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Gynaecology, Fertility and Family Planning
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Kopal Singhal Agarwal, Chawan Baran, Lauren Laws, Maria Garcia de Frutos, Black Benjamin
Abortions can occur spontaneously, also referred to as miscarriages, or as the result of a deliberate intervention, also known as ‘induced abortion’. In 95% of countries, induced abortion is legal in order to save the life or preserve the health of the woman. However, there are often administrative requirements that are difficult to fulfil in refugee situations. Healthcare providers should familiarise themselves with the local policies and speak with the community in order to provide the safest and most appropriate service for women in need.
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Published in Hanna Laako, Georgina Sánchez-Ramírez, Midwives in Mexico, 2021
Georgina Sánchez-Ramírez, Geicel Llamileth Benítez Fuentes
The study included 14,859 women between the ages of 15 and 55; 966 of these women reported having had an induced abortion during the past five years. The authors learned that women from lower economic status, with less education, and from Indigenous origins were more likely to have had their abortions under unsafe conditions. The main variable used by the authors to determine whether an abortion was unsafe was whether the abortion had been attended by a doctor or performed in a hospital setting. This criterion reflects an important assumption: that “In Mexico only doctors are formally trained to perform abortions” (Sousa et al. 2010, 302). Therefore, we ask: are all abortions that are performed in non-hospital settings and with non-medical personnel assisting the woman ipso facto unsafe, or is the role of other health agents and their ability to perform safe practices in countries like Mexico being underestimated? In other words, Sousa et al. (2010) seem to omit the fact that, in a country such as Mexico, the use of a wide range of medicines—usually referred to as “traditional” or “alternative”—has persisted since colonial times. These medicines continue to co-exist with the hegemonic (Western) medical practice, and it is common for people to hybridize different options to achieve equilibrium between health and sickness (Sánchez-Ramirez 2010). The case of induced abortion is no different, as this chapter will show.
The decriminalisation of abortion in Colombia as cautionary tale. Social movements, numbers and socio-technical struggles in the promotion of health as a right
Published in Emily E. Vasquez, Amaya Perez-Brume, Richard G. Parker, Social Inequities and Contemporary Struggles for Collective Health in Latin America, 2020
The AICM relies on two types of data to estimate the number of abortions: ‘the number of women who receive facility-based treatment for induced abortion complications; and the proportion of all women having abortions who receive facility-based treatment for complications’. In many cases an inflation factor is applied to the number of women treated in health facilities for induced abortion complications to yield the total number of induced abortions. In the Colombia case this is done because the quality of hospital records has ‘deteriorated to an unacceptable level after decentralisation and the reform of the health system in 1993’ (AGI, 2012, p. 4).
Estimating induced abortion incidence and the use of non-recommended abortion methods and sources in two provinces of the Democratic Republic of the Congo (Kinshasa and Kongo Central) in 2021: results from population-based, cross-sectional surveys of reproductive-aged women
Published in Sexual and Reproductive Health Matters, 2023
Pierre Akilimali, Caroline Moreau, Meagan Byrne, Dynah Kayembe, Elizabeth Larson, Suzanne O. Bell
Induced abortion is a common reproductive health event globally, with approximately 39 abortions per 1000 women* aged 15–49 annually.1 Measuring abortion incidence is important for understanding pregnancy and fertility patterns, but abortion also has public health significance as nearly half of all abortions each year are considered unsafe.2 Induced abortion is extremely safe when performed according to medical guidance, however, unsafe abortion is responsible for an estimated 8% of maternal mortality worldwide.3 The majority of these deaths occur in the Global South, including many countries in sub-Saharan Africa where a large proportion of abortions occur outside the formal healthcare system due to legal restrictions, stigma, cost, and limited availability or accessibility of safe abortion services.4
Comparison of the Efficacy of Two Laparoscopic Surgical Procedures Combined with Hysteroscopic Incision in the Treatment of Cesarean Scar Diverticulum
Published in Journal of Investigative Surgery, 2022
Chao Peng, Yan Huang, Ye Lu, Yingfang Zhou
Seven patients in the folding suture group had pregnant intention after six months of surgery, including four successful pregnancy, with an average time of 17.75 months after surgery (81,12,428 months respectively). Ultrasound examination showed that the myometrial of the lower uterine segment was continuous during pregnancy. Scheduled cesarean sections were performed at 37-39 weeks of pregnancy. The operation was smooth without surgical complications. One patient was pregnant 11 months postoperatively, underwent a midterm induction at 13 weeks of gestation due to fetal malformation. One got pregnant at 18 months performing an induced abortion due to early embryonic death. A cesarean scar pregnancy occurred after 14 months of the surgery, uterine artery embolization was performed and no pregnancy was attempted after induced abortion.
Fertility preservation immediately after therapeutic abortion results in multiple normal follicular growth with the absence of mature oocytes due to early luteinization: a case report and literature review
Published in Gynecological Endocrinology, 2021
Haru Hamada, Tomonari Hayama, Akifumi Ijuin, Ai Miyakoshi, Michi Kasai, Shiori Tochihara, Marina Saito, Mayuko Nishi, Hiroe Ueno, Mizuki Yamamoto, Mitsuru Komeya, Yasushi Yumura, Hideya Sakakibara, Etsuko Miyagi, Mariko Murase
A 20-year-old female presented with dizziness and pancytopenia. She was referred to our hospital and diagnosed with mixed-phenotype acute leukemia and pregnancy (gestational age at presentation: five weeks). After a detailed hematology examination, it was concluded that early induction of chemotherapy and future stem cell transplantation were necessary. Therefore, the obstetrician performed an induced abortion at nine weeks of gestation. She was referred to our reproductive medical center for fertility preservation before cancer therapy that included high-risk infertile chemotherapy and total body irradiation. The patient’s ovarian reserve was normal with an anti-Mullerian hormone level of 3.65 ng/mL. The hCG was elevated at 116,420 IU/L, as was the progesterone (P4) (16.4 ng/mL). To hasten leukemia therapy, we explained to the patient the possibility of failure of follicle growth and/or early ovulation and gained her consent, and ovarian stimulation was initiated.