Unsafe abortion and health care: a scoping review
DOI:
https://doi.org/10.22421/1517-7130/es.2025v26.e1060Keywords:
Induced abortion, Reception, BioethicsAbstract
Abortion is considered unsafe when the procedures used to perform it are not carried out according to medical standards. The practice of unsafe abortion takes place under prohibitive legislation. The aim of this scoping review is to map out what the literature reveals about women's health care after unsafe abortion. The question is, what does the literature reveal about healthcare for women after unsafe abortion? The three databases PubMed, BVS, Scielo and CAPES were used and 46 articles were selected to structure the discussion. It was discussed that there are different abortion routes and that these are related to social inequality and racism. In addition to economic difficulties, marital violence, psychological violence and lack of support are part of the scopes surveyed. The conclusion is that unsafe abortion results in poor health care, with difficulties in post-abortion care, generating avoidable consequences.
References
Andersson IM, Christensson K, Gemzell-Danielsson K. Experiences, Feelings and Thoughts of Women Undergoing Second Trimester Medical Termination of Pregnancy. PLoS ONE [Internet]. 2014 [citado 23 de jan 2025];9(12):e115957. Disponível em: https://doi.org/10.1371/journal.pone.0115957
Aquino EML, Menezes GMS, Barreto-de-Araújo TV, Alves MT, Almeida MCC, Alves SV et al. Avaliação da qualidade da atenção ao aborto: protótipo de questionário para usuárias de serviços de saúde. Cad Saude Publica [Internet]. 014 [citado 23 de jan 2025];30(9):2005-16. Disponível em: https://doi.org/10.1590/0102-311x00009214
Avila FE, Fragoso GR, Czepula AIS, Novellino AMM. Malformações congênitas em uma cidade da região metropolitana de Curitiba-PR. Espac Saude [Internet]. 2023 [citado 20 de fev 2025];24:1-12. Disponível em: https://doi.org/10.22421/1517-7130/es.2023v24.e916
Billings DL, Walker D, Mainero del Paso G, Clark KA, Dayananda I. Pharmacy worker practices related to use of misoprostol for abortion in one Mexican state. Contraception [Internet]. 2009 [citado 23 de jan 2025];79(6):445-51. Disponível em: https://doi.org/10.1016/j.contraception.2008.12.011
Bo M, Zotti CM, Charrier L. Conscientious objection and waiting time for voluntary abortion in Italy. Eur J Contracept Amp Reprod Health Care [Internet]. 12015 [citado 23 de jan 2025];20(4):272-82. Disponível em: https://doi.org/10.3109/13625187.2014.990089
Britton LE, Mercier RJ, Buchbinder M, Bryant AG. Abortion providers, professional identity, and restrictive laws: A qualitative study. Health Care Women Int [Internet]. 2016 [citado 23 de jan 2025];38(3):222-37. Disponível em: https://doi.org/10.1080/07399332.2016.1254218
Chima SC, Mamdoo F. Ethical and legal dilemmas around termination of pregnancy for severe fetal anomalies: A review of two African neonates presenting with ventriculomegaly and holoprosencephaly. Niger J Clin Pract [Internet]. 2015 [citado 23 de jan 2025];18(7):31. Disponível em: https://doi.org/10.4103/1119-3077.170820
Czarnecki D, Anspach RR, De Vries RG, Dunn MD, Hauschildt K, Harris LH. Conscience reconsidered: The moral work of navigating participation in abortion care on labor and delivery. Soc Sci Amp Med [Internet]. 2019 [citado 23 de jan 2025];232:181-9. Disponível em: https://doi.org/10.1016/j.socscimed.2019.03.034
Dickens BM. Post‐abortion care: Ethical and legal duties. Int J Gynecol Amp Obstet [Internet]. 2019 [citado 23 de jan 2025];147(2):273-8. Disponível em: https://doi.org/10.1002/ijgo.12951
Duarte NIG, Moraes LL, Andrade CB. A experiência do aborto na rede: análise de itinerários abortivos compartilhados em uma comunidade online. Cienc Amp Saude Coletiva [Internet]. 2018 [citado 23 de jan 2025];23(10):3337-46. Disponível em: https://doi.org/10.1590/1413-812320182310.14062018
Farrell RM, Mabel JHD, Reider MW, Coleridge MLGC, Yoder Katsuki M. Implications of Ohio’s 20-Week Abortion Ban on Prenatal Patients and the Assessment of Fetal Anomalies. Obstetrics and Gynecology [Internet]. 2017 [citado 23 de jan 2025]; 129(5): 795–99. Disponível em: https://doi.org/10.1097/AOG.0000000000001996
Fernandes IB, Xavier RB, São Bento PAS, Rodrigues A. Nas vias de interromper ou não a gestação: vivências de gestantes de fetos com anencefalia. Cienc Amp Saude Coletiva [Internet]. 2020 [citado 23 de jan 2025];25(2):429-38. Disponível em: https://doi.org/10.1590/1413-81232020252.14812018
Fetters T, Raisanen K, Mupeta S, Malisikwanda I, Vwalika B, Osur J et al. Using a harm reduction lens to examine post-intervention results of medical abortion training among Zambian pharmacists. Reprod Health Matters [Internet]. 2014 [citado 23 de jan 2025];22(sup44):116-24. Disponível em: https://doi.org/10.1016/s0968-8080(14)43794-7
Fragoso M. Taking Conscience Seriously or Seriously Taking Conscience?: Obstetricians, Specialty Boards, and the Takings Clause. NDLR [Internet].2011 [citado 23 de jan 2025]; 86(4). Disponível em: https://scholarship.law.nd.edu/ndlr/vol86/iss4/6/
Harris LH. Recognizing Conscience in Abortion Provision. New Engl J Med [Internet]. 2012 [citado 23 de jan 2025];367(11):981-3. Disponível em: https://doi.org/10.1056/nejmp1206253
Hostiuc S, Buda O, Hostiuc M. Late abortion. Attitudes amongst young physicians in Romania. Arch Gynecol Obstet [Internet]. 2013 [citado 23 de jan 2025];288(2):431-7. Disponível em: https://doi.org/10.1007/s00404-013-2763-6
Huberfeld N. With Liberty and Access for Some: The ACA’s Disconnect for Women’s Health. Fordham Urb L J [Internet]. 2013 [citado 23 de jan 2025]; 40. Disponível em: https://ir.lawnet.fordham.edu/ulj/vol40/iss4/4/.
Jogee F. Partial-birth abortion – is it legally and ethically justifiable? Lessons for South Africa. South Afr J Bioeth Law [Internet]. 2018 [citado 23 de jan 2025];11(2):96. Disponível em: https://doi.org/10.7196/sajbl.2018.v11i2.623
Keogh LA, Gillam L, Bismark M, McNamee K, Webster A, Bayly C et al. Conscientious objection to abortion, the law and its implementation in Victoria, Australia: perspectives of abortion service providers. BMC Medical Ethics [Internet]. 2019 [citado 23 de jan 2025]; 20(1)11. Disponível em: https://doi.org/10.1186/s12910-019-0346-1
Kluge EH. Ethical Considerations on Methods Used in Abortions. Health Care Anal [Internet]. 2012 [citado 23 de jan 2025];23(1):1-18. Disponível em: https://doi.org/10.1007/s10728-012-0232-1
Lima NDF, Cordeiro RLM. “A minha vida não pode parar”: itinerários abortivos de mulheres jovens. Rev Estud Fem [Internet]. 2020 [citado 23 de jan 2025];28(1). Disponível em: https://doi.org/10.1590/1806-9584-2020v28n158290
Lyus RJ. Response to: ‘Why medical professionals have no moral claim to conscientious objection accommodation in liberal democracies’ by Schuklenk and Smalling. J Med Ethics [Internet]. 2016 [citado 23 de jan 2025];43(4):250-2. Disponível em: https://doi.org/10.1136/medethics-2016-103643
Madeiro AP, Rufino AC. Maus-tratos e discriminação na assistência ao aborto provocado: a percepção das mulheres em Teresina, Piauí, Brasil. Cienc Amp Saude Coletiva [Internet]. 2017 [citado 23 de jan 2025];22(8):2771-80. Disponível em: https://doi.org/10.1590/1413-81232017228.04252016
Magelssen M, Le NQ, Supphellen M. Secularity, abortion, assisted dying and the future of conscientious objection: modelling the relationship between attitudes. BMC Med Ethics [Internet]. 2019 [citado 23 de jan 2025];20(1). Disponível em: https://doi.org/10.1186/s12910-019-0408-4
Marván ML, del Río A,A Campos Z. On Abortion: Exploring Psychological Meaning and Attitudes in a Sample of Mexican Gynecologists. Dev World Bioeth [Internet]. 2012 [citado 23 de jan 2025];14(1):29-36. Disponível em: https://doi.org/10.1111/dewb.12005
Nunes MD, Madeiro A, Diniz D. Histórias de aborto provocado entre adolescentes em Teresina, Piauí, Brasil. Cienc Amp Saude Coletiva [Internet]. 2013 [citado 23 de jan 2025];18(8):2311-8. Disponível em: https://doi.org/10.1590/s1413-81232013000800015
Pereira VN, Oliveira FA, Gomes NP, Couto TM, Paixão GPN. Abortamento induzido: vivência de mulheres baianas. Saude Soc [Internet]. 2012 [citado 23 de jan 2025];21(4):1056-62. Disponível em: https://doi.org/10.1590/s0104-12902012000400022
Rocha BNGA, Uchoa SAC. Avaliação da atenção humanizada ao abortamento: um estudo de avaliabilidade. Physis [Internet]. 2013 [citado 23 de jan 2025];23(1):109-27. Disponível em: https://doi.org/10.1590/s0103-73312013000100007
Shaw J. Full-Spectrum Reproductive Justice: The Affinity of Abortion Rights and Birth Activism. Stud Soc Justice [Internet]. 2012 [citado 23 de jan 2025];7(1):143-59. Disponível em: https://doi.org/10.26522/ssj.v7i1.1059
Suter SM. The Politics of Information: Informed Consent in Abortion and End-of-Life Decision Making. Am J Law Amp Med [Internet]. 2013 [citado 23 de jan 2025];39(1):7-61. Disponível em: https://doi.org/10.1177/009885881303900101
Wataganara T, Nawapun K, Phithakwatchara N. Fetal Anomalies in Twin Pregnancies. Donald Sch J Ultrasound Obstet Gynecol [Internet]. 2016 [citado 23 de jan 2025];10(3):308-12. Disponível em: https://doi.org/10.5005/jp-journals-10009-1477
Wheeler SB, Zullig LL, Reeve BB, Buga GA, Morroni C. Attitudes and Intentions Regarding Abortion Provision Among Medical School Students in South Africa. Int Perspect Sex Reprod Health [Internet]. Set 2012 [citado 23 de jan 2025];38(03):154-63. Disponível em: https://doi.org/10.1363/3815412
Zaręba K, Banasiewicz J, Rozenek H, Ciebiera M, Jakiel G. Emotional Complications in Midwives Participating in Pregnancy Termination Procedures—Polish Experience. Int J Environ Res Public Health [Internet]. 2020 [citado 23 de jan 2025];17(8):2776. Disponível em: https://doi.org/10.3390/ijerph17082776
Zulu JM, Ali J, Hallez K, Kass N, Michelo C, Hyder AA. Ethics challenges and guidance related to research involving adolescent post-abortion care: a scoping review. Reprod Health [Internet]. 2018 [citado 23 de jan 2025];15(1). Disponível em: https://doi.org/10.1186/s12978-018-0515-6
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Copyright (c) 2025 João Moisés Oliveira Lapola, Camila Aparecida Moraes Marques, Leonardo de Souza Cardoso, Maria Cecilia Da Lozzo Garbelini, Leide da Conceição Sanches
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