无痛人流利弊谈

无痛人流术是对早孕妇女的一种人文关怀,它缓解了手术对身体和精神上的痛苦,但也引发了一些医疗、认识和社会问题。文中阐述了我国人流现状和无病人流术的实施方法,分析了无痛人流的利与弊。指出应加强生殖健康教育和避孕知识宣传,规范医疗广告,让青年妇女正确认识无痛人流。     

Abortion in adolescence

Sexual attitudes and behavior of adolescent females have been the topic of much interest over the past decade. Feelings about contraception, conception, and abortion have been described in relation to the adolescents' beliefs about the possibility of becoming pregnant, who will or will not "protect" them, and the influence of significant others on their decision making. This study explores differences in 35 women who had abortions during their teenage years with 36 women whose abortions occurred after the age of twenty. A demographic questionnaire, the Millon Clinical Multiaxial Inventory, and the Beck Depression Inventory were completed by women who were members of a patient-led support group. Premorbid psychiatric histories, the decision-making process itself, and distressing symptoms postabortion are reported. Specific differences in perceptions of coercion, preabortion suicidal ideation, and nightmares post-abortion were found in the adolescent group. Antisocial and paranoid personality disorders as well as drug abuse and psychotic delusions were found to be significantly higher in the group who aborted as teenagers. Hypotheses regarding the influences of adolescent development on mother/child relationships, power struggles, and the use of fantasy as a coping device are explored.     

Severity and cost of unsafe abortion complications treated in Nigerian hospitals

CONTEXT: Each year, thousands of Nigerian women have unintended pregnancies that end in illegal abortion. Many such procedures occur under unsafe conditions, contributing to maternal morbidity and mortality. METHODS: In a 2002-2003 survey of women and their providers in 33 hospitals in eight states across Nigeria, 2,093 patients were identified as being treated for complications of abortion or miscarriage or seeking an abortion. Women's abortion experiences and the health consequences and associated costs were examined through bivariate analysis. Multivariate analysis was used to examine the characteristics of women by type of pregnancy loss and to compare characteristics among three groups of women who had induced abortions in differing circumstances. RESULTS: Among women admitted for abortion-related reasons, 36% had attempted to end the pregnancy before coming to the hospital (including 24% with and 12% without serious complications), 33% obtained an induced abortion at the facility (not withstanding the country's restrictive law) without having made a prior abortion attempt and 32% were treated for complications from a miscarriage. Of women with serious complications, 24% had sepsis, 21% pelvic infection and 11% instrumental injury; 22% required blood transfusion and 10% needed abdominal surgery. The women in this group were poorer and later in gestation than those who sought abortions directly from hospitals. They paid more for treatment (about 13,900 naira) than those who went directly to the hospital for an abortion (3,800 naira) or those treated for miscarriage (5,100 naira). CONCLUSIONS: Policy and program interventions are needed to improve access to contraceptive services and postabortion care in order to reduce abortion-related morbidity and mortality.     

Conscientious objection and emergency contraception

This article argues that practitioners have a professional ethical obligation to dispense emergency contraception, even given conscientious objection to this treatment. This recent controversy affects all medical professionals, including physicians as well as pharmacists. This article begins by analyzing the option of referring the patient to another willing provider. Objecting professionals may conscientiously refuse because they consider emergency contraception to be equivalent to abortion or because they believe contraception itself is immoral. This article critically evaluates these reasons and concludes that they do not successfully support conscientious objection in this context. Contrary to the views of other thinkers, it is not possible to easily strike a respectful balance between the interests of objecting providers and patients in this case. As medical professionals, providers have an ethical duty to inform women of this option and provide emergency contraception when this treatment is requested.     

Emergency contraception for women who have been raped: must catholics test for ovulation, or is testing for pregnancy morally sufficient?

On the grounds that tape is an act of violence, not a natural act of intercourse, Roman Catholic teaching traditionally has permitted women who have been raped to take steps to prevent pregnancy, while consistently prohibiting abortion even in the case of rape. Recent scientific evidence that emergency contraception (EC) works primarily by preventing ovulation, not by preventing implantation or by aborting implanted embryos, has led Church authorities to permit the use of EC drugs in the setting of rape. Doubts about whether an abortifacient effect of EC drugs has been completely disproven have led to controversy within the Church about whether it is sufficient to determine that a woman is not pregnant before using EC drugs or whether one must establish that she has not recently ovulated. This article presents clinical, epidemiological, and ethical arguments why testing for pregnancy should be morally sufficient for a faith community that is strongly opposed to abortion.     

Sample Attrition in Studies of Psychosocial Sequelae of Abortion: How Great a Problem?1

This study examines sample attrition problems in abortion research and the implications for conclusions reached about psychosocial sequelae of abortion. A review of 17 recent studies shows that the percent of the initial sample lost to follow-up ranges from a low of 13% to a high of 86%. Younger women and Catholic women appear to be less likely to participate in follow-up. Since both of these characteristics are associated with a greater likelihood of negative sequelae, follow-up studies may be underestimating the extent of negative reaction to abortion. Data from a recent study are presented; comparisons are made between characteristics of initial volunteers and the total population and between the volunteers who return for the follow-up interview and those who do not. Results support the suggestion that women for whom the abortion was more stressful are less likely to be represented in the final sample. Factors affecting the likelihood of participating in research are explored and strategies for improving the representativeness of samples are suggested.     

Emotional response to abortion: a critical review of the literature

Anti-abortion groups in the US cite the existence of a post-abortion syndrome--a sense of loss, emptiness, and grief similar to that reported by trauma survivors. Although research on the longterm effects of induced abortion is marred by methodological errors, most studies have found no adverse psychological sequelae; rather, there appears to be a sense of relief and opportunity for personal growth. Nevertheless, there is a small group of women who do experience emotional distress after abortion and it is important to identify the demographic, social, and psychological factors that place women at risk of such a reaction. In terms of demographic factors, young age (adolescence), low or nulliparity, 2nd-trimester procedures, and Catholicism have been characteristics of women who suffered post-abortion depression. Of the social variables that have been examined, a lack of support from significant others (parents or partner) has been linked in some studies to emotional distress after abortion. A relatively consistent finding is that women who feel coerced to abort or are ambivalent about their decision at the time of the procedure are most likely to experience regret, depression, and anger. Women whose coping style involves avoiding responsibility are also prone to post-abortion distress. As noted, the literature does not support the contention that abortion causes longterm trauma. On the other hand, given the fact that 1.5 million abortions take place each year in the US, the existence of some post-abortion distress in even as small percentage of acceptors is enough to indicate a need for pre- and post-abortion counseling to help women determine the meaning of the experience and own their decisions.     

Condom Use and Contraception Non-Use Amongst 16-19 Year Olds: A Within Subjects Comparison

Abstract

The present study used a within subject design to examine which situation specific factors discriminated between the use of condoms and non-use of contraception in the context of preventing unwanted pregnancy. Adapting the methodology of Gold et al (1991, 1992), 215 16 to 19 year olds completed a questionnaire concerning the most recent time they had experienced sexual intercourse without using contraception (the “without contraception” encounter) and me most recent time they had experienced sexual intercourse using a condom (the “with a condom” encounter). The results showed that although past behaviour did not differentiate between the two encounters, situational factors relating to preparation for action, affect and interpersonal interaction were important. However, when analysed for men and women separately most of the differences were only found for women. In particular, the results suggest that women report non-contraception use as associated with feeling more guilty, having a partner who is less motivated to use contraception than they are, with neither themselves nor their partner raising the desire to use contraception, not expecting to have sex and not discussing contraception and not having contraception available. In contrast, for men, only the availability of contraception appeared to differentiate between the two encounters. The results are discussed in terms of the usefulness of the methodology and the associated shift in emphasis from users and non-users of contraception to use and non-use. The implications of the results in terms of health education interventions are also considered.     

Differential impact of abortion on adolescents and adults.

The purpose of this study was to compare adolescent and adult reactions to abortion. A sample of 252 women from 42 states was obtained from a national survey of organizations serving as support groups for women who have had negative reactions to abortion. The age analysis was run using t-tests. Results indicated that the adolescents were significantly more likely to be dissatisfied with the choice of abortion than were the older subjects, to have abortions later in the gestational period, to be dissatisfied with services at the time of the abortion, to feel forced by circumstances to have the abortion, to report being misinformed at the time of the abortion, and to report greater severity of psychological stress. The conclusions suggest that the adolescents' problems may be due to a combination of developmental limitations and the nature of counseling at the time of the abortion.     

Connotative meaning of abortion and attitude towards M.T.P

Acceptance of India's Medical Termination of Pregnancy Bill, enacted in 1972 to liberalize abortion, has been affected by cultural and psychological factors. To clarify the affective meaning accorded the term "abortion," the Osgood Semantic Differential technique was used with 354 subjects from South Delhi. Attitudes toward abortion were more favorable among men than women, unmarried women than married women, women with at least 2 living children, and those with at least a high school education as opposed to less educated men and women. The 6 abortion-related factors with the highest loadings were: volition, safety, morality, evaluation, legality, and potency. Analysis of mean composite attitude scores revealed a polarity profile of concepts, with rape, infanticide, promiscuity, and premarital abortion eliciting negative association and physician, baby, small family, and marital relationship eliciting positive associations. Of the 20 concepts that emerged from factor analysis, 2 clusters were identified: 1) goal-oriented concepts baby, doctor, small family, fertility, pregnancy, marital relationship, delivery, population control, birth control, and child as gift of God; and 2) means-oriented concepts Medical Termination of Pregnancy Act, sterilization, abortion, infertility, morbidity, premarital abortion, promiscuity, quacks, infanticide, and rape. These findings suggest that minimal use of the term "abortion" should be made when referring to the Medical Termination of Pregnancy Act, since this term provokes a negative affective meaning. Moreover, given the positive affective connation awarded doctors, more emphasis should be placed on their role in imparting health education material.     

A COMPARATIVE STUDY OF RECIDIVISTS AND CONTRACEPTORS ALONG THE DIMENSIONS OF LOCUS OF CONTROL AND IMPULSIVITY

The research examined personality differences between repeat aborters, initial aborters, and nulliparas. A review of the literature in the area has documented the demographic characteristics of women who continually seek repeated abortion. This study was an attempt to differentiate between women who contracept from those who seek abortion repeatedly on the basis of personality differences. The findings indicate that repeaters who seek abortion at the time of personality testing perceive themselves low in impulsivity, a finding similar to that for women who have never been pregnant and are seeking contraceptive services. Results are examined from the perspective of inaccurate vs accurate self-perceptions. No differences were found with respect to locus of control.     

“I'm Not That Type of Person”: Managing the Stigma of Having an Abortion

Drawing on interviews with U.S. women, this article offers a social–psychological framework for understanding the stigma of having an abortion and identifies the individual stigma management strategies women use to mitigate negative intrapersonal and interpersonal consequences of abortion stigma. We also contribute to contemporary understandings of abortion stigma by theorizing how aspects of abortion stigma—such as its concealability and episodic expression—interfere with women's potential to collectively manage or dismantle abortion stigma. Finally, we discuss how our conceptual framework can be used to inform the development of a measure of the stigma experiences of women who have had an abortion, which can help improve health and well-being outcomes for women.     

Views on Abortion: A Comparison of Female Genetic Counselors and Women from the General Population

While literature characterizing individual genetic counselors’ abortion attitudes is sparse, the National Society of Genetic Counselors takes a clear stance for reproductive autonomy. To determine genetic counselors’ views, this study compared (1) genetic counselors’ abortion attitudes to those of women from the general population and (2) genetic counselors’ professional abortion attitudes to their personal abortion attitudes. Genetic counselors were invited to complete an online survey. Response rate was 44.3% (709/1,601). Compared to women from the general population, female genetic counselors were significantly more likely to agree abortion should be an option in all cases (p < .001). Controlling for other possible confounders, regression analyses revealed that being a genetic counselor, religious service attendance and age were significantly predictive of abortion attitudes. Although the vast majority of genetic counselors agree that abortion should be available, they are significantly less likely to personally consider abortion under all circumstances presented (p < .001), and the percentage of genetic counselors who would consider terminating in the case of a severe birth defect is similar to studies of other women.     

The impact of college‐level sex education on sexual knowledge,attitudes, and practices: The knowledge/sexual experimentation myth revisited

In recent years, many persons have opposed sex education believing that such courses will lead to increased participation in sexual intercourse by young people, but their fears are not supported by most previous research. The influence of sex education material integrated into functional marriage and family courses, however, has not been the subject of in‐depth, scientific investigations.

An anonymous questionnaire was administered to never‐married undergraduate students enrolled in a college‐level marriage and family course at a state university. A pretest and post‐test design was utilized with experimental groups of 50 women and 26 men and comparison groups of 60 women and 28 men.

The findings indicate that the sex education content had a significant impact on the experimental groups, especially for women. Substantial increases in knowledge regarding abortion and contraception, more favorable attitudes toward masturbation, and frequency of masturbation were reported by experimental group women as contrasted with comparison group women. Experimental group men indicated increased knowledge about female hygiene and contraception in contrast to comparison group men. From these findings, sex educators should be able to better meet the criticisms of sex education opponents given this greater understanding of the impact of sex education material on the sex lives of their students.     

Purity, Privacy and Procreation: Constructions and Experiences of Sexual and Reproductive Health in Assyrian and Karen Women Living in Australia

It is widely recognised that sexual and reproductive health services are underutilised by culturally and linguistically diverse migrant communities, leading to risk of poor health outcomes. This study examined the constructions and experiences of reproductive and sexual health, and associated services, in Assyrian and Karen women who had arrived in Australia as refugees. Forty two women, across a range of age groups and marital status, participated in five focus groups, with thematic analysis and positioning theory used to analyse the results. Two major themes were identified. The first, the ??Premarital Chastity Imperative?? centres on the cultural prohibition of coital hetero-sex before marriage, and taboos associated with same-sex relationships. This has implications for unmarried women??s access to sexual health services, such as contraception, cervical screening, and abortion; prohibition of sex education and communication about sex; and lack of recognition of non-heterosexual identities. The second theme, ??Marital Sex and Reproductive Imperative??, positioned coital sex and motherhood as mandatory within marriage, and was associated with women??s inability to refuse marital sex, limited knowledge about contraception and sexual pain, acceptance of fertility services, as well as lack of recognition of post-natal depression. It is concluded that health care workers need to be aware of cultural constructions of sex and sexuality, as well as the construction of gendered roles within heterosexual relationships, when designing and offering sexual health services to non English speaking or migrant communities.     

Self-Esteem, Erotophobia, and Retention of Contraceptive and AIDS Information in the Classroom

It has been well documented that people with negative emotional reactions to sex (e.g., "erotophobia,""sex guilt") have less knowledge about contraception than do people with more positive reactions. Recent research has suggested that this deficit is not related to an inability to learn the information, but is due at least in part to the fact that erotophobics actively avoid contraceptive information. The current study was designed to examine the role of erotophobia and high self-esteem in resistance to learning sexual information. More specifically it compared pretest and posttest knowledge of contraception and AIDS in high self-esteem and low self-esteem, erotophobia, and erotophilic women in a university class on human reproduction. As expected, high self-esteem erotophobic subjects were less Likely than other subjects to retain contraceptive and AIDS information presented in the class. Implications of this study for contraceptive and AIDS educational strategies are discussed.     

Perceived social support, self-efficacy, and adjustment to abortion

Prior to their having a 1st trimester abortion, women's perceptions of social support from their partner, family, and friends and self-efficacy for coping were assessed. Depression, mood, physical complaints, and anticipation of negative consequences were measured after the 30-min recovery period. As predicted, perceived social support enhanced adjustment indirectly through its effects on self-efficacy. Women who perceived high support from their family, friends, and partners had higher self-efficacy for coping. Higher self-efficacy, in turn, predicted better adjustment on the psychological measures but not on the physical complaint measure. No direct path between social support and adjustment was observed. In addition, women who told close others of their abortion but perceived them as less than completely supportive had poorer postabortion psychological adjustment than either women who did not tell or women who told and perceived complete support.     

The psychosocial factors of the abortion experience: a critical review

The literature on the psychosocial factors of abortion is critically reviewed. It is concluded that due to faulty methodology no general statements can be made about these factors for women receiving illegal abortions. It appears that the data showing that women receiving therapeutic abortions experienced favor- able psychological conseuqences are stronger than the data indicating negative consequences. Studies of abortion on request, which, for the most part, have been methodologically sound, indicate that the new abortion patients are mostly young, unmarried women who are not in a social position to bear and care for a child. They tend to end their pregnancies for social and economic reasons. Further, they are either not aware of or not concerned about the possibility of getting pregnant at the time of intercourse, or they have a contraceptive failure. Finally, the psychological consequences of abortion on request appear to be most1 y benign.     

Against the golden rule argument against abortion

R. M. Hare and Harry J. Gensler have each argued that abortion can be shown to be immoral by appealing to a version of the golden rule. I argue that both versions of the golden rule argument against abortion should be rejected: each rests on a version of the golden rule which is objectionable on independent grounds, each is unable to support its conclusion when the rule is satisfactorily modified, and each is unable to avoid the implication that contraception is as wrong as abortion and for the same reason. In addition, some further problems particular to each position are identified.     

Gender,Employment Status,and Abortion: A Longitudinal Analysis

Building upon extant literature, we examine the influence gender and employment status exert on abortion attitudes among the mass public. Specifically, we assess if men, employed women, and homemaker women view the abortion issue differently and if the same factors account for variation in each group's attitudes toward abortion. Analysis of General Social Survey data from 1973 to 2000 indicates that although homemaker women tend to be more pro-life than do men or working women, the attitudes of all 3 groups exhibit similar changes over time. In addition, our results suggest that the same variables account for variation in abortion attitudes for all 3 groups. Our results suggest that the causes and effects of abortion attitudes do not appear to be gender-specific, but rather are relatively uniform across genders and employment statuses.