The Adolescent’s Right to Confidential Care When Considering Abortion

Braverman, Paula K.; Adelman, William P.; Alderman, Elizabeth M.; Breuner, Cora Collette; Levine, David A.; Marcell, Arik V.; O’Brien, Rebecca

doi:10.1542/peds.2016-3861

Cited by 20 publications

(7 citation statements)

References 77 publications

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“…To guarantee quality PAC, interactions between service providers and patients must ensure confidentiality by establishing an atmosphere of trust and empathy and respecting the patient’s rights [ 3 , 43 ]. Patient-centered care dictates the need to understand the specific needs of individual women, including future fertility intentions, contraceptive preferences and past experiences with care.…”

Section: Introductionmentioning

confidence: 99%

Policy, law and post-abortion care services in Kenya

et al. 2018

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BackgroundUnsafe abortion is still a leading cause of maternal death in most Sub-Saharan African countries. Post-abortion care (PAC) aims to minimize morbidity and mortality following unsafe abortion, addressing incomplete abortion by treating complications, and reducing possible future unwanted pregnancies by providing contraceptive advice. In this article, we draw on data from PAC service providers and patients in Kenya to illustrate how the quality of PAC in healthcare facilities is impacted by law and government policy.MethodsA cross-sectional design was used for this study, with in-depth interviews conducted to collect qualitative data from PAC service providers and seekers in healthcare facilities. Data were analyzed both deductively and inductively, with diverse sub-themes related to specific components of PAC quality.ResultsThe provision of quality PAC in healthcare facilities in Kenya is still low, with access hindered by restrictions on abortion. Negative attitudes towards abortion result in the continued undirected self-administration of abortifacients. Intermittent service interruptions through industrial strikes and inequitable access to care also drive unsafe terminations. Poor PAC service availability and lack of capacity to manage complications in primary care facilities result in multiple referrals and delays in care following abortion, leading to further complications. Inefficient infection control exposes patients and caregivers to unrelated infections within facilities, and the adequate provision of contraception is a continued challenge.DiscussionLegal, policy and cultural restrictions to access PAC increase the level of complications. In Kenya, there is limited policy focus on PAC, especially at primary care level, and no guidelines for health providers to provide legal, safe abortion. Discrimination at the point of care discourages women from presenting for care, and discourages providers from freely offering post-abortion contraceptive guidance and services. Poor communication between facilities and communities continues to result in delayed care and access-related discrimination.ConclusionGreater emphasis should be placed on the prevention of unsafe abortion and improved access to post-abortion care services in healthcare facilities. There is a definite need for service guidelines for this to occur.

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Section: Introductionmentioning

confidence: 99%

Policy, law and post-abortion care services in Kenya

et al. 2018

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“…Desde luego, si el embarazo ha sido el resultado de relaciones esporádicas sin un componente afectivo de la pareja y desde la familia se presiona para forzar un vínculo de «conveniencia» entre la adolescente y el «embarazador», ello va a generar consecuencias nocivas para el desarrollo de la mujer y la pareja, así como para la crianza del hijo o hija a corto o medio plazo 31 . De ahí que promover y respetar la autonomía de la adolescente en la toma de decisiones sea una obligación ética, personal y profesional imprescindible 32 , 33 .…”

Section: Problemática Del Embarazo En La Adolescenciaunclassified

“…Aunque no es imprescindible ni obligatoria, puede significar en algunos casos una ayuda en el proceso de maduración psicológica de la adolescente. Además, si la embarazada se niega a notificar esta decisión, puede tratarse simplemente de que fue el resultado de un encuentro sexual voluntario, sin pensar en las posibles consecuencias, con una persona sin ningún vínculo afectivo, pero también puede hacernos pensar que la relación que condujo al embarazo se realizó de forma inconsciente, bajo presiones biológicas o psicológicas o fue fruto de un abuso sexual o estupro 32 , 61 .…”

Section: Consideraciones Generales Para La Atención Preventiva Desde ...unclassified

“…De ahí la importancia de afrontar este acontecimiento vital mediante el respeto y el acompañamiento de las personas queridas y de los profesionales. Es fundamental proporcionar toda la información y resolver las dudas para que la madre pueda decidir libremente y sin coacciones si desea proseguir con el embarazo, si opta por su interrupción voluntaria o, si piensa dar en adopción a su hijo 32 , 76 , 77 .…”

Section: Consideraciones Generales Para La Atención Preventiva Desde ...unclassified

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Prevención de los trastornos de la salud mental. Embarazo en la adolescencia

et al. 2022

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“…Clinicians should familiarize themselves with relevant laws to know when parental notification is required. 35,[38][39][40] Clinicians should also reassure their adolescent patients by explicitly stating the confidentiality of their encounters. 30 As anticipated, LGB youth self-reported greater difficulty communicating with a clinician about topics they wanted to discuss.…”

Section: Jama Network Open | Public Healthmentioning

confidence: 99%

Analysis of Reported Health Care Use by Sexual Orientation Among Youth

et al. 2021

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IMPORTANCEIn the United States, adolescents who are lesbian, gay, or bisexual (LGB) face disparities across physical and mental health outcomes compared with non-LGB youth, yet few studies have looked at patterns of health care utilization by sexual orientation. OBJECTIVE To compare health care utilization indicators for LGB and non-LGB youth. DESIGN, SETTING, AND PARTICIPANTS This cohort study analyzed wave 3 data from Healthy Passages, a longitudinal observational study of diverse public school students in Birmingham, Alabama; Houston, Texas; and Los Angeles County, California. Multivariable logistic regression models tested sexual-orientation differences in the past 12-month health care utilization measures, controlling for youth age, gender, race and ethnicity, household education, income, and marital status. Data collection began in 2010 when students were in the 5th grade (mean [SE] age, 11.13 [0.01] years) (wave 1) and continued 2 years later (wave 2, 7th grade) and 5 years later (wave 3, 10th grade). Permission to be contacted was provided for 6663 children, and 5147 (77%) participated in audio computer-assisted self-administered interviews. This study included 4256 youth (640 LGB, 3616 non-LGB) who completed interviews at wave 1 and wave 3 and answered key items used in this analysis. Analyses were completed in June 2021. EXPOSURES Sexual orientation (LGB vs non-LGB).MAIN OUTCOMES AND MEASURES Health care utilization and communication difficulty with a physician in the past 12 months. RESULTS Among 4256 youths included in the study at baseline in 5th grade (wave 1), 2171 (48.9%) were female; 1502 (44.5%) were Hispanic or Latino; 1479 (28.9%) were Black; the mean (SE) age was 11.19 (0.03) years; and 640 (14.5%) were LGB at wave 3. Compared with non-LGB youth, a higher proportion of LGB youth reported not receiving needed medical care in the last 12 months (adjusted odds ratio [aOR], 1.68; 95% CI,1.38-2.05), most commonly for sexually transmitted infections, contraception, and substance use. LGB youth more frequently reported difficulty communicating with their physician (aOR, 1.71; 95% CI, 1.27-2.30) than non-LGB youth.CONCLUSIONS AND RELEVANCE This study's results found that health care utilization differs by sexual orientation for youth. These findings suggest that clinician training is needed to address the health care needs of LGB youth. Routinely capturing sexual orientation data might enable tracking of health care utilization indicators for LGB youth.

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The Adolescent’s Right to Confidential Care When Considering Abortion

Cited by 20 publications

References 77 publications

Policy, law and post-abortion care services in Kenya

Policy, law and post-abortion care services in Kenya

Prevención de los trastornos de la salud mental. Embarazo en la adolescencia

Analysis of Reported Health Care Use by Sexual Orientation Among Youth

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