Women interviewed in NFHS-2 were not asked to provide the exact dates of pregnancy terminations. In the birth history segment of the questionnaire, they were asked to report whether they had a terminated pregnancy between each birth, as well as before and after the first and last births. Because the pregnancy outcome record is linked to the birth records, the only way to determine the approximate date of when an inducedabortion occurred is to look at abortions that happened after the most recent birth or births. Inducedabortion during last 5 years could have been analyzed to minimize lifetime abortion experience and give a better association between inducedabortion and reproductive health. However, when we looked at women whom we knew had an inducedabortion in the last 5 years because they had at least one birth in the last 5 years, we realized we were biasing the sample toward more fertile women— exactly the women who were least likely to have experienced reproductive health problems, as many reproductive health problems can lead to infertility. A major limitation of the current analysis, therefore, is the possible time elapsed between experience of inducedabortion (which could have happened at any point in a woman’s lifetime) and reproductive health problems in the 3 months before the interview. Moreover, the study is based on reported symptoms and experiences of reproductive health problems. Therefore, although we get a clear positive association between number of induced abortions and reproductive health problems, the results should be interpreted with caution.
Objectives: To identify the nursing academics positions front the practice of inducedabortion; to verify the focalization approached about the question of abortion during the nursing academic formation and to discuss the influence of verify positions in the care the woman who had an abortion. Methods: Utilizing the qualitative approach has with instrument for collection of dies one questionnaire. The subjects were 35 nursing academics of 6th, 7th and 8th period from one public university of the city of Rio de Janeiro. Results: After analysis two categories emerged: 1) weaving judgement of value; and 2) obstacles in the apprentice. Conclusion: We realized the necessity to incorporate discuss more clespen in the formation of nurses about this thematic, to who the judgements everyone not interfere of negative way in the care with the women who had an abortion, terminating with the personal culpability. Descriptors: Abortion, Nursing, Nursing students.
We found the following variables to be determinants (p<0.001) of practicing an inducedabortion: women age from 10 to 19 years old (OR=23.60; CI 5.08 – 109.5), having a partner (OR=4.6; CI: 2.51 – 8.45), women aged up to 13 years old at first sexual intercourse (OR=7.1; CI:0.88 – 57.0), age of first pregnancy up to 14yo (OR: 1.82; CI: 0.23 – 14.38), not having any children (OR: 13.12; CI: 4.29 – 40.09). Having used condom during last sexual intercourse (OR: 2.74; CI: 1.24 – 6.05) was also determinant of inducedabortion (p=0.013). A high proportion of women who underwent an inducedabortion (86.8%) did not attend a single antenatal care (ANC) visit and this was determinant (p=0.032) of occurrence of inducedabortion (OR: 1.97; CI: 0.47 – 8.25). Other determinants were not considered to be statistically significant. Details for each variable are listed on Table 3.
Among single women (Table 3) the trend in the inducedabortion differentials is the inverse of that observed previously. The proportion of abor- tions per pregnancy did not differ among users or between users and non-users of contraceptive methods (p = 0.141). It is thus quite plausible that non-users of contraceptives include women less exposed to the risk of pregnancy, even virgins, who thus fail to exercise effective control over their fertility, but end up using inducedabortion in extreme situations. The case of contraceptive users is different. Since they are more exposed to becoming pregnant, they seek to exercise control over their fertility, but turn to inducedabortion should their contraceptive method fail. But among users of effective contraceptives the probability of an unwanted pregnancy is certain- ly lower than among users of other less effective
Providing care to women in situations of inducedabortion constitutes one of the most challenging eth- ical problems for healthcare professionals, especial- ly for gynecological and obstetric doctors. This chal- lenge is reflected in the fact that, in Brazil, although permitted by the Penal Code of 1940, access to legal abortion is still problematic, mainly when the preg- nancy results from rape. In some reference services, prevails a regime of constant suspicion about the ve- racity of the woman’s narrative on rape: her story is not sufficient for getting access to the procedure, be- ing necessary to prove herself as a victim of aggres- sion and to present subjective traits that characterize her as such. 1 Obstruction to legal abortion also oc-
Though the analysis presented in the present ar- ticle refers only to information collected by conven- tional methods, that is by direct survey, it should be noted that it is exactly the RRT that lends credibility to the results given here. More precisely, the con- frontation of RRT results with those derived from direct survey permitted the identification of the cat- egories of women who resort most frequently to in- duced abortion with the women who most often avoid this practice. In other words, the tendencies detected by conventional, explicit survey questions on induced abortions are trustworthy. However, the RRT was indispensable in determining levels of induced abor- tion. Since abortion is considered a criminal action, the incidence of inducedabortion is severely under- estimated. The RRT provides evidence to the effect that this underestimation rate, during a calendar year, is something around 80%.
AbstrAct: Objectives: This study aims at estimating the prevalence of women with inducedabortion among women of childbearing age (15-49 years) who had any previous pregnancy, in the city of Sao Paulo, Brazil, in the last quarter of 2008, and identifying the Sociodemographic characteristics (Sc) associated with it. Methods: A cross-sectional survey was carried out. The dependent variable was dichotomized as: no abortion and inducedAbortion. The independent variables were: age, paid work/activity, familial monthly income, schooling, marital status, contraceptive use and number of live births. Statistical analysis was performed using log-binomial regression models with approximation of Poisson to estimate the Prevalance ratios (Pr). Results: Of all women with any previous pregnancy (n = 683), 4.5% (n = 31) reported inducedabortion. The inal multivariate model showed that having now between 40 and 44 years (Pr = 2.76, p = 0.0043), being single (Pr = 2.79, p = 0.0159), having 5 or more live births (Pr = 3.97, p = 0.0013), current oral contraception or iUD use (Pr = 2.70, p = 0.454) and using a “non efective” (or of low eicacy) contraceptive method (Pr = 4.18, p = 0.0009) were sociodemographic characteristics associated with inducedabortion in this population. Conclusions: inducedabortion seems to be used to limit fertility, more precisely after having reached the desired number of children. The inadequate use or non-use of efective contraceptive methods, and / or the use of contraceptives “ non efective”, exposed also the women to the risk of unintended pregnancies and, therefore, induced abortions. in addition, when faced with a pregnancy, single women were more likely to have an abortion than married women.
hypothesis of normality, α = 0.9639; the maximum likelihood test for the redundancy of ixed efects indicated that these were diferent at a level of signiicance of 0.01% (83.40; p < 0.0001). he results showed how higher levels of average national income and increased investments in public health reduced the incidence of inducedabortion [GDP (-6.1841; p = 0.0000), ISALUD (-7.7007; p = 0.0002)]. he variability of the sociodemographic factors afecting the reproductive behavior manifested in the sign and statistical signiicance of sociodemographic factors peculiar to each country: civil status, female employment, migration rate and adolescent fertility rate [SYD (21.4442; p = 0.0023) TEF (-4.2911; p = 0.00001), TFADOLESCENTES (-3.0200; p = 0.0423), TMIGRACION (3.6991; p = 0.0000)].
From the analysis of the data, regarding the perceptions of these nursing professionals about healthcare provided to women in process of inducedabortion, the following categories were obtained: they understand abortion as a crime and a sin, a fact that drew our attention primarily, and second, that the healthcare provided is discriminatory. In short, even in cases regarded by law, i.e. when the woman has already been through the judicial process, with a sentence in favor of the interruption of pregnancy, the nursing professionals still consider this practice as a crime.
In the above m entioned regions, inducedabortion is a sensitive issue, and, in most cases, also illegal. Truthful responses on surveys can result in moral or even legal coercion. As a con- sequence, conventional face-to-face interviews have found high levels of refusals and of non- responses. Because of the fear of moral and legal coercion am ong wom en, m ore than ensuring confidentiality, an abortion survey has to give respondents a strong feeling of confidentiality. The ballot-box technique is one of the simplest ways to give this feeling. It consists of a self-re- sponded written questionnaire, answered by lit- erate women which is then put in a ballot-box. The ballot-box is promptly associated with the secrecy of political elections, an association that increases response rates.
Lara D, Garcia SG, Ellertson C, Camlin C, Suarez J. The m easure of inducedabortion levels in Mexico u sin g r an d o m r esp o n se t ech n iq u e. Sociological Methods and Research 2006; 35(2):79-301. Zam u dio L, Ru bian o N, War ten berg L. The in ci- den ce an d social an d dem ographic characteristics of abortion in Colombia. In: Mundigo AI, Indriso C, editors. Abortion in the developing world. Lon - don, New York: Zen Books; 1999. p. 149-172 Lara D, Strickler J, Olavarrieta C, Ellertson C. Mea- suring inducedabortion in Mexico: a com parison of fou r m eth odologies. Sociological M ethods and Research 2004; 32(4):529-558.
Objective: This study is aimed to develop and validate the contents of the Mosaic of Opinions on InducedAbortion (Mosai), a structured questionnaire intended to be used as a tool to collect information about the views of health professionals about the morality of abortion. Methods: The contents of the first version of the questionnaire was developed based on the technique of thematic content analysis of books, articles, films, websites and newspapers reporting cases of abortion and arguing about their practice. The Mosai was composed of 6 moral dilemmas (vignettes) related to inducedabortion, of which outcomes should be chosen by the respondents and could be justified by the classification of 15 patterns of arguments about the morality of abortion. In order to validate its contents, the questionnaire was submitted to the scrutiny of a panel of 12 experts, an intentional sample consisted of doctors, lawyers, ethicists, sociologists, nurses and statisticians, who evaluated the criteria of clarity of writing, relevance, appropriateness to sample and suitability to the fields. These scores were analyzed by the method of concordance rate, while the free comments were analyzed using the analysis technique content.
As shown in Chart 2, the age of girls inter- viewed at the time of inducedabortion ranged from 12 to 17 years. Three young girls performed abortion between 12 and 14 years of age, and sev- en young girls did so between 15 and 17 years of age. The age of partners at the time of inducedabortion ranged from 17 to 42 years. Only one teenager aborted a partner under the age of 18. Six of them underwent abortion with a much older partner, with age gaps ranging from 6 to 30 years. Nine young females were abused by a part- ner over the age of 18. Two young girls (3 and 8) aborted with the same partner from the first kiss- es and the first sexual intercourse. Data regarding the ages and age gaps between the young girls and partners caused a stir. According to some of them, this is something normal, because older men are more experienced.
In Brazil, abortion is among the leading causes of maternal mortality. Research has shown that abortion is practiced clandesti- nely by women of all social classes, but has unequal consequences depending on social inclusion, producing risks to poor women. Although the issue has been widely explored in the past 20 years, there is a lack of data about low-income women. Thus, the pre- sent study aims to estimate the prevalence of women with inducedabortion. Women from a population-based household survey in low-income sectors of São Vicente, São Paulo were recruited. Women of childbe- aring age from 15 to 49 years were eligible. The evaluation of the prevalence ratios for women with inducedabortion was perfor- med by using generalized linear models, with Poisson log-link function and robust variance to approximate the binomial. The most frequent variables that influenced reporting of abortion were: “always accept this practice” (95% CI 2.98 - 11.02), followed by “not having a child born alive” (95% CI 1.35 - 19.78), having “two to ive live births” (95% CI 1.42 - 14.40 ), “having ‘six or more live births” (95% CI 1.35 - 19.78), “age at in- terview” (95% CI 1.01 - 1.07) and “income” < R$ 484.97’ (95% CI 1.04 - 2.96). A widespread campaign about the practice of abortion, which can raise awareness among women in favor of the cause, especially among those in low-income strata is necessary to prevent unnecessary deaths.
Another possibility in relation to the partner’s absen- ce is that they may have not been informed of the suspec- ted pregnancy. Considering the increase in female con- trol over reproduction as well as greater participation and ascension in the employment market, many women of- ten have other objectives than pregnancy, and fear con- trary opinions from partners or not do not wish to con- tinue the pregnancy, choosing not to inform their partner and to take responsibility alone. In relation to women’s perception in relation to their partner’s reaction when discovering the pregnancy, it was verified that a high num- ber of women that inducedabortion mentioned positive reactions from their partner, showing that other motives could have led to the abortion, and not necessarily their partner’s dissatisfaction in relation to the pregnancy. It is worth reiterating that positive reactions may also be related to issues of male virility and not necessarily their involvement in fatherhood.
One of the qualitative studies that analyzed empirical attitudes was developed exclusively with nursing staff (Lunardi and Simões, 2004). When asked about their involvement in cases of legal abortion, some professionals demonstrated a cer- tain resignation regarding decisions made by other professionals: “[…] I do not have to solve anything, I have to accept the decisions regarding the procedu- re.” In another study, the fact that the decision for abortion (in the case of rape) was made by the woman seemed to exempt the professionals from any ethical responsibility: “[…] it is the woman’s decision, it is her problem, not that of the professional” (Soares, 2003). Thus, although the researchers in the same study revealed personal conflicts, unanimity with regard to the duty to maintain a neutral and impar- tial posture regarding the woman’s decision was observed: “[…] the professional must not persuade the woman to have or not to have an abortion.” A possible consequence of this quest for neutrality, which was sometimes a tacit condemnation of abor- tion, was the establishment of a distant relationship with the patient: “[…] we do not get involved with the story or the woman’s feelings, and we keep a distance.” Perhaps the extreme of this neutrality is indifference. In another study, HPs were found to discriminate women who had inducedabortion, prioritizing pregnant women, lactating women, and high-risk pregnancies: “[…] discrimination begins from the time of attendance” (Gesteira et al., 2008). Opinions on the role of SUS
Much of the selected literature refers to the lack of infor- mation about the risks and severity of CZS. In fact, there is a need to discuss various points of view, and, from there, allow women access to safe and legal abortion. An abortion provided in Brazil can be considered unsafe because of the ignorance of the professionals 18 and the fact that abortion is a crime according to Brazilian law, and it is among the main causes of maternal mortality in the country. Therefore, it is considered a public health problem, indicating that we must consider its dimension. 19,20 In addition, the discussion should be a way to educate, from personal impressions, life experiences, beliefs and cultures of the people involved, regardless of the socio- economic level, to the technical knowledge of the related professionals in the context. In Brazil, inducedabortion is related to unfavorable socioeconomic conditions. 21,22 From the bilateral elucidation of the suggestion of abortion, as well as its risks and indications, patients may be able to make an informed decision. 23
Using the abortion complication data from the GDH system we employed a similar method to Dias and Falcão (2000) in order to estimate the number of illegal abortions in Portugal. Inducedabortion complications can be registered in four categories: spontaneous abortion, legal abortion, illegal abortion and non-speciﬁed abortion. Not all of these categories can be used to estimate the number of illegal abortions in Portugal, more speciﬁcally legal abortions and spontaneous abortions. Registered spontaneous abortions in countries where abortion is illegal frequently does not corresponds to the number of natural spontaneous abortions. This is because some illegal abortion complications are registered as being spontaneous abortions in order to protect women from being criminally charged (Singh and Wulf 1991). Another way that illegal abortions were covered, was by registering them as non-speciﬁed abortions. As in Dias and Falcão (2000) we considered all the non-speciﬁed abortions as illegal abortions. Table 10 clearly shows a rapid decrease of both the number of spontaneous abortions and the number of non-speciﬁed abortions, which provides grounds to infer that these registering procedures were taking place in Portugal. It is also important to point out the rapid reduction of the number of post-abortive complications after abortion was made legal in 2007. The ﬁrst step we took to estimate the number of illegal abortions was to disentangle the real spontaneous abortions from the illegal abortions registered as being spontaneous. This was done using a similar method to Singh and Wulf (1991) who estimated that the natural number of spontaneous abortion is 2.45% of the number of total births. This natural rate of spontaneous abortions was computed using spontaneous abortions data of countries that had abortion legal. Inspired on this strategy, we computed the Portuguese natural spontaneous abortion complications’ rate with resource to data of spontaneous abortion after the
Thus, to investigate the occurrence of abortion, emphasis was given to the total number of pregnancies, total number of births, total number of living children, and the type of delivery for each pregnancy. Similarly, direct questions concerning the inducedabortion were replaced by questions that addressed the desire to be pregnant, if abortion was considered or if they were pressured to abort, and the use of abortive methods. Therefore, it is worth mentioning that there was no clear distinction on the abortion type, whether spontaneous or induced, during the interviews. However, it is possible to conclude that abortion was induced, by means of the questions concerning the use of abortion methods and the speciication of the method used. Age-years of schooling adequation index was used in this study to evaluate the proportion of adolescents who have achieved adequate education to their age. This index considers that the appropriate population to attend high school would be adolescents aged 15 – 17 years 16 .
This study aimed to determine the association determines the attitude of women of childbearing age fertility status, health and social - economic and general Inducedabortion is performed. In sum, none of the demographic age, education, occupation, and generally not associated inducedabortion parity only those with (p=0.000) had a significant association only with the overall abortion, according to the results the majority of the people has inducedabortion overall, has been Parity 3 or more. Research has shown that with increasing age in women and the passing of reproductive age (over 35 years) increased abortion rate (21). The study shows that maternal age is associated with intentional abortion and for each year of maternal age increases the risk of abortion up to 0.08 percent (22). In a study of risk factors induced abortions, maternal age, maternal unemployment, and low education there has been a mother to chronic disease risk (23).The reasons for not wanting have more children Known to have induced abortions (24). Probably because educated people and working