Abstract

Introduction: Unwanted pregnancy is a serious consequence for women who experience sexual violence. Although deciding on abortion is frequent in these cases, there is not much information on women who give up abortion in this circumstance.
 Objective: To analyse the associated factors in abortion withdrawal of sexual violence pregnancy.
 Methods: A cross-sectional epidemiological study with a convenience sample of adolescents and women with pregnancy due to sexual violence and requesting legal abortion between August 1994 and December 2012, at Hospital Pérola Byington, São Paulo, Brazil. Pregnant women who gave up abortion after receiving the procedure approval were included and, in another group, pregnant women who completed the abortion. The variables were selected from a digitized database and analyzed using SPSS 15.0 software. The outcome was abortion withdrawal. The study variables were age; low education level; gestational age; color/black ethnicity; not being united; declare religion; serious threat from the aggressor; known offender; and residence of the aggressor. Odds ratios with 95% confidence intervals were calculated. The analysis used Wald's chi-square test (?2W) and logistic regression with variable of interest defined as the known aggressor. The research was approved by the Research Ethics Committee of the Federal University of São Paulo, Opinion No. 6767.
 Results: The study included 941 women, 849 (90.2%) who had an abortion and 92 (9.8%) who gave up after being approved. Age ranged from 10-46 years, mean 23.2 ± 7.9 years, gestational age 4-22 weeks, average 11.9 ± 4.5 weeks. Among those who gave up abortion, 12.0% were <14 years old; 50.0% had gestational age ? 13 weeks; 50.0% had low education; 14.2% were black; 90.2% single; 85.9% declared to have religion; 50.0% were threatened; 12.0% of the cases occurred at the perpetrator's residence and 53.3% of the victims were raped by known perpetrators. In logistic regression, the only significant variable was the known perpetrator, increasing the victim's chance of giving up abortion twice.
 Conclusion: The known sex offender has influenced the woman or adolescent's decision to give up legal abortion.

Highlights

  • Unwanted pregnancy is a serious consequence for women who experience sexual violence

  • The known sex offender has influenced the woman or adolescent's decision to give up legal abortion

  • Abortion is well founded and legally supported, such as when pregnancy results from sexual violence; when there is a risk of death for the pregnant woman, as provided for in Article 128 of the law[1]; or in cases of anencephaly, according to a Supreme Court ruling in 20122

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Summary

Introduction

Unwanted pregnancy is a serious consequence for women who experience sexual violence. In cases where abortion is legally permitted, the World Health Organisation recommends that these countries promote measures that increase women's access to safe and humane abortion health services[3]. Strengthening health services and public policies on abortion should be based on women's human rights and health needs and evidence, within a rigorous understanding of each country's social, cultural, political and economic context[3]. Changes in this direction have been observed in Brazil in recent decades, slowly and in the face of obstacles and resistance[4]. Public policies include the implementation in 1989 of health services organised to assist women who resort to legal abortion and the technical regulations of the Ministry of Health to guide managers and health professionals, published in 19991,4,5

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