Approximately 47 000 women die each year worldwide as a result of the complications of unsafe abortion, almost exclusively in low‐ and middle‐income countries with restrictive abortion laws. In these ...countries, very few women who comply with the conditions imposed by the law can access safe abortion services in the public health system. The main obstacle is the unwillingness of gynecologists and obstetricians to provide abortion services by claiming conscientious objection, which is often used to hide their fear of the stigma associated with abortion. This happens because many colleagues are unaware that without access to legal services these women will resort to an unsafe abortion and its consequences. This violates the statement from FIGO's Committee for the Ethical Aspects of Human Reproduction and Women's Health, which asserts that: “The primary conscientious duty of obstetrician–gynecologists is at all times to treat, or provide benefit and prevent harm, to the patients for whose care they are responsible. Any conscientious objection to treating a patient is secondary to this primary duty.”
Providing safe abortion services to women who comply with the law is the ethical duty of gynecologists and obstetricians, and contributes to reduce unsafe abortion and its consequences.
Abstract Unsafe abortion is one of the main causes of maternal mortality and severe morbidity in countries with restrictive abortion laws. In 2007, the International Federation of Gynecology and ...Obstetrics (FIGO) created a Working Group on the Prevention of Unsafe Abortion and its Consequences (WGPUA). This led to a FIGO initiative with that aim which has the active participation of 43 FIGO member societies. The WGPUA has recommended that the plans of action of the countries participating in the initiative consider several levels of prevention shown to have the potential to successfully reduce unsafe abortions: (1) primary prevention of unintended pregnancy and induced abortion; (2) secondary prevention to ensure the safety of an abortion procedure that could not be avoided; (3) tertiary prevention of further complications of an unsafe abortion procedure that has taken place already, through high-quality postabortion care; and (4) quaternary prevention of repeated abortion procedures through postabortion family planning counseling and contraceptive services. This paper reviews these levels of prevention and the evidence that they can be effective.
Abstract Unsafe abortion continues to be a major cause of maternal death; it accounts for 14.5% of all maternal deaths globally and almost all of these deaths occur in countries with restrictive ...abortion laws. A strong body of accumulated evidence shows that the simple means to drastically reduce unsafe abortion-related maternal deaths and morbidity is to make abortion legal and institutional termination of pregnancy broadly accessible. Despite this evidence, abortion is denied even when the legal condition for abortion is met. The present article aims to contribute to a better understanding that one can be in favor of greater access to safe abortion services, while at the same time not be “in favor of abortion,” by reviewing the evidence that indicates that criminalization of abortion only increases mortality and morbidity without decreasing the incidence of induced abortion, and that decriminalization rapidly reduces abortion-related mortality and does not increase abortion rates.
Abstract The provision of abortion care represents a great ethical challenge to physicians, particularly in countries where the law states that abortion is a crime. The concept that it is a crime ...carries a stigma that is worse than that associated with other acts qualified by law as crimes. This stigma leads to at least two different kinds of unethical behavior. One is the refusal to provide safe abortion services to women who comply with the legal requirements, alleging conscientious objection, and the other is to discriminate against women consulting with complications of induced abortion. Both unethical behaviors may be associated with severe consequences for the health of women whose care was refused or delayed. Less attention is given to the ethical obligation to prevent induced abortion from recurring by offering post-abortion contraception, in order to comply with the ethical obligation of preventing harm to the patients for whose care they are responsible.
Sexual violence is a problem that affects children and adolescents regardless of social class, age, origin, religion, education level, marital status, race, or sexual orientation. This study aimed to ...analyze the associations between victim-offender relationships and the victim's age in cases of sexual violence involving female victims.
This cross-sectional, retrospective observational study used data from the Brazilian Ministry of Health's Department of Public Health Surveillance in Brasília regarding the reportable crime of rape as informed by female victims in the Federal District between January 1, 2012, and December 31, 2018. The age of the victim was classified as <15 years or 15-19 years. The offenders were classified into eight different categories according to their relationship with the victim: father, stepfather, brother, husband, boyfriend, friend, stranger, and others. The association between the victim-offender relationship and the victim's age was assessed.
Overall, there were 4,617 reported cases of sexual violence, with 78.3% of these (n = 3614) corresponding to children under 15 and 21.7% to adolescents 15-19 years old (n = 1003). Close relatives, including brothers, and friends were the main perpetrators in cases of girls < 15 years old. Strangers and friends were the principal perpetrators in the group of girls 15-19 years old.
Children under 15 are the group most affected by sexual violence. Strategies must be developed to prevent the sexual abuse of children and adolescents and to facilitate the rehabilitation of victimized children.
Las leyes sobre aborto son liberales en la mayor parte de los países desarrollados y muy restrictivas en países en desarrollo, particularmente América Latina, con dos excepciones. Organismos ...internacionales de Salud y Derechos Humanos promueven un mayor acceso al aborto seguro por su efecto inmediato de reducción de morbilidad y mortalidad materna. A pesar de eso las leyes permanecen muy restrictivas en la mayor parte de los países de América Latina, donde prevalece el concepto errado de que liberalizar la ley va a llevar a un aumento en el número de abortos, lo que casi todos prefieren evitar. Ese es un importante malentendido, porque las evidencias son que no hay menos aborto donde las leyes son restrictivas y no aumentan los abortos cuando las leyes se hacen más liberales. Así mismo, se cree que la mayor parte de la población está contra liberalizar la ley, pero preguntando mejor se descubre que la mayor parte está contra castigar a la mujer que aborta. Pero, el principal malentendido es creer que hay personas ‘a favor del aborto’, en circunstancia que ni siquiera a la mujer que se provoca el aborto le gusta abortar. La diferencia está en pensar que prohibiendo se soluciona el problema, o aceptar las evidencias que muestran que aumentando el acceso al aborto seguro no solo reduce el sufrimiento y la muerte, sino contribuye a reducir los abortos.
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