The Shift From Criminalization to Legalization of Abortion in Argentina

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

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

BACKGROUND

Contraceptive use and sexual health behavior remain a prominent public health concern in South Africa. Despite many government interventions, unplanned pregnancies, number of abortions, and maternal mortality remain relatively high. Due to high pregnancy levels and the stigma associated with termination of pregnancy, more women turn to unsafe and illegal abortions despite the risks involved. Risky sexual behavior pose a serious risk of contracting HIV/AIDS. The main objective of this study is to map evidence on factors influencing contraceptive use and sexual behavior in South Africa.

METHODS

We will conduct a scoping review guided by framework by Arksey and O'Malley. This study will search for eligible literature from peer-reviewed articles and grey literature. Databases such as PubMed/MEDLINE, American Doctoral Dissertations via EBSCO host, Union Catalogue of Theses and Dissertations (UCTD) and SA ePublications via SABINET Online and World Cat Dissertations, Theses via OCLC, and Google Scholar will be searched. Websites such as the World Health Organization (WHO) and governmental websites and statistics institutions will be explored for policies and guidelines on contraceptive use and sexual behavior. The review will be conducted on studies that were published from January 1990 to 2018. The PCC framework will be employed in this study to determine the eligibility of research question. The PRISMA chart will be utilized to report the screening of results. The MMAT Tool version 11 will be used to determine the quality of the included primary studies.

RESULTS

We anticipate finding a considerable number of published articles presenting evidence on contraceptive use and sexual health behavior in South Africa. Findings of this scoping review will be disseminated electronically, in print, and through peer presentation, conferences, and congresses.

Induced abortion: incidence and trends worldwide from 1995 to 2008

BACKGROUND

Data of abortion incidence and trends are needed to monitor progress toward improvement of maternal health and access to family planning. To date, estimates of safe and unsafe abortion worldwide have only been made for 1995 and 2003.

METHODS

We used the standard WHO definition of unsafe abortions. Safe abortion estimates were based largely on official statistics and nationally representative surveys. Unsafe abortion estimates were based primarily on information from published studies, hospital records, and surveys of women. We used additional sources and systematic approaches to make corrections and projections as needed where data were misreported, incomplete, or from earlier years. We assessed trends in abortion incidence using rates developed for 1995, 2003, and 2008 with the same methodology. We used linear regression models to explore the association of the legal status of abortion with the abortion rate across subregions of the world in 2008.

FINDINGS

The global abortion rate was stable between 2003 and 2008, with rates of 29 and 28 abortions per 1000 women aged 15-44 years, respectively, following a period of decline from 35 abortions per 1000 women in 1995. The average annual percent change in the rate was nearly 2·4% between 1995 and 2003 and 0·3% between 2003 and 2008. Worldwide, 49% of abortions were unsafe in 2008, compared to 44% in 1995. About one in five pregnancies ended in abortion in 2008. The abortion rate was lower in subregions where more women live under liberal abortion laws (p<0·05).

INTERPRETATION

The substantial decline in the abortion rate observed earlier has stalled, and the proportion of all abortions that are unsafe has increased. Restrictive abortion laws are not associated with lower abortion rates. Measures to reduce the incidence of unintended pregnancy and unsafe abortion, including investments in family planning services and safe abortion care, are crucial steps toward achieving the Millennium Development Goals.

FUNDING

UK Department for International Development, Dutch Ministry of Foreign Affairs, and John D and Catherine T MacArthur Foundation.

[International cooperation in implementation of the program of reproductive health protection in the Samara region]

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

Abortion policy and practice in Greece

Despite its illegality until recently, abortion is estimated to have been responsible for almost half of the sharp postwar decline in the Greek birth rate. This article examines abortion as a part of a Greek contraceptive culture which has taken shape during the postwar period both in response, and in resistance to, a variety of macro- and micropolitical institutions and forces. During much of this period, pronatalist policies and discourses of both state and church combined to foreclose most medical contraceptive alternatives. In contrast, illegal abortion was a relatively safe, medicalized procedure widely practiced by doctors. Even after being legalized in 1980, female medical contraceptive methods continue to be rejected by the great majority of Greek women, and abortion and male methods of birth control remain the principal means of controlling fertility. The article focuses on the specific abortion practices and meanings of three generations of married women living in the city of Rhodes, capital of the Dodecanese Province of Greece's Eastern Aegean, and explores the ways in which they have been shaped by, and reflect, local cultural understandings of the body, health, sexuality, morality, motherhood and childhood, as well as micropolitical relations within the family.

Women's perspectives on abortion in Romania

Romanian women have commonly used abortion (both legal and clandestine) to prevent unwanted births. We introduce this paper with a brief summary of the recent history of abortion in Romania, then we combine quantitative data from a previous report ([1] Johnson et al., Lancet 341, 875, 1993) of the research with women's own words about the following issues: their decisions to have an abortion, the impact of abortion restrictions under the Ceauşescu government, and their needs and desires for improved reproductive health services. We also present gynaecologists' views of abortion restrictions and needs for improved family-planning services to make a compelling case for the need for safe, legal, comprehensive abortion care in Romania and elsewhere.

Induced abortion in Indonesia

Induced abortion is one of the most difficult sociomedical problems facing the Indonesian government. While well-known in traditional society, the practice was discouraged by all Indonesian religious groups, and forbidden by the Dutch colonial authorities. Although abortion was technically illegal under the criminal code, a judicial interpretation in the early 1970s permitted medical professionals to offer the procedure so long as they were discreet and careful. The numbers of medical abortions carried out in Indonesia rose dramatically, and there was evidence of matching declines in the incidence of morbidity and mortality caused by dangerous illegal procedures. Medical and community groups campaigned for a more liberal abortion law to protect legal practitioners and stamp out illegal traditional practices. Their efforts appeared to bear fruit in the draft Health Law, but when the law was passed by the legislature in late 1992, the issue was again clouded by contradictions and inconsistencies.

The clandestine epidemic: the practice of unsafe abortion in Latin America

In Latin America, induced abortion is the fourth 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 percent 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. One of every three to five 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 abortion can be more broadly interpreted, and legal constraints on abortion practices can be officially relaxed.

Commentary on a community-based approach to reproductive health care. Society for Education, Action and Research in Community Health Team

Reproductive care needs to be broadened beyond maternity care and family planning to include care for gynecological and sexual problems, safe abortion services, and sex and reproductive health education. Our epidemiologic study of rural women has shown a very high prevalence of gynecological diseases. We tried to develop a community-based approach to comprehensive reproductive care by undertaking participatory research, fostering mass education with the people's involvement, and by making care available through village-based female workers and improved referral services. We end with two appeals: "MCH" needs to be replaced by WCH: not merely Maternal and Child Health but Woman and Child Health. Care should be provided through a community-based participatory approach, not through narrow technocratic vertical programs. Let people shape their own lives!

Commentary on women-centered reproductive health services

From women's perspectives, the primary principles of a reproductive health framework in the developing world are as follows: Family planning is a basic human right to which all human beings are entitled. Provision of family planning services must be comprehensive, including safe and low cost methods, freedom of choice about both contraception and pregnancy termination, timely and honest information, privacy and confidentiality, individual needs assessment, and counseling of women, men or the couple. Wide contraceptive choice requires more research on methods that are less invasive of women's anatomy and physiology and more supportive of women's control of their own bodies. These parameters of quality care in family planning must be centered on women's needs, desires and expectations. The concept of conscious contraception implies an attitude of conscious sexuality. When a woman accepts that sexual gratification independent of reproduction is a legitimate right, she is better prepared to engage in the pursuit of her own health and happiness. If family planning programs do not include sexuality as a key issue to discuss with clients, all long-term strategies will fall short in modifying people's attitudes, especially women's reluctance to contracept. Sexual and reproductive health includes emotional health. As Dr. Sai points out, the effects of underdevelopment and poverty strike women in dramatic ways, and quite often all the pressures to which they are exposed lead to precarious emotional health. They become victims of violence and repeat the cycle of violence with their children. We, as advocates of sexual and reproductive rights, must also consider the psychological and emotional implications of sexuality and reproduction, and learn to deal with them in our clinics and services.(ABSTRACT TRUNCATED AT 250 WORDS)