Conclusions

Studies on abortion in Latin America and the Caribbean, as well as in other parts of the world, have predominantly centered on the effects of the practice of abortion on women. Nonetheless, over the past several years, several although insufficient studies have examined the attitudes and involvement of males. Their results demonstrate the relevance of the theme, not only as part of acquiring a broader understanding of abortion, but in that it points out the urgent need to include men within the sphere of public interventions.

As part of the review accomplished here, it is worth highlighting the theoretical and methodological framework used in the studies conducted in the region on the role of males in the practice of abortion. One perspective is the “relational" one, which places emphasis not only on social and cultural processes, but also mainly on relationships between the actors within the circumstances in which abortion takes place. A second, closely linked approach is that of the gender perspective, within which special attention is paid to masculine and feminine identities and roles, power relationships, inequality between the genders, and male domination of woman, as part of the cultural constructs of a set social structure. Both approaches have raised pertinent questions on the traditional focus according to which reproduction and its processes are the exclusive responsibility of women, and sexuality is the area of male dominance. Similarly, both the relational and gender perspectives illustrate the need to advance beyond the classical indicators included in socio-demographic research. From these approaches, it is possible to construct a more precise, comprehensive analysis of the social, cultural, and institutional dimensions intervening in the domain of sexuality and reproduction, and therefore, abortion.

The evidence presented as well as in preceding chapters on the male role in the issue of abortion in different issues and circumstances is overwhelming and demonstrates the pertinence of both perspectives. In the public sphere, men are nearly always charged with legally regulating the practice of abortion or determining the moral, social, or religious sanctions imposed on those who abort. They tend to establish public policies on reproductive-health matters, which determine, among other things, the functioning of the medical services where abortions are practiced. In private confines, males also tend to wield a determining influence in matters concerning abortion, as authors, protagonists, and those responsible (together with women) for women’s sexual and reproductive practices. The male is often the partner who decides on whether contraceptives will be used to prevent unwanted pregnancies than can end in abortions, and he frequently influences and determines, whether directly or indirectly, whether the woman continues or ends a pregnancy.

The regional studies conducted in the region concur on the diversity of roles that males assume in unwanted pregnancies and the practice of abortion. These include various levels of presence and participation, passive as well as active, and acceptance, rejection, coercion, or indifference in the use of contraceptive methods, and in the abortion decision-making process, the way abortion is carried out, and the consequences of this act. Some research demonstrates and warns that these roles are not unequivocal, nor can they be generalized, in that they depend on diverse material conditions, socially constructed cultural norms, and attitudes among the various social and generational groups. Moreover, the dynamic and changing character of male participation in abortion is underscored in terms of distinct male life experiences at different points in their sexual and reproductive lives.

Other findings highlight the perceptions and significance of males regarding responsibility for preventing a pregnancy. Many males hold that this responsibility is exclusively that of the woman, their partner; if she accepts sexual relations, she should assume the consequences regarding her health, the risk of ending a pregnancy, and other aspects of her life. On the other hand, an ambiguous, preventive and even contradictory attitude prevails among other males. Many of them tend to elude their responsibility regarding contraception while at the same time affirming their dominant position in the relationship with regard to controlling whether their partner continues with an unexpected pregnancy. The evidence suggests that males use contraception (specifically, condoms) when they perceive that their health is threatened, for example, when faced with the possibility of acquiring STDs. However, when the health of their partners could be at stake (as a result of abortions performed under risky conditions, for example), males do not always participate in preventive measures, often do not accept any contraceptive practice, will only use less effective methods, or use the methods incorrectly.

In this regard, other researchers explore the different attitudes towards the practice of contraception, which are closely linked to occurrences of abortion. It has been stated, for example, that information on and availability of contraceptives does not guarantee their use, and that its use depends on the existence of a culture of prevention and the co-responsibility of the couple when having sexual relations. Further, condom use, as one of the few preventive methods available to males and the one most frequently employed by them, leads to situations of tension and conflict in the couple’s relationship. Studies document the negative perception and rejection of condom use, due to an expectation of reduced sexual pleasure, decreased spontaneity in relations, physical discomfort, or fear that the condom will fail. Studies also mention the processes of negotiation for condom use, processes which suggest a situation of greater dependence by the women and of control and dominance by the male.

There have also been significant findings on the importance of the couple’s type of emotional bond, the formality of their relationship, and their living arrangement, in the decision whether or not to use contraception or to end a pregnancy. The greatest male responsibility and support is found among stable couples and in those who maintain affective relationships, a situation generally not found in parallel or sporadic relationships or in relationships in which there are no sentimental ties. Likewise, evidence has been found that the degree of consensus or conflict in the couple determines the way in which men as well as women process the decision on abortion. It has been proven that agreement or disagreement in a couple concerning this practice it is associated on communication and negotiation within the couple. This is also closely related to evidence suggesting that, in couples whose interrelationship is more equal, with less gender inequality, there is a greater tendency to negotiate on whether or not to resort to an abortion and the conditions under which it is practiced.

Despite these findings, there continue to be few research projects conducted in Latin America and the Caribbean on the influence of the male on the practice of abortion according to socioeconomic conditions, intergenerational differences, and access to institutional programs such as family planning. Notwithstanding this, some empirical evidence suggests, for example, the presence of intergenerational ruptures regarding their perceptions and practices, particularly among young men. This population sector engages in more frequent questioning and reconstruction of the traditional and hegemonic masculinity model, particularly in the middle and upper class sectors, which can contribute to males’ assuming an attitude of greater co-responsibility in the decision to end an unexpected pregnancy or to prevent one.

Knowledge remains scarce on male attitudes and practices concerning the interruption of an unwanted pregnancy. There has been an increase in the theoretical-conceptual development of this issue, which must be incorporated into specific studies in the region. Another limitation is the nearly total absence of quantitative studies on a national scale, in urban or rural contexts or studies differentiated by socioeconomic strata directed specifically toward males, which would provide information on the various characteristics and modes of participation in this problematic issue. In this respect, it is important to emphasize the contribution of existing qualitative research that delve profoundly into, among other items, knowledge on the perceptions, attitudes, and involvement of males. The results of these studies show the complexity of the circumstances influencing decision-making associated with sexuality and reproduction, including decisions to end a pregnancy. Above all, these studies offer pathways to orient future research investigations that will allow a deeper understanding of the other significant protagonist in reproductive processes: the male.

Broader and more rigorous knowledge on the theme should undoubtedly contribute to obtaining more efficient public interventions in reproductive-health, a field in which the great majority of countries in the region continue to experience severe backwardness. In the meantime, the lack of information on aspects such as male reproductive behavior is reflected in different ambits. It is evident, for example, that campaigns and interventions to promote contraceptive used continue to be oriented mainly toward women, without taking into consideration the relevance of the negotiation that must occur with her partner in deciding whether to utilize or reject these methods, or the fact that in many cases, the woman’s partner is the one who imposes his will. In the face of this situation, researcher Hernando Salcedo (1999, cited p.6 in GIRE, 2001) underscores the need “...for the politics of contraception to incorporate masculine representations and practices, with the objective of including men’s potential in the diverse forms of contraception and to change the attitudes of women who do not accept masculine support in the matter”. In this same respect, Guevara (2000) emphasizes that it is necessary ”…to incorporate males into sexual and reproductive health programs, particularly if the existence of .relationships that facilitate the assumption of certain practices of co-responsibility and others that justify delegating the costs and obligations of pregnancy prevention and abortion resolution to women is recognized” (quoted p.6 in GIRE, 2001).

At present in Latin America, there is increasing recognition of the importance that males have in the sphere of reproduction, as in the case of abortion. Nonetheless, research on the theme should be promoted to a greater extent. Better understanding of this issue could contribute to, among other things, facilitating public politics that pave the way for substantially reducing the cost abortion continues to exact on a large number of Latin American women, on whom it is usually performed in unsuitable conditions.

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