Abortion Practices Research Articles

Views and practice of abortion among Queensland midwives and sexual health nurses.

BackgroundA significant barrier to the access of safe abortion is the lack of trained abortion providers. Recent studies show that with appropriate education, nurses and midwives can provide abortions as safely as medical practitioners.AimsTo examine the attitudes and practices of registered midwives (RMs) and sexual health nurses (SHNs) in Queensland toward abortion.Materials and MethodsA cross‐sectional mixed‐methods questionnaire was distributed to RMs and SHNs from the Queensland Nursing and Midwifery Union. Data were described and analysed both quantitatively and qualitatively.ResultsThere was a 20% response rate (n = 624) to the survey from the overall study population. There were 53.5% who reported they would support the provision of abortion in any situation at all; 7.4% held views based on religion or conscience that would make them completely opposed to abortion. There were 92.9% who felt that education surrounding abortion should be part of the core curriculum for midwifery and/or nursing students in Australia. The qualitative responses demonstrated a variety of views and suggestions regarding the practice of abortion.ConclusionsThere was a wide variation in views toward induced abortion from RMs and SHNs in Queensland. While a proportion of respondents opposed abortion in most circumstances, a significant group was in support of abortion in any situation and felt involvement in initiating and/or performing abortion would be within the scope of RMs and SHNs.

Factors influencing the practice of artificial termination of pregnancy

In the article, abortion is presented as one of the indicators of the demographic transition, characterized by a low birth rate and mortality, a change in marital and family behavior, and the transformation of the composition of the population of modern Russian society. The practice of abortion is in the center of our attention and is considered in interaction with other social phenomena.The purpose of the study is to determine the factors influencing the practice of abortion in the current demographic situation. As the methodology of this research, the authors of the article use the analysis of the scientific literature of domestic scientists, the results of their own sociological research and the results of sociological research of VTSIOM.The authors identify socio-cultural, institutional, psychological factors that influence the practice of abortion. At the individual level, a woman's attitude to "unexpected pregnancy" plays an important role, the availability of opportunities for termination of pregnancy (formal and informal rules and regulations, legislative acts, public approval or condemnation), the perception of abortion as a social problem, forms of behavior of individuals participating in the practice of artificial termination of pregnancy. The novelty of the study is presented as an analysis of the factors that influenced the practice of abortion and the results of the author's sociological research. The analysis of scientific literature has shown that the traditions that have developed in a particular society, the level of development of the health and education system, as well as the specific situation in which a woman who decides to have an abortion finds herself are of great importance. The results of sociological research, official statistics show that formal and informal norms and rules, the development of pharmacology, the emergence of new methods of contraception, changes in basic institutions have an impact on the practice of abortion in the context of demographic transition.

Abortion Policy in Nigeria: A Challenging National Health Concern

Introduction: Unsafe abortion cases resulting from the prohibition of abortion in Nigeria continue to be growing exponentially. Abortion cases and their related complications are a public health concern. Over one million abortions are estimated to be carried out annually in Nigeria with related morbidity, mortality, and complications under the country's restrictive abortion policy. However, the law remains static and fails to approach the current realities as abortion-related offences still carry 14 years of jail terms. This has forced people to seek abortion clandestinely through unsafe hands. Nigeria has two different abortion laws. The northern part of the country is ruled by the Penal Code 18 of 1959, while the southern part is governed by the Criminal Code of 1916. Both Codes strictly prohibit abortion. Purpose:This paper aims to examine abortion law in Nigeria, its effect on women, especially women of reproductive age, and make pertinent recommendations that can improve the current situation. Conclusion: Relaxing the very restrictive abortion law will encourage safe abortion practices by fostering easy access to quality post-abortion-related care. This will reduce complications leading to morbidities and mortalities. Recommendation: A repeal and re-enactment of the existing abortion law should be done. The new law should consider pregnant women's mental or emotional health, especially women who are victims of incest or rape. Such women should be allowed to have access to abortion. The law should also be devoid of third-party authorizations for minors and married women. In other words, the new law should exclude discrimination on the grounds of age and marriage.

Difficulties and Rights of Women in Pregnancy of Anencephalic Fetuses

Abstract: Despite a series of advances in the establishment of specialized services for women in all regions of the country, many still face great difficulties in accessing abortion services. Even in relation to anencephaly, there are still challenges for the proper structuring of legal abortion services, as it is difficult to identify health professionals available for abortion care permitted by law. This article discusses the issues involved in these cases. It was concluded that, due to the moral and religious stigma, there is a refusal of doctors related to the practice of abortion, despite the existence of Brazilian technical norms that regulate this practice. However, the right to conscientious objection is not necessarily recognized in the absence of another medical professional to assist women when there is a risk of death. Keywords: Anencephaly, Abortion, Women's Rights.

Care across divides: militant abortion and film around the Veil Law

ABSTRACT During the years that preceded the legalisation of abortion in France by la loi Veil in 1975, feminists and activist doctors provided women alternative modes of reproductive care and advocacy. Militant and documentary filmmakers captured these developments in films such as Y’a qu’à pas baiser ! (Carole Roussopoulos and Vidéo Out, 1971–1973), Histoires d’A (Charles Belmont and Marielle Issartel, 1974) and Regarde, elle a les yeux grand ouverts (Yann Le Masson, 1982). While reframing abortion as an act of care and self-governance for women and their families and communities, filmmakers strive to both expand access to and increase safety in abortion practices, while arguing their significance in the socio-economic and political landscape of 1970s France.

Uterine Rupture with Gangrene of the Rectum Following a Criminal Abortion - Case Report

The Indian Government legalised abortion by the enactment of the Medical Termination of Pregnancy(MTP) Act 1971. This was done in the view to reduce the number of unsafe abortions and provide safe abortions services for women of the country. However, due to the patriarchal mindset of some people, unsafe practices of abortion to terminate the female fetus still exist. We report such a case of criminal abortion leading to traumatic uterine rupture and rectal gangrene

Critical Introspection of Abortion Laws in Nigeria

An abortion is a procedure to end pregnancy, either by surgery or Medicine. The procedure is expected to be done by a licensed health care professional. Abortion is however illegal in Nigeria as there are legislations which prohibit abortion except in cases where the carriage of the pregnancy to term is detrimental to the health and life of the mother. Statistics has shown that 1,000 out of 100,000 maternal deaths stem from the estimated 1,000,000 abortions done in the country annually. Unfortunately, the law on abortion in Nigeria fails to recognize the actual state of happenings, this has in a way given room for illegal abortion and high maternal mortality rate in Nigeria. The main focus of this paper is to explore abortion practices and it’s regulation in Nigeria, how the laws on abortion in Nigeria affects healthcare and maternal mortality rates and whether or not the present abortion laws are still relevant to the milieu of the average Nigerian woman. This paper relies on existing literature for data and this literature suggests that the present abortion laws are heavily influenced by religion and faux morality rather than empirical evidence to the effects of abortions in the society. This paper investigates both influences and recommends a different approach to abortion legislation and calls for a reformation of the laws on abortion in Nigeria. It concludes that abortions should be made legal in the first trimester of pregnancy when it is safe for the mother.

Reproductive health education: a qualitative study of health seeking behaviour of in-school female adolescents

INTRODUCTION: Adolescents in developing countries are often vulnerable to sexually transmitted diseases (STDs) and unplanned pregnancies. It is estimated that about 13 million adolescent girls have unplanned births each year in developing countries. This study examined the scope of the School Health Education Programme (SHEP) and health-seeking behaviours of female adolescents in Junior High School (JHS). METHODS: this qualitative research used the narrative approach. Group discussions were conducted among 100 female adolescents aged 12-19 years. Interviews were conducted among five community health workers in five health centres that provide reproductive health services. The in-depth interviews and group discussions were documented, transcribed and analyzed using NVivo 11, whilst thematic analysis was used in analyzing data. RESULTS: the mean age of adolescents was 15.5 years, with 74% reporting having knowledge of STDs. It was observed that the SHEP offers various information on health issues such as menstrual hygiene, STDs, personal hygiene, contraceptives, personal development and unsafe abortion practices. Adolescent reproductive health services were also available in the health centres but patronage was low as a result of perceived negative attitude of health workers and trust. Knowledge on issues of reproductive health is insufficient among JHS female adolescents, with many of them relying on the media and peers for reproductive health support. CONCLUSION: in this study, female adolescents are generally involved in risky sexual behaviour due to their low level of knowledge on reproductive issues and their unwillingness to patronize available reproductive health services because of the health system and cultural barriers.

Unsafe abortion - A Risk factor for maternal mortality in Liberia - An analysis of the characteristics of unsafe abortion clients and risk factors for maternal morbidity and mortality.

Worldwide, an estimated 68,000 women die yearly due to unsafe abortion practices. In Liberia, the maternal mortality ratio is 1072 deaths per 100,000 live births. However, there has not been a study conducted to understand the relationship between unsafe abortion and maternal mortality. We conducted a retrospective cohort study at three county hospitals and assessed obstetric data gathered using a defined questionnaire in 2016 - 2018, from maternal-child health units. The results of the study suggest a strong association between unsafe abortion and maternal morbidity and mortality and also provide insight into the characteristics and factors that put women and girls who have unsafe abortions at risk. The results can inform programs and policies on age disaggregation of women and girls who choose abortion. The variation in the association between unsafe abortion and the risk factors, have implications for maternal morbidity and mortality.

Easing of Regulatory Barriers to Telemedicine Abortion in Response to COVID-19.

For many people seeking abortion during the continuing COVID-19 pandemic, telemedicine abortion is the safest and most acceptable method, posing lower risk of exposure to the virus. In addition, by reducing in-person visits with health care providers, increased use of telemedicine for abortion can reduce pressure on overburdened health systems. Given the benefits of telemedicine during the pandemic, government agencies in several countries took measures to temporarily allow telemedicine abortion. We conducted key-word English-language searches to identify examples of government action to remove regulatory barriers to the practice of telemedicine abortion in response to the pandemic. We found instances of government agencies in eight countries taking steps to ease regulatory barriers to telemedicine abortion. Telemedicine abortion is safe, cost-effective, and may be the preferred method of abortion during acute periods of COVID-19 transmission, as well as after the pandemic has abated. As one step to expanding access to abortion with medicine where abortion is legal, health agencies and other regulatory bodies can take steps to remove barriers specific to telemedicine abortion.

Liberal sexual morality, religion, and attitudes toward abortion in Turkey

AbstractThe present study examines the association between sexual morality, religion, and attitudes toward the practice of abortion in Turkey. Drawing upon data from the 2008–2010 European Value Survey in the case of Turkey, several hypotheses were tested concerning the role of liberal sexual relations and many aspects of religion on abortion attitudes. Findings reveal that support of liberal sexual relations demonstrates the strongest justification for abortion. As a religious determinant, prayer practice indicates the most robust opposition to the practice of abortion. Additional religious factors, personal religious identity, and personal faith were also found to be significantly associated with antiabortion attitudes. The findings are discussed and have implications for future research on attitudes toward abortion.

KNOWLEDGE, ATTITUDE AND PRACTICE OF ABORTION IN SLUM AREA OF KATHMANDU

Background: Abortion is legal up to 12 weeks’ gestation period in Nepal. Due to a lack of proper abortion services and socio cultural stigma, every year many women died due to abortion. The aim of this study was to asses the knowledge, attitude and practice of abortion in the residents of slum area of Kathmandu district. Methods: The cross-sectional study was conducted in slum area of Kathmandu district from 20th December, 2020 to 15th January, 2021. The sample size was 255 and convenient sampling technique was used to select the participant aged above 15years. The collected data were enter in MS excel and analysis was performed using SPSS version 22. Results: The prevalence of abortion was 25.27%.The level of knowledge was found significant with education status. Age, marital status, ethnicity were found significant with attitude of the respondents. Ten percentages of the female respondents had done unsafe abortion. The complications after abortion were the bleeding (54.3%), trauma (15.20%), loss of consciousness (13.0%) and abdominal pain (2.20%). Conclusions: The level of knowledge of participants of the present study found to be satisfactory but attitude was less satisfactory with compared to the knowledge about the abortion.

Ethical and Legal Aspects of Using the Abortion Pill RU-486 in Italy in the Years 2020-2021

In some countries, one of the most difficult bioethical challenges of the SARS-CoV-2 coronavirus pandemic has been a sharp rise in the number of chemical abortions performed in hospitals, outpatient clinics, or at home. Limited access to medical services at public and private healthcare facilities and the development of telemedicine have resulted in the practice of chemical abortion having largely moved from hospitals and clinics to the home. Chemical abortion is a method used only in the early stages of pregnancy, i.e. up to 7-9 weeks. The first stage of abortion involves taking RU-486, a pill containing a preparation called Mifepristone which kills the newly conceived life in the mother’s womb. The second stage of chemical abortion involves the use of a preparation called Misoprostol, which leads to the expulsion of the dead embryo from the woman’s body.
 The main goal of the article is to analyze the ethical and legal dispute in Italy in the years 2020 and 2021 concerning new ways of using the abortion pill RU-486. In August 2020, the Italian Ministry of Health decided that chemical abortion – performed using the medical preparation RU-486 – should not be practiced at hospital gynecological and obstetric wards, but in day hospitals, without the requirement of hospitalization for women performing such abortions. Analyses carried out in the article show that chemical abortion not only kills the life of a human embryo, but in some cases may also be dangerous to the life and health of the mother. The liberalization of chemical abortion in Italy has led to an increase in the number of unborn children who are aborted, as it facilitates access to this type of abortion and makes it a procedure that is largely self-administered at home. The Italian dispute over home abortion and the RU-486 pill is linked to other serious bioethical debates that are currently taking place in many countries around the world

The Social Circumstances that Criminalized Abortion in the 19th Century

To say abortion is a controversial subject is an understatement. While there was no federal law against abortion in the 19thcentury, the majority of the states in the U.S. introduced anti-abortion laws after the Comstock Laws outlawed the drugs and practices that made abortion possible in 1873.[1] Legal or not, women have been subject to unrelenting criticism regarding the termination of unwanted pregnancies for centuries. To form realistic conclusions about abortion in the 19thcentury, it is essential to take into consideration far more than the dispute of morality. Regulation of abortive practices was, as this paper will indicate, less about medical safety and gestational awareness than sexual inequality and racial disparities; the aim of this research is to determine the social circumstances that influenced the conceptualization of abortion and inspired legal action against it.
 
 [1] https://www.loc.gov/law/help/statutes-at-large/42nd-congress/session-3/c42s3ch258.pdf

Kazus Alecka Bourne’a a konstytucyjne zasady ochrony życia i zdrowia

The article presents the case of Dr. Aleck Bourne, which the author proposes to include in the catalog of borderline cases constituting the basis for in-depth discussions on ethical and legal aspects of human life with regard to the development of biology and medicine. The starting point is the presentation of the worldwide models for regulating the practice of abortion as well as the Polish regulation, together with a discussion on the role of the Constitutional Tribunal in shaping current legal provisions. The author notes that the interpretation of the right to life adopted by the Tribunal encourages the repeal of the indication model and the introduction of a complete ban on abortion, which will have significant consequences for ordinary legislation. Apart from describing the facts in the Bourne case, the strategy adopted by the defense and the sentence itself, the possible further areas of considerations regarding the limits of permissibility of termination of pregnancy have been signaled. Then, the conclusions resulting from legal analysis of the case were transferred to the exegesis of the constitutional principles of the right to life and the right to healthcare. Their constitutional form, interpretation resulting from the rulings of the Constitutional Tribunal and the ordinary legislation have been presented. The author indicates the main terminological deficiencies identified in this respect: the lack of any definition of the beginning of a human being, the existence of two separate criteria for determining death, which could lead to different results and the lack of an unambiguous definition of disease adopted by the legislator. Based on the concepts presented in the case, the right to healthcare has been defined as a legal right resulting from the right to life. The final thesis is that there are no grounds for hierarchizing these rights, as they are intertwined in content and function.

ORAL ABSTRACTS: O2 IMPLEMENTATION OF AN HIV PRE-EXPOSURE PROPHYLAXIS STRATEGY INTO ABORTION CARE

Objectives: Family planning clinics are well-suited to offer HIV pre-exposure prophylaxis (PrEP) care as a part of a sexually transmitted infection (STI) prevention strategy. We sought to evaluate implementation outcomes of a PrEP care strategy in a hospital-based academic abortion practice.

Knowledge, Acceptability, Perception and Stigmas on Safe Abortion among the women of reproductive age group (15-49 years) in Bhaktapur District.

Introduction: The termination of pregnancy by the removal of a foetus or an embryo before surviving outside the uterus or before attaining its viability is called abortion. This study was conducted to study the knowledge, acceptability, perception and stigma of safe abortion among women of reproductive age group. 
 Methods: A cross-sectional analytical study was carried out in Bhaktapur District, Nepal from July 2019 to December 2019. Women of reproductive age group were included in the study. The semi-structured questionnaires were used as a data collection tool and Likert scales were used for perception and stigma which were self-designed. For Likert scale on perception and stigma, Cronbach’s α was calculated from the pre-tested samples which was found to be acceptable i.e., 0.649 and 0.856. Interview was taken as data collection technique. Data-entry was done in Epi-Data and analysed through SPSS 16.0. Chi square test was used to measure the association between dependent and independent variables.
 Result: The association between “Knowledge and Perception” was found to be significant with p-value of 0.04, the association between “Knowledge and Stigma” was also noted to be significant with p-value of 0.00 and “Knowledge and Acceptability” was also found to be significant with p-value of 0.00 through the assessment of knowledge, acceptability, perception and stigma.
 Conclusions: The study emphasises on educating and making aware every woman on safe abortion, its legalisation and its amended law to avoid the stigma and unsafe abortion practices.

A Mixed-Methods Analysis of Physician Abortion Practice After Residency.

In the United States, 89% of counties have no clinics providing abortion care. Though training residents increases intention to provide abortion care, rates of postresidency abortion provision are low. This study, conducted at one family medicine residency program in the Southwest United States, examines graduates' postresidency practice of abortion care in the context of their intent to provide during residency training. We collected cross-sectional data from a survey of graduates of University of New Mexico Family Medicine Residency from 2005 to 2017. We performed a mixed-methods analysis using descriptive statistics and conceptual content analysis, including a new methodology of performing content analysis of four subgroups based on intention to provide abortion care at different time points. The response rate was 46%, with 54 responses to 115 surveys. Only 35% residents who intended to provide abortion care had done so after graduation from residency. Barrier analysis revealed that the three most frequent barriers were structural, with 52% of respondents saying that their workplace would not allow abortion care. The two most frequent themes affecting intention were "competence" and feeling that abortion care was "medically necessary." However, the two most common themes affecting actual practice were "workplace support" and local "patient access." This study provides information about the themes associated with changing intentions and practice of abortion care, which may help elucidate new strategies for training residents to anticipate and address challenges to postresidency provision. The study also provides some insight into residents with no intention to provide abortion care in residency who develop an intention to provide abortion care after graduation, which is a group of people for whom there is little information.

Abortion rights beyond the medico-legal paradigm

ABSTRACT Abortion rights in international law have historically been framed within a medico-legal paradigm, the belief that regulated systems of legal and medical control guarantee safe abortion. However, a growing worldwide practice of self-managed abortion (SMA) supported by feminist activism challenges key precepts of this paradigm. SMA activism has shown that more than medical service delivery matters to safe abortion and has called into question the legal regulation of abortion beyond criminal prohibitions. This article explores how abortion rights have begun to depart from the medico-legal paradigm and to support the novel norms and practices of SMA activism in a transformation of the abortion field. Abortion rights as reimagined in SMA activism increasingly feature in human rights agendas related to structural violence and inequality, collective organising and international solidarity, and democratic engagement.

Incidence of self-induced abortion with misoprostol, admitted to a provincial hospital in Papua New Guinea: A prospective observational study.

Misoprostol is a life-savingmedication in obstetric practice but the prevalence of misoprostol-related self-induced abortion is increasing in many communities. To investigate the hospital incidence, clinical management, and legal framework of self-induced abortions with misoprostol. This was a prospective observational study conducted over 18months. All patients <20weeks pregnant who were admitted with a diagnosis of misoprostol-induced abortion were included in the study. Of 186 women with abortion-related admissions during the study period, 51 (27.4%) women reported using misoprostol to induce abortion. The majority were young (27.8±5.5) married women (32/51: 62.7%), particularly educated (27/51: 52.9%) employed women (27/51: 52.9%), who were not on any contraception (46/51: 90.1%). Most abortions were induced in the first trimester (39/51: 76.5%) and patients were admitted because of prolonged bleeding (23/51: 45.1%). A significant proportion of participants who did not receive the correct dose of misoprostol developed sepsis compared to those who received a correct dose (6/18 (33.3%) vs 1/30 (3.3%); P=0.008). The use of misoprostol as an abortifacient is increasing in Papua New Guinea, particularly among educated and employed women. A review of the laws to meet the demand for abortion services and to limit complications of unsafe abortion practices is required.