Statistical Methods in Medical Research.

Abortion stigma is widely acknowledged in many countries, but poorly theorised. Although media accounts often evoke abortion stigma as a universal social fact, we suggest that the social production of abortion stigma is profoundly local. Abortion stigma is neither natural nor ‘essential’ and relies upon power disparities and inequalities for its formation. In this paper, we identify social and political processes that favour the emergence, perpetuation and normalisation of abortion stigma. We hypothesise that abortion transgresses three cherished ‘feminine’ ideals: perpetual fecundity; the inevitability of motherhood; and instinctive nurturing. We offer examples of how abortion stigma is generated through popular and medical discourses, government and political structures, institutions, communities and via personal interactions. Finally, we propose a research agenda to reveal, measure and map the diverse manifestations of abortion stigma and its impact on women's health.

/pdf/conceptualising-abortion-stigma-14qdznuqj3.pdf

Conceptualising abortion stigma.

https://obgyn.onlinelibrary.wiley.com/doi/pdf/10.1111/j.1471-0528.2010.02793.x

Women’s preference for caesarean section: a systematic review and meta‐analysis of observational studies

Caesarean section (C-section) rates are rising in many middle- and high-income countries, with the justification that higher rates of C-section are associated with better outcomes. A review of 79 studies comparing outcomes of elective caesarean sections with vaginal deliveries, including both observational studies and randomized trials, suggests that caesarean sections may have substantially greater risks than vaginal deliveries. In this issue of Epidemiology, Leung and colleagues present data from Hong Kong on morbidity in offspring related to C-section. Such studies are needed to widen the scope of possible health outcomes related to elective C-sections, including such endpoints as maternal satisfaction and women's relationship with their child. Testing of interventions to reduce unnecessary C-sections is also needed, with strategies to enhance the role of women in the process of their obstetric care.

Health consequences of the increasing caesarean section rates.

This article provides a brief summary of abortion laws in 152 nations and dependent territories with populations of at least a million and documents changes in these laws since 1985. Classification of abortion laws according to level of restrictiveness (to save the mothers life to preserve the mothers physical health to safeguard her mental health on socioeconomic grounds and without restriction as to reason) reveals that 41% of the worlds population lives in the 49 countries that allow abortion without restriction as to reason. The article then reviews the prevalence of other legal restrictions such as gestational age third-party authorization type of medical facility and personnel mandatory counseling requirements restrictions on information and fees. The review of trends since 1985 shows that 19 countries have reduced restrictions on abortion and only one country has increased restrictions. This review provides regional summaries and also notes important changes in individual countries. The final section of the article covers factors that affect abortion availability such as varying interpretations of laws enforcement the attitude of medical staff and responses to the efforts of anti-abortion groups. It is concluded that most of the worlds women live in countries where abortion is legal under many circumstances and that the global trend toward liberalizing abortion laws has continued and has enhanced the availability of safe abortion services.

A global review of laws on induced abortion, 1985-1997.

http://bhpelopartonormal.pbh.gov.br/estudos_cientificos/arquivos/the_opinion_of_brazilian_women_regarding_vaginal_labor_and_cesarean_section.pdf

The opinion of Brazilian women regarding vaginal labor and cesarean section

OBJECTIVE : To investigate knowledge of HPV and HPV vaccines in men and women, users of the Brazilian Unified Health System, and the intention to get themselves and their teenage children vaccinated. METHODS : A descriptive, cross-sectional study with 286 women (18-49 years old) and 252 men (18-60 years old), users of five primary health units and two polyclinics in Campinas, SP, Southeastern Brazil, was carried out. Participants were interviewed in 2011 using a structured questionnaire. Bivariate and Poisson regression analysis were performed to identify variables associated with knowledge of HPV and HPV vaccines, and participants vaccination intentions. RESULTS : Almost 40.0% of the participants reported having heard of HPV and 28.9% mentioned adequate information. The main information source was the media (41.7%). Only 8.6% of the participants had heard of the HPV vaccines. Once the participants were informed of the existence of HPV vaccines about 94% of them said they would get vaccinated and/or vaccinate their teenage children, if the vaccines were available in the public health system. Schooling of over 8 years and being female were the variables independently associated with having heard of HPV, the vaccines and having adequate knowledge of the virus. Advanced age was associated with having heard of HPV vaccines. There were no variables associated with the vaccination intentions. CONCLUSIONS : These results reinforce the need for educational activities that provide the population with adequate information on HPV and preventive measures.

/pdf/sus-users-knowledge-of-and-attitude-to-hpv-virus-and-3omnkt7059.pdf

SUS users' knowledge of and attitude to HPV virus and vaccines available in Brazil

The Closer You Are, the Better You Understand: The Reaction of Brazilian Obstetrician–Gynaecologists to Unwanted Pregnancy

OBJETIVO: Analisar a perspectiva de homens de uma comunidade universitaria que viviam em uniao legal ou consensual acerca do aborto provocado. METODOS: Estudo descritivo de corte transversal em que se analisaram informacoes de 361 entrevistados, pertencentes a diferentes categorias de uma universidade. Utilizou-se o teste de qui-quadrado para avaliar a associacao das variaveis dependentes com as independentes. RESULTADOS: Dos entrevistados, 53% afirmaram que as mulheres tem direito a interromper a gestacao; as situacoes de maior aceitacao foram: risco de vida da gestante (85%), gravidez resultante de estupro (80%) e anomalia fetal (75%). As variaveis associadas a opiniao masculina favoravel ao aborto foram: maior escolaridade dos homens e das parceiras e o grupo (docente/aluno) a que pertencia o entrevistado. CONCLUSOES: Os entrevistados tenderam a ser mais favoraveis ao aborto nas situacoes ja legitimadas legal e/ou socialmente. O maior grau de escolaridade, tanto deles quanto das parceiras, apareceu como relevante para determinar a postura em relacao ao aborto.

http://www.scielo.br/pdf/rsp/v36n3/10487.pdf

Perspectiva masculina acerca do aborto provocado

OBJETIVO: Estimar a prevalencia de violencia em mulheres usuarias da atencao primaria em saude, se essas situacoes eram detectadas e como eram tratadas pelos profissionais desses servicos. METODOS: Estudo descritivo, de corte transversal, com 14 coordenadores municipais de saude da mulher, 2.379 usuarias de unidades basicas de saude, 75 gestores e 375 profissionais, em 15 municipios do estado de Sao Paulo, realizado entre agosto de 2008 e maio de 2009. Os dados foram coletados por questionarios estruturados e realizou-se analise descritiva. RESULTADOS: Protocolo de atendimento especifico para as mulheres em situacao de violencia foi mencionado em cinco municipios. A maioria dos coordenadores disse que situacoes de violencia entre as usuarias eram detectadas, embora 74% dissessem que isso nao era investigado rotineiramente, o que foi confirmado por 72,3% dos profissionais. Entre as mulheres, 76,5% referiram ter sofrido algum tipo de violencia ao longo da vida e 56,4% relataram violencia por parceiro intimo; cerca de 30% mencionaram pelo menos um episodio nos ultimos 12 meses; 6,5% disseram ter procurado ajuda em Unidade Basica de Saude. CONCLUSOES: Relevante proporcao de usuarias vivenciava violencia em seu cotidiano, especialmente por parceiros intimos. Maior parte das mulheres nao era identificada ou abordada nesses servicos e nao recebia ajuda. Gestores e profissionais de saude, embora percebessem a magnitude do problema, nao consideravam a atencao basica preparada para atender essas mulheres. Evidenciou-se a ausencia de rede intersetorial de cuidados para atender mulheres em situacao de violencia.

/pdf/violence-among-female-users-of-healthcare-units-prevalence-4o2wb9wcmp.pdf

Graciana Alves Duarte

Papers

The opinion of Brazilian women regarding vaginal labor and cesarean section

SUS users' knowledge of and attitude to HPV virus and vaccines available in Brazil

The Closer You Are, the Better You Understand: The Reaction of Brazilian Obstetrician–Gynaecologists to Unwanted Pregnancy

Perspectiva masculina acerca do aborto provocado

Violence among female users of healthcare units: prevalence, perspective and conduct of managers and professionals