Knowledge on medical abortion among Brazilian medical residents in Gynecology and Obstetrics.

Rodolfo De Carvalho Pacagnella,Karla Simônia De Pádua,Tatiana Benaglia,Danielle Miyamoto Araújo,Tatiana De Figueiredo Fanton,Graciana Alves Duarte,Isabela Dias Fahl,Silvana Ferreira Bento,Anibal Faúndes,Karayna Gil Fernandes,Maria José Duarte Osis

doi:10.1590/0102-311x00187918

Rodolfo De Carvalho Pacagnella, Karla Simônia De Pádua + Show 9 more

Open Access

https://doi.org/10.1590/0102-311x00187918

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Abstract

Medical or drug-induced abortion has been proven as an effective means for termination of pregnancy. However, training of providers in the use of misoprostol has been limited. The current article aims to identify the degree of knowledge on medical abortion among Brazilian medical residents in Gynecology and Obstetrics. A multicenter cross-sectional study was performed with residents regularly enrolled in residency programs in Gynecology and Obstetrics in 21 teaching hospitals. A self-responded questionnaire was used. Correct responses to each of the alternatives were identified, and a binary response variable (≥ P70, < P70) was defined by the 70th percentile of the number of questions on misoprostol. Four hundred and seven medical residents returned the questionnaire, of which 404 were completed and three were blank. The majority (56.3%) of the residents were 27 years or younger, females (81.1%), and single or not living with a partner (70%). Two-thirds (68.2%) were in the first or second year of residency. Only 40.8% of the participants answered 70% or more of the questions correctly. In the multivariate analysis, enrollment in the third year of residency or greater (OR = 2.18; 95%CI: 1.350-3.535) and having participated in treatment of a woman with induced or probably induced abortion (OR = 4.12; 95%CI: 1.761-9.621) were associated with better knowledge on the subject. Among Brazilian medical residents in Gynecology and Obstetrics, knowledge on medical abortion is very limited and poses an obstacle to proper care in cases of legal termination of pregnancy.

Highlights

According to estimates, from 2010 to 2014 there were 25.1 million unsafe abortions in the world, of which 24.3 million occurred in developing countries 1
A multicenter cross-sectional study was performed with residents regularly enrolled in the medical residency program in Gynecology and Obstetrics in 21 teaching hospitals in Brazil, some of which were affiliated with universities
Ninety residents were not invited by their supervisors to participate in the study either because they were assigned to other health units at the time or were working on different shifts from the supervisor, and were not located during the data collection period

Summary

Introduction

From 2010 to 2014 there were 25.1 million unsafe abortions in the world, of which 24.3 million occurred in developing countries 1. In countries like Brazil with legal restrictions, clandestine abortion is practiced by women of all social and economic levels, but the consequences are most severe for those living in situations of social vulnerability (low schooling, low income, young age, and single marital status), given the precarious health conditions in which such abortions are performed [2,3]. The World Health Organization (WHO) classified this type as unsafe abortion 4. Medical or drug-induced abortion has proven to be an effective means for termination of pregnancy [9,10,11]

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