Abortion;
Medical abortion;
Latin America;
Caribbean;
Misoprostol;
Mifepristone;
UNSAFE ABORTION;
MEXICO-CITY;
MIFEPRISTONE-MISOPROSTOL;
LEGAL-ABORTION;
AVAILABILITY;
PREGNANCY;
TRENDS;
PERSPECTIVES;
EXPERIENCES;
TERMINATION;
D O I:
10.3109/13625187.2013.824564
中图分类号:
R1 [预防医学、卫生学];
学科分类号:
1004 ;
120402 ;
摘要:
Background Abortion rates in Latin America and the Caribbean (LAC) are nearly triple those in Western Europe, due to less use of contraception and highly restrictive abortion laws. Women resort to clandestine and often unsafe methods to end unwanted pregnancies, exposing themselves to the risk of complications and mortality. Medical abortion (MA) presents a safer alternative. Objectives To present evidence of MA's contributions to reduced complications, describe strategies to enhance safe MA, and highlight existing barriers to access in LAC, while examining MA's role in newly legal abortion services. Results Substantial declines in abortion-related morbidity and mortality and lower costs of treating complications are observed in LAC with MA than with other self-induction methods. Telephone hotlines, telemedicine and harm reduction models enhance access to safer abortion and help reduce complication rates by facilitating information on MA's proper use. Misoprostol is registered in most LAC countries, but access is increasingly limited by regulations and cost. Conclusion Despite highly restrictive abortion laws in LAC, MA increases access to safer abortion. Yet, significant barriers remain and much more must be done to enhance use of modern contraceptive and safer abortion methods among women in the region.
机构:
Ctr Study State & Soc CEDES, Buenos Aires, DF, Argentina
Adolescent Hlth Fdn FUSA, Buenos Aires, DF, ArgentinaCtr Study State & Soc CEDES, Buenos Aires, DF, Argentina
Zamberlin, Nina
Romero, Mariana
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机构:
Ctr Study State & Soc, Buenos Aires, DF, Argentina
Consejo Nacl Invest Cient & Tecn, Natl Sci & Tech Res Council, RA-1033 Buenos Aires, DF, ArgentinaCtr Study State & Soc CEDES, Buenos Aires, DF, Argentina
Romero, Mariana
Ramos, Silvina
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机构:
Ctr Study State & Soc, Buenos Aires, DF, ArgentinaCtr Study State & Soc CEDES, Buenos Aires, DF, Argentina
机构:
World Hlth Org, UNDP UNFPA WHO World Bank Special Programme Res D, CH-1211 Geneva 27, SwitzerlandWorld Hlth Org, UNDP UNFPA WHO World Bank Special Programme Res D, CH-1211 Geneva 27, Switzerland
Kapp, Nathalie
Whyte, Patti
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机构:
Deakin Univ, Deakin Strateg Ctr Populat Hlth, Burwood, Vic 3125, AustraliaWorld Hlth Org, UNDP UNFPA WHO World Bank Special Programme Res D, CH-1211 Geneva 27, Switzerland
Whyte, Patti
Tang, Jennifer
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机构:
Univ N Carolina, Dept Obstet & Gynecol, Chapel Hill, NC 27599 USAWorld Hlth Org, UNDP UNFPA WHO World Bank Special Programme Res D, CH-1211 Geneva 27, Switzerland
Tang, Jennifer
Jackson, Emily
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机构:
Univ So Calif, Dept Family Med, Los Angeles, CA 90015 USAWorld Hlth Org, UNDP UNFPA WHO World Bank Special Programme Res D, CH-1211 Geneva 27, Switzerland
Jackson, Emily
Brahmi, Dalia
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机构:
Ipas, Chapel Hill, NC 27514 USAWorld Hlth Org, UNDP UNFPA WHO World Bank Special Programme Res D, CH-1211 Geneva 27, Switzerland