Restrictive Abortion Laws Research Articles

Exploring the relationship between induced abortion and HIV infection in Brazil

The impact of HIV on the decision to interrupt pregnancy remains an understudied topic in Brazil and the world. The technical means to implement HIV prevention and treatment interventions are widely available in Brazil. Although Brazil has restrictive abortion laws, induced abortion occurs frequently. This qualitative study investigates the extent to which Brazilian women are motivated to seek abortion as a consequence of having HIV disease, and the extent to which the decision is part of a larger reproductive decision-making context. Researchers interviewed 30 women who were living with HIV and had terminated pregnancies or attempted to do so. Many women identified their HIV status as an important aspect of their decision-making regarding abortion. Women also took into account issues such as the stage of life when the pregnancy occurred and the absence of support from partners and families. Contraceptive practices, pregnancy and abortion in this population are influenced by multiple factors that act on the structural, social, interpersonal and individual levels. We hypothesize that HIV infection and abortion are sometimes associated with similar contexts of vulnerability. Health services therefore should address HIV and reproductive issues together, with reproductive and sexual rights serving as the fundamental basis of health care.

Fetuses in a Thai Buddhist Temple as Chaotic Irruption and Public Embarrassment

In late 2010, about 2000 human fetuses were discovered in the mortuary of a Buddhist temple in Bangkok. This article examines the subsequent affair from two perspectives: the magico-religious and the socio-political. The first deals with the fetuses as a symbol: it examines the beliefs regarding fetuses in Buddhism and Thai folk religion, and the manner with which the irruption of the fetuses into the Buddhist temple was dealt with. The second deals with the fetuses as an exposure of a widespread social problem with complex legal and social policy implications, and the way the authorities treated it. The two perspectives are related through Buddhism, which helped to resolve the magico-religious issue of dispatching the fetuses’ spirits, while constituting a barrier to the resolution of the socio-political issue of change in the Thai abortion law. This created an irresolvable conundrum: the issue of abortion cannot be resolved in a sustainable way without affecting some of the fundamental premises on which Thailand's abortion law and its “regime of images” is based. The authorities preferred to uphold the law and sustain the image, rather than to resolve the basic underlying problem of which the discovered fetuses were just the most blatant symptom. This problem is the discrepancy between the restrictive abortion law and current sexual practices, which have engendered a growing demand for abortions by the younger generation of Thai urbanites.

Ireland's restrictive abortion law: a threat to women's health and rights?

The Grand Chamber of the European Court of Human Rights has recently handed down its judgement in the case of three women contesting the abortion law in the Republic of Ireland, which has one of the most restrictive abortion laws in the world. Although the Court ruled that Ireland had to clarify the current law following the success of one of the three claims, the failure of the other two claims allows Ireland to continue to enforce its law, which has an adverse effect on women's health. This paper, therefore, proposes an amendment to abortion legislation in the Republic of Ireland that would be compatible with safeguarding women's health, highlighting several circumstances in which the continuation of a pregnancy may have a detrimental impact on a woman's physical and/or mental health.

Knowledge and perception of the Nigerian Abortion Law by abortion seekers in south-eastern Nigeria

One in four pregnancies worldwide is voluntarily terminated. Approximately 20 million terminations are performed under unsafe conditions, mostly in developing countries with restrictive abortion laws. A total of 100 consecutive abortion-seekers were interviewed, to ascertain their knowledge and perceptions on the Nigerian Abortion Law. The majority (55.0%) of the respondents were students. Most of them (97%) had at least secondary education and the majority (62.0%) were within the 20–24 years age range. Only 31.0% of the women interviewed were aware of the Nigerian Abortion Law. While 16% perceived the law as being restrictive, 2% opined that ‘it was alright’; 1% perceived it as very restrictive and 12% had no opinion on the abortion law. Knowledge of the abortion law had no significant relationship with either the educational level of the respondent or the number of previous pregnancy terminations and overall demand for abortion services. It is necessary to ensure a wide dissemination of the abortion law and its provisions to the Nigerian public, in order to arm them with the necessary information to participate actively in debates on abortion law reforms.

Restrictive abortion laws, antiabortion attitudes and women’s contraceptive use

This study empirically examines the public and social policy question: Do state restrictive abortion laws affect the likelihood that women use more highly effective contraceptive methods? Using contraceptive use data from the Behavioral Risk Factor Surveillance System 2002 survey, the empirical results show that Medicaid Funding Restrictions, Informed Consent Laws, and Two-Visit Laws have no significant impact on adult women’s (ages 18–44, 18–24, 25–34, 35–44) use of highly effective contraceptive methods. A state’s antiabortion attitudes, which likely contribute to the enactment of restrictive abortion laws in a state, are a major factor in inducing greater use of highly effective contraceptive methods by adult women at-risk of an unintended pregnancy. The empirical findings remain robust for various population subgroups of adult women (i.e., married, single, employed, unemployed, with children, no children and college educated).

Total Ileal Resection with Right Hemicolectomy Following Unsafe Abortion: Unusual Ileojejunal Prolapse

Background: Unsafe abortion accounts for 13% of maternal mortality in Africa. Most of these abortions are performed by unskilled practitioners, which often results in complications, including bowel injury. This case is reported because of the unusual presentation of the bowel injury—prolapse of a cut end of the bowel through the cervix via a fundal laceration—and the extensive bowel surgery performed. Case: A case of unsafe abortion complicated by uterine perforation, with injury to the small bowel and shock, is presented. The patient presented with 1.5 m of gangrenous ileum extruded through the cervix via a laceration in the fundus of the uterus. She had exploratory laparotomy with uterine repair, jejunal resection, total ileal resection, right hemicolectomy, and colonojejunal anastomosis. Results: Her complications were managed successfully. Conclusions: Much needs to be done in the area of health education, improvement of health care services, and changes in the restrictive abortion laws, so as to stem the tide of death caused by unsafe abortion. (J GYNECOL SURG 27:185)

Unsafe abortion and postabortion care - an overview

Forty per cent of the world's women are living in countries with restrictive abortion laws, which prohibit abortion or only allow abortion to protect a woman's life or her physical or mental health. In countries where abortion is restricted, women have to resort to clandestine interventions to have an unwanted pregnancy terminated. As a consequence, high rates of unsafe abortion are seen, such as in Sub-Saharan Africa where unsafe abortion occurs at rates of 18-39 per 1 000 women. The circumstances under which women obtain unsafe abortion vary and depend on traditional methods known and types of providers present. Health professionals are prone to use instrumental procedures to induce the abortion, whereas traditional providers often make a brew of herbs to be drunk in one or more doses. In countries with restrictive abortion laws, high rates of maternal death must be expected, and globally an estimated 66 500 women die every year as a result of unsafe abortions. In addition, a far larger number of women experience short- and long-term health consequences. To address the harmful health consequences of unsafe abortion, a postabortion care model has been developed and implemented with success in many countries where women do not have legal access to abortion. Postabortion care focuses on treatment of incomplete abortion and provision of postabortion contraceptive services. To enhance women's access to postabortion care, focus is increasingly being placed on upgrading midlevel providers to provide emergency treatment as well as implementing misoprostol as a treatment strategy for complications after unsafe abortion.

Unsafe Abortion as a Birth Control Method

Reproductive health research and policies in Cambodia focus on safe motherhood programs particularly for married women, ignoring comprehensive fertility regulation programs for unmarried migrant women of reproductive age. Maternal mortality risks arising due to unsafe abortion methods practiced by unmarried Cambodian women, across the Thai-Cambodia border, can be considered as a public health emergency. Since Thailand has restrictive abortion laws, Cambodian migrant women who have irregular migration status in Thailand experimented with unsafe abortion methods that allowed them to terminate their pregnancies surreptitiously. Unmarried migrant women choose abortion as a preferred birth control method seeking repeat "unsafe" abortions instead of preventing conception. Drawing on the data collected through surveys, in-depth interviews, and document analysis in Chup Commune (pseudonym), Phnom Penh, and Bangkok, the authors describe the public health dimensions of maternal mortality risks faced by unmarried Cambodian migrant women due to various unsafe abortion methods employed as birth control methods.

Unsafe Abortion: The Silent Endemic; An Avoidable Cause of Maternal Mortality. A Review

Unsafe abortion (UA) is still a main cause of maternal mortality in countries with restrictive abortion laws. Our objective was to review current concepts about septic abortion (SA), its epidemiology, diagnosis, management and prevention. A wide variety of methods for inducing abortion exist. Lastly, misoprostol has replaced more dangerous methods. Septic abortion is a polymicrobial ascending infection. It should be suspected in any young women presenting with lower abdominal pain, fever and vaginal bleeding, as well as with severe sepsis or septic shock. Broad-spectrum antibiotics and source control should be initiated promptly. Removal of retained products of conception should be performed as soon as possible. Indications for laparotomy are failure to respond to uterine evacuation and adequate treatment, uterine perforation with suspected bowel injury, pelvic and adnexal abscesses and clostridial myometritis. Indications for hysterectomy are a uterus of woody appearance or discolored, clostridial necrotizing myometritis, crepitation of the pelvic tissue and radiographic evidence of air within the uterine wall. Aggressive surgical wound debridement and hysterectomy should be performed whenever gas gangrene is present. Effective contraception has been shown to reduce UA but is not enough to cope with high fertility regulation demands. Legalized, safe and accessible abortion services are required.

The story of abortion: Issues, Controversies and a case for the review of the Nigerian National Abortion Laws

Abortion continues to be a major public health issue that evokes social, political, legal, cultural and religious sentiments and debates in all societies. This is particularly so in countries with restrictive abortion laws. It is one of the leading causes of maternal mortality and morbidity. Despite variations in the legal status of abortions in favor of restrictiveness in developing countries compared with developed countries, overall rates are quite higher in the developing countries. This review article therefore, examines the historical perspectives of induced abortion as well as the issues and controversies associated with induced abortion. Also, a review of the Nigeria national abortion law is made. We believe that this is capable of identifying useful interventions for designing programs that will lead to a reduction in the burden of unsafe abortion in developing countries.

Abortifacient properties of alligator pepper (<i>Aframomum melegueta</i>) seeds

Alligator pepper (Aframomum melegueta) is used in the Surinam cuisine to flavour dishes such as vegetables (okra and tomatoes recipes), soups (lentil and chicken) and fish recipes. It has a wide use and the eating does not exclude pregnant women who actually use it to terminate unwanted pregnancy. A large percentage of maternal deaths in Nigeria is related to unsafe abortions. Abortifacient drugs are not generally available in the country which has restrictive abortion laws. To investigate possible abortifacient effect of Aframomum melegueta seeds, three groups of pregnant female Wistar albino rats were used. Group one, served as control, received no alligator pepper. Groups two and three were given aqueous extract of and the granulated alligator pepper respectively. Every group was fed normal rat chow while tap water was allowed ad libitum for the period of gestation. The results showed that the number and mean weight of litters were not significant between control and aqueous recipient groups suggesting that the extract had no deleterious effect on fertility. However group three that received granulated alligator pepper in doses above 4.0mg/kg body weight did not litter. While not advocating abortion the dose if worked out in humans could be utilized in fertility clinics, as a safe abortifacient if the mother’s life is seriously endangered by the pregnancy. Keywords: Abortifacient; Alligator pepper; Aframomum melegueta; Seeds

A strategic assessment of unsafe abortion in Malawi

As part of efforts to achieve Millennium Development Goal 5 – to reduce maternal mortality by 75% and achieve universal access to reproductive health by 2015 – the Malawi Ministry of Health conducted a strategic assessment of unsafe abortion in Malawi. This paper describes the findings of the assessment, including a human rights-based review of Malawi's laws, policies and international agreements relating to sexual and reproductive health and data from 485 in-depth interviews about sexual and reproductive health, maternal mortality and unsafe abortion, conducted with Malawians from all parts of the country and social strata. Consensus recommendations to address the issue of unsafe abortion were developed by a broad base of local and international stakeholders during a national dissemination meeting. Malawi's restrictive abortion law, inaccessibility of safe abortion services, particularly for poor and young women, and lack of adequate family planning, youth-friendly and post-abortion care services were the most important barriers. The consensus reached was that to make abortion safe in Malawi, there were four areas for urgent action – abortion law reform; sexuality education and family planning; adolescent sexual and reproductive health services; and post-abortion care services.

Public Preferences, Political Party Control, and Restrictive State Abortion Laws

This study examines the process by which state legislators respond to the public’s preferences about abortion policy over time. We examine the determinants of the enactment by a state of a parental involvement law employing the event history analysis approach. The empirical results suggest that, in the short-term, neither the public’s abortion preferences nor institutional control of state government by the generally prolife Republican Party has a significant impact on the enactment of a parental involvement law, while institutional control by the generally prochoice Democratic Party significantly decreases the likelihood of the passage of a parental involvement law. In the long-term, the public’s abortion preferences are positively associated with the enactment of a parental involvement law. However, when the Republican Party or the Democratic Party have institutional control of the executive and legislative branches of state government, this allows each political party to support or oppose the enactment of a parental involvement law consistent with each party’s public position on the abortion issue, regardless of the public’s abortion preferences or the competitive electoral environment. The empirical results remain robust for a variety of alternative specifications.

Access to safe abortion: building choices for women living with HIV and AIDS

In many areas of the world where HIV prevalence is high, rates of unintended pregnancy and unsafe abortion have also been shown to be high. Of all pregnancies worldwide in 2008, 41% were reported as unintended or unplanned, and approximately 50% of these ended in abortion. Of the estimated 21.6 million unsafe abortions occurring worldwide in 2008 (around one in 10 pregnancies), approximately 21.2 million occurred in developing countries, often due to restrictive abortion laws and leading to an estimated 47,000 maternal deaths and untold numbers of women who will suffer long-term health consequences. Despite this context, little research has focused on decisions about and experiences of women living with HIV with regard to terminating a pregnancy, although this should form part of comprehensive promotion of sexual and reproductive health rights.In this paper, we explore the existing evidence related to global and country-specific barriers to safe abortion for all women, with an emphasis on research gaps around the right of women living with HIV to choose safe abortion services as an option for dealing with unwanted pregnancies. The main focus is on the situation for women living with HIV in Brazil, Namibia and South Africa as examples of three countries with different conditions regarding women's access to safe legal abortions: a very restrictive setting, a setting with several indications for legal abortion but non-implementation of the law, and a rather liberal setting.Similarities and differences are discussed, and we further outline global and country-specific barriers to safe abortion for all women, ending with recommendations for policy makers and researchers.

Nonmarital Births and State Abortion Policies

This study examines the impact of various restrictive abortion laws on nonmarital childbearing since the passage of the 1996 welfare reform bill. The empirical results find that the price of an abortion, a Medicaid funding restriction, and a waiting period law are associated with a decrease in a state's nonmarital birthrate. The negative effects of restrictive abortion laws on a state's nonmarital birthrate are found to occur in various age groups. These findings are consistent with the hypothesis that restrictive abortion laws induce unmarried women to change their level of unprotected sexual activity or contraceptive behavior, thereby reducing the likelihood of an unwanted nonmarital pregnancy.

Fetopatia por misoprostol caso clínico con análisis postmortem

Many women, especially in countries with restrictive abortion laws, attempt to end an early pregnancy with misoprostol. However, due to the lack of standardized information and instructions, women use misoprostol in a variety of forms, with wide variability in the dose and stage of pregnancy. Misoprostol is a synthetic prostaglandin I 2 analog, used in obstetrics for cervical ripening, medical abortion, uterine evacuation in embryonic and fetal death, and labor induction.Multiple forms of teratogenicity due to the indiscriminate use of this drug have been described, such as Moebius syndrome, club foot, hydrocephalus and arthrogryposis multiplex congenita. We report a case of fetopathy due to misoprostol with postmortem analysis. A review of the topic in the world literature is also provided.

Women's experiences of the abortion law in Cameroon: “What really matters”

While prosecutions of women who have had an illegal abortion are rare in Cameroon, women who have a legitimate claim to a legal abortion, e.g. following rape, can rarely take advantage of it. This is because the law in Cameroon is not applied, either when it is violated or when it is indicated. This paper examines the histories of four young women who became pregnant and had an abortion in the Anglophone region of the Cameroon Grassfields. Three of them became pregnant following rape or sexual coercion, in one case by the girl's priest, in the second case by her employer's son, and in the third case by a stranger. The fourth young woman, who sold sex for survival money and food, had two abortions while in prison for committing infanticide following a failed attempt to abort an earlier pregnancy. The four young women were interviewed as part of a qualitative, hospital-based study among 65 women who had had abortions in 1996–97. The women's affecting personal histories illuminate the reality of living under a restrictive abortion law, the troubling conditions in which they have to manage their lives, and the harsh circumstances in which they become pregnant and seek (but may not find) a safe abortion.

The Relationship Between State Abortion Policies and Abortion Providers

This study empirically examines whether restrictive state abortion laws have an impact on the number of abortion providers over the period 1982–2005. The empirical results find that medicaid funding restrictions, parental involvement laws and targeted regulation of abortion providers (TRAP laws) annual licensing fees significantly deter physicians or organizations from becoming or remaining abortion providers. The numerical impact of a Medicaid funding restriction, parental involvement law and a TRAP licensing fee is to reduce the number of abortion providers per 100,000 pregnancies by 12.8, 19.6 and 15.5, respectively, as compared to states without these restrictive abortion laws. The empirical results also show that parental notification laws have a significantly larger negative impact on the number of abortion providers than parental consent laws.

Unsafe abortion in urban and rural Tanzania: method, provider and consequences

To describe unsafe abortion methods and associated health consequences in Tanzania, where induced abortion is restricted by law but common and known to account for a disproportionate share of hospital admissions. Cross-sectional study of women admitted with alleged miscarriage: 278 in rural Tanzania and 473 in urban Tanzania. Women who had undergone a clandestinely induced abortion were identified by an empathetic approach and interviewed in detail about the procedure. Information about complications was obtained from the patient file. Sixty-two per cent in rural Tanzania and 63% in urban Tanzania stated that they had had an unsafe induced abortion. The abortion had been induced by an unskilled provider in 46% of rural women and 60% of urban women. Herbs and roots had commonly been used for induction, in 42% of rural and 54% of urban women. The method most often associated with abortion complications was catheter/roots, whereas the method least often associated with complications was herbs. The large number of women identified as having had unsafe abortion together with the prevalent use of herbs calls for attention.

From Iran to Latin America: Must Prenatal Diagnosis Necessarily Be Provided With Abortion for Congenital Abnormalities?

The article examines the question of whether it is ethical to introduce and provide prenatal diagnosis and antenatal screening in areas where termination of pregnancy for congenital abnormalities is legally prohibited. The article explores the various reasons according to which people seek prenatal genetic information and the factors affecting their decision to continue pregnancy despite congenital abnormalities. It concludes that with a proper emotional support and cultural sensitivity it is ethically justifiable to introduce prenatal diagnostic tests and screening, and that taken as a whole, the benefits of such an introduction outweigh the general harm already associated with restrictive abortion laws.