposium was important because it provided a good opportunity to look at the field of contraception and to benefit from the participation of many people involved in women's health. Van Look said that future research efforts would focus on barrier methods which protect against HIV/AIDS. In his interview, Fathalla, an advisor to the Rockefeller Foundation, stated that the consensus reached in the symposium will influence the direction of research and make it more responsive to women's needs. He also called for additional investment into male methods and for a new look at barrier methods. Barzelatto, of the Ford Foundation, identified user control as the first priority in contraceptive development followed by development of methods to protect against transmission of disease.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Annotation. Sex and the State explores patterns of gender-related policy reform in Argentina, Brazil, and Chile.
Web site : http://www.loc.gov/catdir/toc/cam031/2002031349.htmlAbstract : Except for a few private associations, no institution provides adolescents in Mexico with sex education. The school curriculum has only a chapter on human reproduction in natural science textbooks. Political pressure from different sectors has thwarted government plans for sex education to prevent unwanted pregnancies and sexually transmitted diseases (STDs). Many people believe that lack of information means innocence. Yet, lack of information means girls do not understand the changes their bodies are undergoing and the new feelings which accompany these changes. Ignorance makes them not know that these feelings lead to sexual intercourse, unwanted pregnancy, abortion, STDs, or early motherhood. In 1989, 30% of all 15-19 year old females were pregnant. 57% of the 1,400,000 pregnant 15-19 year olds did not want to be pregnant. Teenagers make up 40% of all abortion seekers. Most women in Mexico were sexually active while still in their teens. They tend to have little education and no sex education, to be unprepared to work, and not to realize that they would have to care for themselves and an unplanned child. 64% of teens do not use contraceptives during 1st intercourse. Those who do tend to use unreliable methods (e.g., rhythm and spermicides). Just 22% of all teens who use the rhythm method know when they are fertile. Reasons for not using contraception during 1st intercourse are: not planning on having intercourse, desire to become pregnant, male partners not using contraception, and not thinking about contraception. Political or economic interests should no longer postpone the education and health services needed for adolescents.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 099335Abstract : Apresentaçao a 3a. ediçao ; Apresentaçao ; Planejando o programa ; Reconhecimento de informaçoes e atitudes no grupo de participantes ; Anatomia e fisiologia sexual humana ; Masturbaçao ; Namoro e relaçoes sexuais fora do casamento ; Papéis sexuais ; Controle voluntário da reproduçao ; Aborto ; Doenças sexualmente transmissiveis ; Homosexualidade ; Aids ; A'guisa de concluçao ; Bibliografia.
Notes : Español/espagnol/SpanishAbstract : Os agentes do processo ; Orientaçao, ou educaçao sexual? ; Quem orienta? ; Abordagem pedagogica ; Adolescencia ; Abordagem com os paíse com a comunidade escolar ; Trabalhando com temas especificos ; Corpo nosso de cada dia ; Relaçoes de género ; Homossexualidade ; Aborto ; Aids ; A primeira vez ; Na prática ; Um projeto bem-sucedido ; Material didatico para aulas de Orientaçao Sexual ; Os autores
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This work examines the rapid population growth of recent decades and its attendant social and environmental problems, and it analyzes the conscious and subconscious sources of opposition to family planning. The author provides a synthetic vision in the first chapter of the principle aspects of the current population crisis, which are then examined in greater detail in subsequent chapters. Chapter 2 analyzes the use of the concept of demographic aging as a scare tactic to promote maintenance of high fertility and population growth in the developed countries. Chapter 3 sets out to demonstrate that the roots of the population crisis are to be found in the sociology of sexuality and population. Chapter 4 discusses sex and religion in history, while chapter 5 analyzes the opposition of the Catholic Church to birth control, both in doctrine and in the aggressive population policy of the Vatican. Chapter 6 examines both extremes of the abortion debate and attempts to identify a middle course. The final chapter analyzes Marxist ideologies regarding population control and revolution in Latin America that were current in the mid-1960s and that threaten to resurge.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 126292Abstract : Annotation. Brings together a rich, multidisciplinary, multicultural collection of case studies focusing on sexual and reproductive health education problems and programs from across the Americas. Annotation. To guide future research into the sexual and reproductive health education of this growing population, community health educators at the U. of Massachusetts, Amherst introduce 19 case studies from both sides of the border which appeared in the over the past decade. They represent culturally-sensitive research into relevant cultural constructions, and health promotion strategies through popular culture and community participation. Annotation (c)2003 Book News, Inc., Portland, OR (booknews.com)
Notes : Inglés/anglais/EnglishAbstract : This article presents an analysis of Demographic and Health Survey (DHS) data from developing countries that sheds light on the reproductive behavior of adolescent women. Topics include sex behavior and marriage; contraceptive knowledge/usage; contraceptive usage at first intercourse; and contraceptive failure, switching, and discontinuation. Tables illustrate 1) the percentage of all adolescents aged 15-19 who have ever had sex and who have ever married in 37 DHS countries; 2) the percentage of those aged 20-24 and of women aged 40-44 who first married and first had sex by age 18 in 36 DHS countries; 3) the percentage of women aged 15-19 and 20-49 who know any contraceptive method by marital and sexual activity status in 37 DHS countries; 4) the percentage of women aged 15-19 and 20-49 currently using contraception by marital status and sexual activity status in 43 DHS countries; 5) the percentage of people who used contraception at first intercourse by country, age, sex, and marital status in 6 countries; and 6) 12-month life-table gross discontinuation rates by country and age at start of use, by type of discontinuation. It is concluded that adolescent sex behavior and contraceptive knowledge/usage vary widely across and within regions, but that overall patterns show that the gap between first intercourse and marriage has increased. Levels of contraceptive knowledge are high, and usage is higher but less successful among unmarried than married adolescents. More research should be directed toward adolescent males.
Web site : http://www.popcouncil.org/publications/sfp/default.htmAbstract : At the University of Antioqia, Colombia, a survey was conducted with the voluntary participation of 836 students enrolled in the final year of study with the objective of preventing health problems resulting from risky sex behavior. A self-administered questionnaire contained 45 questions relating to demographic and sex behavior aspects. Among 793 sexually active participants, 10.9% (17.2% of men and 3.3% of women) said they had contracted some type of sexually transmitted disease (STD). The most common diagnoses were for gonorrhea (42%), genital warts (23%), and genital herpes (19%). The risk of contracting an STD was 4.2 times greater in those reporting sex with strangers; 3.4 times greater in those with four or more sexual partners; and 2.5 times greater in those reporting homosexual relations as compared with students not practicing such behaviors. Some 28.4% of 790 survey respondents or their partners had been pregnant; 49% of these pregnancies had ended in abortions of which 77% of had been induced abortions. Only 51.3% of the survey participants reported customary use of contraceptives; those most frequently cited were condoms (32% of users), oral contraceptive pills (20%), the rhythm method (18%), and coitus interruptus (17%). With regard to sex education, 30.2% of men and 34.8% of women obtained adequate information in the home; 45.7% of men and 42.9% of women in school; and 26.1% of men and 30.3% of women at the university. Women tended to rely more than men on their families, while men tended to rely on books to obtain information. They consulted very little with clerics, family members, or teachers. Over one-third reported that they had obtained information from health workers. The group under the age of 25 showed a greater tendency to consult health workers, family members, teachers, and friends. The students who received adequate information also reported a somewhat lower incidence of high-risk sex behavior, induced abortions, and STDs. The university should establish programs to increase knowledge, prevent STDs and unwanted pregnancies, and encourage responsible behavior.
Web site : http://publications.paho.org/english/moreinfo.cfm?Product_ID=557Abstract : Since the late 1980s, the UNDP/UNFPA/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction ("the Programme")has supported a number of social science research initiatives on under-investigated areas of sexual and reproductive health care. Four of these initiatives,on the dynamics of contraceptive use, the determinants and consequences of induced abortion, sexual behaviour, and the role of men, also covered the needs and perceptions of young people. These four initiatives comprised 146 research projects and, of these, 34 studies in 20 countries in Africa, Asia, and Latin America addressed young people, including adolescents (aged 10-19 years) and youth (aged 15-24 years). Fieldwork for these case studies was conducted chiefly between 1992 and 1996. A summary review of the studies is now available from the Programme. The studies cover a variety of sociocultural settings. In some, premarital sexual activity is taboo, using contraception is forbidden among unmarried youth, and abortion is viewed as the only solution to premarital pregnancy among adolescents. In others, premarital pregnancy may be condoned and childbearing among unmarried women is not unknown. Most studies focus on unmarried youth. However, some focus on special groups such as pregnant young women or those who have terminated a pregnancy, young reproductive health seekers in general, or young clients of services for sexually transmitted infections (STIs). Many common themes emerge from these studies. In every setting, sexual activity begins during adolescence among many young people. Much of this activity is risky, contraceptive use is often erratic, and unwanted pregnancy and unsafe abortions are observed in many settings. Sexual relations may be forced. There are wide gender-based differences in sexual conduct, and in the ability to negotiate sexual activity and contraceptive use. Despite this, relatively few young people think they are at risk of disease or unwanted pregnancy. Awareness of safe sex practices seems to be superficial, and misinformation regarding the risks and consequences of unsafe sex is wide- spread. This paper reviews these and other findings, discusses their implications for policies and programmes, and highlights research gaps. For the sake of consistency, the term, youth,is used to refer to young people of all ages between 10 and 24. A number of recommendations are offered on the basis of the summary review of these case studies. These include programmatic recommendations to build negotiation skills, dispel misconceptions, counter sexual violence, involve young people in programme design, tailor fertility regulation services to meet young people's needs, and communicate the message that every unprotected sexual act risks disease and unwanted pregnancy. The review suggests a need for more in-depth behavioural research on the perspectives and experiences of youth in different settings. It points to the need to study positive outcomes, in addition to risk assessment, and stresses that research should explore the ways in which gender roles and power imbalances affect life skills among youth and how social constraints make young women particularly vulnerable and unlikely to exercise choices relating to their sexual and reproductive lives. Research is also needed to document how young women can exercise greater autonomy. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 174328Abstract : This paper analyses beliefs about sexuality and the use of family planning among Pentecostal Protestants and charismatic Catholics in Brazil. Many have assumed that these new churches are conservative, if not fundamentalist, in their views on these issues. This study shows that both groups tend to evaluate sexuality in a positive way, separating it from reproduction. Although they agree that sexual life is permitted only within marriage, they differ in their attitudes and values in relation to the use of family planning. More charismatic Catholics use natural methods of family planning than any other religious group studied while Pentecostal Protestants opt almost entirely for modern methods. 7'he more flexible Pentecostal position offers religious support to poor women who want to control, or feel that the conditions of their lives force them to control, their fertility. While both religious movements grant women moral authority and strengthen their self esteem in some ways, both also reinforce gender imbalances through the guest for sanctification.
Web site : http://www.rhmjournal.org.ukAbstract : This work presents information on sexuality and reproductive rights (SRR) for young people in an easy to comprehend format including abundant use of cartoons. The work begins with a brief introduction to the concept of SRR and the need for the power and resources to make informed decisions regarding fertility, child rearing, gynecological health, and sexual activity. A cartoon follows which depicts issues in personal Decision making and societal attitudes regarding the initiation of sexual activity. The next chapters discuss common problems in coming to terms with one's sexuality (heterosexual or homosexual), and the nature of rape and myths concerning it. A brief guide to contraceptive methods provides information on the efficacy, advantages, and disadvantages of methods appropriate for young people. Information on the transmission and prevention of AIDS and other sexually transmitted diseases follows, including a table of common symptoms and the diseases they may signal. Instructions are included for purchase, storage, and correct use of condoms. The next chapters discuss unplanned and unwanted pregnancy, and advise on options in the Mexican context if the pregnancy is still undesired after a period of reflection. An estimated 850,000 abortions occur in Mexico each year despite legal obstacles. The final chapter lists organizations, books, and mass media programs that provide information on contraception and SRR.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 135139Abstract : Contiene información que facilita la reflexión y la toma de decisiones con respecto a la sexualidad y la reproducción
Notes : Español/espagnol/SpanishAbstract : Investigación de la fecundidad y sexualidad del adolescente, enfocado en la situación de la joven en México. Análisis de los resultados y factores que influyen en la vida sexual de los adolescentes y las consecuencias de iniciar una vida sexual temprana
Notes : Español/espagnol/SpanishAbstract : These are the proceedings of a conference on reproductive health in Mexico, held in March 1995. There are papers on such topics as adolescent pregnancy, unwanted pregnancy, the desire for children, abortion, maternal mortality, the knowledge and use of contraception, fertility preferences, maternal and family health, reproductive behavior and infant mortality, and rural fertility. (ANNOTATION)
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND RH83124Abstract : Este libro contiene los once trabajos y los comentarios y reflexiones expuestos en el Seminario Internacional sobre Avances en Salud Reproductiva y Sexualidad celebrado en la ciudad de México en noviembre de 1996, así como una introducción que intenta ofrecer una visión global de los trabajos y de la reunión en su conjunto. Hablar de salud reproductiva es enfrentarse a un campo de multiplicidades de todo tipo en el que convergen no sólo diversas perspectivas teóricas sino disciplinas que abrevan tanto del área de las ciencias sociales como de las ciencias biomédicas. En el campo de las ciencias sociales el debate entre las po-siciones universalistas y las relativistas ha sido constante, y se refleja tambien en el área específica de la salud reproductiva cuando se plantea que los com-portamientos reproductivo y sexual deben entenderse como conductas social-mente estructuradas y no como conductas guiadas por determinismos biológicos. La mayoría de los trabajos presentados en este volumen tiene co-mo trasfondo dicho debate. Además de capítulos sobre elementos teóricos y conceptuales en torno al constructivismo social, de la salud reproductiva, el género y la sexualidad, se presentan trabajos sobre temas específicos de investigación tales como la ética y la sexualidad, la coerción sexual, el aborto, el embarazo adolescente, y los jóvenes y el SIDA, entre otros. La mayoría de los autores de los capítulos son investigadores reconocidos como líderes en sus respectivos campos a nivel mundial, por lo que confia-mos en que este volumen contribuirá a aportar una visión actualizada de los avances recientes en el campo de la salud reproductiva y la sexualidad desde la perspectiva de las ciencias sociales. Se incluyen los siguientes trabajos: Presentación / Claudio Stern y Juan Guillermo Figueroa ; Introducción / Claudio Stern y Mariana Yanes ; Acciones virtuosas en ausencia de un dogma convincente: la salud reproductiva en un mundo socialmente construido / John H. Gagnon ; Construccionismo social y sexualidad: el sujeto y la autogestión (comentario) / Ana Amuchástegui Herrera ; El discurso de la salud reproductiva: ¿un nuevo dogma? / Vania Salles y Rodolfo Tuirán ; Cuatro líneas de reflexión en torno a los elementos sociales de la salud reproductiva (comentario) / Carolina Martínez Salgado ; Salud reproductiva, género y sexualidad: legitimación y nuevas interrogantes / Sonia Correa ; La "normalización" esteriliza. Conceptuar pero no cristalizar (comentario) / Nelson Minello Martini ; La definición de salud reproductiva en el contexto de la vida de las mujeres / Joanne Leslie, Jane Rubin-Kurtzman y Ana María Goldani ; Comentario al trabajo de Joann Leslie, Jane Rubin-Kurtzman y Ana María Goldani / CarlosJavier Echarri Cánovas ; Derechos y ética en las intervenciones, experiencias e investigación en el campo de la sexualidad / Radhiha Chandiramani ; Algunas reflexiones sobre derechos y ética en intervenciones e investigaciones en el campo de la sexualidad (comentario) / Juan Guillermo Figueroa Perea ; La coerción sexual y la salud reproductiva de las mujeres / Lori Heise ; Comentario al trabajo de Lori Heise / Irma Saucedo Gonzalez ; El estudio del aborto inducido en América Latina: un balance parcial y algunas propuestas a futuro / Juan José Llovet y Silvina Ramos ; Comentario al trabajo deJuan José Llovet y Silvina Ramos / Adriana Ortíz-Ortega ; Hacia un nuevo enfoque en el campo del embarazo adolescente / Claudio Stern y Elizabeth García ; Embarazo adolescente, hacia un nuevo enfoque (comentario) / Xóchitl Castañeda ; Prácticas sexuales, enfermedades de transmisión sexual y SIDA entre jóvenes / Peter Aggleton ; Comentario al trabajo de Peter Aggleton, Mario Bronfman ; El papel de los distintos actores sociales / Juan José Llovet ; Reflexiones sobre el estado y las políticas públicas en México / Viviane Brachet ; Comentarios finales sobre el Seminario Internacional Avances en Salud Reproductiva y Sexualidad / Jane Rubin-Kurtzman - Otros comentarios finales sobre el Seminario Internacional Avances en Salud Reproductiva y Sexualidad / Cathy Creenblat.
Notes : Español/espagnol/SpanishAbstract : This book focuses on reproductive health matters and some associated subjects among Pilaga, Mataco and Toba Indians of Argentine Chaco and peasant women, immigrants from northeast Argentina and Paraguay to Great Buenos Aires City. In the chapter is analysed the rejection of western contraceptive methods by immigrant women to Buenos Aires. Exploring the causes of the rejection, the author mentions the etno-physiological concepts, the usefulness of traditional contraceptive methods, and the refiguration in negative terms of the western contraceptives. In the second chapter is dedicated to conceptions, pregnancy and birth representations and practices among the Pilaga. The next chapter is dedicated to explore the abortion an infanticide practices and meanings. In chapter IV are analysed the last two subjects, but this time, focusing on the Mataco Indians. In the next chapter sexuality is explored both into the marriage and during the youth ness. In the following chapter the authors focuses on seduction songs, and the expression of the sacred. Chapter VII is dedicated to passion love and the marriage as two kinds of affective links between women and men. In the next chapter I the author focus again on ideas and practices of conception, pregnancy, birth, abortion, infanticide, females rituals initiation among Pilaga, Toba and Mataco Indians. The last chapter refer to the myth of the menstruation woman and the aquatic cataclysm.
Notes : Español/espagnol/SpanishAbstract : Sexualidade e reproduçao: direitos e discursos ; Escolhas e discursos ; Direitos e projetos de vida ; Saude reprodutiva e direitos individuais ; Bibliografía
Notes : Portugués/portugais/Portuguese, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : In order to inform the abortion debate with an increased understanding of why so many women worldwide undergo induced abortions and how societies can respond, this report offers the most reliable facts available about the determinants, levels, and consequences of induced abortion in many parts of the world. When considering abortion as a response to unplanned pregnancy, the report reviews: 1) what factors lead to unplanned pregnancy in developing and developed countries, 2) the prevalence of unplanned pregnancy, and 3) why women decide upon abortion. Data in this report focus on 15 developing and three developed countries. In its review of the status of induced abortion, the report looks at: 1) laws and regulations in countries with a population of a million or more; 2) the annual number of induced abortions, the proportions of women having abortions, and the characteristics of these women; 3) the relationship between legality and safety of abortion; 4) the quality and availability of abortion services in settings where it is legal; 5) the quality and availability of abortion services where it is severely restricted or prohibited; 6) the kinds of abortion practitioners and methods used to abort or self-abort in developing countries; and 7) the safety of modern abortion techniques and risks of abortions performed outside of medical settings. Finally, the report discusses what can be done to reduce levels of unplanned pregnancy and lessen the adverse effects of unsafe abortion. Additional data are provided in six appended tables.
Web site : http://www.guttmacher.org/pubs/sharing.pdfAbstract : Nicaragua's Penal Code permits "therapeutic abortion" without defining the circumstances that warrant it. In the absence of a legally clear definition, therapeutic abortion is variously considered legal only to save the woman's life or also to protect the health of the woman, and in cases of fetal malformation and rape. This paper presents a study of the theory and practice of therapeutic abortion in Nicaragua within this ambiguous legal framework. Through case studies, a review of records and a confidential enquiry into maternal deaths, it shows how ambiguity in the law leads to inconsistent access to legal abortions. Providers based decisions on whether to do an abortion on women's contraceptive behaviour, length of pregnancy, compliance with medical advice, assessment of women's credibility and other criteria tangential to protecting women's health. The Nicaraguan Society of Obstetrics and Gynecology aimed to clarify the law by developing a consensus among its members on the definition and indications for therapeutic abortion. If the law designates doctors as the gatekeepers to legal abortion, safeguards are needed to ensure that their decisions are based on those indications, and are consistent and objective. In all cases, women should be the ultimate arbiters of decisions about their reproductive lives, to guarantee their human right to life and health.
Web site : http://www.rhmjournal.org.ukAbstract : Abortion is legal in Nicaragua only to save the life of the woman. In 2002, amendments to the Penal Code to change the penalties for obtaining and providing illegal abortions and regulations on the authorisation of legal abortions are due to be debated in the legislature. In a context of extensive media coverage and debate between women's health and rights groups and a powerful movement to make all abortions illegal, medical professionals have also been effective in influencing law and policy. In May 2001, the Nicaraguan Society of Obstetrics and Gynecology presented the results of a study of the views of 198 obstetrician-gynaecologists on pending legislation regulating therapeutic abortion and the medical and ethical implications of providing therapeutic abortion services. All but nine of the 198 participants in the study, who comprised 76% of all registered obstetrician-gynaecologists in Nicaragua, believed that therapeutic abortion should not be criminalised and over 90% believed that there were cases in which therapeutic abortion was necessary to save women's lives. Some also supported legislative reform to allow abortion in cases of rape and fetal malformation. These results countered claims by the Nicaraguan Medical Association (AMN), taken up by the Church and anti-abortion legislators and groups, that therapeutic abortion was no longer necessary due to modern medicine. The election of anti-abortion politicians to powerful positions in early 2002 has created a formidable challenge when the proposed revisions to the Penal Code are debated.
Web site : http://www.rhmjournal.org.ukAbstract : Este trabajo buscó identificar y analizar, desde una perspectiva de derechos, los discursos y acciones de distintos sectores y actores en torno a la salud sexual y reproductiva, focalizando en su (no)vinculación con Cairo, Cairo+5 y/o las Metas del Milenio (MDMs). Bolivia es un país que ha suscrito los compromisos del Cairo, Beijing y la Declaración del Milenio. Recientemente también ha ratificado la Declaración de Principios sobre Población y Desarrollo Sostenible, centrada en un enfoque amplio e integral de derechos. Las MDMs no incluyen explícitamente el acceso a la salud reproductiva (SR), aunque este se asume como supuesto letal para su consecución. Las Metas se constituyen, formalmente, en el eje articulador de la Estrategia Boliviana de Reducción de la Pobreza, del Plan General de Desarrollo Económico y Social (PGDES) y de las políticas sectoriales. En ese marco la meta de reducción de la mortalidad materna es de 416 a 200 en el período entre 1990 y 2015. Datos de la última Encuesta Nacional de Demografía y Salud (ENDSA) presentan una tasa de mortalidad materna de 230, mucho menor a la tasa de 314 fijada para este año. Sin embargo, un escenario tendencial del financiamiento para salud muestra que no tendrían recursos suficientes para cumplir las metas en los plazos previstos. Con relación a la salud y los DSR, el estudio concluye que en un contexto de crisis y fundamentalismos étnico-culturales, sociales, económicos, de género y generación, su carácter implícito hace altamente vulnerable su observación. Las preocupaciones productivas de la lucha contra la pobreza, reivindicaciones étnicas, raciales y regionales de grupos fundamentalistas fortalecidos después de los sucesos de octubre de 2003, y la Asamblea Constituyente como centro de atención, desplazan los DSR a un segundo plano de las preocupaciones del Estado y de las demandas de la sociedad civil. Por otra parte, las MDMs se insertan en un contexto de gran debilidad institucional, técnica y económica del Estado, que no ejerce plenamente como garante de los derechos humanos y, menos de los DSR. En Bolivia estos últimos no han logrado consolidarse como parte de los derechos humanos, como lo demuestra su omisión en distintos informes del Defensor del Pueblo. Así, barreras culturales, religiosas, económicas y condicionamientos de la cooperación internacional, impiden incluso la aplicación de un marco normativo y de servicios de DSR comparativamente avanzado para la región, que incluye el aborto legal en ciertos casos, la anticoncepción de emergencia y la atención de hemorragias del primer semestre como prestaciones del SUMI. Frente a ello se suma el poder de influencia de la Iglesia sobre el Estado, amparado en la Constitución Política del Estado, que le ha permitido recientemente vetar una Ley de Derechos Sexuales y Reproductivos por sus objeciones a derechos de los/as adolescentes, los/as homosexuales y el derecho a servicios de aborto legal seguros. Ante esta arremetida conservadora se ratifica la necesidad de abogar por un Estado laico en el marco de la Asamblea Constituyente. En general el panorama actual de la cooperación internacional resulta menos que alentador con relación a la salud y los DSR. En términos de disponibilidad global de recursos para el cumplimiento de los compromisos de la Conferencia del Cairo, los fondos para apoyar servicios de salud sexual y reproductiva ya estaban muy por debajo de lo acodado inicialmente antes de los sucesos del 11 de septiembre, y el 2003 sólo habrían alcanzado menos de la mitad de lo necesario. En cuanto a las MDMs, el Informe de Progreso del 2002 para Bolivia califica como bueno el estado de las condiciones de apoyo para la equidad de género, pero insuficiente aunque "mejorando" para los objetivos de salud materna y VIH/SIDA.
Notes : Español/espagnol/SpanishAbstract : An operations research project was conducted between June 1995 and December 1997 at the General Hospital Doctor Aurelio Valdivieso in Oaxaca, Mexico, to evaluate a program intended to improve the quality of postabortal care. The evaluation utilized pre-and post-tests to measure the effectiveness of the intervention, whose objectives were to modify hospital procedures to reduce waiting time, improve pain management, and assure patient privacy; train all medical personnel in correct use of vacuum aspiration as a substitute for instrumental curettage; train personnel in the importance of respectful and humane treatment of patients in the areas of providing information, psychological support, and counseling with emphasis on postabortal contraception; and design print materials to reinforce the messages. Largely as a result of adoption of manual endouterine aspiration under local anesthesia instead of instrumental curettage under general anesthesia, post procedure hospital stays declined by 7 hours and the total hospital stay was reduced by 10.6 hours. The quantity and quality of information provided to patients regarding their diagnosis, treatment, and postabortion care were significantly increased. Distribution of pamphlets and other materials in the hospital contributed significantly to the improvement. The number of patients who received family planning counseling increased by 86% after the intervention. The proportion of patients who accepted a family planning method increased from 29% to 57%. The proportion accepting reversible methods instead of tubal ligation increased substantially.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 153741Abstract : This is a multicenter comparative study conducted to investigate and compare women's experiences with side effects of mifepristone-misoprostol medical abortion versus surgical abortion in China, Cuba, and India. Six urban clinics participated in this study, which ran from October 1991 to August 1993. Women with pregnancy durations of 56 days or less (based on the onset of the last menstrual period, bimanual examination, and ultrasound) were the subjects of the study. Medical abortion clients received 600 mg mifepristone orally on their first visit and were observed for 30 minutes afterwards. Two days later, 400 mcg oral misoprostol was given to these women, and they remained in the clinic under observation for 4 hours. The final follow-up was 14 days after, and those women who had not had a complete abortion received surgical intervention. Surgical abortion clients received their abortions on the first visit according to standard clinical practices in each site. Data on side effects came from the women's reports at each of their clinic visits. Results show that mifepristone-misoprostol medical abortion clients experienced more side effects than did surgical abortion clients. Medical abortion clients experienced pain during their abortions; however, this could be managed with analgesics. The disparity between the two groups was particularly pronounced with respect to bleeding and pain. Despite more reports of side effects among medical abortion clients, assessments of well-being and reports of satisfaction at exit interviews were similar between the two treatment groups.
Web site : http://www.sciencedirect.com/science/journal/14700328Abstract : Este trabajo presenta un estudio comparativo de los sistemas jurídicos de catorce países de América latina en materia de aborto: Argentina, Bolivia, Brasil, Colombia, Chile, Ecuador, El Salvador, Honduras, México, Panamá, Paraguay, Perú, Puerto Rico y Uruguay. A través de un recorrido histórico de sus legislaciones, de las iniciativas legales presentadas y los debates producidos, se intenta delinear tendencias que buscan ser de utilidad para el diseño de estrategias regionales y nacionales orientadas a lograr la despenalización de la interrupción voluntaria del embarazo. La investigación comprometió los esfuerzos de los grupos nacionales de CLADEM en los respectivos países.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Silences, Stands and Debates on Abortion in Puerto Rico and the Hispanic Caribbean addresses the issue of abortion in various Spanish-speaking countries of the Caribbean, including Puerto Rico, the Dominican Republic and Cuba. Produced by the Atlantea Project to foster academic exchange in the Caribbean, this publication is part of the effort to promote the work of the Red Mujer Caribena (Caribbean Women's Network) founded in 1994.Warren Colon, Alice Larrinaga, Elsa Planell, eds.Cuadernos Atlantea, San Juan, Puerto Rico: Fundacion Atlantea, Universidad de Puerto Rico, 2001. 141 p.For more information, contact the Fundacion Atlantea, website: atlantea.upr.clu.edu
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Silences, Stands and Debates on Abortion in Puerto Rico and the Hispanic Caribbean addresses the issue of abortion in various Spanish-speaking countries of the Caribbean, including Puerto Rico, the Dominican Republic and Cuba.
Web site : http://atlantea.upr.clu.eduAbstract : Estudio que abarca la estructura de la población femenina en México, así como su papel y participación en los temas ya descritos
Web site : http://www.conapo.gob.mx/Abstract : According to official statistics, Peru's adolescent fertility rate is 77/1000, and 11% of adolescent females are mothers, while 2.5% are pregnant. In 1998, an estimated 1.3 million women aged 15-19 were sexually active but not using contraception. The average age at first intercourse was 16.8 for males and 18.9 for females. Peruvian adolescents have high rates of maternal mortality and abortion. Those in poverty especially often lack prenatal care, and an estimated 15% of maternal deaths are in adolescents. Adolescent mothers go on to have more children, more closely spaced pregnancies, and perhaps more unsafe abortions than do women who were not pregnant before age 20. Children of adolescent mothers weigh less at birth and are 36% more likely to die in the first year of life than children of older mothers. Adolescent pregnancy is considered a public health problem because of the medical problems and social risks it entails. It is usually unplanned and often unwanted. Sexual abuse, forced sex, early union, and very low rates of contraceptive usage are among factors in adolescent pregnancy. Nearly one-third of sexually active adolescents report use of a method, but generally it is periodic abstinence not supported by adequate knowledge of the fertile period. Studies of adolescents throughout Peru have revealed relatively high rates of sexual activity, poor image and little use of condoms, lack of knowledge of the fertile period, and inadequate sexual negotiating skills among young women. Most adolescents were unaware that they had reproductive rights but desired to be respectfully treated by health personnel. Cultural attitudes that do not recognize the right of adolescents to sexual and reproductive health services are the greatest barrier to their access to care.
Web site : http://www.fhi.org/en/Youth/YouthNet/Publications/FOCUS/ProjectHighlights/redess-jovenesperu-span.htmAbstract : Incluye un cuadro comparativo con la situación legal del aborto en diversos países de América Latina.
Web site : http://www.gire.org.mx/Abstract : In Mexico, the practice of abortion is generally illegal. If a woman becomes pregnant and wants to interrupt her pregnancy, she is obliged to carry out a clandestine abortion. Some may use hygienic and safe services. The majority, however, puts her health and even her life at risk because she lacks the resources necessary to receive adequate medical attention. (excerpt)En México la práctica del aborto es, en general, ilegal. Si una mujer queda encinta y decide interrumpir su embarazo, se ve obligada a practicarse un aborto en la clandestinidad. Algunas pueden acudir a servicios higiénicos y seguros. La mayoría, sin embargo, pone en riesgo su salud y hasta su vida, porque carece de recursos para recibir atención adecuada. (extracto)
Notes : Español/espagnol/Spanish, nbsp;179612Abstract : The "Paulina case" is the story of a 13-year-old girl in Mexico who became pregnant in 1999 after being raped. Although she received permission to obtain a legal abortion, the hospital convinced her mother through misleading information to decline the abortion. This case has become an almost obligatory point of reference when abortion is discussed in Mexico. This paper analyses how the Mexican press portrayed the Paulina case and the social actors who participated in it ; Paulina herself, Paulina's allies, the state government, the Catholic Church, members of the political party PAN and the National Human Rights Commission. One of the great breakthroughs of this case was that the denial of an abortion was judged to be a form of negligence. In demanding justice for Paulina, Paulina's allies were given moral authority in the press to denounce those who denied her an abortion. While the government of Baja California state and members of the PAN were held responsible for their role in the case, the Catholic Church, who was also responsible, seemed to escape criticism. It is probable that the large emotional weight of the Paulina case accomplished more in terms of changing public opinion in support of women's right to decide on abortion than any other single event to date.
Web site : http://www.rhmjournal.org.ukAbstract : This study aims to provide the medical, research, and public health communities with reliable information concerning some aspects of the abortion situation in the Dominican Republic, where induced abortion is illegal under any circumstances, including rape and incest, yet rarely prosecuted. Specifically, this study explores the possible impact of some basic social determinants on certain factors related to the Decision making process connected with abortion. The social determinants selected were age, education, marital status, household situation and the occupational status of both the woman and her husband. The study was conducted in two large maternity hospitals in Santo Domingo, between March and May of 1992. The data were collected through structured interviews with abortion patients seeking services, mostly for post-abortion complications. Overall, it was found that mostly young, married women with children, who have completed childbearing and have at some time worked outside the home, are the ones seeking treatment for abortion complications. However, their occupational status shows no significant association with their reproductive behaviors, and surprisingly, neither does their educational level. Analysis of the data on contraception provides the most suggestive findings. The number of women obtaining family planning services has dropped dramatically, indicating the need for integrated health and family planning services covering postpartum and post-abortion care. These findings demonstrate an urgent need for the implementation of a national abortion prevention program.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : This study departs from the argument that intensive diffusion in Brazil of prenatal ultrasound would give rise to new problems for pregnant women, their families, health care team, and society in coping with fetal malformations, considering the existence of a very restrictive induced abortion legislation. It aims to examine the social visibility of these problems, manifested or not, in the written mass media from January 1991 to 1996. The investigation covers selected articles related to abortion and fetal malformations, fetal malformations and medical technologies, and health, genetics and medical science contained in 4 most important daily newspapers and 2 medical council journals. The study indicates that the main elements in the existing relationships between medical technology, prenatal diagnosis, fetal malformations, and induced abortions remained the same throughout the study period. This finding suggests a restrictive Penal Code, public recognition of disseminated and tolerated practice of induced abortion done in risky conditions with very evident outcomes on maternal health, a divided Congress, a divided public opinion, religious disagreement, and development of new scientific and technological practices in health care. However, increasing diagnosis of fetal malformation and impossibility of access to legal abortion, created a social tension which demands to be addressed. This results in the introduction of new elements that offer a possible accommodation, without the need for major political modifications. Response includes development of new alliances between science, judiciary, and obstetrical leaders, which benefit individual efforts rather than a public recognition of the problem and making necessary changes in the law.
Web site : http://www.sciencedirect.com/science/journal/02779536Abstract : In this document, the determinants of reproductive behavior and various related information concerning the community, households, women, mothers, and children gathered by the 1989 Demographic and Health Surveys of Bolivia are analyzed using Bongaarts' model and the Easterlin Framework.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 171229Abstract : Socioeconomic, health, fertility conditions affecting reproductive health in Latin America the Caribbean are analyzed, including gross national product inflation rates, fertility rates, increasing urbanization, life expectancy, infant child mortality, maternal mortality. Major factors influencing fertility practices - ethical, religious, moral consideration - are discussed. Barriers to use of contraception are also addressed, eg: the lack of access to information supply; the lower status of women, which results in unregulated fertility, poor quality of health services, low education levels, dependency on men; lack of education services for adolescent women, who have a very high birthrate. Recommendations are made for intervention strategies that will improve reproductive health. 10 References. Adapted from the source document.
Web site : http://baywood.metapress.com/app/home/journal.asp?wasp=746fca2a6ef542f9a75007a13783354d referrer=parent backto=linkingpublicationresults,1:300315,1Abstract : Discusses family planning, abortion, maternal morbidity and mortality, perinatal and neonatal mortality, sexually transmitted infections, and the difficulty of measuring the full dimensions of reproductive health in developing countries; includes studies from Gambia, Bangladesh, and Latin America and the Caribbean; 10 articles. Summaries in French and Spanish
Web site : http://www.who.int/bulletin/en/Abstract : Despite solid economic growth, Brazil has one of the world's widest income disparities. In the early 1990s, nearly 40% of urban and 66% of rural Brazilians lived in poverty. The streets of Brazil's cities are home to a large population of street children. Although it is difficult to estimate, 10 million children and youths may be either homeless or making a meager living off of the streets. Street children may be linked to prostitution and drugs and be the targets or perpetrators of violence. Child labor is an issue in Brazil. Today an estimated 30% of rural children and 9% of urban children ages 10-13 work in the formal economy. In some rural areas, 60% of workers are ages 5-17. Child labor also contributes to Brazil's relatively low educational attainment levels. UNICEF estimates that around 1990 only 1/3 of all Brazilian children continued on to secondary school, compared to 74% and 47%, respectively, for the Latin America and Caribbean regions. Immunization rates among Brazil's children are rising but still lag slightly behind regional averages. The mortality rate for children under age 5 decreased dramatically from 181 deaths for every 1000 live births in 1960 to 61/1000 in 1994. During the same time period, the average number of children born to a woman during her lifetime dropped from 6.2 to 2.8. This fertility decline is related in part to increased access to and acceptance of family planning. Contraceptive prevalence, including traditional and modern methods, is around 66%, with female sterilization and the pill being the most popular methods. Brazil's abortion rates are high, despite laws limiting access to abortion services. One estimate suggests that about 30% of all pregnancies are terminated through abortion each year.
Web site : http://www.prb.org/template.cfm?Section=Population_Today1 Template=/PopulationToday.cfmAbstract : In his statement to the 1994 International Conference on Population and Development (ICPD), the Brazilian Development Minister characterized the ICPD as the latest in a series of efforts by the international community to promote broad-based economic and social development as well as a new approach to demographic problems. He maintained that the effects of demographic variables can only be gauged properly if they are viewed in the context of their relationship with other factors such as the exploitation of natural resources, the environment, quality of life, settlement patterns, education, public health, and human rights. Assuring human rights in terms of reproduction is an activity that impacts upon traditional, cultural, and religious concerns. The Brazilian delegation believes that the Programme of Action takes these concerns into account and upholds existing international commitments. For example, abortion, which is illegal in Brazil, is not promoted as a method of family planning. Brazil will welcome efforts to strengthen family development and inform young people (especially adolescents) about reproduction so that they can avoid the harmful effects of adolescent pregnancy. The status of women must also be improved through increased access to education and employment on equal terms with men. Brazil supports the concept of sustainable development and encourages efforts to reduce the growing international migration resulting from political tension or economic factors. Brazil further supports the goal of securing a commitment of 4% of foreign aid to population projects. Brazil's new policies aim to improve the quality of life of all Brazilians by increasing education levels, improving the health care system, improving the nutrition of the most vulnerable groups of people, stimulating growth in employment and wages, and improving social security. Brazil has worked closely with its neighbors to draft a Regional Plan of Action on Population and Development, and the Brazilian ICPD delegation will approach the work of the ICPD in the same spirit of respect for the diversity of societies and readiness for open dialogue that the delegation exhibited in these preliminary meetings.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 101726Abstract : According to a review of maternal mortality from 1978-87 in a municipal hospital in Rio de Janeiro, abortion-related deaths accounted for nearly one-half of all maternal deaths. 32 maternal deaths occurred at the study hospital over the past 10 years (a maternal mortality rate of 177 maternal deaths per 100,000 live births for the period). Deaths directly related to pregnancy made up of 82% of the total. These included abortion complications (47%), toxemia (19%), hemorrhage (13%) and infection (3%). The remaining 18% of maternal mortality were the result of indirect causes including cardiac arrest (6%), respiratory illness (6%), diabetes (3%), and anesthesia accident (3%). It is also noted that two-thirds of the abortion-related deaths were the result of illegal abortions performed during the second trimester of pregnancy, with sepsis diagnosed as the main cause of death. Uterine perforation with resulting sepsis and hemorrhage occurred in one-half of the second-trimester abortions that led to death. The study has some implications for improving health care for women in Rio de Janeiro.
Web site : http://www.guttmacher.org/Abstract : A chief medical officer makes a statement that in 1997 and during the first half of 1998, an estimated 140,000 women, mainly among the poor Indians, were sterilized in Peru. Additionally, thousands of forced abortions occurred, often under deficient health care conditions. This amounts to a gigantic, veritable genocide on a level not even achieved by the Spanish colonists in the 1500s. The government of Peru bears principal responsibility for this murder, but Peruvian medical circles that carry out these evil acts are also partially to blame. The question since has been one of how the Swedish Medical Association is to act through its international contacts to condemn these activities. The executive director and spokesman of the World Medical Association (WMA) has responded by saying that this issue will be taken up with his Peruvian colleagues at the next meeting of the board in April 1999. If the allegations are correct, within the WMA all efforts will be exerted in collaboration with the Peruvian medical association to stop forced sterilizations. In the early 1990s several Peruvian doctors were sentenced to 20 years' imprisonment for collaboration with the terrorist organization Sendero Luminoso (Shining Path). The only crime of these doctors was that they treated sick or wounded people who later reported them to the police as sympathizers with Sendero Luminoso. WMA believes that they should be free. The WMA's stance on this matter illustrates that it is well aware of the importance of human rights in the health care sector.
Notes : Sueco/suédois/Swedish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 141775Abstract : Outpatient laparoscopy procedures have made sterilization possible for millions of women in developing countries. This report describes the experience of a team of doctors, nurses, and support staff that performed 107 laparoscopic tubal sterilizations during on eight-day sojourn in a remote north-central area of Nicaragua. Minimal analgesia (oral ibuprofen) and anesthesia (1% lidocaine) were used since most of the patients walked to and from the hospital-some up to 15 miles. Because the Nicaraguan government's support for birth-control programs is unreliable and because illegal abortion is the leading cause of maternal mortality in Nicaragua, this safe, minimally invasive surgical method is the favored means of birth control.
Web site : http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve db=PubMed dopt=Citation list_uids=9242025Abstract : Research in contraceptive technology, investments in family planning programs, and the availability of safe abortion are essential not only to control population growth and improve the health of mothers and children, but also to improve the status of women. At present, however, it is estimated that 25% of married women in sub-Saharan Africa, 18% in Latin America and the Caribbean, and 13% in Asia, the Middle East, and North Africa have an unmet need for contraception. Without rapid advances in access to family planning, more women will die during this decade from pregnancy, childbirth, and abortion than in any other decade in history. Although the 1994 Cairo Conference achieved consensus on a range of reproductive health issues, strategies for implementing and funding these programs remain undefined.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 113041Abstract : An Ipas/Ministry of Health/DFID project carried out in Bolivia from 1996 to 1999 aimed to improve access and quality of postabortion care. A research component of the project on physicians' abortion discourse supported humanisation of care through developing innovative methods for medical education and staff training. Participant observation and interviews in two hospitals focused on gynaecologists, medical residents and women receiving postabortion care. Story dossiers were compiled, each comprising four or five speakers' narratives concerning treatment received by a particular woman. Critical analysis of these accounts pointed to the varying agendas and experiences of those who provide, receive and research postabortion care. The method proved especially effective for exploring contrasting representations of emotion, conflict and pain. In a subsequent period of action-research, story dossiers were presented and discussed with groups of medical students, teachers and residents. Theie reflections served to emphasise the partiality of medical discourse and the need for physicians to consider alternative accounts, particularly women's narratives of their hospital experiences. The study shows how narrative analysis methods can heighten participants' awareness about differing human experiences and needs in medical education and practice, including the sensitive field of postabortion care.
Notes : Inglés/anglais/EnglishAbstract : This study focuses on lowest income Mexican women attended for abortion-related complications in a public hospital. The objective was to investigate the women's experience of having a so-called "spontaneous" abortion and their related strategies to avoid stigmatization. Four strategies emerge from women's testimonies: presenting themselves as women who "play by the rules," pleading ignorance of the pregnancy, stating that they had already accepted their pregnancy, or presenting the abortion as the result of an accident. Women use these strategies to deflect any blame to which they might be subjected and as a means of dealing with the stigma attached to a behavior that transgresses social norms regarding reproduction. Far from being passive receptors of the social imperative, which makes motherhood compulsory, women oscillate strategically within the margins of a seemingly uniform normative discourse and thereby ensure their moral survival. The authors discuss results within the framework of praxis theory. (author's)
Notes : Inglés/anglais/English, nbsp;283254Abstract : PURPOSE: An optional half-day clinical experience in abortion care was offered to third-year medical students rotating through the core obstetrics and gynecology (Ob/Gyn) clerkship at the University of New Mexico to improve education about women's reproductive health. This study using survey methods was conducted to rate the acceptability of the clinical experience and to document any changes in students' attitudes toward women's access to abortion. METHOD: All 145 students who rotated through the Ob/Gyn clerkship between March 2000 and March 2002 were provided an 11-item, confidential questionnaire to complete. Students who did not participate in the abortion care experience were asked questions about their reasons for declining participation; students who did participate were asked questions about the value of the experience. RESULTS: Of the 145 students who rotated through the clerkship during the study period, 126 (87%) completed the questionnaire. Of these students, 86 (68%) participated in the clinical experience and 40 (32%) did not. The majority of students who participated in the clinical experience rated it very highly. Of the 86 students who participated in the clinical experience, 33 (38%) reported a change in their attitudes about abortion; 31 (94%) of these became more supportive of women's access to abortion services. CONCLUSION: Clinical experiences in abortion care are acceptable to and valued by a diverse group of medical students and should be offered at medical schools throughout the United States.
Web site : http://www.academicmedicine.org/Abstract : Many clinics and hospitals which provide reproductive health services must meet clients' immediate needs while also reaching out to those clients who also want to plan ahead for future contraceptive use. This challenge is of particular concern in facilities which provide contraceptive counseling to women who present for treatment following an incomplete abortion. While such women may be most immediately concerned with obtaining medical attention, they are also likely to be interested in learning about contraception in order to prevent future unintended pregnancy and abortion. Orientame is a Colombian organization working to provide reproductive and sexual health services and to defending and promoting sexual and reproductive rights. In addition to its other services, Orientame provides high-quality, compassionate treatment of incomplete abortion, as well as counseling and services for postabortion contraception to all of its clients. Findings from a 1995-96 study conducted at Orientame and two other Colombian institutions which provide similar services, ProMujer and SiMujer, both clients and providers believe that when a woman comes to the clinic for treatment of an incomplete abortion, her first concern is to be treated for her medical concern. However, more than half of women in such situations also want information on contraception. Family planning counseling and information should be made available at any point during a client's visit. Steps are being taken at these three organizations to make counseling and information services more available. Additional findings on the need for providers to be well-informed, inconsistency in the way in which different methods are supplied and priced, and the role of men in family planning are presented.
Web site : http://www.affection.org/sante/asvc/www.igc.apc.org/avsc/site/Abstract : Formal research can be used to measure acceptability of abortions induced by RU-486. The primary acceptance method determines whether women will or will not choose RU-486 in the absence of other abortion methods, if offered it, and how many women will indeed undergo a medical abortion. The comparative acceptance method determines how many women will choose RU-486 if other methods are available. Another acceptability approach is interviewing women to learn if they suffered any side effects or have anycomplaints. Researchers can also see if women think that they would choose RU-486 again should the need arise. This method would work best with women who have undergone both surgical and medical abortions. It is important to examine acceptability because medical service delivery systems in developing countries cannot always perform safe and effective surgical abortions and individual choice is important in matters concerning stressful and intimate issues, such as abortion. Research is beginning to show that women in both developed and developing countries tend to be motivated by the same issues when choosing RU-486 over surgical abortion. For example, women in Cuba, India, and Europe chose RU-486 because it avoids surgery and hospital admission and is easy andconvenient. More than 90% of the women in studies in India and Cuba considered their RU-486 experience to be at least satisfactory. 83% who had earlier undergone a surgical abortion preferred RU-486 induced abortion. 90% of repeat abortion seekers would choose RU-486 again. Feasibility studies examine whether medical institutions can handle medical abortion technology. Feasibility depends on cost, clinic facilities (e.g., availability of sonograms), clinic management, professional training, and the presence of back-up systems (e.g., high quality surgical services with transfusion capability). Researchers also need to determine whether medical abortion burdens medical systems and patients.
Web site : http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve db=PubMed dopt=Citation list_uids=1434760Abstract : A number of surveys have been conducted using a new approach to questioning women about their abortion history. Data on the incidence of abortion is essential 1) to expose the severity of the public health problems caused by complications from illegal abortions, 2) to support legislative and programmatic change, 3) to determine the demand for contraception, and 4) to estimate fecundity and understand fertility dynamics. The use of an indirect approach may improve the accuracy of data collection about induced abortion. A study in Estonia used a filter question approach by asking women if any of their pregnancies did not result in a live birth and then asking them to describe the pregnancy outcome. This paper reports on the results of using a set of indirect questions that reminded the woman of having an unwanted pregnancy and then asked about the outcomes of the pregnancy. After achieving promising results in a field test in the Ivory Coast, the filter question and follow-up probe technique was used in clinic-based (in Ghana, Egypt, and Turkey), employment-based (in Bolivia), and population-based (in Mali) sample surveys. Based on results from these trials, the Demographic and Health Surveys used indirect questions in Indonesia and Senegal in 1993. In each case, the level of induced abortion appears to be underreported. In a 1994 Situation Analysis in Senegal, the indirect methodology was tested using a split-halves design with family planning (FP) and maternal/child health (MCH) clients. In each group (564 women asked direct questions and 557 asked indirect questions about abortion), 2% of the women admitted to having undergone abortion. However, reported levels of unwanted pregnancy are low in Senegal, and this topic may have been too sensitive to serve as an adequate filter question. A summary of results from studies on the use of the unwanted pregnancy filter question plus follow-up questions on abortion reveals that abortions are more commonly reported in FP/MCH clinic studies and in settings where abortion is legal. The mixed findings of the studies indicate that no single universally sensitive context exists for discussing abortion. More research is required to identify the best filter questions or the best way to establish a nonthreatening context.
Web site : http://www.popcouncil.org/publications/sfp/default.htmAbstract : IPAS promotes appropriate and prompt treatment for abortion complications; alternatives for safe, voluntary abortion; and inclusive family planning services and counseling to decrease the need for abortion. Each year about 200,000 women die from complications of an unsafe abortion done by untrained practitioners. Most of these women lived in developing countries. IPAS is confronting the challenge of unsafe abortion by promoting sustainable programs for high quality, well-managed abortion care through clinical and management training in regional and national health systems and advancing the availability of safe appropriate abortion care technologies, including manual vacuum aspiration instruments (MVA). IPAS manufactures and distributes these technologies. IPAS has conducted MVA training in Bolivia, Cameroon, Child, Ecuador, The Gambia, Ghana, Kenya, Mexico, Nicaragua, Nigeria, Romania, Tanzania, Turkey, Zaire, Zambia, and Zimbabwe. IPAS also advocated integration of postabortion care with family planning services. It uses programmatic research to identify interventions that improve the quality of abortion care. It provides technical assistance to local leaders to generate longterm approaches to strengthen and expand programs. IPAS has various publications to provide more people with information about MVA and other safe abortion issues (e.g., 2 publication series, Advances in Abortion Care and Issues in Abortion Care.
Notes : Inglés/anglais/EnglishAbstract : These are the proceedings of a workshop held November 1-2, 1993, in Buenos Aires on aspects of reproductive health and sexuality in Argentina. Topics covered include abortion, public health services and institutions, population policies and women's status, and adolescent pregnancy and sexual behavior. (ANNOTATION)
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - IND RH8C042Abstract : Se plantea interrogantes sobre la identidad, maternidad y aborto; en busca de planteamientos y propuestas para presentar al estado, se releva la situación de las mujeres de las diferentes regiones. Espacio de entrenamiento en el díficil ejercicio del respeto a las diferencias
Notes : Español/espagnol/SpanishAbstract : Unsafe abortion is a leading cause of maternal death in the developing world. Access to postabortion care (PAC) services, including emergency treatment of complications and contraceptive counseling and supply, is an important strategy for decreasing maternal mortality and can be easily implemented in most health care settings. However, because of the political, religious, and social implications of abortion, little has been recorded about the behavior and needs of women who seek abortion when faced with an unwanted pregnancy. A key factor in making PAC accessible and effective is tapping community opinion to determine how reproductive health services can best serve women's needs. In low-resource settings, a short community PAC survey is a simple, inexpensive way to involve the community in health promotion that addresses unsafe abortion. The short survey is not a formal needs assessment, but rather a tool for gathering community experiences, opinions, and ideas that can be used to tailor PAC services to community needs. The survey can also serve as an opening for community members to become involved in a give-and-take dynamic with the health sector by both providing their input and receiving potentially life-saving information about the dangers of unsafe abortion. Survey results can be used to inform stakeholders about the nature and extent of unsafe abortion in the community; to sensitize hospital personnel; to enrich medical, nursing, and other health/education training; and to propel the formation within health facilities of quality of care committees that have community representation. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 181495Abstract : In 1990, there were 81 million 15-24 years olds in Latin American and the Caribbean and this number could climb to 128 million by 2000. Further the percentage of total births for adolescents grows while fertility falls for women >25 years old. The percent of adolescents (15-19 years) having babies each year in the region ranges from 6% in Chile and Uruguay to 15% in El Salvador and Grenada. Moreover 60% of births in Mexico and 50% in the Dominican Republic, El Salvador, Peru, and Trinidad and Tobago were not wanted. >90% of Latin American males and between 45-60% of females have had sexual intercourse by 19 years old. In fact, the average age of 1st intercourse for adolescent males is 15 years and 17 for females. Adolescent contraceptive use ranges form 7% in Quito, Ecuador to 30% in Sao Paulo, Brazil. Further those that do use contraceptives generally use unreliable methods, e.g., withdrawal and rhythm. Moreover few Latin American adolescents actually know when a woman is most fertile. In Quito, only 17% of females and 26% of males could identify the fertile period. As the age of 1st intercourse and years of education increases so does contraceptive use. In addition, it is higher among urban adolescents and adolescents who have had sex education. In fact, adolescent females in Guatemala and Mexico who had sex education were 5 and 2 times respectively more likely to use a contraceptive than those who did not have any sex education. Low contraceptive use can be attributed to inadequate access to contraceptives and sex education and no responsibility for sexual decision making. There are substantial risks for teenage pregnancy and childbearing, such as death from illegal abortions (around 35% in Argentina and Chile) and low standard of living. Many teenagers do not use condoms during intercourse to protect themselves from sexually transmitted diseases and AIDS.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 065190Abstract : This book describes and discusses abortion as experienced by a group of 20 women Puerto Rican women living in Chicago. The introductory chapter considers theories about cultural stories (which portray the "normative order") and the alternative collective stories (which, in this case, are about self-determination and resisting male control) as fulcrums for narrative analysis, places this research project in the realm of the reflective tradition, reviews research on abortion, and discusses characteristics of Puerto Rican women. Chapter 2 considers the various uses of abortion in women's lives, including maintaining identity, preserving life or health, coping with abandonment, and resisting male control. The third chapter recounts the women's experiences and beliefs about relationships with an emphasis on male control versus egalitarian power setups, surviving an abusive relationship, and evaluating the relationship in the context of an unplanned pregnancy. Chapter 4 explores the parameters of the cultural story of Puerto Rican women and leads into a consideration of how a culturally resistant act becomes redefined from an isolated act to part of a collective story through a look at the specific cultural values (virginity, family life, abortion) contained in the individual narratives and how these values affected the abortion decision (chapter 5). Chapter 6 present the abortion experience of these women as a moral passage that fosters the beginnings of a collective story by redefining the meaning of abortion and womanhood, looking at shameful secrets and the spiral of silence, recasting abortion as an acceptable act, and sharing experiences. The concluding chapter delineates the parameters of the collective story created by these women after their abortion experience undermined the bedrock of the patriarchal cultural story.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 118572Abstract : Presentación ; Aspectos conceptuales ; Salud reproductiva: Nueva orientación para los programas de salud / Horacio Toro Ocampo ; Por que hablamos ahora de sexualidad y salud reproductiva / Winston Uzin Vargas ; Salud reproductiva en los programas de salud pública / Horacio Toro Ocampo ; Aspectos institucionales y de politicas de salud ; Estrategias comunitarias de salud reproductiva en servicios de atención priMaría de salud / Horacio Toro Ocampo ; Calidad de la atención prenatal / Ubaldo Farnot ; Calidad de la atención del parto por agentes comunitarios / Alberto de la Galvez Murillo ; Atención del recién nacido / Eduardo Correa-León ; Prevención de las infecciones en los programas de atención integral de la mujer / Erwin Hochstatter ; Mortalidad Materna: Un problema de salud pública / Germán Mora ; Aspectos de políticas de salud sexual y reproductiya para la adolescencia ; Promoción de la salud sexual y reproductiva de la adolescencia en el contexto de la salud integral / Graciela Castelo ; Los servicios de salud del adolescente y del joven. Desafíos de acceso y calidad / Elsa Moreno ; 11 Salud reproductiva de los adolescentes. Componentes y elementos de trabajo en el contexto de la salud integral / Horacio Toro Ocampo ; Salud sexual y reproductiva para adolescentes: Una perspectiva de gestión logística / Ingrid M. Hernandez-Matheson ; Aspectos clínicos ; Genética y salud reproductiva / Carmen Rosa Serrano ; Infecciones del tracto genital femenino. Diagnóstico y tratamiento / Luis Jauregui Peredo ; Observaciones sobre el uso de agentes antimicrobianos. Diagnóstico y tratamiento de infecciones relacionadas con el tracto reproductivo / Luis Jauregui Peredo ; El aborto como problema de salud pública y su repercusión en la salud reproductiva / Evelio Cabezas ; Estudio de la pareja infertil / Joaquín Costa Lopes y María Cecilia AC Brandi ; Climaterio y menopausia: Definiciones. Indicaciones y contraindicaciones en terapia hormonal sustitutiva / Nestor Siseles y Martin A. Capria ; Aspectos de género y aspectos socioculturales ; Género y poder / Anibal Faundes ; Salud y género. Enfoque para pensar en hombres y mujeres en los procesos salud-enfermedad / Argelia Londono ; Salud reproductiva en las poblaciones indigenas de América Latina / Isabel Hernández ; Recursos humanos ; El papel de la matrona profesional en las acciones de salud reproductiva / Ivelise Segovia ; Desarrollo y capacitación de los recursos humanos en el área de la salud / Ingrid M. Hernandez-Matheson ; La enseñanza de la salud reproductiva y su importancia en los servicios de salud / José Gorrín Peralta ; Nuevo enfoque de la evaluación como proceso dinamizador del programa de salud reproductiva / Jose García-Nurlez ; Planificación familiar: programas de país ; Planificación familiar en los servicios públicos de salud. El caso de Brasil / Jose Ferreira Nobre Formiga Filho ; Aspectos de la planificación familiar en los programas nacionales de salud reproductiva. El caso de Chile / René Castro Santoro ; De la planificación familiar a la salud sexual y reproductiva / Rene Castro Santoro .
Notes : Español/espagnol/SpanishAbstract : Se evalúan las tendencias de los derechos reproductivos y la condición jurídica y social de las mujeres, reveladas en un estudio sobre las leyes y las políticas nacionales de nueve países de América Latina y el Caribe. Las características regionales proporcionan una guía para calcular el esfuerzo que se requerirá para hacer que se observen los derechos reproductivos. Se determinan leyes nacionales pertinentes que podrían servir de base para reformas legislativas en otros países. Se señalan la ausencia de reglamentos en campos particulares y propuestas para leyes y políticas en proceso de adopción, y también las limitaciones de la información existente en cada país. La primera de cuatro secciones principales describe el marco legal y político del país, incluida la estructura del gobierno nacional y el local, y fuentes internacionales de leyes. La segunda sección examina leyes y políticas relativas a la salud y la población. Se analizan los objetivos de la política nacional y la financiación, la infraestructura y la regulación de los servicios de salud, y los derechos de los pacientes. Luego se examina la política de población, la legislación relativa a la salud reproductiva, y los servicios de planificación familiar prestados por el gobierno. Los análisis de la anticoncepción, el aborto y el VIH/SIDA y las enfermedades de transmisión sexual examinan la legislación y la prevalencia al respecto. La tercera sección principal evalúa la condición social y jurídica de la mujer como influencia en el ejercicio de sus derechos reproductivos, incluidos los derechos civiles dentro del matrimonio, derechos socioeconómicos y el derecho a la integridad física. Las características de las relaciones maritales y familiares y su nivel de educación, el acceso a los recursos económicos y a la protección legal determinan las posibilidades de las mujeres de satisfacer sus necesidades de salud reproductiva y los derechos a los servicios. La última sección principal examina los derechos de las adolescentes en el campo de la salud reproductiva, matrimonio, delitos sexuales contra las niñas y las jóvenes, y educación sexual.
Web site : http://www.crlp.org/Abstract : No quadro das relações político-jurídicas da Ilha com os Estados Unidos, as portorriquenhas enfrentam séria ofensiva anti-aborto. Embora permitido por lei, o aborto é praticado como ato censurável e clandestino, dado que a legalização não tem respaldo social. Este estudo investigou o discurso dos setores anti-aborto e pró-opção em Porto Rico e seus vínculos com os similares norte-americanos através do exame das comunicações apresentadas em amplo debate público na Assembléia Legislativa de Porto Rico entre 1992 e 1993. A análise dos argumentos da retórica anti-aborto (vida desde a concepção, crime contra a humanidade, ameaça à moral familiar, imposição imperialista, prática racista, causa de criminalidade) e do discurso pró-opção (morbimortalidade devida ao aborto inseguro, direito de opinião, separação igreja-Estado, respeito à integridade física feminina, ingerência em decisão pessoal inviabilizando a eqüidade, pleito de direitos reprodutivos) é complementada por um breve histórico da querela jurídica em torno do tema nos Estados Unidos. Em Porto Rico atualmente, enquanto se consolida o direito das mulheres à opção, medidas legais reduziram o período de tempo para que a exerçam; também se mantém muito limitado o acesso ao aborto, já que este foi excluído dos serviços médicos a que têm acesso as comunidades de baixa renda. O direito à opção continua, portanto, sob ameaça, prenunciando longo percurso de luta.
Notes : Portugués/portugais/PortugueseAbstract : Se estudiaron 40 mujeres que tenían 49 días de amenorrea, a partir de la fecha de la última menstruación, y diagnóstico de embarazo mediante test uterino, ultrasonido ginecológico y niveles plasmáticos de Bhog. De ellas 20 recibieron RU-486 en forma fraccionada durante 3 días, 125 mg (grupo 1) y las 20 restantes, recibieron una dosis única, 600 mg (grupo 2). En ambos grupos esta dosis se complementó con un supositoriovaginal de un análogo de prostaglandina, ONO-802, que se colocó al cuarto día. A todas se les determinaron los niveles plasmáticos de Bhcg, progesterona, estradiol, prolactina y cortisol antes del uso del RU-486 y a los 2, 3, 4, 8, 15 y 43 días después. Se logró expulsión completa en el 95 % de las mujeres del grupo 1 y en el 80 % del grupo 2, en 3 de las restantes de este último grupo la expulsión fue incompleta. Dos mujeres, una de cada grupo, no expulsaron. Las manifestaciones secundarias fueron mínimas. Los niveles plasmáticos de Bhcg, progesterona y estradiol variaron de acuerdo con la presencia o no del embarazo. Algo similar se vio en los niveles de prolactina. Los niveles plasmáticos de cortisol no tuvieron cambios.
Web site : http://www.bvs.sld.cu/revistas/end/vol6_1_95/end05195.htmAbstract : This study evaluated the effectiveness of a single dose of the abortifacient effect of vaginal misoprostol followed by prolonged observation. Women with =42 days of amenorrhea, pregnancy confirmed by ultrasound, and approved request for termination received 800 µg of vaginal misoprostol once and were observed for 1 week. The gestational sac was measured before misoprostol administration, and 24 h and 7 days afterward. Women reported bleeding, expulsion of sac, and other complaints. After 1 week, those who had not aborted received a second dose of 800 µg. Those who had not aborted by 24 h later were treated by vacuum aspiration of the endometrial cavity. Twenty-four hours after treatment, 71.8% had aborted, and 87.1% aborted 3 days after treatment. After the second dose, 7 days later, the cumulative abortion rate reached 92.1%. None of the subjects who aborted required curettage or vacuum aspiration. The main complaints were pain (84.5%), nausea (21.4%), and headache (17.5%). No clinical differences between responders and nonresponders was found. Vaginal misoprostol, 800 µg, is effective in inducing early termination of pregnancy, and there is no need for an additional dose within 72 h after the first administration of misoprostol.
Notes : Inglés/anglais/EnglishAbstract : Fetal abnormality incompatible with life is a fact and the options for dealing with it are abortion or birth followed by death. This paper reports a qualitative study of the experience of ten women who had a pregnancy termination in a university hospital in Brazil for fetal abnormality incompatible with life. The women were interviewed approximately 40 days after the procedure. The experience was marked by strong emotions for the women, who had a terrible shock on learning of the diagnosis, which was given between 13 and 25 weeks into their pregnancies. They cried, and experienced fear, despair, anguish, a sense of uselessness and refusal to accept the situation. When they took the decision to terminate their pregnancies, the women experienced sadness, despair and guilt, and all these feelings caused them intense suffering. The killing of the fetus was the most difficult part of the termination for them. Nevertheless, afterwards they were satisfied with the decision taken and believed that it was the correct one, despite the anguish it caused. The inclusion of fetal abnormality incompatible with life in the Brazilian law on pregnancy termination would help to reduce women's suffering and contribute to the provision of supportive care by the health services.
Web site : http://www.rhmjournal.org.uk/Abstract : A comprehensive look at the phenomenon of abortion in the countries of the world classifies countries by abortion availability and incidence, explores demographics, describes methods. There are 11-18 million estimated abortions yearly. Countries can be classified as those with abortion is legal with open access to contraception, those with legal abortion and limited contraception (USSR and Eastern Europe), those with limited abortion but access to contraception (e.g. Chile) and those with both restricted (much of Latin America, sub-Saharan Africa and Islam). Abortion ratios range from 1.5/100 pregnancies in Bangladesh to 68 in the USSR. Actual abortions in the USSR are believed to be 3/live birth. The average abortion ratio, including illegal abortion, is 24-32/100 pregnancies worldwide. The availability of a variety of effective contraceptives determines the abortion rate, as seen with the high abortion rate in the US and the low rate in Holland compared to other developed nations. There are perhaps 9-30 million contraception failures annually. Abortion rates are highest among young people in developed countries, but among older married women in India, Tunisia and Singapore. For the medical abortion methods, morbidity and mortality increase with gestational age. The most widely used methods of nonmedical abortion are insertion of a foreign body, soapy water or disinfectants into the uterus, and abdominal massage, all with high rates of morbidity and mortality. There are 200,000 abortion related maternal deaths annually, 99% in developing countries.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 065096Abstract : ¿Qué es el aborto? ¿Qué otras cosas están implicadas en él, qué aspectos de nuestro orden social se está poniendo en juego, qué resortes del poder estamos tocando? En este artículo se pretende mostrar como los lugares socialmente asignados a lo femenino y a lo masculino, y a la relación de dominación-subordinación que signa las relaciones de género, definen no sólo las prácticas en torno al aborto, sino -y fundamentalmente- las representaciones y discursos correspondientes.
Web site : http://www.chasque.net/frontpage/comision/dossieraborto/cap9_3.htmAbstract : Unsafe abortion is a serious public health problem in Bolivia, accounting for up to 25 percent of maternal mortality. Postabortion care (PAC) was recognized as a priority public health action in Bolivia in 1994 in the country's preparatory statement for the ICPD. In 1999, PAC services, known as the "treatment of complications of hemorrhage during the first half of pregnancy," were included in Bolivia's revised national health plan, the Seguro Básico de Salud (SBS). Inclusion in the SBS makes PAC services free of charge to women and aims to: 1) increase women's access to services; 2) reduce the cost of service delivery and hospital length of stay; and 3) improve the quality of care. The operations research (OR) project carried out from May 1999 through August 2001 and summarized in this report was undertaken at the request of the Ministry of Health (MSPS) to help guide the improvement of PAC services as the SBS was implemented. A non-experimental design with pre- and post-intervention measurements was implemented in three major maternity hospitals - Hospital de la Mujer (La Paz), Maternidad Percy Boland (Santa Cruz) and Hospital "Jaime Sánchez Porcel" (Sucre). Given the differences in infrastructure, size, and characteristics of the population served, comparisons are made between pre- and post-intervention results within but not between hospitals. A variety of data collection methods were used, including interviews, observations and record reviews. Data were collected from women treated for incomplete abortion, male partners (with women's consent and only in the Sucre site), and physicians. Three-month follow-up interviews were conducted with women in the Sucre site. The intervention consisted of re-organization of services to ambulatory care, PAC training, refresher training, and supportive supervision. (excerpt)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 180117Abstract : The use of RU-486 to induce abortion represents a new era in reproductive technology and merits ethical attention. The feminists principles of concern for women's well-being, paying attention to the specific needs of women in specific circumstances, and balancing risks and benefits can be applied to an examination of RU-486. RU-486 has invoked the image of women's medical empowerment and has been deemed "the moral property of women." Support for RU-486 has come from major international health and feminist organizations, while the opposition of the anti-choice forces has been matched by that of the Feminist International Network of Resistance to Reproductive and Genetic Engineering. Issues critical to the introduction of RU-486 include 1) access and suitability, 2) whether RU-486 increases women's control over reproduction in a safe manner, and 3) the political problems involved when feminist leaders press for testing and attempt to explain varied and even opposing feminist positions in productive ways.
Web site : http://www.reddesalud.org/english/sitio/021.htmAbstract : Faced with a situation in which an estimated 60,000 illegal abortions (a major cause of maternal mortality) were performed annually, the Dominican Republic has adopted a new Health Code which contains a chapter dedicated to maternal health. Included in the new code are cases in which abortion is allowed: 1) when 2 specialists affirm that the pregnancy or childbirth constitutes a risk to the mother's health or life; 2) if the medical history of the parents and 2 doctors confirm the likelihood of the baby being born seriously disabled or deformed; or 3) if the mother's mental health is put in jeopardy by continuing the pregnancy. Despite the disapproval of church representatives, the legalization of abortion was unanimously approved by the Congress. The debate which surrounded the process was increased by a petition signed by more than 260 women decrying the lack of input that women had in the Decision making process. Women's action groups have been trying to widen the context in which the political discussion is taking place to stress the importance of viewing abortion from a reproductive rights perspective. The women's groups wish to prevent a situation in which the discussion surrounding the issue will be limited to legislators and church leaders. The women have pointed out that women should make the decisions about their lives and their bodies. In the meantime, the president of the Congress predicts that illegal abortion will continue in the Dominican Republic regardless of the current provisions for legal abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 081418Abstract : This book compares, contrasts and links the abortion debate globally by using multiple sources of evidence, including a study involving 162 elite interviews. Particularly, it examines the emergence and construction of the abortion debate beyond the Western liberal democracies and how the Catholic Church, the most visible transnational actor in this dispute, engages this issue worldwide. Divided into five chapters, chapter 1 outlines the key dimensions to "the policy conundrum" posed by abortion, the scope and purpose of the study, the issues and themes with which it is concerned, as well as the reasons for looking at Kenya, Mexico and Poland, respectively. In addition, it addresses a range of shared underlying concerns with a focus on what is salient in each country and its wider region. A description of "the tyranny of silence", which is a characteristic of much of Africa is presented in chapter 2, while an explanation on how concerned parties are "negotiating a hidden reality" in order to seek alternative ways out of this situation is discussed in chapter 3. Chapter 4 shows how and why conflict over abortion at times upstaged the whole process of systemic transformation as political theater in Poland and East Central Europe. Finally, chapter 5 reviews the main findings and examines a number of major themes, which weave through the study. It provides a more focused comparison between the three countries and their regions, set within a broader international context.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 150841Abstract : A field study of the availability and use of so-called "high-dose estrogen-progestogen" drugs in Cusco, Peru, was done in 1987 by making an inventory of available drugs, discussing drugs with pharmacists and women, observing 112 consultations with midwives and physicians, interviewing doctors, midwives and nurses, "fake patient" approaches to all 19 pharmacies, and interviewing salesman in pharmacies. 12 such injectable combinations are registered for secondary amenorrhea in Peru, although none are on the 1986 Essential Drug list. Their sales make up 66% of the market for sex steroids (including oral contraceptives), which account for 10% of drug sales in Peru. Women, who are discouraged from using contraception by the Church and by husbands who fear an effect on their virility, demand the drugs for abortifacients, and prefer injections over pills. Injection were done in pharmacies, at health centers, or at home. DOctors also regard them as pregnancy tests, although they have been banned for this use in developed countries. Only 8 of 19 health providers questioned believed the steroids may harm the fetus, and then erroneously only in late pregnancy. 26 incidents of patients being prescribed high dose estrogen-progestins were observed: only 11 patients had pelvic exams. 17 were given for pregnancy termination, 3 with no reason mentioned, and 6 for pregnancy diagnosis or to induce menstruation. Pharmacy sales staff, who stated that they receive information from pharmaceutical representatives, held a wide range of views on indications for these drugs, from the best agent to induce menstruation to the drug to use for an abortifacient. While pregnancy is a contraindication for these medications, they are abused for abortion, indicating a great need for a safe medical abortifacient in Peru.
Web site : http://www.sciencedirect.com/science/journal/02779536Abstract : To assess the acceptability of medical abortion in developing country settings, women presenting to six urban clinics in China, Cuba, and India were given a choice between surgical or medical abortion. The final sample included 799 medical and 574 surgical abortion clients. The former received 600 mg of mifepristone followed, 48 hours later, by 400 mcg of misoprostol, while the latter underwent dilatation and sharp curettage. Medical abortion patients tended to base their choice on the avoidance of surgery and anesthesia, while surgical abortion patients viewed that option as faster and simpler. 92% of Chinese, 80% of Cuban, and 89% of Indian medical abortion patients aborted by the end of the day the prostaglandin was administered. Failure rates for medical and surgical abortion were highest in Cuba (16% and 4%, respectively), intermediate in China (8.6% and 0.4%, respectively), and lowest in India (5% and 0%, respectively). Side effects such as nausea, vomiting, cramping, pain, diarrhea, and bleeding were significantly more frequent among medical than surgical abortion patients, yet general assessments of well-being given at exit interviews were similar. 84-95% of medical and 94-100% of surgical abortion patients were either satisfied or highly satisfied with their experience. Medical patients were more likely than surgical patients to state they would select the same method if they needed another abortion. Of 28 providers surveyed, 14 preferred to offer medical abortion, 5 preferred surgical abortion, and nine had no preference. These findings suggest that medical abortion can be delivered safely and effectively to women in at least some developing countries.
Web site : http://www.agi-usa.org/pubs/journals/2307397.pdfAbstract : This 1992 annual report on regional activities undertaken in the Americas by the Special Programme of Research, Development, and Research Training in Human Reproduction of the World Health Organization identifies the objectives for the year as implementing subregional and national strategic plans for research in reproductive health and promoting intraregional research and training cooperation. Regional activities were developed to further the strategies of 1) developing regional and national strategic plans and establishing priorities for reproductive health research, 2) evaluating the research productivity and overall impact of the collaborating centers, 3) strengthening regional and national research networks and creating new "twinning" programs, 4) strengthening research skills in reproductive epidemiology, 5) strengthening research skills in the social sciences, 6) increasing the region's ability to supply itself with hormone assay reagents, 7) promoting intraregional training, 8) increasing skills in specific areas (in this case scientific writing), 9) implementing collaborative activities in the Caribbean subregion, and 10) initiating activities within the initiative for the strengthening of technical collaboration between developing countries. The evaluation of research programs (number 2 above) revealed that the 18 centers used Programme support to conduct 323 reproductive health research projects (33% in the area of reproductive biology, 24% in contraception, 22% in maternal/infant health, 11% in reproductive tract diseases, 7% in abortion, and 3% in sexually transmitted diseases). The research projects were classified by source of funding and type of research, the publication output of the centers was examined, and the impact of longterm support was evaluated. This annual report contains a review of the collaborative work of the Programme in 14 of the 21 countries of the Latin American region (Argentina, Bolivia, Brazil, Chile, Colombia, Costa Rica, Cuba, Guatemala, Jamaica, Mexico, Panama, Peru, Uruguay, and Venezuela).
Notes : Español/espagnol/SpanishAbstract : Infant mortality has been collected in Argentina's hospitals in a variety of ways. In this study the initial questionnaire employed by Centro de Estudios de Población (CENEP) and by CELADE for data collection from the Zonal Hospital of Zarate was modified to enrich the quality of the data and to expand the scope of the study. This came about as a consequence of the involvement of the mother's midwives in collecting the information and of the active participation of an obstetrician in the study. Data were collected with the initial questionnaire between June and December, 1990, after which it was modified. The quality was improved by registering the woman's previous child, indicating whether it was a single or multiple birth, and completing the questionnaire in 2 steps, before and after delivery. Objectives were expanded to include registration of the number of abortions and stillbirths prior to the present delivery, the regular collection on incidence of stillbirths, record of gestational age, and record of birth weight. The last 2 variables were viewed as measures of changes in standard of living of the population. the results were a registration of 1503 previously live-born children between June 1, 1990 and May 15, 1992, of which 54 died before the age of 1 year for an infant mortality rate of 35.9/1000. When the period is divided equally the more recent period shows higher mortality, which may reflect higher quality data. Closer examination reveals that the higher mortality is due to the overrepresentation of very young mothers (<20 years) and the underrepresentation of mothers >30 years old both groups have high infant mortality. The population showed 58.5% of first births delivered by adolescents. The women's education tended to end with the primary level. The number of abortions, both spontaneous and induced, and stillbirths increased with the age of the mother. Stillbirths were 2% of total births. Of the 1961 cases, 292 (15%) were births with <38 weeks gestation and subject to a higher risk of infant mortality. Of the 1893 live births, 220 (27%) weighed <3 kg. Further improvements will include the recording of stillbirths among prior births and the incidence of AIDS and HIV infections. These refinements will require additional costs, unlike earlier changes.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 090059Abstract : A qualitative study of the complex social, economic, cultural, and psychological contexts of adolescent pregnancy in Nicaragua revealed close links to the problem of poverty. Data sources included in-depth interviews with 10 female adolescents, 5 adult women, and 5 adult men, and 2 focus groups of 12 teenage girls. Nicaragua's economic crisis, combined with a lack of political will to challenge traditional gender relations, has increased the rate of unwanted pregnancies. Moreover, the economic, political, and cultural situation fails to provide favorable conditions for women to gain power over their bodies and reproductive lives. Unwanted pregnancy was overwhelmingly associated with absent fathers, broken families, problematic stepfather relations, poor mother-daughter communication, economic dependence, romantic illusions, needs for emotional affection, and a lack of alternative opportunities. Machismo-based relations between men and women are consolidated by the Catholic religious tradition and the "Virgin Mary syndrome." Few respondents used contraception during their first sexual experience, despite awareness of available methods of protection, and the adult female respondents continued this pattern until they were unable to bear more children and underwent sterilization. Contraception, promoted only by nongovernmental organizations and women's groups, is widely considered to have severe negative health effects. Lacking is recognition of the close association between women's health and sexuality, reproduction, and contraception information and services.
Notes : Inglés/anglais/EnglishAbstract : A Brazilian study of 1986-92 sales of the prostaglandin analogue, misoprostol (Cytotec), often used as an abortifacient in Brazil, shows that an increasing trend began in January 1989 and was maintained until July 1991, when the Ministry of Health (MOH) imposed restrictions on Cytotec sales. Cytotec introduced in mid-1986 as a treatment for gastric and duodenal ulcers. Sales reached their lowest levels in 1992 (150,207 vs. 189,199-581,003 annual sales). Other factors contributing to the fall in sales wee reduced production due to an agreement between the manufacturer and MOH, a newspaper campaign by anti-Cytotec groups, and a law for a double-copy prescription. Hospital surveys in the early 1990s indicated that many women used Cytotec to induce an abortion. The media, pharmacies, physicians, women, and the manufacturer spread the news that Cytotec could be used to induce abortion. Women take 4-16 doses of Cytotec to induce abortion, generally during the first trimester. The use Cytotec because it is relatively inexpensive and less traumatic than other abortion methods and can be taken in privacy. Women also consider Cytotec to be safe. Nevertheless, most women complain of the pain they experience and the need to eventually go to a hospital. These negative views are a result of lack of information about the physical process of the drug. Gynecologists of the Sao Paulo public health system confirm the widespread use of Cytotec as an abortifacient. Cytotec allows gynecologists to perform abortions without the police being involved since women induce an abortion with Cytotec, and gynecologists perform a curettage. Hospital staff consider this type of induced abortion more acceptable than other methods. It also allows them to avoid the feelings of inadequacy they experience when women are admitted for an infection caused by a botched abortion or perforated uterus. These findings demonstrate that a favorable atmosphere exists in Brazil to promote the legalization of abortion.
Web site : http://www.popcouncil.org/publications/sfp/default.htmAbstract : In 1994, governments attending the International Conference on Population and Development (ICPD) recognized the need to improve reproductive health. Since then, most Latin American countries have initiated programs to develop reproductive health services and make them available to the majority of men and women. This was not easy, given resistance by the Vatican and other conservative sectors that viewed this as promoting abortion and "liberal" sexuality. Promotion of emergency contraception (EC) reopened the debate, partly because of the term "morning-after pill". The term creates confusion because some claim it has an "abortive" effect on implantation of a fertilized egg cell. EC actually has a contraceptive effect because its fundamental mechanism prevents fusion of the egg cell and sperm. (author's)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 170444Abstract : Annotation: Critically examines public stances and political initiatives of the Catholic Church in Chile, as represented by individual bishops and the Episcopal Conference in the postmilitary period. Stresses that Chilean bishops have defended traditional Catholic positions on divorce, abortion, and sexual morality, and argues that the Church has formed a new alliance with Chile's political right, and has exhausted most of the prestige and credibility that its defense of democracy and human rights had won for it in progressive circles during the years of military rule.
Notes : Inglés/anglais/EnglishAbstract : In Latin America, induced abortion is the 4th most commonly used method of fertility regulation. Estimates of the number of induced abortions performed each year in Latin America range from 2.7 to 7.4 million, or from 10 to 27% of all abortions performed in the developing world. Because of restrictive laws, nearly all of these abortions, except for those performed in Barbados, Belize, and Cuba, are clandestine and unsafe, and their sequelae are the principal cause of death among women of reproductive age. 1 of every 3-5 unsafe abortions leads to hospitalization, resulting in inordinate consumption of scarce and costly health-system resources. Increased contraceptive prevalence and restrictive abortion laws have not decreased clandestine practices. This article addresses how the epidemic of unsafe abortion might be challenged. Recommendations include providing safer outpatient treatment and strengthening family planning programs to improve women's contraceptive use and their access to information and to safe pregnancy termination procedures. In addition, existing laws and policies governing legal abortion can be applied to their fullest extent, indications for legal abortions can be more broadly interpreted, and legal constraints on abortion practices can be officially relaxed. (author's).
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 084673Abstract : In Brazil, abortion is legally restricted but highly prevalent. The objective of this study was to obtain data on the opinions of obstetrician-gynaecologists regarding abortion and to verify whether there is consistency between their personal opinion with respect to abortion and their private decision when confronted personally with an unwanted pregnancy or with a request for abortion from a patient or relative. A structured questionnaire was sent to obstetrician-gynaecologists, members of the Brazilian Federation of Gynaecological and Obstetrical Societies (FEBRASGO). A total of 4,261 physicians responded, a 30% response rate. Almost a quarter of female physicians and a third of male physicians had had an unwanted pregnancy, and 80% of these were aborted. Even among those for whom religion was very important, almost 70% chose abortion when personally faced with an unwanted pregnancy. Twice as many respondents accepted abortion as a solution for themselves or their partners as for their patients. The difference was much smaller only if the physician had personally experienced abortion. Thus, the closer physicians are to the problem of abortion, the greater their understanding that there are circumstances under which abortion is the best or only alternative. We expect the publication of these data to contribute towards liberalisation of the abortion law in Brazil.
Web site : http://www.rhmjournal.org.ukAbstract : This paper provides a descriptive analysis of the impact of changes to the abortion laws in El Salvador, using an analysis of files on abortion prosecutions opened since Penal Code provisions were made more restrictive in 1998. Moreover, this paper analyzes interviews with prosecutors and judges in the Salvadoran justice system, with a view to gain a fuller understanding of the impact generated by the application of these reforms, and to determine which women are not impacted in practice. The themes taken into account include: the criminal process; relevant terminology with regard to participation and criminal liability in abortion offenses; prosecution of abortion since the Penal Code reform came into effect; analysis of prosecutions involving women who have had abortions; and other abortion prosecutions.
Web site : http://www.crlp.org/Abstract : In order to explore ways of dealing with this phenomenon of illegal abortions and restrictive abortion laws in Latin America, several special sessions were held at last summer's international conference in Toronto, sponsored by the American Society of Law, Medicine Ethics. The sessions brought together lawyers, health professionals, and reproductive rights advocates from a number of Latin American countries; their counterparts in the developed world; and representatives of non-governmental agencies concerned with this issue, including Catholics for a Free Choice. The goal of the sessions was to share information on the status of abortion in various countries and to try to devise strategies to make abortion law reform more palatable to Latin American governments and public opinion. One major component of the sessions was a series of papers prepared by some of the Latin American representatives describing and analyzing the situations in their countries. The papers illustrate some of the issues facing women in this part of the world.
Notes : Inglés/anglais/English, nbsp;11652125Abstract : Guatemala has the second lowest level of contraceptive use of any country in Latin America, despite an active private family planning program for over 30 years. Previous analyses identify correlates of contraceptive use but fail to address the fundamental question: Why does Guatemala differ so markedly from the rest of Spanish-speaking Latin America in the acceptance of family planning? This case study explores political historical factors at the macrolevel that have shaped the evolution of family planning in Guatemala. These include the anti-imperialistic leftist movements of the 1960s 1970s; the large percentage of the population that is indigenous; the civil unrest that peaked in the 1980s paralyzed social programs, especially in the western highlands; the powerful alliance between the government the Catholic Church. Although none of these factors is unique to Guatemala, the convergence of the four in a single country explains why Guatemala lags far behind its Latin American neighbors in the acceptance of family planning. However, recent events give reason for guarded optimism that Guatemala is advancing toward greater acceptance of family planning. 3 Figures, 43 References. Adapted from the source document.
Notes : Inglés/anglais/EnglishAbstract : Data on unsafe abortions, defined as those provided by persons lacking the necessary skills in an environment failing to meet medical standards, are scarce given the legal and ethical implications of reporting such procedures. However, the World Health Organization estimates that 20 million unsafe abortions occur each year, 90% of them in developing countries under conditions of illegality. The rate is 8/1000 women of reproductive age in more developed countries compared with 17/1000 in less developed countries; the highest rate (47/1000) exists in Latin America. Worldwide, there are an estimated 70,000 unsafe abortion-related deaths each year; again, the risk of mortality is at least 15 times higher in developing than developed countries. In addition, about 20-30% of unsafe abortions result in reproductive tract infections, many of which produce infertility. Of concern is the increase in unsafe abortion among unmarried adolescents who lack access to fertility control services. Urged is a reframing of the abortion issue on the basis of a commitment to women's reproductive health and well-being.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 107637Abstract : The feminist contribution to the defence of reproductive and sexual rights in Mexico has been based on two elements: activist campaigns and public discourses. In this paper I analyse the ways in which political contexts have affected how the feminist discourse on abortion has developed and argue that the effective defence of reproductive and sexual rights depends on further discursive work. We in the feminist movement in Mexico must reformulate and articulate shared values that oblige other sectors to join in the defence of these rights within the context of the development of democracy.1 This requires patient translation of old principles into new concepts and the integration of reproductive and sexual rights into the definition of modern citizenship.
Web site : http://www.rhmjournal.org.ukAbstract : This book chapter focuses on the fertility transition in Cuba. Data were obtained from fertility surveys, census data, and vital statistics. Cuba's general reproduction rate (GRR) in 1955-60 was 1.83 and is similar to rates in Argentina. The GRR rose to 2.30-2.28 in 1963-64 and declined until 1979, when it was 0.95 daughters/woman; it was 0.78 in 1981. Increased fertility just after the revolution is attributed to factors such as the need for social and economic security. Social changes included increased women's labor force participation (27% in 1975) and free health services. Infant mortality declined to 19.4 deaths/1000 live births in 1979. Child labor disappeared, and children had less economic value. The revolution produced structural changes that stimulated and extended the desire to limit family size. By 1979, fertility had declined to 2.74 children/woman and was concentrated among young women. In 1965, fertility was sharply differentiated by rural and urban area, regions, and educational levels. By 1977, variation in fertility narrowed. Fertility fluctuated but remained below replacement level during the 1980s. By 1985, differences in fertility by province, economic activity, and educational status became less important. In Cuba, the proximate determinants of fertility are (in order of importance) contraception, induced abortion, and marriage. Marriage formation increased, as did termination of unions and remarriage. Induced abortions increased by 47% during 1980-87, to 1.53 in 1988. Abortion and fertility are greatest among women aged under 30 years. 88% used contraception in 1988, mostly the IUD.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 136376Abstract : It is argued that access to contraception, voluntary sterilization, and safe abortion had a direct impact on fertility decline in two countries (Cuba and Korea) that differed in religion, economic conditions, culture, and attitudes. Both countries achieved below replacement fertility through high rates of contraceptive prevalence and ready access to legal abortion. Family planning services were provided in both countries through the public sector and in Korea through a subsidized private sector. Fertility decline in both countries occurred at the same time as the initiation of family planning programs. Family planning was introduced in Korea in order to reduce population growth and in Cuba in order to reduce the incidence of induced abortion and not for demographic reasons. Both Korea and Cuba had successful family planning programs over the past ten years that combined awareness, accessibility, and perceived quality. Korea adopted legal abortion as a means of reducing high maternal mortality rates and fertility. Cuba adopted legal abortion, during a period when the government lacked hard currency and consumer items such as birth control pills. Even antibiotics were difficult to obtain, particularly for teenagers. Both countries worked to improve services for teenagers. The experiences with family planning in both countries provide support for the theory that socioeconomic forces are not needed to push fertility lower. It is suggested that access to reversible and permanent contraception and safe abortion increases the speed of the transition and permits lower fertility than would otherwise be achieved without formal family planning programs. Fertility decline occurred in Korea under rising incomes and Cuba experienced declines during a period of economic declines. Both countries need to expand options for reducing exposure to pre-union adolescent pregnancies.
Web site : http://www.cambridge.org/uk/journals/journal_catalogue.asp?historylinks=ALPHA mnemonic=JBSAbstract : Overview of the fertility transition: a comparative perspective ; Proximate determinants of fertility change ; Social determinants, reproductive intentions, and fertility change ; Consequences of fertility decline ; Patterns of fertility change: case studies
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Legislators are in a position to take action on the issues that contribute to the high maternal mortality in developing countries. These issues were the focus of a session (Legislation and Maternal Mortality: Opportunities for Parliamentary Action in Reproductive Health) at the 1993 Andean Safe Motherhood Conference attended by representatives from Bolivia, Colombia, and Ecuador. The following actions were identified as essential at the legislative level: acceptance of international agreements and national commitments to women's health; implementation of the Convention to Eliminate All Forms of Discrimination Against Women, adopted by the United Nations in 1979; availability of family planning services and information to men and women in all regions of the country; strict penalties against marital rape; assurance that all women are able to give birth in a clean, safe environment; and validation of the social role of motherhood through maternity leaves and the provision of child care. Also recommended at the Conference were specific legislative actions in the areas of family planning (amend laws restricting the access of adolescents to contraception, introduce sex education in primary schools, overrule legal norms restricting access to family planning information, increase national budget allocations to family planning, and raise the minimum age for marriage without parental consent), abortion (timely treatment for complications of abortion, decriminalization), women's status (greater access to land ownership and education, mandate the establishment of child care facilities in the workplace, eligibility for social security benefits, and ban sexual stereotypes in textbooks and advertising), and violence against women (set up special domestic violence units within police departments, expedite procedures to control sexual harassment on the job, establish shelters for battered women, and raise public consciousness of violence against women as a criminal act).
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 091776Abstract : Teen magazines are a vital source of information about sexuality prescripts, contraceptive use, and reproductive health in Brazil (Bassanezi, 1996; Miranda-Ribeiro, 1997). Two magazines in particular, Querida and Capricho, were identified in Miranda-Ribeiro's research (1997) as one of the sources to which adolescents turn to most frequently to learn about sexuality. The magazines influence teens by contributing to the formation of what is determined as normative behavior in adolescent sexuality by informing the girls' attitudes and intentions as well as providing a forum against which the girls measure their own actions. This project aims through content analysis to identify the prescribed sexual, contraceptive, and fertility behavior that these two magazines lay forth as appropriate to describe what is considered normative behavior among adolescent girls as well as some boys in Brazil. The magazines presume a heterosexual readership with the goal of matrimony or at least monogamy. While both magazines are progressive in advocating more liberal sexual behavior than is accepted by the readership, the roles promoted remain within a patriarchally-accepted definition of female power. The contraceptives that both magazines promote are the pill and the condom while Querida also encourages the use of the rhythm method. Both magazines present abortion in a negative light although Capricho is in favor of legalizing abortion in Brazil. Querida glorifies and celebrates motherhood, even in the teen years. The magazines facilitate a class-based analysis of the subject matter since Querida is marketed towards lower-income girls and Capricho is marketed towards middle-to-upper-income girls. The Brazilian magazines are compared briefly with North American and British teen magazines to internationally contextualize teen magazines and to draw attention to the behavior promoted in Brazilian teen magazines which is different than that of the North American and British adolescents. Brazil's sexual culture merits particular scholarly attention due to the unique nature of its many-dimensional elements. (author's)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 171239Abstract : Producto de la Conferencia del Consejo Nacional para la Salud Internacional sobre "Salud de las Mujeres : Agenda para la Acción" que tuvo lugar en 1991. Considera el estatus de la mujer y su trabajo como factores que influyen en su salud y en su acceso a la atención médica. Intenta sistematizar y resumir los principales hilos conductores de la experiencia de las participantes en cuanto a atención a la salud de las mujeres y sugiere formas concretas de promover la atención internaciona
Notes : Inglés/anglais/EnglishAbstract : This book describes incidences of women's human rights violations complied by Human Rights Watch from 1990-95. The introduction reviews the range and severity of abuse, the climate of silence and impunity surrounding human rights violations, the challenge ahead, and recommended actions. Individual chapters open with a general discussion of the topic and end by presenting specific recommendations to the responsible government and the international community of actions to end the impunity and prevent future abuses. The first chapter concentrates on the use of rape as a weapon of war and a tool of political repression and presents case studies of rape and murder of civilian women in Bosnia-Herzegovina, Somalia, Haiti, India, and Peru. Chapter 2, covering the sexual assault of refugee and displaced women, describes the plights of Burmese refugees in Bangladesh and Somali refugees in Kenya. The third chapter deals with abuses against women in custody using examples from Pakistan, the US, and Egypt. Chapter 4 discusses the trafficking of women and girls into forced prostitution and coerced marriage and highlights the plight of Burmese females sent to Thailand, Nepali females trafficked to India, and Bangladeshi females taken to Pakistan. Chapter 5 reviews abuses against women workers through a look at Asian domestic workers in Kuwait and discrimination against woman workers in Russia and in post-Communist Poland. The sixth chapter examines domestic violence by considering violence against women in Brazil, Russia, and South Africa. The final chapter is concerned with human rights violations in the areas of reproduction and sexuality. Examples include forced virginity examinations in Turkey, the abortion debate and civil rights violations in Ireland, and abortion restrictions in post-Communist Poland.
Notes : Inglés/anglais/EnglishAbstract : This study examines the incidence of and circumstances surrounding induced abortion in Colombia. Quantitative and qualitative methods are applied to analyze key determinants of why urban women undergo abortion. Of all the abortions reported, 14.8% were among adolescents 15-17 years old, and a third were among women under 20 years of age. In the lower socioeconomic level 31.1% of abortions were among single women; in the upper classes, 54.6% were among single women. 78.4% of all abortions were the result of unintended pregnancy due to non-use of contraception. 21.6% were due to contraceptive failure or misuse. It is hoped that the findings will help to delineate policy actions and preventive strategies that will lower induced abortions in the country.
Web site : http://www.who.int/reproductive-health/publications/Abstracts/abortion.htmlAbstract : This report presents data on the incidence of abortion and abortion rates worldwide, the methods used to measure incidence, maternal health implications of unsafe abortion, and the role of abortion in fertility decline. Abortion statistics are difficult to estimate, provide a context for more in-depth studies of abortion and fertility decline, and help further the debate about the legal status of abortion. Estimates on the extent of unsafe abortion are persuasive examples of the public health consequences of illegal and unsafe practices of abortion and abortion complications. Fertility declines tend to be attributed to effective contraception without proper attention to incorrect use of effective methods and nonuse. There are huge gaps between attitudes and practice. Abortion is practiced moderately in most regions. Some countries, regions, and subgroups have high abortion rates. Abortion incidence does not conform to its legal status. The motivation to control and time births has risen faster than contraceptive use rates. Women continue to risk their lives to avoid an unwanted birth. The World Health Organization estimated that about 50 million abortions occurred worldwide in 1990; 30 million safe and 20 million unsafe. Induced abortions were about 25% of all pregnancies. Many legal abortions occur in Southeast, South, and West Asia. Many unsafe abortions occur in Eastern and Southern Europe. Eastern and Western Africa have higher abortion rates than Middle, Northern, or Southern Africa. Latin America has the highest average abortion rate of all regions in the developing world.
Notes : Inglés/anglais/EnglishAbstract : This study relied on national official sources on legal abortions to estimate the incidence of induced abortion in 57 countries in 1996. The World Health Organization (WHO) provided data on illegal abortions. The data reflect a variety of sources and degrees of underreporting. Findings indicate that about 46 million abortions were performed worldwide in 1995. About 26 million were legal; 20 million were illegal. The abortion rate was about 35/1000 women aged 15-44 years. Legal abortions appear to have declined since 1987; illegal abortions have increased. WHO estimates that unsafe abortions rose from 3.7 to 5.0 million during 1990-95 in Africa. Most illegal abortions occur in Africa and Central and South America. Most legal abortions are performed in Europe. 64% of legal and 95% of illegal abortions are performed in developing countries. The legal and illegal abortion rate is 39/1000 women aged 15-44 years in developed countries and 34/1000 in developing countries. Abortions per 100 pregnancies are higher in developed countries. Central and Eastern Europe have very high abortion rates. Asia (59% of total abortions) has the largest total number of abortions. North America has only 3% of abortions. The subregion abortion rate is highest in Eastern Europe (90/1000). Countries with high abortion rates include Viet Nam, Romania, and Cuba. Russia and Romania have the highest recorded proportions of pregnancies that end in abortion (63%). 25% of 180 million pregnancies globally are resolved by abortion each year. Mistimed and unwanted pregnancies and contraception deficits are the main causes.
Web site : http://www.agi-usa.org/pubs/journals/25s3099.pdfAbstract : This report presents data on the incidence of abortion and abortion rates worldwide, the methods used to measure incidence, maternal health implications of unsafe abortion, and the role of abortion in fertility decline. Abortion statistics are difficult to estimate, provide a context for more in-depth studies of abortion and fertility decline, and help further the debate about the legal status of abortion. Estimates on the extent of unsafe abortion are persuasive examples of the public health consequences of illegal and unsafe practices of abortion and abortion complications. Fertility declines tend to be attributed to effective contraception without proper attention to incorrect use of effective methods and nonuse. There are huge gaps between attitudes and practice. Abortion is practiced moderately in most regions. Some countries, regions, and subgroups have high abortion rates. Abortion incidence does not conform to its legal status. The motivation to control and time births has risen faster than contraceptive use rates. Women continue to risk their lives to avoid an unwanted birth. The World Health Organization estimated that about 50 million abortions occurred worldwide in 1990; 30 million safe and 20 million unsafe. Induced abortions were about 25% of all pregnancies. Many legal abortions occur in Southeast, South, and West Asia. Many unsafe abortions occur in Eastern and Southern Europe. Eastern and Western Africa have higher abortion rates than Middle, Northern, or Southern Africa. Latin America has the highest average abortion rate of all regions in the developing world.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 132053Abstract : This paper presents arguments for documenting the incidence of abortion and demonstrates the usefulness of such data for policy-makers and service providers. The paper also provides an overview of the numbers of abortions and abortion rates worldwide in both developed and developing countries and for major regions and subregions, differentiating between abortions in countries where the procedure is legal and generally implemented using medically safe procedures, and countries where it is available on restricted grounds or is prohibited or unsafe. The paper also presents estimates of unintended pregnancy and briefly discusses the safety of abortion provision and its consequences for maternal mortality and morbidity. It concludes by highlighting priorities for future research and discussing policy changes to reduce unsafe abortion.
Notes : Inglés/anglais/EnglishAbstract : Worldwide some 20 million unsafe abortions take place each year and account for approximately 13% of all maternal mortality and serious complications associated with it, such as sepsis, hemorrhage and trauma. Only a quarter of all women in the world do not have any access to legal abortion, whereas 40% have a legal right to decide for themselves. This liberalization of abortion legislation has seen a tremendous drop in abortion-related maternal mortality. Death from unsafe abortions are almost unknown in countries where abortion is available on request. Reduction of the need for induced abortion through the provision of good family planning services should be an integral part of healthcare. Consistent use of contraception greatly reduces the need for abortion, but it cannot completely eliminate this need. Thus, it is essential that safe medical abortion services should be made available to all women in the world in cases of contraceptive failure.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : The Regional Population Council of the Inka Regional Government convened a meeting of locally-influential public and private institutions on May 27, 1994 to adopt the Inka Declaration on Reproductive Rights (IDRR). The IDRR is based on the consideration that reproductive health (RH) refers to the life and health of the person and his or her role in society, with the corresponding tasks applying to both men and women. Because RH is currently considered a matter for women and not men, inequities in the expenditure of resources will result in greater risks for women until the services are based on equity as defined by need. The RH problems of the approximately 1.3 million inhabitants of the Inca Region are exacerbated by a lack of integrated health care, a concentration of resources in urban areas, insufficient training and health education, high fertility rates, and high maternal mortality and morbidity. The principle rights outlined in the IDRR are to decide family size, to receive sex education and information on methods of fertility control, to have children regardless of marital status, to create parental role models, to maintain bodily integrity, to share child-care responsibilities, to have an identity beyond that of reproductive capacity, to engage in consensual sexual relations which preclude violence and coercion, to health care services (which for women includes health care throughout their lives and reproductive care), to freedom from employment discrimination because of pregnancy or marital status, to free choice of a partner, and the right of women to participate equally in population policy-making and programs. To achieve these rights, the signers of the IDRR are committed to the following: the encouragement of RH policies and programs in the region to make RH services more accessible, an increase social security benefits to reduce maternal morbidity and mortality, to study and evaluate abortion as a public health problem, to eliminate discrimination, to educate men to share equally in their responsibilities, to target extremely poor families for RH policies and programs, to foster research and training, to support statistical data collection, to foster inter-agency communication, to increase funding for RH programs, and to promote coordination to avoid duplication of efforts.
Notes : Inglés/anglais/EnglishAbstract : For many women in developing countries there is little choice other than marriage and children. In Africa 50%, Asia 40% and Latin America 30% of the women are married by age 18 according to fertility surveys. In these regions there are over 700 million women in their reproductive years, and another 700 million under age 15. Male preference is evident in health care and education as well as other examples such as land ownership. Abuse of women is also common: a study of bangkok's largest slum found that 50% of the women were beaten regularly. Complications from illegal abortions and pregnancy are the main cause of death of women in the age group of 20-40 in developing countries. Abortion laws are restrictive in Latin America and nonexistent in Africa. In developing countries food production is the main activity of women: in some African countries they produce as much as 80%. In many countries including Columbia, Nepal, Kenya, Ethiopia, Panama City, Iraq, and Egypt women are not allowed to own land. Women's education is also s problem: 49% of women in developing countries is illiterate. Studies have shown more educated women have less children, improved health and later marriages. New accounting methods to recognize the unpaid work of women at home and in agriculture are needed. This could be done by using any 12w or a combination of 4 methods. These include the hours that a women takes in each activity, the wages that would be paid if someone where hired to handle an activity, the volume of her production and the market value of the product produced. The consequences of ignoring the health, economic, and educational status of women is enormous. They include uncontrolled population growth, high child and infant mortality, failing economics, unproductive agriculture, environmental problems, a divided society and a lower standard of living for everyone. The main responsibility is on the social and political leaders of the world to improve the status of women.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 060762Abstract : Economic, cultural, and social changes are continuing in Chile, but the issues of sexuality, reproductive choice, sex education, contraceptive availability, and abortion have been neglected in the process. Contradictions prevail. One Catholic charity publicizes its construction of an AIDS hospital, but fights attempts to promote condom use, which would prevent AIDS sexual transmission. Sexual well being is not being advanced by a forward looking government. Major decisions must be negotiated between Civil authorities and partisans of the past regime. Political decentralization has weakened health and education, and the government takes a nonreactive position on health issues. Private insurance proliferates for the 23% who can afford it. HIV- infected people are actively discriminated against by excessive use of HIV screening. Condoms are expensive at a dollar per condom, and are available only at pharmacies. A television campaign to promote condom use with sexual abstinence and exclusive sexual partnerships was blocked by government officials as to explicit. The government has considered AIDS to be under control, meaning that the identities of those with AIDS were known. There were police roundups of homosexuals and prostitutes in the early stages of the AIDS epidemic. The Catholic church continues to exert pressure; abortion remains illegal and sex education is not available in the schools. There is a prevailing ignorance of sexuality. The impact of the military over the years has been an entrenched view that the private sector is more competent to administer services. Catholic support of General Pinochet meant limited availability of contraceptives, particularly for unmarried youth or women without at least one child. Population control has meant reducing family size, and has not been concerned with quality of life and choice.
Notes : Inglés/anglais/English, nbsp;095137Abstract : The purpose of this study is to apply the WHO method of separating induced abortions from spontaneous abortions to new data from four Latin American countries ; Bolivia, Colombia, Peru and Venezuela ; to obtain more reliable estimates of the treatment of complications that resulted from induced abortion. Our second aim is to describe the demographic and medical characteristics of women hospitalized for abortion complications in these four countries and to discuss the differences between women who are classified as likely to have had an induced abortion and those likely to have had a spontaneous abortion. Consideration is given to the effects of marital status, parity, age factors, and contraceptive use. (SUMMARY IN FRE AND SPA) (EXCERPT)
Web site : http://www.guttmacher.org/Abstract : In order to reduce the morbidity and mortality caused by a lack of access to safe abortion services and by the difficulty women face in receiving appropriate care in centralized health systems, reproductive health care must be decentralized to lower level facilities where midwives can be educated in and authorized to perform the necessary procedures to save women's lives. International advisory agencies have recommended this development and suggest that 1) supervised midwives be educated in performing vacuum aspiration for incomplete abortion or for early induced abortion; 2) midwives be taught the warning signs of incomplete abortion so they can provide emergency stabilization, resuscitation, and referral; and 3) midwives be trained to provide family planning (FP) counseling and services, especially for postabortion women. An example of the first approach can be found in Nigeria, where the government is supporting manual vacuum aspiration service delivery and sponsoring training programs for a wide variety of health professionals including midwives. An example of the second approach can be found in Turkey, where midwives and nurses are receiving special training in abortion-related skills. An example of success with the third approach is a program in Chile, where midwives have been authorized since the early 1960s to provide contraceptive services in addition to FP information and counseling. This program has led to an increase in the use of effective methods, a decrease in infant mortality, a decrease in the number of women hospitalized for incomplete abortion, and a reduction in the percentage of maternal mortality attributable to abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 103277Abstract : The shortage of physicians trained to perform abortion procedures threatens the right of an individual to safe medical abortion, rather than by the political or ethical debates surrounding the issue. This paper describes a simple and direct effort to raise awareness among medical students about this trend, and hopefully, in the process, also increasing the number of future physicians with training in the provision of abortion services. There are several reasons why there is a shortage of physicians. Instead of focusing on these reasons, it is more important to address this problem. Thus, a small group of volunteers and staff at a local Planned Parenthood affiliate developed an educational brochure that provides factual information to 63,133 medical students in the US and Puerto Rico on the shortage of providers and training programs. The brochure also included quotes from established and well-known physicians and professors about the hazards of lack of access and the need for trained, committed physicians. The concluding part of the brochure sends a plea to all students to seek training in abortion for themselves and to advocate for increased training at their own academic institutions. The response rate of the program was positive. The brochure stimulated awareness and debate among many other students who did not take the time to respond immediately.
Web site : http://journals.cambridge.orgAbstract : Liberalization of the abortion law and improved family planning services are essential to protect the health and lives of Chilean women. Due to strong Catholic Church influence, abortion is illegal in the country. Family planning is available, but clinic staff have been cut dramatically by the government, meaning that poor women lack ready access to effective contraception. In 1990, the number of women hospitalized for treatment of complications of illegal abortion was 44,500. In part, increased resort to unsafe abortion has been precipitated by increased family size resulting from dramatic declines in infant mortality (18.1 in 1990). In response to pressure from Chilean physicians, the Ministry of Health has instructed hospitals and clinics to provide information about contraception to all women and to offer free supplies of reversible methods. The wider use of contraception resulting from this intervention has reduced the number of hospitalizations for abortion, but clandestine abortions remain an urgent national health problem.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 092564Abstract : National policies to influence fertility, focusing on Africa, China, India, and Latin America. Based on papers presented at a seminar held in Bellagio, Italy, Feb. 1990. Topics include the effects of Islamic doctrine in Africa and of feminist political action in Brazil, Nigeria, and the Philippines; inaction of the Vatican since issue of the encyclical, Humanae Vitae, in 1968; and transnational abortion politics.
Notes : Inglés/anglais/English, nbsp;LIBRARY OF CONGRESS CARD NUMBER: 94-8051Abstract : The economic liberalization and overall economic success achieved by the former military dictatorship in Chile paradoxically increased inequities and "feminized" poverty. By 1990, when a democratically elected government came into power, 40% of the population was living in poverty and suffering from large-scale reductions in state welfare. This led to a huge increase in self-help community organizations, many run by women and set-up by the church, to insure survival. These groups have been an important catalyst to women's ability to create political organizations. One factor which led to increased poverty was the involvement of women in "flexible," low-paid jobs. In 1987, women earned 65% of male wages, although women and men had approximately the same level of education. The democratic government is committed to helping women and has created a National Women's Service to develop public policies for women in the areas of legal reform, labor laws, welfare, rights, economic support, and domestic violence. Issues such as divorce and abortion, however, remain highly divisive. It is ironic that the traditional gender-based division of labor was shaken during the military dictatorship but that a return to democracy had failed to decrease the pressures on women.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 122382Abstract : Two of the most striking characteristics of contraceptive practice in the world today are the wide variation in patterns of use across countries and the tendency of the distribution of use by method to persist or narrow, even as new methods become available. The argument advanced in this article is that the disposition to commit to a reduced range of methods results from positive feedback in the process of contraceptive choice, and follows the logic of path dependence. The positive feedback derives, in large part, from social interaction among both the providers and the users of contraceptive methods. The persistence of outmoded contraceptive regimes is illustrated with the experience of Mexico and Brazil. In each case, it is argued that the conditions, events, and policies in the early stage of the adoption process have had a determinant bearing on the contraceptive practice prevailing in the late 1990s.
Notes : Inglés/anglais/EnglishAbstract : Annotation: Informative and insightful analysis of success of the Catholic Church and its political allies in blocking legalization of divorce and liberalization of laws governing abortion during years since the restoration of democratic institutions and despite indications of strong support for such goals on the part of most Chileans. Author attributes these impressive though unexpected expressions of political clout to the initiatives of the more conservative bishops appointed by Pope John Paul II since 1979, the ongoing efforts of predominantly conservative media (newspapers and television), the initiatives of revitalized and well-financed traditionalist organizations and social movements, the ambivalence of many Christian Democrats, and the political fears of both Christian Democrats and leftist political figures of being painted as antifamily and antilife.
Notes : Inglés/anglais/EnglishAbstract : The last decade has been marked by a rapid growth in the women's health movement around the world. There has been a marked shift in activities away from the developed countries, as campaigns increase in intensity in Africa, Asia, and Latin America. The practice of women's health politics has also become increasingly international with sustained and effective collaboration across the north-south divide. Both the goals of these campaigns and their methods vary with the circumstances of the women involved. But despite this diversity, common themes can be identified: reproductive self-determination; affordable, effective, and humane medical care; satisfaction of basic needs; a safe workplace; and freedom from violence.
Notes : Inglés/anglais/English, nbsp;8932601Abstract : This news brief reports that the Roman Catholic pope campaigned against contraception, abortion, and divorce during the Second Annual Conference on the Family held in Rio de Janeiro, Brazil in 1997. The pontiff remarked that abortion was a crime against the unborn and subjected the innocent unborn to an unjust death. The pope's remarks preceded by weeks the November 25th plenary debate by Brazil's legislators on whether public hospitals should provide abortion services as part of the country's universal health care system. Two Catholic legislators introduced a motion to consider whether a full debate should be held before the entire House of Deputies for a vote of the entire House. Brazilian women's groups have organized a campaign in support of the abortion law. Representatives from over 100 feminist organizations, university groups, and health workers gathered in southern Brazil to draft a letter to the pontiff. A spokesperson for the National Women's Network claims that several people within the Catholic Church are actively lobbying in Congress against the bill. The spokesperson believes that the Catholic Church should be capable of holding open discussions on the issues of abortion and contraception and that the Vatican is not entitled to speak unilaterally on this issue. Brazil's first lady was opposed to the Catholic's Church's attempts to influence the congressional debate on abortion. It is expected that few Catholics will follow his words in practice. Although 80% of Brazilians are Catholic, only 15% regularly attend mass. Most Brazilians report in opinion polls disagreement with the church's teaching on contraception, divorce, and abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 129703Abstract : Population control programs were instituted in Brazil in the 1960s and resulted in as 50% reduction of the fertility rate in 20 years with a reduction in population growth from 2.9%/year in the 1960s to 2.1% in the 1980s. The rapid urbanization which has occurred in Brazil also contributed to this process. While the Brazilian government has eschewed foreign intervention, it encourages the population control programs which are funded by international agencies. The women's movement became involved in policies relating to reproductive rights in 1980, and attempts were made to change the focus of women's health care and the right of women to make reproductive choices. 71% of Brazilian women of reproductive age who are married or living in consensual union use contraception. This compares with 70% of women in developed countries. In Brazil, however, 44% of the women have been sterilized, 41% use oral contraceptives (OCs), and 12% use natural or barrier methods, compared to 7, 13, and 41%, respectively, in developed countries. Sterilization is illegal in Brazil, although it is widespread; the high number of Cesarean section births may determine a medical need for sterilization (after three such deliveries, for example). Abortion is also illegal (except in cases of rape or if the mother's life is in danger) and widespread. The 2 to 3 million abortions each year are thought to be the third cause of maternal mortality. Studies of OC use have shown that Brazilian women often use OCs without medical monitoring or in cases when the contraceptive is absolutely contraindicated. In the past few years, Brazilian women's groups have demanded that the government deal with the issue of family planning in order to stop the intervention of international population control agencies. Brazil has never had the sufficiently modern and effective policy to help women to use contraception safely during the various stages of their reproductive lives.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 081417Abstract : This study examines the potential role of further increases in contraceptive prevalence and effectiveness in reducing abortion rates. The model used in this analysis links the abortion rate to its direct determinants, including couples' reproductive preferences, the prevalence and effectiveness of contraceptive practice to implement these preferences, and the probability of undergoing an abortion to avoid an unintended birth when a contraceptive fails or is not used. An assessment of the tradeoff between contraception and abortion yields estimates of the decline in the total abortion rate that would result from an illustrative increase of 10 percentage points in prevalence. This effect varies among societies, primarily because the tendency to obtain an abortion after an unintended pregnancy varies. For example, in a population with an abortion probability of 0.5, a 10 percentage-point increase in prevalence would avert approximately 0.45 abortions per woman, assuming contraception is 95% effective. If all unintended pregnancies were aborted, this effect would be three times larger. Eliminating all unintended pregnancies and subsequent abortions would require a rise in contraceptive prevalence to the level at which all fecund women who do not wish to become pregnant practice contraception that is 100% effective. A procedure is provided for estimating this "perfect" level of contraceptive prevalence. (author's)
Web site : http://www.popcouncil.org/publications/sfp/default.htmAbstract : An estimated 300,000 to 3 million illegal abortions are performed in Brazil each year and nearly half of the country's obstetrical budget goes toward treating the complications of clandestine abortion. A study conducted by the Institute of Philosophy and Social Sciences at the Federal University of Rio de Janeiro sought to identify the personal and societal factors that impel low-income women to seek illegal abortion. Rapid assessment anthropological research methods were applied in interviews with 130 women from three low-income communities and 110 postabortion patients and 65 health providers from three public hospitals in Rio de Janeiro. Economic reasons ; likely job loss, abandonment by boyfriend or parents, and the burden on household resources of another child ; motivated most clandestine abortions. Among the other circumstances cited that drive women to seek unsafe abortions were logistic obstacles (distance, cost, and long waiting times) to visiting health centers; poverty, which compromises the ability to plan ahead; the lower cost of obtaining contraceptives and health information from untrained friends, relatives, and street vendors; a tendency for women to regard their reproductive health needs as less important than the general needs of their families; women's readiness to believe rumors about formal health care services; and a lack of knowledge about how to use contraception correctly. Because of a lack of staff time, abortion patients are not given information on the prevention of future unwanted pregnancies. Recommended, in addition to steps to address the logistic and psychosocial obstacles to reproductive health services, are postabortion family planning services in the hospitals where abortion patients are treated.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 127675Abstract : Abstract: WHO's Technical Working Group on Unsafe Abortion met in April 1992 to establish guidelines on the prevention and management of unsafe abortion to provide more effective support to countries. More specifically, the group has identified clinical guidelines for emergency treatment of abortion complications at the first contact and first referral levels. The report begins with a preface, introduction, and background information on unsafe abortion (definitions and overview of the contribution of unsafe abortion to maternal mortality). The next section discusses draft guidelines for the clinical management of complications of unsafe abortion. The discussion encompassed expanding access to care, services at the primary care level, services at the first referral level, and use of the clinical guidelines. A discussion of the need for more research in management and complications of unsafe abortion follows. Specific discussion topics included referral and communication, antibiotics, training and staff roles, women's perspectives, management issues, attitudes toward abortion, and specific areas of focus for WHO's Maternal Health and Safe Motherhood Programme. The next section addresses indicators of progress in the management of unsafe abortion. The section on provision of immediate postabortion contraception examined sociomedical characteristics to be considered regarding postabortion contraception and development of guidelines on contraception after an unsafe abortion. Need for additional clinical and operations research in immediate postabortion contraception is discussed in the next section. The next-to-last section examines indicators of progress in the provision of postabortion contraception and prevention of repeat unsafe abortion. The report ends with a conclusion and follow-up actions.
Web site : http://www.who.int/Abstract : CONTEXT: Intimate partner violence is associated with a number of reproductive and mental health problems. However, the relationship between intimate partner violence and women's ability to control their fertility has not been adequately explored, especially in developing countries. METHODS: Data from the 2000 Demographic and Health Survey for Colombia were used in multivariate logistic regressions to explore the relationship between intimate partner violence and unintended pregnancy, which was included as a measure of fertility control. Regional differences in the relationship were also explored, and populationattributable risk estimates were calculated. The sample consisted of 3,431 ever-married women aged 15-49 who hadgiven birth in the last five years or were currently pregnant. RESULTS: Fifty-five percent of respondents had had at least one unintended pregnancy, and 38% had been physicallyor sexually abused by their current or most recent partner. Women's adjusted odds of having had an unintended pregnancy were significantly elevated if they had been physically or sexually abused (odds ratio, 1.4); the association was observed in the Atlántica and Central regions (1.7 each), but was not significant elsewhere in the country. Eliminating intimate partner violence in Colombia would result in an estimated 32,523-44,986 fewer unintended pregnancies each year. CONCLUSIONS: These findings indicate the need to include intimate partner violence screening and treatment in reproductive health programs, to promote men's involvement in fertility control programs, and to improve the social and political response to intimate partner violence.
Web site : http://www.guttmacher.org/pubs/journals/3016504.pdfAbstract : National and regional estimates of the incidence of induced abortion in Brazil, Colombia, and Mexico from the late 1970s to the early 1990s indicate a clear rise in the abortion rate in Brazil and increases in the abortion ratio in all three countries. Crosssectional analysis showed no significant correlation between the abortion rate and contraceptive use, except in Mexico in the early 1990s, where a strong positive association was observed. Longitudinally, the abortion rate increased as contraceptive use increased in most regions of Brazil and Mexico throughout the study period, and in parts of Colombia until the mid-1980s. In Colombia and the most urban region of Mexico, the abortion rate declined as contraceptive use stabilized or increased. The abortion ratio was positively associated with contraceptive use over time in nearly every region of each country. The role of abortion in fertility decline was greatest in Brazil, where the general fertility rate would have been nearly 13% higher in the early 1990s if the abortion ratio had not increased from its level in the late 1970s. Abortion tended to have a greater impact on fertility in regions where contraceptive use was low. Overall, contraceptive use appears to have been a more important determinant of fertility than abortion, but abortion has played an important subsidiary role in determining fertility levels and trends in these countries. (author's)
Web site : http://www.guttmacher.org/pubs/journals/2300497.htmlAbstract : This book documents the massive deprivation of human rights resulting from governmental censorship, manipulation, and control of reproductive health and sexuality information. The introductory chapter applies a human rights perspective to reproductive health to show that women must have full and impartial information to be able to choose services which further their goals rather than governmental policies. Examples of different types of state manipulation are provided, and demographic, biomedical, and reproductive health paradigms of contraceptive delivery programs are described. Chapter 2 identifies the binding obligations imposed on governments by the international principle that women have a right to appropriate reproductive health information. The third chapter provides a global overview of such topics as health expenditures, fertility rates, infertility, literacy and education, infant and child mortality, maternal mortality, child spacing, contraceptive usage, unmet need, abortion, HIV/AIDS, and sexually transmitted diseases (STDs). Chapters 4-13 present country reports for Algeria, Brazil, Chile, Ireland, Kenya, Malawi, Pakistan, the Philippines, Poland, and the US. The country reports reveal the overwhelming need of women to have access to this information and the innumerable ways in which governments control such access. The country reports also describe factors such as religion, culture, tradition, state of development, and influence of foreign donors which have an impact on access to information. Each country report ends with specific recommendations, and the concluding chapter defines seven obligations of national governments imposed by the right to information contained in international law and contains recommendations of ways nongovernmental organizations can use these obligations to lobby governments for improvements.
Notes : Inglés/anglais/EnglishAbstract : The qualitative fertility-inhibiting effect of induced abortion is compared with that of contraception for 4 major regions of the developing world in the 1980s. A number of alternative calculations were conducted for a given population by assuming fertility levels under conditions of no contraception, no induced abortion, and universal marriage patterns. In East Asia the proportion of births averted by induced abortion was 22%. Under the assumption that between 5.2 and 12.5 million induced abortions occur in South and South East Asia annually, between 11% and 23% of births are being averted by induced abortion. In India close to 1 million legal medical terminations of pregnancy and probably 5 million illegal abortions are performed annually; in Bangladesh possibly 800,000 abortions are performed; in Indonesia, the Philippines, and in Thailand illegal induced abortions are widely practiced. In this region the calculations indicate that between 11% and 23% of births are averted by induced abortion. Numerous hospital studies in large and small African countries document that large proportions of admissions to hospitals and maternal deaths are attributed to unsafely performed induced abortions. One-quarter of deliberate fertility regulation appears to be caused by induced abortion in Latin America. For East Asia the effect of induced abortion is possibly a little less because of higher prevalence and more effective use of contraception. In South and South East Asia induced abortion accounts for about one-sixth of deliberate fertility regulation. In Africa, the fertility-inhibiting effect of induced abortion is estimated at 10% to 20% of deliberate fertility regulation. In the contemporary efficient contraceptive societies of the West, induced abortion incidence is low. Because of the high prevalence and effectiveness of contraception, the qualitative effect of induced abortion in fertility regulation remains low, under 10%. In contrast, calculations for the former USSR indicate that around 60% of deliberate fertility control is attributable to induced abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 084943Abstract : This book chapter reviews patterns of induced abortion in Latin America, generates estimates of the impact of abortion on births averted, and discusses the causes of the high incidence of induced abortion. Survey data indicate abortion ranged from 20% among women in Mexico to 46% among women in Argentina. In the 1960s, women surveyed by CELADE had approximately 1 induced abortion in their lifetime. Other survey data indicate a range from 1.0-4.1 induced abortions/woman/lifetime. The IPPF estimates that 5 million illegal abortions were performed in the early 1970s, which corresponds to an abortion rate of about 65/1000 women aged 15-44 years, or a total abortion rate of 2.0/woman. Prior to the 1960s, only Argentina and Uruguay had begun a fertility transition. Since the 1960s, fertility declined differentially between countries due to contraceptive prevalence and induced abortion. Bongaarts calculates that between 25-40% of fertility control is due to nonexposure to the risk of pregnancy, and the rest is due to contraception and abortion. In the late 1980s, there were 12.4 million live births out of a potential of 21.3 million assuming no fertility control. Scenarios indicate that low abortion amounts to under 6% of births averted due to induced abortion, and high levels amount to almost 28%. Abortion use is due to the motivation to have small families, limited availability of contraception, and unequal access. Unwanted pregnancy is a result of lack of comprehensive and respectful delivery of health services, inaccurate ideas, fears, machismo and male domination, and contraceptive failures.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 136370Abstract : Principles of religious freedom protect physicians, nurses and others who refuse participation in medical procedures to which they hold conscientious objections. However, they cannot decline participation in procedures to save life or continuing health. Physicians who refuse to perform procedures on religious grounds must refer their patients to non-objecting practitioners. When physicians refuse to accept applicants as patients for procedures to which they object, governmental healthcare administrators must ensure that non-objecting providers are reasonably accessible. Nurses' conscientious objections to participate directly in procedures they find religiously offensive should be accommodated, but nurses cannot object to giving patients indirect aid. Medical and nursing students cannot object to be educated about procedures in which they would not participate, but may object to having to perform them under supervision. Hospitals cannot usually claim an institutional conscientious objection, nor discriminate against potential staff applicants who would not object to participation in particular procedures.
Notes : Inglés/anglais/EnglishAbstract : The nature and interpretation of a country's abortion laws will be pivotal to women's access to RU-486/prostaglandin (PG). Anticipated can be widespread confusion arising from the medically imprecise language (e.g., pregnant, abortion, miscarriage) central to most abortion legislation. An analysis of the legal response to menstrual regulation in the mid-1970s, another postcoital method that does not fall clearly into either side of the contraception-abortion dichotomy, suggests possible outcomes for RU-486/PG. In countries with liberal abortion laws, RU-486/PG is likely to be classified as an abortifacient and its use will be subject to the regulations that govern abortion procedures in general and, above all, to political factors. In countries such as New Zealand and Liberia, which have defined pregnancy as beginning after completion of implantation, early use of RU-486 could occur outside the framework of abortion laws. The greatest obstacles can be expected in countries, largely in Latin America and Africa, with restrictive abortion laws and no specifications as to when pregnancy begins. Most Latin American jurisprudence indicates that prosecution of abortion as a crime requires proof of pregnancy ; verification that is impossible to obtain in the immediate post-conception period when RU-486/PG use is indicated, especially in Third World countries with limited laboratory resources. In many former French colonies, intent to terminate a pregnancy is sufficient for prosecution. Unclear, however, is the likely response if a doctor administer RU-486 to medically resolve the problem of delayed menses, not to terminate a pregnancy. The experience of Bangladesh with menstrual regulation suggests that countries can accommodate new fertility control technologies without changes in abortion law. There, menstrual regulation is regarded as "an interim method of establishing non-pregnancy for the woman who is at risk of being pregnant." Optimal would be a shift in abortion law from criminal sanctions to the close supervision and regulation of newly introduced fertility control technologies.
Web site : http://www.rhmjournal.org.ukAbstract : Investigates the sexual reproductive health content of 16 Latino 5 African American magazines in the US (N = 373 articles items from 194 issues). The most frequently covered topics were pregnancy sexual activity. Least mentioned were abortion sexually transmitted diseases (STDs), including human immunodeficiency virus/acquired immune deficiency syndrome (HIV /AIDS). Generally, ethnic magazines did a poor job of covering sexual reproductive health topics relevant to these communities, despite epidemic rates of HIV/AIDS STDs pregnancy rates 80%-90% higher than those of Anglo Americans. 5 Tables, 113 References. Adapted from the source document
Web site : http://www.tandf.co.uk/journals/titles/10646175.aspAbstract : Purpose : The state of North Carolina has the fastest growing Latino/a population in the country. Despite the increasing contribution of Latinos/as to the state economy, this population is characterized by disproportionate poverty levels and growing health disparities. The purpose of this assessment was to learn about the sexual- and reproductive-health issues faced by Latina women in North Carolina in order to contribute to efforts to increase theiraccess to reproductive-health care. Methods : In-depth interviews were conducted by a Masters of Social Work intern from the University of North Carolina at Chapel Hill. The interviews were conducted with 20 key informants in five NC counties. Counties were chosen based on the percentage of Latinos/as in the overall population and on the percent increase in the Latino/a population over the last decade. The key informants were identified by their involvement in the field of reproductive health and/or their knowledge of the Latino/a community. An effort was made to speak to a variety of informants, including health-care providers, directors andstaff of community-based organizations, and health educators. The data were subjected to qualitative analysis.Major findings Latinas address their reproductive-health needs through the formal medical system, informal care and self-medication. Informal care includes the services of alternative healers. Contraceptive use varies depending on cost, availability, education levels and cultural norms. Adolescent pregnancy, high rates of sexually transmitted infections (STIs) and domestic violence were identified by study participants as major problems. Clandestine abortions are occurring despite the perception that there is a cultural preference among Latinas to maintain pregnancies. Respondents reported the existence of a variety of beliefs concerning reproductive health among their Latina clients. Barriers to care include transportation, language, lack of knowledge, and cultural norms.ConclusionThe most urgent reproductive-health issues among Latinas in North Carolina are the high rates of unintended adolescent pregnancies and STIs and the problem of domestic violence. There is a need to find effective and culturally appropriate ways of providing reproductive health-care services to this population; relying on existing resources and strengths intrinsic to the culture and the community is recommended. The findings of this assessment may have implications for further research, the design of future interventions and the direction of public-health and advocacy initiatives.
Web site : http://www.ipas.org/publications/en/NCLAT_E05_en.pdfAbstract : Adolescents, globally, need the information and services required to prevent pregnancy and sexually transmitted disease (STD), particularly acquired immunodeficiency syndrome (AIDS). More than half of all women in African countries have their first child before the age of 20; in Latin America, more than one-third do; and, in the United States, the country with the highest teenage pregnancy rate among developed countries, approximately 20% do. 5 million out of an estimated total of 50 million induced abortions worldwide occur in women aged 15-19. 1 in 20 teenagers are estimated to acquire STDs annually. Although most youngsters are sexually active before the age of 20, they are less likely to use contraceptives, including condoms. All societies need to acknowledge the sexuality of adolescents and address their special sexual health needs. The Population Action Report (PAI) has called for greater emphasis on condom use in adolescents; an estimated 2/3 of those who acquire AIDS are infected by the age of 25. Pregnancy and childbirth are more hazardous for girls under 16; hypertension, anemia, obstructed labor, toxemia, and hemorrhage are more common among teenagers than among women aged 20-34, and teenagers seeking an abortion are more likely to delay finding a provider or to try inducing the abortion themselves. Pregnant teenagers often leave school early and are more likely to be poor. Youth programs that encourage the delay of sexual activity, while also providing information about Safer Sex and contraception, are more successful than those that promote abstinence alone. Clinics that serve adolescents only, youth centers that include contraceptive counselling and services with recreational and educational activities, and community outreach programs that use young people as peer counselors have all been effective. In societies where women derive their status through motherhood, programs which improve self-esteem in girls and promote alternate opportunities would help girls stay in school and delay childbearing. The elimination of harmful traditional practices, including child marriage and female genital mutilation, would improve adolescent sexual and reproductive health.
Notes : Inglés/anglais/English, nbsp;105485Abstract : Cuba has maintained low fertility in the Latin American region throughout the period 1955-87. The socioeconomic changes brought about by the revolutionary takeover in 1959 speeded the demographic transition. Cuban population numbered 10,869,218, of which 22.7% were aged under 15 years and 12.2% were aged 60 years and older. Although economically underdeveloped, Cuba completed its demographic transition by 1992. By the early 1990s, 57.3% of university students were women. 30% received degrees in scientific and technical fields. Female economic activity increased. 39.1% of economically active persons in 1991 were women. 58% of all professionals were women. Fertility rates for daughters were below replacement during 1955-60, increased to over replacement during 1961-64, and declined thereafter to a low of 0.94 daughters/woman. During 1970-87 fertility decline was dominated by declines in rural areas. In 1953 and 1970 the greater share of fertility was among women aged over 25 years. During the early 1980s a large proportion of fertility was accounted for by women aged under 20 years. During the late 1970s and early 1980s fertility was dominated by women aged 15-19 years. In the late 1980s fertility was concentrated among women aged 25-29 years. Recent trends favor early childbearing, which is attributed to early sexual activity without contraception, ignorance or insufficient knowledge about sexuality, lack of responsibility for childbearing, and lack of parental and educational guidance. The 1987 Fertility Survey indicated a high level of knowledge about contraception. During 1970-90 the number of abortions increased by 109%. During 1989-90 rates of fertility and abortion declined, but menstrual regulation increased 2.4 times. The proportion of single and married women declined and the proportion in consensual unions increased by 1987. The divorce rate and break-up rate varied during 1975-90.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 121258Abstract : This document tackles relevant issues faced by women in Rio de Janeiro, Brazil. In 1986, the struggle of women to assert themselves and their rights led to the establishment of the first Special Crime Unit for the Protection of Women. While the performance of this unit brought changes in the institutional framework, it also created a more consistent response to sexual and domestic violence. The police work in these units has significantly contributed to improvements in providing assistance to victims as well as on the success of investigations of crimes thereby preventing the occurrence of new crimes and the creation of new victims. The setting up of special units to attend to women in conjunction with police units in Brazil is a major step forward in fighting violence against women. This paper also reviews several laws and legislation relevant to the prosecution and punishment of crimes against women such as bodily injury, abandonment of disabled person, abortion caused by a third party, mistreatment, illegal coercion, threats, kidnapping and illegal imprisonment, rape, sexual assault, corruption of minors, seduction and carnal knowledge.
Notes : Inglés/anglais/EnglishAbstract : Misoprostol is a prostaglandin analogue with uterotonic properties. A group of 141 women with less than 70 days of pregnancy received up to 3 doses of 800 micrograms of misoprostol every 48 hr. Failure was defined as the need for surgical abortion and success as the complete expulsion of the products of conception pharmacologically. In total, 132 cases (93.6%, 95% CI 89.4-97.8) aborted pharmacologically and 9 cases (6.4%) failed. The decrease in hemoglobin was statistically significant (p = 0.001) but without clinical repercussions; before treatment: 11.95 mg/dI (SD 1.19) and after: 11.14 (SD 1.20). Statistically significant differences were not noticed between success rates and failures in relation to gravidity, parity, previous abortions, race, or age, but were noticed with a gestation upwards of 9 weeks (p = 0.01). The third dose of misoprostol showed very little efficacy. The convenience of using more frequent doses and shortening the treatment, combined with different routes of administration, are discussed.
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?vol=55 viewtype=issue iss=3#S001078249700020Abstract : Researchers followed 943 women who conceived while using natural family planning (NFP) between January 1987 and March 1993 and had attended NFP centers in Chile, Colombia, Italy, and Washington, D.C., to examine the association between timing of conception and the outcome of pregnancy, especially the spontaneous abortion rate. The analysis included 868 singleton births. 88 (10.1%) of the pregnancies ended in spontaneous abortion. Based on NFP charts, 361 conceptions occurred during the optimal time (days-1, 0 relative to ovulation). Spontaneous abortion took place in 33 (9.1%) of these conceptions. 507 conceptions occurred during the nonoptimal times during the menstrual cycle. 55 (10.9%) resulted in spontaneous abortion. The rate of spontaneous abortion in the index pregnancy was significantly higher in women who had had a prior pregnancy loss than it was n those with no prior pregnancy loss (16.4% vs. 8.6%; relative risk [RR] = 1.96). For women with no prior pregnancy loss and an optimally timed index pregnancy, the spontaneous abortion rate stood at 9.6%, while it was much higher (22.6%) for those with prior pregnancy loss and nonoptimally timed pregnancies (RR - 2.35). The spontaneous abortion rate for women with prior pregnancy loss and an optimally timed index conception was 7.3%. The 171 women who had had a previous pregnancy loss had significantly higher age-adjusted spontaneous abortion rates for preovulatory and postovulatory conceptions than did the 697 women who did not have previous pregnancy loss (21-30% and 21%, respectively, vs. 7-10% and 5%, respectively; p = 0.0002). The rates were similar for optimally timed conceptions. A possible explanation for the higher spontaneous abortion rate for nonoptimally timed conceptions was abnormality with aged gametes. These findings suggest that women with prior pregnancy losses may maximize the likelihood of a successful pregnancy by using NFP or other ovulation prediction methods to conceive during the optimal time of the cycle.
Notes : Inglés/anglais/EnglishAbstract : OBJECTIVE: An evaluation of the perception, resources and practices regarding abortion of traditional midwives in a rural area in the municipality of Yecapixtla, state of Morelos, located in the central region of Mexico. METHODS: A qualitative methodology consisting of a detailed interview, focal groups and participating observation, was used. The subjects investigated were socio-cultural aspects, reproduction, sexuality and health related to abortion. Nine midwives were interviewed and a focal group was formed in which 16 midwives participated. RESULTS: The results demonstrated a profound rejection of abortion whether inducted or spontaneous. The former was considered a major sin and the latter a serious failure of a womans reproductive function. Women who abort are called "pigs", "hogs" or "bitches" and the midwives are reluctant to attend them. However, a common practice among the women in the community is to "regulate the menstruation", that is, to use substances that provoke menstruation when this is delayed. This specific practice is not considered abortive by these women. CONCLUSION: Local popular beliefs about abortion are indispensible for the construction of effective strategies, which when provided by the institutional health services, reinforce the bonds between these and the traditional midwives in such a way as to increase accessibility to the health services as well as the quality of care to women.
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89101999000400003 lng=en nrm=isoAbstract : This work reviews sociodemographic studies of the interrelationship between work and family in Mexico from 1950 to the present. 3 main themes are distinguished and examined in separate sections. The 1st are labor market studies focusing on aggregates of individuals, a trend most prominent through the mid 1970s but still somewhat in evidence. The 2nd type of studies stress the household or domestic unit as the relevant unit of analysis and often conceptualize economic participation as part of the family life strategy or survival strategy. This perspective reached its maximum development in the late 1970s and early 1980s but also still appears. The last type of study stresses the increasing heterogeneity of labor markets related to the increase in nonsalaried employment and increasing female employment. The domestic unit is present as a determinant of family-based economic activity and female employment, but differences and conflicts between generations within the household are stressed. This perspective began to gain importance in the mid-1980s. The objective of the differentiation into 3 periods and types of study is to analyze changes in theoretical elements considered, principal thematic contents, methodological tools utilized, and results. The work is based on a selective review of literature considered representative. On the theoretical level, relations between work and family are now perceived as more complex and incorporate more elements of social reality than they did in the earlier studies. Most studies of this type have concerned female employment. The belief that male employment depends less on the family context requires reassessment, especially in view of the differential employment opportunities of men and women. Quantitative sociodemographic research in Mexico has been greatly aided by the growing availability of detailed survey data. This, together with advances in statistics and computation, has allowed a greater use of multivariate analysis to clarify relationships between different variables taking into account the influence of important intervening factors. Multivariate analysis has allowed the effect of specific aspects of household structure to be identified. Increasing interest was shown in the 1980s in combining quantitative and qualitative information in Mexican sociodemographic research. This focus was apparent in studies of family formation, temporary migration, health and mortality, and abortion and contraception as well as in research on family and employment. These works attempt to complement data from censuses or surveys with a few in-depth case studies. Data from case studies and interviews has permitted the intentions of individuals to be analyzed and not just assumed. The articulation of individual and group interests in the household is more complex than a simple response to precarious socioeconomic conditions, and it may include elements of coercion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 066660Abstract : Los trabajos presentados en este encuentro fueron publicados en ocho volúmenes, separados por áreas temáticas, cuyo contenido es: Determinantes del aborto y factores asociados - Determinantes socio-culturales del aborto inducido en países en desarrollo. Caso peruano. Magdalena Chú y A. Vásquez. - Aborto en el cono urbano de Buenos Aires. Opiniones, evidencias e interrogantes. Elsa López y Alicia Masautis. - El aborto: qué papel juegan los hombres, esposos y compañeros. Kathryn Tolbert. - Algunos hallazgos en torno a los condicionantes sociales del aborto inducido en la República Dominicana. Denise Paiewonsky. - Aborto inseguro: el caso de Nicaragua. Flor de María Marín. - Determinants of induced abortion among poor women admitted to hospitals in Fortaleza, North Eastern Brazil. Chizuru Misago, Walter Fonseca, Luciano L. Correria y Marilyn Nations. - Determinantes del aborto en adolescentes mexicanas: una evaluación cuantitativa. Maríana Romero. - La realidad del aborto en Puerto Rico: investigar para educar. Yamila Azize Vargas. - Factores asociados al aborto adolescente. Lucy Wartenberg. Atención hospitalaria y costos del aborto - Abortos hospitalizados: entrada y salida de emergencia. Silvina Ramos y Anahí Viladrich. - Algunos resultados de la encuesta sobre opiniones acerca del aborto clandestino realizada por el Instituto Alan Guttmacher en Brasil, Chile, Colombia, México, Perú y República Dominicana. Mónica Weisner, Delicia Ferrando, Sarah Hawker Costa, Silvia Llera, Denise Paiewonsky, Elena Prada, Susheela Singh, Deirdre Wulf. - Factores condicionantes y costos del aborto. Dina Li y Virgilio Ramos. - El aborto dentro del sistema nacional de salud. Su organización en el municipio de la Ciudad de La Habana. María Teresa Martínez Pérez. 76 - Informe preliminar sobre la caracterización de los casos y costos del tratamiento del aborto hospitalizado en Santiago de Chile. Pablo Lavin, F. Lavin, S. Vivanco, R. Tuane, C. Bravo, H. Bierschwale, H. Melo, P. Silva y R. Cerón. - Costos y utilización de recursos para el tratamiento de complicaciones de aborto en México. Janie Benson, Aurora Rábago Ordónez, Beatriz Vásquez Cuarto y Brooke R. Johnson. Impactos demográficos y psicosociales del aborto - Desde las mujeres: visiones y circunstancias del aborto. Rosario Cardich. - Embarazo indeseado y aborto. Conflicto de valores. Margoth Mora. - No me vas a pensar esas cosas: actitudes y prácticas que inciden en el embarazo no deseado y el aborto inseguro en Bolivia. Susana Rance. - Un informe psico-sociodemográfico del aborto en Cuba. Luisa Alvarez Vásquez. - El impacto del aborto inducido en Colombia. Lucero Zamudio, Norma Rubiano y Lucy Wartenberg. Incidencia - Niveles estimados de aborto inducido en seis países latinoamericanos. Susheela Singh y Deirdre Wulf. - La incidencia del aborto en Colombia. Lucero Zamudio, Norma Rubiano y Lucy Wartenberg. - Interrupçoes da gravidez no Brasil. Mário F. G. Monteiro. - El aborto en el Perú: estudio epidemiológico hospitalario en las ciudades de Iquitos, Piura y Puno - Perú. Jesús L. Chirinos, Luis Sobrevilla y Elsa Alcántara. - Aborto complicado: la punta de iceberg de la práctica clandestina. Elena Prada. - Mortalidade por aborto: a causa nao declarada. Néia Schor, Ana Cristina d'A. Tanaka, Augusta Thereza de Alvarenga, Arnaldo Augusto Franco de Siqueira. Servicios y prácticas del aborto - Calidad de atención en mujeres con aborto en la IX Región. Servicio de Salud de la Araucanía - Chile. Ricardo Celis, Carmen Hernández, Margaret Massardo y Luilfried Julio-Diener. - La experiencia de los servicios alternativos de salud en relación con el aborto. Ana María Pizarro. - Manejo ambulatorio del aborto como estrategia para aumentar la cobertura y reducir los costos. Luis Alberto Tavara Orozco. - Investigación cualitativa: La salud reproductiva y el papel que juega el embarazo no deseado. Elizabeth de Bocaletti. - Aborto en adolescentes con RU/486. Evelio Cabezas, Mario García, Elina Guzmán. Representaciones sociales y movimientos sociales - El parlamento y el debate sobre el aborto en Brasil. María Isabel Baltar da Rocha. - 1979: un año crítico en la historia del debate sobre el aborto en Colombia. Mara Viveros. - Desde el movimiento feminista hacia el sistema político: estrategias y representaciones de los actores que participan en el debate sobre el aborto en la prensa Mexicana 1974-1990. María Luisa Tarrés Barraza. - Opinión de las mujeres sobre las circunstancias en que deberían tener derecho a abortar. Aníbal Faúndes, Ellen Hardy, María José Duarte Osis. - Actitudes, representación social y variables psicosociales relacionadas con el aborto y la contracepción: una integración de investigaciones. Caridad Teresita García. - El aborto en Armenia: un estudio de casos. Mónica María Alzate. - Resultado de tres encuestas nacionales de opinión sobre aborto, México 1991-1993. Sussan Pick de Weiss, Marta Givaudan y Gillian Fawcett. - En busca de un objetivo compartido: del feminismo a la sociedad, la lucha por legalizar el aborto en México. Marta Lamas. - Una aproximación al aborto inducido en el eje cafetero. Rosalba del Socorro Sánchez. 77 - Aportes de la psicología y el género al problema del aborto inducido. María Raguz. - El personal de salud ante el aborto: valores y contraindicaciones. María del Carmen Elú. - Imaginarios, representaciones e identidades masculinas sobre el aborto inducido. Hernando Salcedo Fidalgo. Aspectos metodológicos - Algunos aspectos metodológicos de la investigación sobre experiencias de aborto inducido. Magdalena León T. - Metodología para estimar el aborto inducido en Costa Rica. Breda Muñoz. - Incidencia y características del aborto inducido en Sao Paulo. Rebeca de Sousa e Silva. - Metodología usada para estudar frequência e questoes relativas ao aborto provocado: principais problemas e vantagens. Rosely Gomes Costa, María José Duarte Osis y Ellen Hardy. - Representatividad, confiabilidad y significación: problemas prácticos de la investigación sobre aborto inducido. Lucero Zamudio, Norma Rubiano y Lucy Wartenberg.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Traditional midwives play an important role in women's reproductive health in Mexico, in both rural and urban areas. However, little effort has been put forth to incorporate them into the process of ensuring that women receive prompt postabortion care. The project described in this article addresses the issue of unsafe abortion with traditional midwives, and provides training that can improve the ability to stabilize and refer women seeking treatment for abortion complications. Research results regarding traditional midwives' understanding of and practices surrounding abortion and abortion care indicates negative attitudes among midwives toward women with abortion complications, whether from induced or spontaneous abortion. However, the training course provided in the project has been successful in broadening the discussion on abortion and abortion complications among midwives and hospital-based providers, and in recognizing the terminology and practices that midwives use when women with abortion complications seek treatment from them. In conclusion, programs and training interventions should address negative attitudes surrounding the issue of abortion, particularly in postabortion care.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 147375Abstract : Entrevistas con promotores y promotoras indígenas y especialistas en salud reproductiva que explican la salud de forma integral. Por salud reproductiva se entiende : el derecho a la información y formación sexual, el derecho a tener acceso a los recursos seguros y sin riesgos para mujeres y varones. La posibilidad de la interrupción de un embarazo no deseado o no planeado . El enfoque de salud reproductiva es un concepto médico y demográfico
Notes : Español/espagnol/SpanishAbstract : Este trabajo analiza el debate feminista y su evolución sobre el derecho a tomar decisiones acerca del propio cuerpo, desde la era de la liberación femenina de los años 60 hasta el decenio de 1990. El enfoque se centra en las diferentes interpretaciones elaboradas por las feministas respecto a la apropiación del cuerpo, la demanda del aborto legal y la demanda del ejercicio de los derechos sexuales y reproductivos. En cada etapa, los argumentos se sitúan en un marco más amplio de las tendencias sociales económicas, culturales y políticas. Las campañas para legalizar el aborto en Francia y los Estados Unidos se describen y sitúan en el contexto. Se explican las justificaciones y los puntos de vista de diferentes escuelas de pensamiento feminista, que reflejan parcialmente las condiciones nacionales. Se examinan las respuestas de las fuerzas antiaborto, incluso el recurso cada vez mayor a la violencia que comenzó en los años ochenta, y se debate su repercusión en los argumentos feministas. Se examina por separado la situación en América Latina, donde el aborto sigue siendo ilegal en casi todos los lugares. Se examinan el efecto del concepto de los derechos de reproducción que ganaron gran aceptación en los años ochenta y las diferentes opiniones de varios grupos feministas relativas a estrategias y posturas. La crítica de la noción occidental del individualismo, vinculada frecuentemente al concepto de los derechos, se ha sumado al debate desde mediados de los años ochenta. También se trata la influencia sobre el debate feminista que han tenido la Conferencia Internacional sobre la Población y el Desarrollo, celebrada en El Cairo, la Conferencia sobre la Mujer, celebrada en Beijin, y la creciente atención a los derechos de reproducción en el movimiento del control demográfico.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 147506Abstract : Este trabajo analiza el desarrollo de las discusiones teóricas acerca del derecho a decidir sobre el propio cuerpo desde el Women´s Lib (década del sesenta)hasta la década del noventa. El eje de análisis está en las diferentes interpretaciones discursivaselaboradas por el feminismo acerca de la apropiación del cuerpo. En otras palabras, el trabajo sedesarrolla entre el discurso por las demandas del aborto legal y las demandas por el ejercicio delos derechos sexuales y reproductivos. Las décadas analizadas significan la puesta en escena deltema de la sexualidad como eje sustantivo en la liberación de las mujeres, dentro de procesospolíticos, económicos y sociales.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Este estudio se realizó como componente de investigación del proyecto Ipas/MSPS/ DFID "Mejorando la calidad y disponibilidad de servicios postaborto en Bolivia" (1996-1999). En el primer año, estudios de caso en dos contextos hospitalarios indicaron un desfase entre la política oficial de tratar humanamente a las mujeres que hubieran abortado y la aplicación rutinaria por parte del personal médico de discursos y prácticas despersonalizantes. En el segundo año (enero a septiembre de 1998) se exploró el manejo del trato humano en la educación médica, en una investigación-acción en la Carrera de Medicina de la universidad estatal paceña. Con métodos sociológicos de investigación cualitativa se analizó los discursos de estudiantes, internos/as, residentes y docentes, registrados mediante la observación participante y entrevistas grabadas. Se identificó los siguientes elementos que inciden en la calidad del trato humano en la Carrera: prácticas de exclusión para reducir la presión numérica de estudiantes en los espacios disponibles; cultura docente que tiende a militarizar e infantilizar las relaciones con estudiantes; exigencia rígida de dedicación exclusiva a los estudios médicos; discriminación de género escasamente reconocida entre los/las estudiantes, pero analizada críticamente por un grupo de docentes en un curso piloto; (mal)trato como objetos para el estudio a cadáveres y a personas que acuden a hospitales docentes; y dificultad para pasar de la nueva teorización psicopedagógica a su aplicación en aula. Se hizo la prueba con grupos de estudiantes y docentes de dos ejercicios de reflexión, desarrollados con insumos de la investigación hospitalaria (1996-97). La primera dinámica constó del análisis grupal de un dossier con diversos relatos sobre la atención a una mujer que tuvo un aborto terapéutico. Fueron registrados los comentarios de cada grupo en torno al tema (aborto) y al método (manejo de versiones contrastantes de un mismo evento). A partir de la apertura a un enfoque social amplio y del reconocimiento a la diferencia demostrados por estudiantes del primer año, en los niveles superiores se notó un progresivo endurecimiento del criterio, intolerancia a la ambigüedad y restricción a una sola versión médica de los hechos. En el segundo ejercicio, se pidió a estudiantes y docentes la redacción de un relato (firmado o anónimo) sobre algún evento crítico en su propia formación médica. Los 34 relatos analizados se enfocan en experiencias del maltrato por parte de docentes y residentes; dureza del régimen de estudios; insensibilidad y mala práctica médicas; manejo del cadáver como objeto; dilemas bioéticos; violación de derechos propios y ajenos; y autocrítica a la práctica docente. El estudio recomienda aportes desde el ámbito académico para promover una mayor equidad social en las políticas de educación y salud; medidas de discriminación positiva en los cupos de ingreso a la Facultad; incorporación al curriculum de métodos y materias de las ciencias sociales; estudio y práctica de la bioética aplicada desde los cursos preuniversitarios y en todos los niveles de la Carrera; normas para el manejo adecuado de los cadáveres; protocolos para asegurar el respeto al consentimiento informado de personas usuarias de los hospitales docentes; y desestigmatización de los elementos afectivos, subjetivos, de duda y ambivalencia en el estudio y práctica de la medicina.
Notes : Español/espagnol/SpanishAbstract : Aborda el debate que se dio en México entre julio y agosto de 1998, contiene las posiciones tanto a favor de la liberación de las leyes de aborto o la despenalización total, así como la oposición a cualquier intento de reformarla
Web site : http://www.gire.org.mx/Abstract : When manual vacuum aspiration (MVA) was introduced to treat incomplete abortion at a regional training hospital in El Salvador, this study evaluated the impact of replacing sharp curettage with MVA. Hospital cost, length of hospital stay, complication rates and postabortion contraceptive acceptance were compared in a prospective, nonrandomized, controlled study of 154 women assigned to either traditional sharp curettage services or MVA services plus contraceptive counseling. Assignment depended on availability of trained providers. Compared to sharp curettage, use of MVA and associated changes in protocol led to a significant cost savings of 13% and shorter hospital stay of 28%. Dedicated family-planning counseling resulted in a threefold higher rate of contraceptive acceptance. Although the difference in cost was significant, much higher savings could be realized if minimal postoperative stays were implemented for both procedures. Barriers to early discharge include patient expectations, physician attitudes and training and hospital systems administration. (author's)
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?iss=5 vol=68 viewtype=issueAbstract : This article presents a comparative analysis on the efficacy of manual vacuum aspiration (MVA), outpatient dilation and curettage (D C), and D C with hospitalization at the Maternal Perinatal Institute in Lima, Peru. Conducted during January-August 1995, the evaluation included timed observations of 22 MVA procedures, 22 outpatient D C procedures, and 16 inpatient D C cost-analysis, interviews and review of medical records. Results revealed that outpatient incomplete abortion could save $50,000 annually, with a total mean patient cost per MVA procedure of $16.30; $16.70 for outpatient D C and $84.11 for in-patient D C. Furthermore, outpatient incomplete abortion offer a shorter hospital stay (MVA and outpatient D C, 4.6 hours; in-patient D C, 44 hours). Moreover, 65% of the physicians interviewed reported that they were more comfortable with MVA since it is simple and a less dangerous technique, with no complications, and required less medication. In conclusion, treatment of incomplete abortion on an outpatient basis, particularly through the use of MVA provides the most number of advantages in terms of financial and human resources, as well as improving patient safety and satisfaction. Further expansion of the postabortion project was suggested.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 147310Abstract : An estimated 25-50% of maternal deaths in Peru are caused by complications related to illegal abortion. In 1994, Pathfinder International initiated a program at the Lima Maternal Perinatal Institute to improve treatment of incomplete abortion through use of manual vacuum aspiration (MVA) without hospitalization. 15 physicians were trained in the MVA technique. Prior to this program, curettage with general anesthesia and hospitalization was the standard treatment regimen. These two techniques was compared through interviews with both physicians and patients and a timed observation of a random sample of women who underwent outpatient MVA (n = 109), outpatient curettage (n = 77), or curettage with hospitalization (n = 675) at the Lima facility in 1994-95. Although providers were still not fully confident in their MVA skills, they perceived the technique as simpler, safer, and less traumatic to patients than curettage. The total time required (preoperative, operative, postoperative) was 271 minutes for MVA, 290 minutes for outpatient curettage, and 2638 minutes for curettage with hospitalization. The total mean cost per patient (manpower, supplies, administration) was US$16.30 for MVA, $16.70 for outpatient curettage, and $84.11 for curettage with hospitalization. Given an average of 20 incomplete abortion cases per day, the Institute would save about $50,000 a year by treating uncomplicated incomplete abortion cases on an outpatient basis.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 135239Abstract : The interrelationships among abortion, contraceptive use, and fertility in Latin America during the late 1970s, the 1980s, and the early 1990s were investigated through use of national survey data from Brazil, Columbia, and Mexico. In Colombia and Mexico, the abortion level stabilized once contraceptive use began to increase in the late 1970s; in Brazil, however, abortion continued to rise through the early 1990s, even as contraceptive use increased. The high intracountry variation in both contraceptive use and abortion levels suggests that sub-areas are undergoing their fertility transitions at different paces, with the role of abortion in the transition varying by area. In Brazil during the 1980s, the abortion rate increased by 17 points while the general fertility rate decreased by 42 points, implying that abortion contributed 40% of the fertility decline. In Colombia and Mexico, where public family planning services are more accessible than in Brazil, abortion accounted for only 9% and 2%, respectively, of the fertility decline from the mid-1970s to mid-1980s. The impact of contraceptive use on fertility decline was fairly constant regardless of the level of abortion. Fertility was at its lowest when contraceptive use was high but abortion was only medium-high; a high level of either abortion or contraceptive use was associated with low fertility levels, regardless of the strength of the other factor. These findings provide general support for the demographic theory that, as couples become increasingly motivated to restrict their family size, they will pursue all available means to achieve their family size goals. However, the practice of abortion is likely to continue, even as the use of modern methods of contraception becomes more widespread.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 122043Abstract : This study analyzes trends in unwanted fertility in 20 developing countries. Data were obtained from Demographic and Health Surveys and World Fertility Surveys. Fertility declined by about half from about 6.0 in the early 1960s to 3.4 in the mid-1990s. Declines are expected to continue into the next century. Fertility declined the most in Asia and Latin America. Sub-Saharan Africa has experienced very limited fertility decline. Couples are controlling fertility, but the rate of unwanted childbearing in many countries has also increased. In the 20 study countries, unwanted fertility rose from 0.82 births to 1.02 births per woman. Findings indicate that the proportion of fecund women in a union who wanted no more children was strongly, positively correlated with development indicators. The trend in unwanted fertility followed a U-shaped pattern. Countries where 0-50% of women wanted a stop to childbearing showed increased unwanted childbearing. Later fertility transition showed declines in unwanted fertility. The increases are attributed to a increased duration of exposure to risk of unwanted pregnancy and increased contraceptive use, during a period of decline in family size desired. Variation between countries in unwanted fertility is attributed to differences in the degree of implementation of preferences, the effectiveness of contraceptive use, and the rate of induced abortion. Differences in unwanted fertility of populations at the same transition stage can be attributed to other proximate determinants. Most developing countries are now at mid-transition, and unwanted fertility is near its peak. Findings suggest the improper use of unwanted childbearing as a measure of family planning program effectiveness, and the need for strong efforts to prevent the expected increase in unwanted fertility during early transition phases.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 126942Abstract : Testimonios de mujeres que piden se haga justicia, porque se les atendió fuera de tiempo el parto y perdieron su útero además del producto, otras fueron esterilizadas sin notificárselo, y esto es una violación a los derechos sexuales y reproductivos de las mujeres. También se denuncia que las enfermeras están expuestas a graves riesgos por el manejo de pacientes con enfermedades infecciosas como el sida
Web site : http://www.gire.org.mx/Abstract : Jane Hurst percorre a história das idéias sobre o aborto na Igreja católica ao longo dos séculos. Revela, de forma simples, a complexidade e a diversidade de opiniões que existem em torno dos diversos aspectos do tema: qual seria o momento do desenvolvimento do embrião em que este se transforma num ser humano (homonização); em que momento se estabelece a unidade entre mente e corpo, quando se constitui a natureza do ser humano; e a relação que existe entre a sexualidade e a condenação do aborto.
Notes : Portugués/portugais/PortugueseAbstract : De lo privado a lo político ; La transición demográfica ; El aborto como método anticonceptivo ; Modelos de género en el discurso médico ; La fuerza inesperada de la Iglesia ; La intervención del Estado ; El recurso de la desobediencia civil
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : A petición del Ministerio de Salud de Nicaragua (MINSA), Ipas llevó a cabo un estudio sobre la disponibilidad y calidad de los servicios de atención postaborto en los establecimientos de salud pública. Los resultados del estudio se utilizarán para promover la elaboración y ejecución de estrategias para aumentar el acceso a los servicios de APA de alta calidad.
Web site : http://www.ipas.org/publications/es/NICAPAC_S03_es.pdfAbstract : The Bush Administration is increasing its efforts to weaken existing international agreements on sexual and reproductive health and rights, including the Programme of Action of the 1994 International Conference on Population and Development (ICPD) and its five-year progress review (ICPD + 5). Hence, at the UN General Assembly Special Session on Children, 8-10 May 2002 in New York, the US delegation - aligning itself with the Holy See, Iran, Iraq, Libya and Sudan - used its superpower status to try to undo the ICPD. Indeed, John Klink, the Holy See's strategist at ICPD, Beijing and ICPD + 5, was this time a member of the US delegation. Fortunately, the US and its allies did not prevail.
Web site : http://www.rhmjournal.org.ukAbstract : Tesis que trata sobre la historia del debate sobre el aborto en México. La investigación se concentra en los grupos que han tenido mayor influencia en el debate: el gobierno, la iglesia, los grupos de mujeres y partidos políticos. Su punto de vista insiste que el aborto ilegal penaliza injustamente a las mujeres más pobres, mientras que el aborto legal no provoca la inmoralidad sino que ayuda más al bienestar para las madres y niñas. Además argumenta que el punto de vista de la iglesia católica como la antagonista central en el debate sobre aborto oculta la realidad de la marginación de las mjeres. La autora concluye que las raíces del problema tienen que ser descritos, pues éstas están relacionadas con actitudes sobre la sexualidad femenina, la ideología sociocultural sobre la maternidad, la falta de poder político de las mujeres y la marginación de mujeres en el trabajo y la educación
Notes : Inglés/anglais/EnglishAbstract : Three models of postabortal care currently in use in Mexican Institute of Social Security hospitals were compared. 251 women underwent manual endouterine aspiration, general counseling involving interaction with the provider, and specific family planning counseling. 270 women underwent instrumental uterine curettage and received interactive counseling and family planning services. 282 women were treated with instrumental uterine curettage and received prestructured information lacking the interactive component and family planning services. The sample included women treated for both induced and spontaneous abortion at 12 weeks or less. 803 women were interviewed before discharge, 610 were followed 7 days later, and 353 were interviewed after 6 months. The women in the 3 groups were similar in socioeconomic characteristics and reproductive history. Fewer than half in each group reported the pregnancy was planned, but over 70% stated it was desired. The data indicate that both techniques were comparable in terms of complication rates during and after the procedure. The proportion of patients with complete uterine evacuation and no obstetrical complications was significantly higher with the manual aspiration technique (98.7% vs. 96.7% and 94.6%). The results also suggest that pain management should be improved for all 3 models. The 2 groups of patients who received counseling and information reported receiving more complete information. Higher proportions in the same 2 groups accepted a contraceptive method and continued using it. The 3 groups had comparable hospital stays.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 139240Abstract : Esta estadística fue extrapolada a partir de la estimación del Ministerio de Salud de 400 fallecimientos de mujeres cada año en Bolivia, relacionados con el aborto en condiciones de riesgo. La cifra fue diseminada en 1997 dentro de la Campana 28 de Septiembre por la Despenalización del Aborto en América Latina y el Caribe.
Notes : Español/espagnol/SpanishAbstract : En la primera parte, compartimos brevemente nuestro marco teórico-metodológico, en el que incluimos los referentes conceptuales que sostienen nuestra mirada y aquellos elementos de la doctrina de la Iglesia Católica, que sin pretender ser exhaustivas, a nuestro entender permiten comprender las creencias, valores y normas internalizadas por las mujeres.En la segunda parte, presentamos los testimonios de las mujeres y nuestro análisis acerca de la realidad por ellos reflejada. Somos conscientes que la selección realizada involucra nuestra subjetividad, otras sensibilidades hubiesen destacado, quizás, otras experiencias. Sin embargo, buscamos que los testimonios elegidos muestren lo común, lo reiterado, lo compartido entre las mujeres y también aquello único, singular, diferente.En el último capítulo, explicitamos las reflexiones y las nuevas interrogantes que el trabajo en su conjunto nos motivó, y que nos desafían a intentar generar, desde la intervención y el debate, espacios y propuestas de cambio, que vehiculicen el potencial creativo que en sus ambiciones, coraje y capacidad de lucha cotidiana nos transmiten estas mujeres.
Web site : http://www.geocities.com/catolicas/libros/silenciada/libro.htmAbstract : Una reflexión desde las propias involucradas ; ¿Quiénes participaron? una breve presentación de los grupos de cada país ; Vivencias en relación a la maternidad ; Los métodos anticonceptivos ; Discutiendo sobre el aborto ; CDD Brasil compartió sus experiencias con una investigación realizada, con iguales objetivos en
Web site : http://www.geocities.com/catolicas/conciencia/www.catolicasporelderechoadecidir.orgAbstract : Although much is said about reproductive rights in Peru, many women in poor neighborhoods and marginal localities lack access to reproductive health services. A health promoter in a low income Lima neighborhood describes the situation of women who are abused and coerced into undesired sexual relations. Such women are not yet in a position to exercise their rights. They may seek illegal and unsafe abortions to end undesired pregnancies. They are at risk of incomplete abortion, hemorrhage, or infection. They wait too long to seek medical treatment, and many die. Women's rights should begin with the right to quality health care in good conditions. The author as a Catholic is not in agreement with abortion, but recognizes the reality that many women of all social levels seek to terminate pregnancies. Women with more resources have access to higher quality services and run less risk of death or impairment. Abortion should be decriminalized not to allow it to be used as a contraceptive method, but because access to information and medical care would be increased. Young people initiating sexual activity should be aware of the risks and responsibilities, and of how to avoid undesired pregnancy. Mothers should talk with their children about responsible sexual behavior.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159735Abstract : The views on the abortion debate of an 18-year-old university student in Lima are presented. The author notes that abortion, while a contentious issue, is also a common occurrence. Adolescents seeking abortions are seldom assisted and have scant access to information. Uppermost at the moment of seeking abortion are a series of traumatic emotions, and little attention is paid to legal implications. The family context, educational level, and social sector may greatly influence attitudes to abortion. Abortion appears to be a limit case not really appropriate for legislative regulation. Persons deciding to abort are less aware of the legal aspects than of the general air of censure, which causes them to proceed in secrecy at the risk of health and life. Criminalization of abortion implies not taking into account the conflicts affecting a person making the decision to seek abortion, and closes doors to persons in very grave situations. Decriminalization might not be the only solution, but would be a significant first step in making programs, information, and health services available. Abortion would be a less taboo theme, enabling individuals to become better informed about means of preventing undesired pregnancies and about alternatives such as adoption. Decriminalization would confront the reality that many pregnancies are undesired and many persons opt for abortion.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 159736Abstract : This International Planned Parenthood Report was published in preparation for the 1994 International Conference on Population and Development. The report examines the extent of adolescent sexual behavior, pregnancy, childbearing, and abortion as well as the incidence of sexually transmitted disease (STD) among young people. The lack of sex education is shown to be a contributing factor to these problems, and the rights of adolescents to family planning services are reiterated. The risks and consequences of unknowledgeable adolescent sexual intercourse include early childbearing, unwanted pregnancies, STDs, and sexual exploitation and abuse. Regional perspectives are given for Africa and the Middle East, sub-Saharan Africa, Asia, Latin American and the Caribbean, and industrialized countries. The success in reducing the incidence of unwanted pregnancies, abortion among teenagers, and STD transmission experienced by the Netherlands is described. This section is also enlivened with actual case histories from around the world. The report then turns to policy and program implications arising from adolescent sexuality issues. The provision of information, counseling, and services as well as the involvement of adolescents in programs are targeted as successful initiatives. The provision of contraception for adolescents is then covered, and charts illustrate the unmet need and current contraceptive use in sub-Saharan Africa, North Africa, Asia, Latin America and (separately) in industrialized countries. The successful and constantly evolving program developed by MEXFAM, the IPPF affiliate in Mexico, is then described. The report ends by providing a list of additional reading.
Notes : Inglés/anglais/EnglishAbstract : Unsafe abortion is entirely preventable. Yet, it remains a significant cause of maternal morbidity and mortality in much of the developing world. Over the past decade, the World Health Organization has developed a systematic approach to estimating the regional and global incidence of unsafe abortion and the mortality associated with it. Estimates based on figures for the year 2000 indicate that 19 million unsafe abortions take place each year, that is, approximately one in ten pregnancies end in an unsafe abortion, giving a ratio of one unsafe abortion to about seven live births. Almost all unsafe abortions take place in developing countries.Women who resort to unskilled or untrained abortion providers put their health and life at risk. Worldwide an estimated 68 000 women die as a consequence of unsafe abortion. In developing countries the risk of death is estimated at 1 in 270 unsafe abortion procedures. Where contraception is inaccessible or of poor quality, many women will seek to terminate unintended pregnancies, despite restrictive laws and lack of adequate abortion services. Prevention of unplanned pregnancies must therefore be the highest priority, followed by improving the quality of abortion services and of post-abortion care.
Web site : http://www.who.int/reproductive-health/publications/unsafe_abortion_estimates_04/index.htmlAbstract : AbstractEvery year, an estimated 2.0-4.4 million adolescents resort to abortion. In comparison with adults, adolescents are more likely to delay the abortion, resort to unskilled persons to perform it, use dangerous methods and present late when complications arise. Adolescents are also more likely to experience complications. Consequently, adolescents seeking abortion or presenting with complications of abortion should be considered as a medical emergency. Issues requiring special attention in the management of abortion complications in adolescents are identified. Approaches to adolescent abortion should involve all levels of the health care system, as well as the community, and should include not only management of the consequences of unsafe abortion, but also post-abortion contraception and counseling. Prevention of unwanted pregnancy by providing information on sexuality, ensuring that reproductive health services are adolescent-friendly, creating a supportive environment, building young people's social and Decision making skills, and offering counseling in times of crisis are highlighted.
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : This paper addresses a number of issues relating to priorities for research and programme implementation in Latin America and the Caribbean. The paper reviews attitude towards abortion, determinants of induced abortion, the incidence of induced abortion, the quality and types of abortion services, abortion among adolescents and the relationship between contraception and abortion. Areas in need of research in Latin America and the Caribbean include analysis of the formation of ideological positions against or in favour of abortion, measuring the prevalence of abortion using household surveys focusing on various subgroups in the population, improving understanding of the Decision making process in dealing with an unwanted pregnancy in the Latin American region, improving understanding of the Decision making process among adolescents regarding sexuality, contraceptive-use, abortion and fertility, and conducting policy-oriented research and the findings with decision-makers, legislators, and those in charge of formulated abortion-related policies and programmes.
Notes : Inglés/anglais/EnglishAbstract : We conducted a retrospective study of induced abortion as a cause of death in Uruguay for the period 1997-2001. Results show that although the maternal mortality rates of Uruguay are similar to those of developed countries, death from unsafe abortion is the main single contributor to that rate, and one of the highest in the world. For the lowest-income women, the absolute frequency of deaths due to this cause is considerably higher than for the rest of the nation's population. Maternal mortality is the most dramatic consequence of pregnancy-related complications. It is also the health indicator the most clearly related to inequity in the distribution of obstetric care. (excerpt)
Web site : http://www.sciencedirect.com/science/journal/00207292Abstract : Millions of women every year have an unwanted pregnancy, which ends through an unsafe abortion. This document presents global and regional estimates of incidence of and mortality due to unsafe abortion. The tabulations consist of data collected from a variety of sources, including health service reporting and surveys. Global and regional estimates are derived from data in the country listings. A description of materials and methods is included. Unsafe abortion is characterized by the lack or inadequacy of skills of the provider, hazardous techniques, and unsanitary facilities. It is one of the great neglected problems of health care in developing countries and a serious concern to women during their reproductive lives. Prevention of unwanted pregnancies must be the highest priority, and every attempt must be made to eliminate the need for abortion. Where contraception is unavailable or inaccessible, many women will seek to terminate unwanted pregnancies despite restrictive laws and lack of inadequate services. Women who resort to unauthorized providers put their health and lives at risk. It is estimated that every year almost 20 million unsafe abortions take place in developing countries, where the risk of death is estimated at 1 out of every 260 procedures
Web site : http://www.who.int/reproductive-health/publications/MSM_97_16/MSM_97_16_table_of_contents_en.htmlAbstract : An estimated 60 000-70 000 women die annually from complications of unsafe abortion and hundreds of thousands more suffer long-term consequences which include chronic pelvic pain and infertility. The reasons for the continuing high incidence of unwanted pregnancy leading to unsafe abortion include lack of access to, or misuse of and misinformation about, effective contraceptive methods, coerced sex which prohibits women from protecting themselves, and contraceptive failure. Unsafe abortion is closely associated with restrictive legal environments and administrative and policy barriers hampering access to existing services. Vacuum aspiration and medical methods combining mifepristone and a prostaglandin for early abortion are simple and safe. For second trimester abortion, the main choices are repeat doses of prostaglandin with or without prior mifepristone, and dilatation and evacuation by experienced providers. Strategies for preventing unsafe abortion include: upgrading providers' skills; further development of medical methods for pregnancy termination and their introduction into national programmes; improving the quality of contraceptive and abortion services; and improving partner communication.
Web site : http://www.intl.elsevierhealth.com/journals/beog/Abstract : Unsafe abortion is a significant yet preventable cause of maternal mortality and morbidity in developing countries. This report contains the papers submitted to an interdisciplinary consultation convened by WHO to assess the problem of unsafe abortion globally and to identify a research agenda aimed at reducing unintended pregnancy, unsafe abortion, and the resultant burden on women, their families, and, public health systems. Experts at the consultation reviewed the available evidence on unsafe abortion, examined the factors that perpetuate the problem, and identified both opportunities for preventing unsafe abortion and constraints on prevention. Participants addressed the theoretical and medical issues relating to research on unsafe abortion and outlined regional priorities for the prevention of unsafe abortion. Both long-standing and emerging issues relating to research on unsafe abortion were discussed.
Notes : Inglés/anglais/EnglishAbstract : Unsafe abortion is preventable and yet remains a significant cause of maternal morbidity and mortality in much of the developing world. Over the last decade, the World Health Organization has developed a systematic approach to estimate the regional and global incidence of unsafe abortion. Estimates based on figures around the year 2000 indicate that 19 million unsafe abortions take place each year, that is, approximately one in ten pregnancies endeed in an unsafe abortion, giving a ratio of one unsafe abortion to about seven live births. Almost all unsafe abortions take place in the developing world. In Latin America and the Caribbean, 3.7 million unsafe abortions are estimated to take place each year, with an abortion rate of 26 per 1000 women of reproductive age, almost one unsafe abortion to every three live births. Asia has the lowest unsafe abortion rate at 11 per 1000 women of reproductive age, but 10.5 million unsafe abortions take place there each year, almost one unsafe abortion to every seven live births. However, excluding East Asia, where most abortions are safe and accessible, the ratio for the rest of Asia is one unsafe abortion to five live births. In Africa, 4.2 million abortions are estimated to take place per year, with an unsafe abortion rate of 22 per 1000 women, or one unsafe abortion per seven live births. In contrast, there is one unsafe abortion per 25 live births in developed countries
Web site : http://www.rhmjournal.org.ukAbstract : Interviews with 626 women treated in 1993 for complications of unsafe abortion at five hospitals in Nairobi (Kenya), Lima (Peru), and Manila (Philippines) revealed marked differences in their demographic characteristics. The percentage under 25 years of age was 26% in Manila, 45% in Lima, and 91% in Nairobi. 84% of abortion patients in Nairobi were single compared with 77% in Manila and 21% in Lima; 77% of women in Nairobi had no children compared with 29% in Lima and 11% in Manila. In general, Nairobi abortion seekers tended to be young women who migrated to the city and were concerned pregnancy would impede their social mobility. In Lima and Manila, abortion was sought to limit births within union, generally for financial reasons. Never-use of contraception was reported by 80% of Kenyan women, 65% of Manila women, and 48% of those in Lima. When presented with 11 scenarios that might justify an abortion, the only indication the majority in all three cities supported was pregnancy resulting from rape. Women reported use of abortifacient agents such as livestock droppings, drinking chemicals and detergents, herbal medicines, and overdoses of over-the-counter medications, as well as insertion of sharp objects into the uterus. 98% of Kenyan respondents compared with 36% in Peru and 24% in the Philippines claimed illegal abortion was common; 92%, 75%, and 35%, respectively, were aware of at least one woman who died after an unsafe abortion. All of the women in Kenya and 89% in the Philippines reported it was difficult or very difficult to obtain an abortion; most were obtained through a secret referral system and involved unsanitary conditions. These findings indicate a need for postabortion family planning counseling as well as scrutiny of existing abortion laws and policies.
Web site : http://www.tandf.co.uk/journals/titles/07399332.aspAbstract : A survey of abortion patients at a reproductive health clinic in Bogota, Colombia, suggests that, even in a country with strong legal and moral sanctions against abortion, women's personal needs to avoid the long-term negative consequences of an unwanted pregnancy will prevail. The Orientame clinic provides among other services vacuum aspiration of retained products of conception to women who present with incomplete abortion. The 602 study subjects were interviewed in October 1990-January 1991 at the clinic before the abortion procedure. Their average age was 27 years (range of 16-48 years) and 31% had some university education. The average age at first intercourse was 19 years (61% became sexually active before this age) compared to the national average of 21 years; the average number of pregnancies was 3, only 1 of which was desired. The frequency of unwanted pregnancy was highest among those who lived with a permanent partner and already had 5-8 children. 43% of subjects did not want any more children. The index abortion was the 1st for 66%, the 2nd for 26%, the 3rd for 7%, and the 4th for 1%. While 87% had some experience with contraception (which is widely available in Colombia despite the illegality of abortion), only 58% had been using a method when this pregnancy occurred. Of those who did not want any more children, 14% were using an effective method, 49% a less effective method, and 37% were not using any method. Overall, the most common methods in use when pregnancy occurred were rhythm (17%), vaginal foam (11%), pill (7%), and condoms (7%). Sterilization is culturally unacceptable in Colombia, there is considerable misinformation regarding the side effects associated with effective methods, and women who use a less effective method often do so incorrectly and without understanding of how it works. Although 80% had been exposed to anti-abortion ideas and 25% considered the procedure a sin, they regarded prevention of an unwanted child a higher value. The main reasons for not wanting pregnancy were fears of single parenting, partner opposition, or restrictions of educational or employment opportunities. Overall, these findings pinpoint a need for increased education about and access to effective contraception.
Web site : http://www.rhmjournal.org.ukAbstract : Although significant progress has been made in promoting family planning and contraception in Latin America and the Caribbean, the region's high number of unwanted pregnancies reveals that the need for family planning remains great. Millions of women in Latin America and the Caribbean suffer the consequences of unintended pregnancies each year, which often leads to tragic consequences. Despite being physically, emotionally, or financially unprepared, many women proceed with childbearing. It is estimated that 1/3 or more of all births in the region are undesired or unintended. Other women opt for abortion, which is illegal just about everywhere in the region. The Pan American World Health Organization lists abortion as the leading cause of pregnancy-related death. Lack of sanitary conditions during delivery also causes the death of many women. These and other factors comprise the list of indicators of unmet need for family planning: 1) the high rate of unwanted pregnancy; 2) the alarmingly high number of illegal abortions ; estimated at 10-12 million each year; 3) the high rate of maternal death; 4) the high prevalence of adolescent pregnancy (in Mexico, for example, 42% of all women give birth during teens); 5) the high number of unwanted children, evident in the 41 million street children in Latin America and the Caribbean; 6) the high rate of contraceptive failure due to lack of knowledge and use; 7) the large number of women desiring permanent contraception (voluntary sterilization) who lack access to such services; and 8) the large number os sexually active women not using contraception who say that they do not want to become pregnant. All these factors conclusively attest to the need for reliable and accessible family planning services.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 070511Abstract : In 1984, in Mexico City, the Reagan administration announced its policy prohibiting USAID from supporting any nongovernmental organization which used its own or US funds for any abortion-related activities. Even though this policy was intended to reduce the incidence of abortion, it had the opposite effect because the cut in funding left some areas of the developing world with no family planning services or information at all. Further, this policy resulted in a loss of $17 million (US) or 25% of the budget of the International Planned Parenthood Federation (IPPF). On January 22, 1993, US President Clinton reversed this policy. IPPF considered President Clinton's action to be a significant event for women's health, human rights, and global development. This reversal will provide family planning services to about 300 million couples who want to practice family planning but could not do so because they did not have access to it. Shortly after President Clinton's announcement, IPPF began writing a proposal to USAID for funds to restore programs that the Mexico City policy eliminated. IPPF hoped the reversal would spark international recognition of the need for safe access to abortion. Other actions President Clinton has taken to promote reproductive health are reversing the Reagan and Bush administrations' rule prohibiting abortion counseling at federally-funded clinics, requesting that the US Food and Drug Administration study the possible marketing of RU-486, removing the ban on abortion in military hospitals, approving regulations allowing fetal tissue research, and appointing an abortion rights advocate as Surgeon General. The Catholic Church opposed all of Clinton's abortion policies. However, many congregations, priests, and Vatican officials are dissatisfied with the Pope's anticontraception position.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - 081143Abstract : Recent data from Brazil, where misoprostol is used widely as an abortifacient and available over the counter, have suggested a relationship between unsuccessful first-trimester use of this prostaglandin and Moebius syndrome (congenital facial paralysis). To confirm or refute such an association, the frequency of misoprostol use was assessed in the mothers of all 96 infants with Moebius syndrome born in 1990-96 at 7 hospitals in Brazil; mothers of 96 matched infants with neural tube defects were enrolled as controls. There were no significant differences between the two groups of mothers in terms of education, gravidity, parity, number of previous miscarriages or induced abortions, smoking, or alcohol consumption during pregnancy. 47 mothers (49%) in the Moebius syndrome group, compared with only 3 (3%) in the neural tube defect group, reported misoprostol use during the first trimester of the index pregnancy (odds ratio, 29.7; 95% confidence interval, 11.6-76.0). 20 mothers of infants with Moebius syndrome had taken misoprostol orally and 20 had taken the drug both orally and vaginally. The mean misoprostol dose was 842 +or- 543 mcg; in Brazil, each misoprostol capsule contains 200 mcg. 33 mothers of Moebius syndrome infants reported vaginal bleeding after taking misoprostol. These findings confirm a strong association between prenatal misoprostol use and Moebius syndrome. The syndrome may be related to vascular disruption of the subclavian artery during weeks 4-6 of embryonic development or to an ischemic event in the embryonic brain stem.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 135094Abstract : Women who choose medical abortion experience significantly more side effects than do those who choose surgical abortion, but are equally satisfied with their abortion experience.[1] According to daily charts kept by 1,373 abortion patients participating in a clinical trial conducted in China, Cuba and India, the incidence of nausea, heavy bleeding, and pain and cramps in all three countries was significantly higher among women who received a medical abortion than among those who chose surgical abortion, and the incidence of vomiting was significantly higher among medical patients in two of the three countries (China and Cuba). Nevertheless, women's rating of their well-being and satisfaction at their exit interview revealed no significant differences between methods. More than nine in 10 women in each group rated their well-being as fair to excellent, and more than eight in 10 said they were satisfied or very satisfied with their abortion experience.
Web site : http://www.guttmacher.org/Abstract : This study was conducted between December 1995 and January 1996 in a public maternity ward of the city of Fortaleza, Brazil. An average of 200 women were admitted per month for the treatment of incomplete abortion. During the 3 months preceding the study, an average of 20 cases of incomplete abortion per month had been treated via manual vacuum aspiration (MVA). Participation in this study was restricted to women with gestation not exceeding 12 weeks and without any major complications. The average hospital stay was 36.5 hours for patients treated via dilatation and curettage (D C) and 8.4 hours for patients undergoing MVA, representing a 77% reduction (p < 0.001). The average waiting period for performing D C was 10.1 hours vs. 3.6 hours for performing MVA, a 65% reduction (p < 0.001). The average time required for the surgical procedure of D C was 1.2 hours vs. 0.4 hours for MVA (p < 0.001). Women who were treated via MVA spent an average of 4.4 hours in the hospital during and after the procedure vs. 25.2 hours for D C, representing an 83% reduction (p < 0.001). The average cost of performing MVA, as compared to D C, was 14% higher (p < 0.001); however, when the expenditures for drugs, supplies, and materials were taken into account, using MVA represented a cost reduction of 66% (p < 0.001). There was an average cost reduction of 41% in treating patients via MVA compared to treating patients via D C (p < 0.001).
Web site : http://www.scielosp.org/scielo.php?script=sci_arttext pid=S0034-89101997000600005 lng=en nrm=isoAbstract : El objetivo de este estudio, fue evaluar la eficacia y seguridad de la autoadministración vaginal de 600 mg de Misoprostol hasta un máximo de tres dosis en un período de 24 h, una cada 8 h para provocar el aborto hasta las 9 semanas de gestación. Un grupo de 90 pacientes voluntarias con embarazos entre 35 y 63 días participaron en este estudio. Todas las pacientes que abortaron recibieron una dosis adicional de 600 mg de Misoprostol. Una paciente abandonó el estudio después de la primera entrevista pero sus datos se incluyeron en las características generales de la muestra. El método se consideró eficaz cuando provocó el aborto completo sin requerir procedimientos quirúrgicos, ni producir efectos secundarios. El aborto completo ocurrió en 57 pacientes (64,0 por ciento). El tiempo de expulsión fue 7,4 ± 3,8 h (mediana 7,2 h, rango 3-20 h) para todas las pacientes que abortaron en las primeras 24 h de la administración del Misoprostol. Treinta y dos casos fallaron, 28 de ellos fue por problemas del método después de administrada la tercera dosis, y en 4 por decisión médica. Los resultados obtenidos en este estudio nos permitieron concluir que la dosis de 600 mg de Misoprostol no es adecuada para producir una alta o aceptable eficacia abortiva(AU).
Web site : http://bvs.sld.cu/revistas/gin/vol29_1_03/gin08103.htmAbstract : El Misoprostol es un análogo de las prostaglandinas con propiedades uterotónicas. Un grupo de 141 pacientes con menos de 70 días de embarazo recibieron hasta 3 dosis de 800 mg de Misoprostol cada 48 horas. El fallo fue definido por la necesidad de practicar el aborto quirúrgico y el éxito por la completa expulsión del producto de la concepción. En total, 132 casos (93,6 por ciento) abortaron normalmente y 9 casos para el 6,4 por ciento, fallaron. El descenso de la hemoglobina fue estadísticamente significativa (p=0,001) pero sin repercusión clínica; antes del tratamiento: 11,9 mg/dL con DS=1,19 y después: 11,1 con DS=1,20. No fueron encontradas diferencias estadísticamente significativas entre las tasas de éxitos y fallos en relación con la paridad, gravidez, abortos previos, color de la piel o edad, pero sí fueron encontradas en las gestaciones de más de 9 semanas (p=0,01). La tercera dosis de Misoprostol mostró muy poca eficacia. La conveniencia de la reducción del tiempo de tratamiento y el empleo de dosis más frecuentes, combinada con diferentes vías de administración, está siendo investigada(AU).
Web site : http://bvs.sld.cu/revistas/gin/vol29_2_03/gin07203.htmAbstract : Este estudio evaluó la eficacia y seguridad de la aplicación intrauterina de una suspensión de misoprostol en el manejo de gestaciones diferidas menores de 12 semanas. Con tal objetivo se obtuvo una muestra de 25 mujeres con diagnóstico de gestación diferida menor de 12 semanas, sin antecedentes patológicos y asintomáticas que acudieron a la Clínica de Manejo de la Pareja Infértil del Centro de Investigación en Reproducción Humana (CIRH) de Panamá, entre enero a diciembre de 2000. Fue aplicado una suspensión de 200 mcg de misoprostol diluído en 4cc de SSN intraútero, a través de cánula de inseminación (Mackel). Se hicieron controles clínicos y ultrasonograficos 24 - 48 horas post aplicación y de biometría hemática al momento del cese del sangrado. Además, se práctico histerosonografía el día 7 del ciclo menstrual siguiente para evaluar posibles efectos. La edad gestacional promedio fue de 27 días; casi la totalidad de las mujeres presentaron expulsión completa. El tiempo promedio de aplicación /expulsión fue de 20 horas. Sólo 12% de la muestra requirió aplicación adicional de la suspensión ; el tiempo medio desde la expulsión hasta el cese del sangrado fue de 5 - 250 horas, con un descenso significativo de hemoglobina, pero ninguna paciente presentó inestabilidad hemodinámica. No se reportaron datos clínicos o de laboratorio de infección, ni reacciones alérgicas. La totalidad de las histerosonografías de control resultaron normales y 92% quedaron satisfecha con el procedimiento y manifestaron que preferían esta técnica al legrado uterino. A pesar de los resultados positivos, el estudio no permite considerar el uso de intrauterino de misoprostol como alternativa segura y eficaz para abortos diferidas.
Notes : Español/espagnol/SpanishAbstract : PRESENTACION: Las circunstancias de la vida me brindan el privilegio y gran honor de escribir la presentación de este manual. Privilegio porque los autores son profesionales idóneos, consagrados en la labor cotidiana de la medicina, que dedican horas de estudio, reflexión y análisis. Ellos han realizado el esfuerzo de sintetizar su experiencia profesional y su aprendizaje para facilitar a otros colegas las claves para una buena practica clínica. Un honor por el contenido de este manual que viene a cubrir una necesidad y se constituye en una herramienta de gran valor, muy didáctica que expone de manera fácil y estructurada el uso del misoprostol en las diferentes condiciones Gineco - obstétricas, evaluando los beneficios y los potenciales riesgos del mismo. La obra nos orienta sobre las indicaciones, uso apropiado y contraindicaciones del misoprostol que si bien no esta aprobado en la gran mayoría de los países para su uso en gineco-obstetricia; una basta experiencia clínica en América Latina ha demostrado su eficiencia con grandes ventajas como ser facilidad de conservación, estabilidad de la misma, aplicación y costo reducido, comparado con las prostaglandinas naturales. El alto índice de morbimortalidad materna es una gran preocupación todavía en nuestro continente, estamos seguros que el uso apropiado del misoprostol en el embarazo redundara en beneficio de nuestras mujeres. Consecuente con esta realidad es que el Comité Ejecutivo de la Federación Latinoamericana de Sociedades de Obstetricia y Ginecología junto a su Comité de Derechos Sexuales y Reproductivos han gestionado la realización de este manual que colocamos a vuestra disposición para el mejor ejercicio de nuestra practica profesional. Dr. Carlos Fuchtner Soruco, Presidente Comité Ejecutivo
Web site : http://www.cedes.org/web_mort/recursos_informativos.asp#publicacionesAbstract : Este folleto, avalado por FLASOG, esta dirigido a prestadores de servicios de salud que están usando la prostaglandina, misoprostol, para la interrupción legal del embarazo. Contiene información básica sobre cuándo se lo puede usar, su eficaz, seguridad y uso y tiene una lista de referencias útiles. Se puede usarlo durante la orientación que se da a una mujer.
Web site : http://www.ipas.org/spanish/publications/abortion.aspwww.ipas.org/publications/es/MISOUSE_S05_es.pdfAbstract : Since the 1980s, misoprostol, a synthetic analog of prostaglandin E1, has been studied for cervical ripening and priming in induced abortion. For gestations of 10-15 weeks the dose used is 800 mg via the vaginal route every 24 hours, for a maximum of 3 doses. For incomplete abortion, repeated doses of misoprostol are needed (400 mg, twice daily/b.i.d. for 2 weeks). Various studies have showed that for cervical dilatation in the first trimester for nulliparas with incomplete abortion the ideal dose is 400 mg of misoprostol 3 hours before curettage or vacuum aspiration. For cervical ripening and induction of labor the ideal dose is 25 mg every 4 hours until frequent contractions, cervical ripening, and spontaneous rupture of the membranes have been attained. Administration of misoprostol in the puerperium has been shown to be effective for reducing postpartum hemorrhage (a single dose of 400 mg). Some of the contraindications include fetal weight of <1800 g or >4000 g, cephalopelvic disproportion, placenta previa or unexplained vaginal bleeding, active infection by herpes simplex, and previous cesarean section. Some side effects consist of fever, diarrhea, hypotension by direct arterial vasodilation, uterine rupture, and hypertonia. Misoprostol is also used in gynecology for endometrial biopsy and hysteroscopy.
Web site : http://www.cnpq.brAbstract : The objective of this study was to evaluate the safety and efficacy of 1000 mcg misoprostol vaginally (Cytotec), self-administered into the vagina for medical abortion. 300 women with gestations between 42 and 63 days, with previous written consent, received vaginal misoprostol every 24 hours up to a maximum of three doses for abortion. Outcome measures assessed included: successful abortion (complete abortion without surgery), side effects, decrease in hemoglobin, mean time of vaginal bleeding, mean expulsion time and mean time of returning of menses. Complete abortion occurred in 279/300 (93.0%; 95% confidence interval: 90, 96) patients. Medication to relieve symptoms was administered to all subjects after every misoprostol dose. Vaginal bleeding lasted 14.7 +or- 5.4 days. Mean expulsion time was 8.1 +or- 3.0 hours for those who aborted after the first misoprostol dose. The mean drop in hemoglobin was statistically significant (p = 0.0001) but without clinical relevance. The frequencies of nausea and diarrhea were high. According to the observed outcomes, 1000 mcg misoprostol vaginally could be a valid method to terminate pregnancies up to 9 weeks' gestation. (author's)
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?vol=63 viewtype=issue iss=3#S001078240100189Abstract : The aim of this study was to demonstrate the effectiveness and safety of misoprostol without the need of post-expulsion systematic curettage (PSC) in early second-trimester abortions. 151 female volunteers were given 800 mcg of vaginal misoprostol every 24 hours for a maximum of 3 doses, without having preventive PSC performed. The results were measured in terms of successful abortion (complete abortion without need for surgical procedure), side effects, mean expulsion time and mean time of vaginal bleeding. Of 151 subjects, 121 (80%) had complete abortion. Side effects included nausea (23%), vomiting (22%), diarrhea (32%), dizziness (11%), headache (20%), fever (32%), chills (59%), rashes (1%), and pelvic pain (95%). Except for pain, all of these side effects were of low intensity and short duration. Vaginal bleeding lasted 6 +or- 3 days; spotting, 6 +or- 3 days; total bleeding, 12 +or- 5 days (median, 11 days; range, 1-29 days). No patient had a clinically important decrease in hemoglobin level. This study concluded that misoprostol by vaginal administration is a useful alternative for interrupting gestation in the early second trimester of pregnancy, based on its efficacy as an abortifacient agent, low hemoglobin loss, and low incidence of side effects.
Web site : http://www.tandf.co.uk/journals/titles/13625187.aspAbstract : The effectiveness and safety of vaginal misoprostol, without the need for postexpulsion systematic curettage, were investigated in 120 Cuban women seeking late first-trimester abortion (10-12 weeks). Women received 800 mcg of misoprostol vaginally every 24 hours, for a maximum of three doses. Complete abortion occurred in 104 women (87%); 87 women (73%) aborted after a single dose, 11 (9%) required two doses, and 6 (5%) received a third dose. The remaining 16 women (13%) underwent surgical abortion. Mean hemoglobin decreased from 12.2 mg/dl before treatment to 11.6 mg/dl after abortion ; a difference that was statistically but not clinically significant. Side effects ; which disappeared within 2 hours ; included nausea (22%), vomiting (17%), diarrhea (54%), dizziness (25%), headache (19%), and chills (72%). Although 99% of subjects reported pelvic pain (99%), only 10% requested an analgesic for pain relief. Vaginal bleeding persisted for a mean of 8 days. According to logistic regression analysis, the only variable significantly associated with treatment success was race. The success rate was 94% among White women compared with 73% among Black and Black Cuban women. The acceptable expulsion period, the fact that a postabortion systematic curettage was not required, the clinically insignificant hemoglobin loss, and the high success rate all demonstrate that misoprostol administered vaginally may be a valid method for interrupting late first-trimester pregnancies.
Web site : http://www1.elsevier.com/cdweb/journals/00107824/viewer.htt?vol=57 viewtype=issue iss=5#S001078249800037Abstract : Si bien la investigación sobre el papel del varón en la sexualidad y la reproducción ha crecido de manera importante en el mundo, no siempre ha expresado el punto de vista de los hombres. De allí que este libro resulte un aporte sustancial en la materia. En él convergen autores y autoras de origen diverso (Argentina, Brasil, Ecuador, México, Perú), lo que permite el abordaje de una amplia variedad temática. Los distintos modelos de ser varón; la iniciación sexual en la adolescencia; las decisiones sobre anticoncepción, incluida la implementación de vasectomías; las enfermedades de transmisión sexual; la violencia sexual y de género; la homofobia y la bisexualidad, son sólo algunos de los temas que se abordan a lo largo de los capítulos. El recorrido sociodemográfico se complementa con otros enfoques que permiten al lector obtener un vasto panorama de las diversas conformaciones subjetivas de los varones de hoy.
Notes : Español/espagnol/SpanishAbstract : Promoción, reflexión y discusión en torno a la fecundidad masculina y la participación del hombre en el proceso reproductivo
Notes : Español/espagnol/SpanishAbstract : In Chile, divorce is illegal, and annulments ; which can be arranged easily by well-connected attorneys ; are expensive, so unhappy couples usually separate and take up with other partners. It is the only South American country where divorce is illegal. Nearly 50% of couples in Chile are unmarried, a fact that reflects the popularity of separations. In addition, nearly half of children born in Chile are not born to married parents. Abortion is illegal in Chile under any circumstances. But since secret abortions are pervasive, the country's rate of abortion could be Latin America's highest. Pregnant teenagers are often forced to leave school by principals until after they give birth.
Notes : Inglés/anglais/EnglishAbstract : Plantea que los efectos del sistema penal sobre las mujeres no apuntan tanto a su criminalización efectiva y objetivable cuantitativamente como a la consagración de la tutela legal y legitima nuestra discriminación, ser sujetas de dicho control social llevó a la necesidad de formular las estrategias regionales y nacionales. Presenta la agenda y conclusiones del seminario sobre aspectos de salud reproductiva y violencia sexual, incluyendo aborto, incesto y prostitución
Notes : Español/espagnol/SpanishAbstract : This paper focuses on the violation of the human rights of women as a result of punitive abortion legislation in El Salvador. It argues that the Salvadoran state has violated provisions and principles contained in national and international human rights instruments by failing to incorporate the necessary and appropriate measures to guarantee all of its citizens, and particularly young, single and low-income women, the ability to exercise their reproductive rights in general, and their right to abortion in particular. The criminalization of abortion resulting from the legal and constitutional reform process in 1998 and 1999 undermines the protection of women's rights by violating rights guaranteed by the Salvadoran Constitution and international conventions ratified by the country. These rights include the right to life, liberty and security of person; the right to health; the right to physical integrity; and the right to privacy. Moreover, it is emphasized that the Salvadoran government has failed to fulfill its commitments arising from the 1994 International Conference on Population and Development and the Fourth World Conference on Women in 1995.
Web site : http://www.crlp.org/Abstract : Any kind of discrimination is violence. When women are discriminated against, it lasts for all their life. Violence towards women is a violation of human rights. Violence is directed against all feminist expression. Being born female means being discriminated against. But a man who wants to develop "female aspects" is also discriminated against. We should integrate the feminine aspects in ourselves. Men and women should work together in a different way. Interdisciplinary and mixed teams should be formed to study violence. Women have developed masculine aspects. Other forms of communication besides language should be used at this conference. Fears, emotions, art, and music should be shared. In this way, the feminine aspects will be integrated. Public violence is more subtle than battered women. During Chile's military dictatorship, women were "in the front line of defense of peace and democracy." Now, they are marginal. Therapeutic abortion is illegal. The victims of repression are a problem. How does one compensate the victims of human rights violations during the military dictatorship? The feminists are trying to prevent this from happening again. A video was made by "Women for Life" (Mujeres por la Vida). All women's organizations and women from opposition political parties took part. It concerned a woman appearing in a downtown street carrying 1000 black cutouts of humans. They had names of repression victims written on them. The question, "Have you forgotten me?" appeared. This had a folk song, "So that you won't forget me" to go along with it. Peaceful demonstrations are needed to raise the Chilean people's consciousness.
Notes : Inglés/anglais/English, nbsp;popline 271867Abstract : The article reviews the contents of several specific articles in the Venezuelan Penal Law for the purpose of demonstrating the impact that the definition of "legally protected right" has on that particular article of the law and the punishments it specifies. With regards to protected legal rights, the discussion is of utmost importance because the definition of Legal Rights provides guidelines in the understanding of the legal oppression of gender. However, it was concluded that there exists no significant difference between the Penal Code in Venezuela and the Projected Penal Code of 1984, with respect to the Legal Right protected by the law which sustains crimes using sex as an instrument or weapon against a female victim. In the context of crimes against sexual freedom, articles in the Penal Code and in the 1984 Reform Project on issues of rape among married and non-married couples, incest, and abortion after rape are discussed. In conclusion, reforming articles as stated in the present Venezuelan Penal Code and the 1984 Reform Project will not solve the penal law problem of sexual violence against women.
Notes : Inglés/anglais/English, nbsp;145359Abstract : Analiza la incidencia de la violencia doméstica durante el embarazo en pacientes que acuden al Hospital Civil de la ciudad de Cuernavaca. La violencia doméstica se considera un problema social que afecta a mujeres y familias. En México es un problema reciente de abordarse, por lo tanto, no existen cifras nacionales de referencia. Las cifras existentes son a nivel regional que representan esfuerzos de organismos independientes, quienes consideran que la situación tanto física como emocional de las mujeres maltratadas representa un problema urgente de considerar como tema de salud pública. Un caso especial a retomar es el impacto de la violencia en la mujer embarazada, el cual se considera otro problema de salud, que puede tener alcances mortales. Hasta el momento no existe en nuestro país programas especialmente dirigidos a la atención de estos casos
Notes : Español/espagnol/SpanishAbstract : Women still die as a result of pregnancy in Latin America. Hispanic culture and Catholicism consider motherhood to be the most honorable and gratifying role a woman can achieve. Women who do not become mothers tend to be scorned or condemned. Women who have experienced abortions face the worst possible criticism. The Catholic Church leads the way in keeping abortion illegal. In Latin America, the role model for mothers is the Virgin Mary. Underregistration of maternal deaths is the norm in Latin America. 36% of maternal deaths take place during pregnancy; 94% could have been prevented. Hemorrhage, complications during puerperium, preeclampsia/eclampsia, and illegal abortions comprise at least 75% of maternal deaths in some countries (e.g., Argentina, Chile, and Venezuela). In Colombia, illegal abortions are responsible for 60% of maternal deaths. 22-63% of pregnant women in Latin America have anemia. Women need to rise up and question why the entire social, economic, and health systems in Latin America allow high maternal mortality to continue. The number of obstetric beds is so low that 2 mothers share 1 bed. They often suffer consequences of this overcrowding and lack of hygiene. Cuba has among the lowest maternal mortality rates in Latin America and the Caribbean because women have access to pre- and postnatal care, abortion is legal, and contraceptives are freely distributed. Attending to women who conduct illegal self-induced abortions makes up a considerable part of the health budget (e.g.,k 1 hospital in Lima, Peru, spent $US 8 million in 1980). Women's groups in Brazil are leaders in promoting women's health. Their efforts have resulted in the establishment of the Integrated Health Care for Women Program, a conference on women and reproductive rights, and discussions about sexuality through the Group for Women's Health. Women in Latin America are indeed demanding to be seen and heard.
Web site : http://www.catholicsforchoice.org/conscience/archives/default.aspAbstract : El estudio descrito formó parte de una investigación sociológica más extensa sobre los discursos médicos en torno al aborto, en el marco del proyecto trienal "Mejorando la Calidad y Disponibilidad de Servicios Postaborto en Bolivia", ejecutado por Ipas y el Ministerio de Salud. El artículo relata el proceso de investigación etnográfica en dos hospitales docentes; la relación establecida con médicos sujetos y colaboradores en el análisis de sus propio lenguaje; formas de registro y análisis de los datos; y la construcción de una tipología de discursos, las voces cambiantes, aplicadas en este caso al tema de la anticoncepción postaborto.
Notes : Español/espagnol/SpanishAbstract : La investigación presentada en este libro se orientó al estudio de los mecanismos y efectos relacionados con la exclusión y censura social que recaen sobre el aborto inducido, y muy especialmente sobre quien se lo practica. El objetivo general del estudio fue colaborar al diálogo y a la reflexión sobre la rigidez normativa y moral que rodea a la sexualidad femenina y al aborto, analizando las significaciones culturales asociadas a ellos que sostienen algunas mujeres que se lo han realizado a través de prácticas clandestinas e inseguras que atentaron contra su salud física y psicoafectiva.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMS Y UNIFEMAbstract : This article highlights the 3-day meeting entitled "Global Meeting on Postabortion Care: Advances and Challenges in Operations Research," in New York, on January 19-21, 1998. Organized by the Population Council in collaboration with Ipas and funded by the US Agency for International Development, the meeting was convened to review the progress in improving postabortion care (PAC) service delivery. It was attended by some 65 researchers; senior program managers; and government officials from Africa, Latin America, the Middle East, and Southeast Asia, in addition to representatives from a number of US-based agencies. The three key objectives of the meeting were identified and the presentation of papers was structured around six main themes. Findings were presented from studies that have taken place in Asia (India, Turkey); Africa (Egypt, Kenya, Zimbabwe, Burkina Faso, Ghana); and Latin America (Mexico, Peru, Bolivia). The key issues discussed included: abortion complications; integration of PAC with safe motherhood initiatives; maintenance of a manual vacuum aspiration (MVA) kit; necessity of clearer guidelines on pain medication during MVA procedure; importance in addressing client-provider relations; and the necessity in considering broader hospital systems.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 160232Abstract : In 1992, film maker Dorothy Fadiman produced a first-person documentary entitled "When Abortion Was Illegal" that told the story of how she almost died after obtaining an illegal abortion in 1962 when she was a 22-year-old financially-strapped graduate student. The abortion cost $600 in cash, and she was blindfolded and unanesthetized. 2 days later she was rushed to the university hospital with peritonitis and blood poisoning and was saved by the physician who had refused to provide her with a safe abortion or a referral. "When Abortion Was Illegal" is the first in a trilogy of documentaries. The second, "From Danger to Dignity," chronicles the decriminalization effort and the story of the underground network that helped women find safe illegal abortions. This documentary features the clergy of many faiths who referred women to physicians who performed abortions or to safe facilities in Mexico. This demonstrates that reproductive choice has broad support in the religious community despite the involvement of the religious right in anti-abortion activities.
Notes : Inglés/anglais/EnglishAbstract : The evolution of Profamilia ; Turning chaallenges into opportunities ; A commitment at the top to a focus on sexual health ; A focus on counseling ; Progress ; Remaining challenges ; Incorporating sexual health into services: a matter of institutional and cultural change ; Conclusion ; References.
Notes : Inglés/anglais/English, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Not "culture" but "gender" / Jessica Horn -- Women's reproductive and sexual rights and the offence of zina in Muslim laws in Nigeria / Ayesha Imam -- Uganda / Lisa Ann Richey -- Mapping the contours / Radhika Chandiramani -- The politics of abortion in Mexico / Adriana Ortiz-Ortega -- Sexual-reproductive health and rights / Benno de Keijzer.
Notes : Inglés/anglais/EnglishAbstract : This paper explores agency in Bolivian actor-networks incorporating the Manual Vacuum Aspiration (MVA) syringe, a technology for extracting uterine contents after incomplete abortion. The author, as consultant employed by the syringe's manufacturers, investigated women's complaints of pain in aspiration procedures. The designers of MVA configured patients as awake and available to provide pain alerts to warn clinicians of possible uterine perforation. However, gynaecology ward staff named patients' screams as traumatic or unwarranted. The author identified parallels with car alarms that provoked disturbance when triggered too easily. Pre-set shock thresholds to avoid this problem were built into the AL 48 Talking Car Alarm, a model offering Instant Panic Protection with "woman's voice screaming" Talking Messages. The AL 48's adjustable sensitivity levels were lacking in MVA patients, whose uncontrolled screams influenced some actors against the technology. The author found flaws in the designer-configuration of human participants in MVA procedures. She concludes that in some scenarios, pain can destabilise theoretical constructions of human/non-human symmetry in actor-networks.
Notes : Inglés/anglais/EnglishAbstract : This paper explains why the Global Gag Rule undermines US foreign policy and harms women's health. The Global Gag Rule aims to force foreign organizations to renounce abortion-related activities as a condition of receiving US family planning funds. This is similar to the so-called Mexico City policy. Current law already bars US taxpayers' funds from paying for abortions overseas. This is in conflict with US foreign policy goals that involve protecting human health, especially by improving access to family planning and reproductive health care, and stabilizing world population size. Such policy restrictions also undermine the effectiveness of US population assistance. Violation of democratic principles is manifested by restricting freedom of speech and association of foreign organizations. The restrictions would discriminate against private organizations, contrary to US efforts to promote their role in civil society. Moreover, cutbacks in family planning services would likely contribute to an increase in abortions. At the clinic level, such policy restrictions interfere with appropriate medical care. The Mexico City policy resulted in the withdrawal of International Planned Parenthood Federation (IPPF) and Planned Parenthood Federation of America. The IPPF and some other groups would likely face another cut-off in funds if the Global Gag Rule were to become law. Public debate and the exchange of information about unsafe abortion would be suppressed; while recent efforts to address unsafe abortion would be undermined.
Notes : Inglés/anglais/EnglishAbstract : Despite concern over high pregnancy rates and levels of risk for sexually transmitted infections, adolescent fertility rates in the Dominican Republic have not changed substantially since the early 1980s, and actually increased during the early to mid 1990s. The present study was undertaken to assess the factors contributing to the recent rise in fertility among Dominican adolescents. The findings suggest that although contraceptive use among adolescents and young adults has increased, this has been more than offset by ominous trends on other determinants of fertility. Among these are declines in mean age at first sex and first marriage/union without a commensurate decline in mean age at first contraceptive use, and stubbornly high discontinuation rates for OCs and condoms. There is also some evidence that rates of induced abortion among adolescent may have increased, without which adolescent fertility rates would have been even higher. Demand for children among Dominican adolescents remains strong, suggesting that efforts to reduce the current high prevalence of risky sexual behaviors need to influence social norms in order to be successful. (author's)
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 170864Abstract : At the suggestion of a social worker who witnessed abusive post-abortion care at a public hospital in Rosario, Argentina, two human rights NGOs collaborated to investigate women's experiences seeking treatment for abortion complications at area public hospitals. During the year-long enquiry, more than 300 women took part. Role play was successfully used to surmount women's initial reluctance to reveal pervasive discriminatory and humiliating mistreatment. Thirty-one women later gave personal testimonies about their experiences, which were contained in the report of the research and later dramatised in a public meeting and video. The report, Con Todo al Aire (With Everything Exposed), was disseminated widely, including to the media, and a formal complaint was made to the local Ombudsman, who called for high-level action to resolve the problems. Initial denial by some health professionals that there was a serious problem was replaced by critical self-assessment within the provincial government, hospitals and medical and nursing schools, who made commitments to reform hospital practices and the medical school curriculum. Women participants also gained an understanding of their right to appropriate and humane health care. The findings from Rosario are not isolated. They are now being shared with activists and researchers in other provinces of Argentina and other countries.
Web site : http://www.rhmjournal.org.ukAbstract : A Bolivian woman with three daughters became pregnant while practicing the rhythm method. Method failure occurred seven years after she bore her most recent child and prompted her, with her husband's consent, to obtain an unsafe abortion. The decision to abort the fetus was based upon her husband's lack of employment, the meager monthly income of US$45 which she earns, and the inability of her to continue working once pregnant. The abortion process consisted of a three-hour scraping/general cleaning which left the woman dizzy. She returned to the physician several days later, bloated and in pain, when the possibility of a perforated uterus was voiced and surgery conducted. The woman regrets having the abortion, for the couple wanted to bear a fourth child once they could afford it.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 099844Abstract : The reproductive health and childbearing patterns of women in Latin America and the Caribbean are being affected by changing social and economic conditions. For example, increased male unemployment, attributable to declines in the productivity of the agricultural sector, has forced more women to enter the labor force, resulting, in turn, in a trend toward smaller families. Also contributing to this trend have been increases in female education, urbanization, and greater exposure to the media. Average family size is 4-5 in 4 countries in region, 3-4 in another 4 countries, and under 3 in Trinidad and Tobago, Brazil, and Colombia. Early childbearing continues, however; 30% of Latin American women have had a child before 20 years of age. On average, desired family size is 3-4 children. The high rate of illegal abortion (1 in every 4 pregnancies is so terminated) and of unplanned pregnancies (24-67% of most recent births were unwanted) illustrate the unmet need for family planning. Contraceptive use levels vary from a low a 23% in Guatemala to a high of 66% in Brazil and Colombia, with most countries falling into the 44-59% contraceptive prevalence rate range. Health-related side effects and improper use of methods combine with a lack of accessible, comprehensive family planning services to create these low rates. It has been estimated that there are 28 million women in the region ages 15-44 years who wish to avoid pregnancy yet are using no family planning method or an ineffective method. Overall, 38% of pregnancies in Latin America and the Caribbean result in a wanted birth, 34% in an unplanned birth (15% mistimed), and 28% in an induced abortion. Program and policy initiatives are needed to enable women in the region to achieve their family size goals and improve their reproductive health.
Web site : http://www.guttmacher.org/Abstract : Preface ; Introduction ; Familiy or families? ; Family types and patterns ; Changes in the family ; Conclusion ; Roles and rights ; Marriages and unions ; Motherhood and mothers ; Breast-feeding and nutrition ; Reproductive rights ; Abortion ; Issues around HIV/AIDS ; Conclusion ; The caring career ; Caring for children ; Caring for older people ; Domestic work ; Conclusion ; Economic relations and realities ; Household negotiations ; The question of maintenance ; Earning an income ; Women-maintained households ; Conclusion ; Born to inequality ; The girl child ; Violence against women and children ; Traditional practices ; Status with age? ; Conclusion ; External influences ; Religion and culture ; The development process ; Economic crisis and recession ; Uprooted families ; A deteriorating environment ; Conclusion ; Building equality in families ; Gaining an identity ; Social policy ; Conclusion ; Conclusion: hope in change.
Notes : Inglés/anglais/English, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : This publication highlights numerous violations made on women who have undergone abortion in Chile, and examines the legal framework of Chile's abortion law, as well as the criminal procedure involved in these prosecutions. Chapter 1 describes the evolution of the protection of reproductive rights and how the prohibition constituted to violations on health-related and other human rights. Chapter 2 discusses Chilean health policy and abortion as the cause of public health problem. Chapter 3 provides analysis of domestic legislation and court records of women who were prosecuted for abortion, with discussions of actual individuals prosecuted for abortion. Chapter 4 summarizes the social and economic data on the women prosecuted for abortion, as well as on the abortion providers, which includes all women who had abortions, even those who were not prosecuted because they were minors or victims of abortion. Lastly, chapter 5 presents several recommendations at the national and international levels in the cessation of prosecution of women who have undergone abortion, with emphasis on the roles of international donors and the universal and regional human rights systems.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 143170Abstract : Estudio sobre la salud de la mujer en general.
Web site : http://www.unifem.org.mxAbstract : In an effort to promote women's reproductive health and rights, this report provides an overview of the manner in which national governments regulate women's reproductive lives in Brazil, China, India, Germany, Nigeria, and the US. By providing a summary of the laws and policies governing specific reproductive health and rights issues, the policy standards set by the individual nations are revealed. Issues discussed for each country are the formal organization of laws and statutes, health, the delivery and financing of health care, population and family planning policies and practices, contraception, abortion, sterilization, sexually transmitted diseases, HIV/AIDS, maternal health, maternity benefits, rape and other sexual offenses, miscellaneous reproductive health matters, and patient's rights. For each country, a table provides statistics on demographics, women's status, maternal health, contraception and abortion, sexually transmitted diseases, and HIV/AIDS.
Web site : http://www.crlp.org/Abstract : This report sets forth the national laws and policies in key areas of reproductive health and empowerment of women in nine Latin American and Caribbean countries; namely, Argentina, Bolivia, Brazil, Colombia, El Salvador, Guatemala, Jamaica, Mexico and Peru. Each country is discussed separately, but the organization of information is provided uniformly in four main sections to enable regional comparisons. The first section of each chapter briefly lays out the basic legal and political structure of the country being analyzed, providing critical framework within which to examine the laws and policies affecting women's reproductive rights. The second section of each chapter details the laws and policies affecting specific reproductive health and right issues. It reviews governmental health and population policies, with an emphasis on general issues relating to women's status. It also examines laws and policies regarding contraception, abortion, sterilization, HIV/AIDS and other sexually transmitted infections. In the third section of each chapter, it provides general insights into women's legal status in each country. It describes laws and policies regarding marriage, divorce, custody of children, property rights, labor rights, access and rules regarding credit, access to education, and the right to physical integrity, including laws on rape, domestic violence, and sexual harassment. The final section of each chapter focuses on the reproductive health and rights of the adolescents. The final segment discusses laws and policies relating to reproductive health, marriage, sexual crimes, and sex education.
Web site : http://www.crlp.org/Abstract : Title: Women of the world: laws and policies affecting their reproductive lives. Latin America and the Caribbean.Source: New York, New York, Center for Reproductive Law and Policy, 1997 Nov. 206 p. Also available in Spanish.Abstract: This report sets forth the national laws and policies in key areas of reproductive health and empowerment of women in nine Latin American and Caribbean countries; namely, Argentina, Bolivia, Brazil, Colombia, El Salvador, Guatemala, Jamaica, Mexico and Peru. Each country is discussed separately, but the organization of information is provided uniformly in four main sections to enable regional comparisons. The first section of each chapter briefly lays out the basic legal and political structure of the country being analyzed, providing critical framework within which to examine the laws and policies affecting women's reproductive rights. The second section of each chapter details the laws and policies affecting specific reproductive health and right issues. It reviews governmental health and population policies, with an emphasis on general issues relating to women's status. It also examines laws and policies regarding contraception, abortion, sterilization, HIV/AIDS and other sexually transmitted infections. In the third section of each chapter, it provides general insights into women's legal status in each country. It describes laws and policies regarding marriage, divorce, custody of children, property rights, labor rights, access and rules regarding credit, access to education, and the right to physical integrity, including laws on rape, domestic violence, and sexual harassment. The final section of each chapter focuses on the reproductive health and rights of the adolescents. The final segment discusses laws and policies relating to reproductive health, marriage, sexual crimes, and sex education.
Web site : http://www.reproductiverights.org/pub_bo_wowlatam.htmlAbstract : Chile is one of the last countries in the world where abortion is absolutely illegal. This paper reports on a study of 80 women who were prosecuted in Santiago for having had an abortion, mostly young women, eight of whom became pregnant following rape; 40 women who were prosecuted for performing aborh'ons, almost all older women; and 12 mainly friends and relatives who were prosecuted as accomplices. Most of the women who had abortions were single mothers; many were domestic workers who had migrated to the city from the countryside. The great majority were reported to the police by the public hospital where they sought treatment for complications. Many spent time in prison, and most had no legal representation or were defended by inexperienced law students from Legal Aid. This paper highlights the gender and poverty-related discrimination that poor women having abortions face in Chile, and how the law is used to undermine medical confidentiality Although the number of court cases for abortion has been decreasing in Chile since the mid-1980s, the threat of prosecution will persist as long as abortion remains illegal.
Web site : http://www.rhmjournal.org.ukAbstract : Citing information published in 2 Lancet articles (one by the research groups of Dr. Helena Coelho and Dr. Walter Fonseca and another by Sarah Costa and Martin Vessey), this article describes the misuse of the anti-ulcer prescription drug, misoprostol, which is actually obtainable over the counter, to induce abortion in Brazilian women. Its safety and efficacy are questionable. During a 2.5 year survey, Coelho found that 32% of the women admitted to the main obstetric hospital at Fortaleza had developed womb infections. Others hemorrhaged badly enough to require transfusions. Also, one-third of those who needed womb evacuations had used misoprostol or other illicit drugs to induce the miscarriage. Costa and Vessey discovered that 10% of the women studied who finished their pregnancies had initially attempted to use misoprostol as an abortifacient. Costa blames the lack of access to contraception for the rise in abortion attempts. Changes in prescription laws pertaining specifically to misoprostol have reduced its use in this manner.
Web site : http://www.thelancet.com/Abstract : Este libro toma en cuenta específicamente los aspectos femeninos en investigaciones demográficas. Examina la posibilidad de mejorar la vida de las mujeres a través del empoderamiento en diferentes contextos étnicos y culturales
Notes : Español/espagnol/SpanishAbstract : The gender approach to reproductive health care has many obstacles to overcome in its implementation in Brazil. Brazil officially endorsed the 1974 Declaration of Bucharest and the right of couples to control fertility and the public responsibility to provide the means of exercising that right. Modernization and the domination of social policy by elites has resulted in a decline in state participation in fertility control and a deterioration in public services. The public sphere was privatized during the military regime and thereafter. Private, internationally supported family planning agencies have operated in Brazil since 1965 and have remained almost completely unintegrated into the public sector. Feminist concerns have resulted in the official legitimization of the women's movement and the establishment of a national women's council. However the public recognition and the general indicators of gender modernity (fertility control and participation in the paid labor force) mask the situation of poor women's inappropriate use of contraception and continued poverty. 71% of women in any form of union in 1986 reported use of some form of contraception: 41% oral pills and 44% sterilization. Yet a 1984 national survey found that 25% of births in the preceding 5 years were a result of unwanted pregnancies, and 70% of women with 4 or more children had a smaller ideal family size. The private sector was the main source of supply for oral pills. Less than 50% of users had received a medical consultation before initiating use, and 23% used the pill incorrectly, as reported in 1984 survey. 40% of pill users were smokers and almost 50% had health problems that contraindicated pill use. Abortion complications have risen dramatically during 1978-90. Fertility control in Brazil has meant long-term cumulative effects of incorrect, contraindicated oral pill use, clandestine, unsupervised surgical sterilization, and illegal abortion; the impact of sexually transmitted disease and anemia is not even known due to poor statistical recording. Brazil's Program of Comprehensive Health Care for Women represents ideological gains, but public institutional inadequacy, insufficient national allocation of resources, and a low level of political priority remain obstacles to improvement in women's status.
Web site : http://www.sciencedirect.com/science/journal/02779536Abstract : Despite strong legal and religious sanctions, an estimated 1.4 million induced abortions occur each year in Brazil. To obtain information on the biopsychosocial determinants of induced abortion, interviews were conducted with 66 women who had recently undergone induced abortion and 25 key informants from Fortaleza, an impoverished city in the extreme northeast of Brazil. Notable were "hidden reproductive transcripts," deeply embedded in popular culture, that served to protect women from the hegemonic anti-abortion ideology. Respondents used euphemistic, veiled terms to avoid the reprisals that direct statements about abortion would provoke. The distinction between intentionally induced and spontaneous abortion was ambiguous. Underlying this transcript was the cultural view of delayed menstruation as a serious illness that disrupts a woman's bodily equilibrium. Women tended to mask undesired pregnancies as a delayed menstrual period. A pregnancy conceptualized as delayed or arrested menstruation could thus be "regulated" by herbal remedies and over-the-counter patent drugs as an essential part of reproductive health care. When these methods failed to induce menstruation, women sought out the now banned abortifacient agent, misoprostol. Women spoke of provoking bleeding, without reference to fetal tissue. This strategy should be viewed as an adaptive collective response on the part of poor, powerless Brazilian women to the chronic lack of family planning services, especially in northeast Brazil.
Web site : http://www.sciencedirect.com/science/journal/02779536Abstract : The aim of this paper is to review the living conditions of women in Latin America and the relationship to maternal mortality. An obstacle is the lack of valid data on maternal mortality and influential factors. Several methods of research analysis, such as use of death registers and census data or sisterhood data, are needed. Maternal health care interventions must be tailored to the population being served and involve intersectoral cooperation, the community served, and health care facilities. Maternal mortality defined as death from obstetric causes is deceptive, because mortality is also affected indirectly by causes outside the delivery room. Scarce medical care resources, poor social circumstances, and the multiple roles of women place them at high risk of maternal death. Lack of education or cultural beliefs affect the awareness of at-risk symptoms; resources available to women also affect access to health care. Treatment, such as abortion, may not even be available. The following social factors are discussed as relevant to placing women at a disadvantage and sometimes endangering their health: the social pressure to have large families, discrimination against women, and working conditions. A cycle of ill health may be perpetuated for generations, or within the woman's life cycle. Distance, transportation problems, cost, and poor quality of available care also impact on maternal health. Within the available health care system, there may be a lack of essential equipment and supplies, unskilled personnel, absence of a referral system, and/or insensitivity of health care providers. For these reasons, women in rural areas of Latin America seek midwives who are respected community members, but may lack the training for a high-risk delivery. In cities, transportation, affordability, and quality of care are issues. The lack of family planning also affects the risk. Other social and economic conditions impacting on risk are income, education, housing, sanitation, and nutrition. The maternal health care model proposed by Dixon-Mueller integrates more maternal health and family planning services into existing primary health care within the community and at first level referral facilities. This model is described. Interventions dealing with reducing death from induced, illegal abortions are also indicated.
Web site : http://publications.paho.org/english/moreinfo.cfm?Product_ID=557Abstract : In Latin America, where abortion is almost universally legally restricted, medical abortion, especially with misoprostol alone, is increasingly being used, often with the tablets obtained from a pharmacy. We carried out in-depth interviews with 49 women who had had a medical abortion under clinical supervision in rural and urban settings in Mexico, Colombia, Ecuador and Peru, who were recruited through clinicians providing abortions. The women often chose medical abortion to avoid a surgical abortion; they thought medical abortion was less painful, easier or simpler, safer or less risky. They commonly described it as a natural process of regulating their period. The fact that it was less expensive also influenced their decision. Some, who experienced a lot of pain, heavy bleeding or a failed procedure requiring surgical back-up, tended to be more negative about it. Regardless of legal restrictions, medical abortion was being provided safely in these settings and women found the method acceptable. Where feasible, it should be made available but cost should not have to be women's primary reason for choosing it. Psychosocial support during abortion is critical, especially for those who are more vulnerable because they see abortion as a sin, who are young or poor, who have limited knowledge about their bodies, whose partners are not supportive or who became pregnant through sexual violence.
Web site : http://www.ipas.org/english/press_room/press_room_pdfs/RHM_LAC_womens_perspec_med_ab.pdfAbstract : This presentation, presented in an international workshop in Mombasa in 2000, argues that rather than just taking postabortion services to scale, it is more important to take a preventive approach to scale, in addressing the legal, political and programmatic factors that perpetuate unwanted pregnancy and unsafe abortion. The paper refers to the rights and needs of women who have experienced complications of abortion or miscarriage and who as such, constitute a major focus of concern in postabortion care services. The areas of internationally recognised human rights which are particularly relevant to women's postabortion care are those relating to gender equity, and to sexual and reproductive life and health. By examining four excerpts of transcripts of interactions observed in Bolivian public health services, the author demostrates gaps between officially stated policy and international agreements, and providers' practices in women's clinic consultations. While not necessarily representative, the mere possibility of the occurrence of negligent or even abusive behaviour in health clinics, can alert policy makers and activists to the need for decisive measures to prevent such barriers to womens' efforts to safeguard their own sexual and reproductive health.
Notes : Inglés/anglais/EnglishAbstract : Las formas discriminacion a las mujeres embarazadas en Perú.
Notes : Inglés/anglais/EnglishAbstract : A politics of silence cloaked the subject of abortion, both in mainstream institutions and alternative political spaces in the first decades of this century in Argentina. Women did not speak out on the issue either, and during the years of Eva Peron sexuality was left out of public debate completely. It was not until the 1970s that the issue of abortion was first articulated and became part of the language of feminism. Fifteen more years would have to pass - and a different historical situation to evolve, alongside the growing feminist movement-for this demand to be widely supported. Abortion is no longer a dark and hidden subject in Argentina. Starting from the liberating impulse of feminism, it is slowly being incorporated into the demands of the women's movement for civil rights. This paper narrates the complex road the women's movement has taken to try to win abortion rights and attempts to stimulate an open discussion about sexual rights.
Web site : http://www.rhmjournal.org.uk/Abstract : In order to break the cycle of unwanted pregnancy and unsafe abortion, IPAS developed an educational campaign to improve quality of care and encourage voluntary use of family planning after abortion. In Bolivia and Chile, female interviewers conducted semi-structured interviews with providers and patients about their perceptions of the quality of care as well as women's informational needs following treatment in the hospitals. In Chile, some follow-up interviews were conducted with women in their homes. In Temuco, Chile, a total of 106 patients and 16 providers were interviewed during March-June, 1993. In La Paz, Bolivia, 12 patients and 14 providers were interviewed during April-July, 1993. Researchers obtained basic demographic and qualitative data, including information on family structure, patient's experience in the hospital, medical complications, attitudes toward use of family planning, and history of and feelings about abortion/miscarriage. After the study, doctors, nurses, aides, and social workers in both countries began to examine their attitudes in order to suggest changes in hospital policies regarding abortion. In Bolivia, some hospital staff believed they were supposed to turn away patients with incomplete abortion. In one Chilean hospital, women suffering from abortion complications were reportedly forbidden to use the toilet unless they themselves washed the toilet with bleach after use. Soon after the study, 2 hospitals changed their policies. Patients in both Temuco and in La Paz communicated a desire for members of the health care team to be more caring and sympathetic. In addition, the women wanted more information about their clinical condition, the treatment, and type of anesthesia to be used. Many Bolivian women feared modern methods, preferring traditional methods. In Chile, most of the 106 women hospitalized for miscarriage were concerned about their future ability to conceive. As a major change the tertiary care hospital in Temuco, Chile, started to provide oral contraceptives to women who wanted them, while continuing to refer women to lower level facilities for other family planning methods.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 101579Abstract : The country reports of national policies concerning induced abortion in different countries
Notes : Inglés/anglais/English, nbsp;source : United NationsAbstract : A recent collection of reports in the World Press Review on the current state of abortion in several nations is discussed. In Brazil, which is predominantly Catholic, abortion is a criminal offense except in the case of rape or endangerment to the mother's life. Still, they reportedly have some 4,000,000 abortions a year. In China, on the other hand, abortion is unintentionally promoted: an unwanted pregnancy implies for the local authorities a failure of the system. Abortions, therefore, go unreported. Ironically, prenatal sex determination contributes to the incidence of abortion if a fetus proves to be a female. India shares this gender prejudice to the extent that the Parliament is considering a Medical Termination of Pregnancy Act prohibiting abortion solely on the prenatal diagnosis of a female fetus. A study of the 1986-87 experience revealed that sex tests led to the aborting of some 50,000 female fetuses. In Japan there are some 500,000 abortions each year. Fear of AIDS is blamed by the government for refusal to legalize the pill. However, some billion condoms are sold each month. Abortion has long been accepted as the most common form of birth control in Russia, where the two condom factories have closed because of lack of latex, and intrauterine devices have been withdrawn from the market. The present supply of contraceptives is expected to run out by the end of 1992. In Turkey, abortion is legal up to the 10th week and the country records some half million annually. Romania has the highest abortion-to-live-birth ratio, with 3 abortions for each live birth. The country leads Europe in maternal deaths and hepatitis B infection. In South Africa only 800 to 1000 legal abortions are performed a year, 77% of which are for psychiatric reasons. Three physicians must authorize the procedure, and Black nurses in Soweto are reported to be extremely hostile to abortion. In Ireland abortion is prohibited, therefore patients go to England for abortion.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 083689Abstract : In the period between 1965-70 and 1980-85, fertility has declined 30% overall among developing countries from 6.0 to 4.2 children/women of childbearing age. This progress is 1/2 of the fertility decline needed to reach replacement levels. This and other information was presented at the Demographic and Health Surveys (DHS) World Conference of August, 1991, attended by 650 participants from 63 countries. It was the result of 36 DHS surveys in 32 developing countries over a 7-year period. In these surveys, DHS questioned over 180,000 women aged 15-49. Men were also interviewed in Ghana, Kenya, Mali, and Burundi. Research was conducted to provide information to countries useful in making policy decisions, expand international population and health data bases, and develop technical skills and resources in participating countries to undertake future surveys. Frequently chosen additional surveys modules explored the height and weight of children, service availability, and health. Observed fertility declines are quite remarkable when one considers the difficulty of challenging attitudes and behaviors about the roles of family, women, and children in many of these countries. While enormous progress has been made, continuing family planning interventions are urgently needed to quash remaining unmet need. To reduce fertility levels to replacement, present achievements must be maintained, while previously unresponsive regions and countries are targeted for change. Declines have been most marked in Eastern Asia and Latin America, while virtually no reductions have occurred across most of sub-Saharan Africa. The DHS will continue monitoring the effect of family planning programs on changing fertility.
Notes : Inglés/anglais/English, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - PIP 070472Abstract : [para los uruguayos] Salvadas las formas, los hechos no cuentan" Carlos Quijano. El eco del juicio de Quijano me acompañó mientras escuchaba los beneplácitos de 98 diputadas y diputados que, el 15 de febrero, votaron a la maestra Nora Castro como presidenta de su Cámara. Un tópico a lo largo del extenso ditirambo rué la afirmación que esta "primera vez en la historia" que se designa una mujer como presidenta, señala un "nuevo momento" una "nueva hora" una "nueva presencia" -entre otras novedades político culturales- en relación con la situación de las mujeres uruguayas.
Web site : http://www.bitacora.com.uyAbstract : The aim of this book is to offer practical guidelines to the adolescent population, 12-19, going through a stage of life filled with doubts and questions generally referred to as "the adolescent crisis". The book is also aimed at faculty, parents and people interested in understanding issues related to the period of adolescence. The themes covered in the book are: 1) biological aspects of human reproduction (male and female); 2) self-esteem (communication, assertiveness, Decision making, responsibility and values); 3) sexual relations and love (a personal decision); 4) methods of contraception; 5) pregnancy (a shared decision); 6) abortion (an option or an accident); 7) sexually transmitted diseases (unnecessary risk); 8) sexual deviations (personal conflicts); 9) nutrition (requirements for healthy development); 10) drugs (a temporary threat); 11) work (a privilege); 12) marriage (a compromise); and 13) achievement and success (reward for the effort). Each chapter contains illustrations and charts highlighting the major themes proposed. A bibliography is included.
Notes : Español/espagnol/Spanish, nbsp;Abstract : Popline (http://db.jhuccp.org/popinform/basic.html) - CPFH 27701cr990Abstract : Latina women have often been portrayed as holding strong traditional family values leading to a greater propensity for rejection of contraception and abortion. Increasingly, the literature has consistently shown that Latina women use contraception effectively when available; however, much less is known about the prevalence of abortion and the factors related to its use in this population. In this article we examine Latinas' use of abortion and identify factors affecting its use among 1,207 ever-pregnant Latina women age 14-24 recruited at two federally-funded family planning clinics in the Los Angeles metropolitan area. Only a small proportion of the young women in our sample (7.5%) had ever had an induced abortion. In multivariate analysis the variables significantly associated with past abortion included less traditional attitudes about women's roles, higher gravidity, shorter periods of sexual activity, and a higher number of lifetime sexual partners. We conclude that use of abortion among Latinas is driven by role orientation and reproductive variables.
Web site : http://www.tandf.co.uk/journals/titles/07399332.aspAbstract : Presentamos un breve análisis de los resultados de las encuestas de opinión que contrataron en cada uno de sus países, las Católicas por el Derechoa Decidir (CDD) de Colombia, Bolivia y México con el apoyo de CFFC (Catholics for A Free Choice) en el año 2003 y CDD de Brasil en febrero del2005. Las encuestas realizadas fueron representativas a nivel nacional y exploraron las opiniones de la feligresía católica acerca de los derechos sexuales y reproductivos, el papel de la Iglesia y sus relaciones con el Estado. Dicha encuesta fue aplicada en áreas rurales y urbanas y recogió además información sobre temas relacionados con el papel de la Iglesia católica en la política y la educación. En el caso del Brasil la encuesta fue aplicada a toda la población, especificando la religión que profesan los entrevistados, lo que permite trabajar con la información proporcionada solamente por las personas católicas.
Web site : http://www.catolicasporelderechoadecidir.org/publicacionesAbstract : De acuerdo con el censo de población de la Argentina, en 1980 los nacimientos a madres entre 14 y 19 años alcanzaron a 66.673, cifra que segun las estadísticas vitales asciende a 91.509 (p.2). Tanto el número absoluto como la tasa de fecundidad de menores de 20 años descendieron entre 1980 y 1985, registrándose en ese último año una tasa de fecundidad de 32,9 por mil entre los 10-19 años y de 67,9 por mil entre los 15-19 años de edad (p.4). Casi la mitad de los nacimientos se da dentro de un matrimonio legal y un 17. adicional en uniones de hecho, siendo probable que los matrimonios se produzcan a raíz del embarazo (p.5). La evidencia sugiere una relación inversa entre el nivel de educación alcanzado y el nivel de la fecundidad.
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Introducción ; La constitucionalidad del aborto en Argentina ; Conclusión ; Notas
Notes : Español/espagnol/Spanish, nbsp;Abstract : PRASSAR/CENEP/OMSAbstract : Lejos de desalentar el aborto en México, la prohibición de esta práctica ha contribuido, sobre todo, a que se realice de manera clandestina y-muchas veces- en condiciones de riesgo. El costo ha sido enorme: cada año un gran número de mujeres mexicanas -mucho mayor de lo que indican las cifras oficiales-interrumpe su embarazo en condiciones inseguras. Muchas de ellas mueren o sufren daños irreversibles a su salud.Este documento tiene el propósito de invitar a las personas interesadas en el tema a conocer más sobre el problema del aborto clandestino y a considerar la necesidad de modificar la legislación vigente, para prevenir las graves consecuencias que éste ocasiona cuando se realiza en condiciones inadecuadas, como ocurre en la gran mayoría de los casos.Contenido: Introducción; 1. El costo de prohibir una práctica socialmente aceptada; II. Acceso al aborto seguro y derechos humanos ; III. Despenalización: una tendencia mundial ; IV. La situación legal del aborto en México: lo que falta por hacer ; Glosario
Web site : http://www.gire.org.mx/www.gire.org.mx/contenido.php?Información=166Abstract : En la ciudad de Santa Cruz de la Sierra, Bolivia, in 1993, una petición de aborto impune (figura reconocida en el Código Penal de 1972) fue presentada a favor de dos hermanas adolescentes, violadas y embarazadas por su padre. La petición fue negada debido a las tácticas de demora implementadas por un juez de la Corte Suprema, respaldadas en sus principios evangélicos. El caso fue documentado por una renombrada periodista, por encargo del Grupo de Trabajo sobre Embarazo No Deseado y Aborto. Esta investigación llegó a constituir la base para la estrategia de grupos de activistas por el derecho a decidir, centrada en la exigencia de la reglamentación del Artículo 266 del Código Penal sobre aborto impune.
Web site : http://www.cladem.org/espanol/nacionales/bolivia/informe_aborto.aspAbstract : Presentación ; 2. Apuntes para una historia de la bioética ; 3. Bioética, la ciencia de la supervivencia ; 4. Bioética (médica) como una disciplina ; 5. Presente y futuro de la bioética ; 6. Bioética: un nuevo concepto y una nueva responsabilidad ; 7. La bioética en la educación médica. El punto de vista de un filósofo ; 8. Fundamentación antropológica de la bioética ; 9. Institucionalización de la bioética ; 10. Bioética ; 11. ¿De qué hablamos cuando hablamos de bioética? ; 12. Veinte años de bioética ; 13. Veinticinco años de bioética ; 14. Bioética en América Latina ; 15. Realidad y sentido de la bioética en el plano mundial ; 16. Funciones del bioéticista.
Web site : http://www.gire.org.mx/Abstract : En marzo del 2001, Planned Parenthood de San Diego y Riverside (PPSDRC) llevó a cabo una encuesta entre a población femenina latina del estado norteamericano de California sobre la planificación familiar y aborto, que fue financiada por Fund for the Future Grant de Planned Parenthood Federation of America. Esta encuesta se extendió a la población femenina residente en el estado mexicano de Baja California mediante la participación del Departamento de Relaciones Binacionales de PPSDRC y gracias al apoyo económico de Planned Parenthood Affiliates of California (PPFA). Para ambas partes de esta encuesta binacional, PPSDRC contrató los servicios del Social Science Research Laboratory of San Diego State University (SDSU) la cual, a su vez, subcontrató a la empresa mexicana Cárdenas, Viveros y Asociados, sociedad civil para realizar las entrevistas en Baja California. Finalmente la presente publicación de los resultados de la encuesta de Baja California estuvo a cargo de la Dra. Norma Ojeda, quien a su vez fungió como investigadora principal del proyecto.Objetivo de la publicación : La planificación famiiar y el aborto son temas que interesan a la opinión pública en general y a un gran número de ciudadanos en lo particular. El levantamiento de encuestas profesionales es un mecanismo que nos permite recabar información confiable y objetiva sobre lo que piensa la opinión pública de estos importantes temas. Sin embargo, la población pocas veces tiene conocimiento de los resultados obtenidos en dichas encuestas debido a mecanismos limitados de difusión. Esta publicación busca hacer más accesible al ciudadano y a la ciudadana promedio, algunos de los hallazgos obtenidos sobre la manera de pensar de la población femenina residente en Baja Califonor, acerca de la planificación familiar y el aborto mediante la realización de la Encuesta de actitudes sobre planificación familiar en Baja California.
Web site : http://www.modemmujer.org/El_Estante/Web's/aborto.htm