Medical abortion: A path to safe, high-quality abortion care in Latin America and the Caribbean

Dzuba, Ilana G.; Winikoff, Beverly; Peña, Melanie

doi:10.3109/13625187.2013.824564

Cited by 50 publications

(43 citation statements)

References 44 publications

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“…Although we are unable to distinguish between arbitrarily induced or self-induced abortions and miscarriages in this study, the data support evidence from prior studies that some women in Ecuador are intentionally terminating their pregnancies despite the ban on abortions 21,23,34. Interestingly, during the analyses, we found that abortion rates had declined in 2014.…”

Section: Discussionsupporting

confidence: 76%

“…Due to the lack of data, the causes of differences in abortion ratios by province have not been studied yet; however, cultural, educational and better health care systems might be related to the higher number of abortions among the most populated provinces 34. When we compared the number of abortions with the number of children born each year, we observed that Pastaza, one of the least populated provinces with high cultural diversity, reported more abortions than any other provinces with numbers totaling 186/1,000 births.…”

Section: Discussionmentioning

confidence: 99%

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Abortion, an increasing public health concern in Ecuador, a 10-year population-based analysis

Ortíz-Prado¹,

Simbaña²,

Gómez³

et al. 2017

POR

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ObjectivesTo describe the epidemiology of abortion in Ecuador from 2004 to 2014 and compare the prevalence between the public and the private health care systems.MethodsThis is a cross-sectional analysis of the overall mortality and morbidity rate due to abortion in Ecuador, based on public health records and other government databases.ResultsFrom 2004 to 2014, a total of 431,614 spontaneous abortions, miscarriage and other types of abortions were registered in Ecuador. The average annual rate of abortion was 115 per 1,000 live births. The maternal mortality rate was found to be 43 per 100,000 live births.ConclusionsAbortion is a significant and wide-ranging problem in Ecuador. The study supports the perception that in spite of legal restrictions to abortion in Ecuador, women are still terminating pregnancies when they feel they need to do so. The public health system reported >84% of the national overall prevalence.

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Section: Discussionsupporting

confidence: 76%

Section: Discussionmentioning

confidence: 99%

Abortion, an increasing public health concern in Ecuador, a 10-year population-based analysis

Ortíz-Prado¹,

Simbaña²,

Gómez³

et al. 2017

POR

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“…Women have long known about misoprostol's abortifacient effect and used it on their own to end unwanted pregnancies, especially in Latin America, where it has been linked to a decline in abortion‐related morbidity and mortality from more harmful methods [14].…”

Section: What Can Obstetrician/gynecologists Do?mentioning

confidence: 99%

What can obstetrician/gynecologists do to support abortion access?

Mark¹,

Wolf²,

Edelman

et al. 2015

Intl J Gynecology & Obste

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Unsafe abortion causes approximately 13% of all maternal deaths worldwide, with higher rates in areas where abortion access is restricted. Because safe abortion is so low risk, if all women who needed an abortion could access safe care, this rate would drop dramatically. As women's health providers and advocates, obstetrician/gynecologists can support abortion access. By delivering high-quality, evidence-based care ourselves, supporting other providers who perform abortion, helping women who access abortion in the community, providing second-trimester care, and improving contraceptive uptake, we can decrease morbidity and mortality from unsafe abortion.

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“…Liberalization of abortion laws could lead to major reductions in abortion‐related morbidity and mortality in Africa; however, such policy changes are slow to occur, suggesting that targeted interventions must be initiated during the interim period. A risk‐reduction approach to unsafe abortion—i.e.…”

Section: Introductionmentioning

confidence: 99%

“…A risk‐reduction approach to unsafe abortion—i.e. harm reduction—has proven an effective strategy for reducing maternal deaths in Latin America and the Caribbean . Harm reduction involves the implementation of strategies that aim to reduce damage caused by behaviors that cannot easily be changed, especially in settings where such behaviors are driven underground by prohibitive and stigmatizing policies and practices .…”

Section: Introductionmentioning

confidence: 99%

Provision of harm‐reduction services to limit unsafe abortion in Tanzania

Kahabuka¹,

Pembe

Meglioli

2016

Intl J Gynecology & Obste

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Objective: To investigate the feasibility of providing harm-reduction services to reduce unsafe abortion in Tanzania. Methods:A cross-sectional study was conducted among 110 women who received harm-reduction counseling at a public health center in Dar es Salaam between February 10 and October 10, 2014. Background and clinical information was collected for all women; a subgroup (n=50) undertook a semi-structured survey that measured the type of services women received, women's perception of the services, and pregnancy outcome. The main study outcomes were attendance at the follow-up visit, type and quality of information women received on both visits, and misoprostol use for pregnancy termination.Results: Overall, 55 (50.0%) women attended follow-up services. Misoprostol was used for induced abortion among 54 (98.2%); 38 (70.4%) of these women had obtained contraception at the follow-up visit. Likelihood of attendance for follow-up was increased among women who were older than 34 years (odds ratio [OR] 2.2, 95% confidence interval [CI] 0.1-35.8), were married (OR 2.1, 95% CI 0.8-5.7), and had a post-primary education level (OR 2.0, 95% CI 0.8-5.3). On average, 44 (87.0%) women received all required information at the initial counseling session and none reported major complications that required hospitalization. Conclusion:Harm-reduction services for unsafe abortion are feasible and acceptable, and could provide an excellent opportunity to fight abortion-related morbidity and mortality in Tanzania. K E Y W O R D SClandestine abortion; Contraception; Counseling; Harm reduction; Maternal mortality; Misoprostol; Unintended pregnancy; Unsafe abortion | INTRODUCTIONUnintended pregnancy is a well-documented reality for women in Africa.1 Nevertheless, the highly restrictive abortion laws of most be initiated during the interim period. A risk-reduction approach to unsafe abortion-i.e. harm reduction-has proven an effective strategy for reducing maternal deaths in Latin America and the Caribbean. 5 Harm reduction involves the implementation of strategies that aim to reduce damage caused by behaviors that cannot easily be changed, especially in settings where such behaviors are driven underground by prohibitive and stigmatizing policies and practices. 6 The best-known application of this approach is needle-exchange programs that are highly effective in preventing transmission of HIV among users of illicit drugs. 7The harm-reduction model for unsafe abortion is centered on the right to information, focusing on the periods before and after the pro- In Tanzania, induced abortion is permitted only when pregnancy endangers the life or health of the woman, 10 and unsafe abortion is reported as the second leading cause of maternal deaths in this country. 3,4,11 The aim of the present study was, therefore, to investigate the feasibility of applying the harm-reduction model to the problem of unsafe abortion in Tanzania. | MATERIALS AND METHODSA cross-sectional survey was conducted among a group of women who had received harm...

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Medical abortion: A path to safe, high-quality abortion care in Latin America and the Caribbean

Abstract: Despite highly restrictive abortion laws in LAC, MA increases access to safer abortion. Yet, significant barriers remain and much more must be done to enhance use of modern contraceptive and safer abortion methods among women in the region.

Cited by 50 publications

References 44 publications

Abortion, an increasing public health concern in Ecuador, a 10-year population-based analysis

Abortion, an increasing public health concern in Ecuador, a 10-year population-based analysis

What can obstetrician/gynecologists do to support abortion access?

Provision of harm‐reduction services to limit unsafe abortion in Tanzania

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