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PubMedDate not supplied

Improving the medical care and counseling of postabortion patients in Egypt.

This report analyzes the results of an operations research project carried out at two sites in Egypt to improve the medical care and counseling of postabortion patients. Preintervention and postintervention surveys and observations were conducted. After the introduction of vacuum aspiration under local anesthesia, the number of cases treated with dilatation and curettage under general anesthesia dropped from an average of 169 per month to 16. The majority of the remaining cases (an average of 119 per month) were treated with vacuum aspiration. Both providers' and women's knowledge about postabortion complications improved. Family planning information provided to postabortion patients increased as a result of the project's training program. The proportion of patients intending to use a contraceptive method increased by 30 percentage points due to the improved counseling. Future programs linking family planning and postabortion medical services should be prepared to improve the medical care of existing emergency health services and to add counseling services.

Abortion, Illegal↗
PubMed1997

Forgiveness intervention with postabortion men.

An intervention designed to foster forgiveness was implemented with postabortion men. Participants were randomly assigned to either the treatment or the control (wait list) condition, which received treatment after a 12-week waiting period. Following treatment, the participants demonstrated a significant gain in forgiveness and significant reductions in anxiety, anger, and grief as compared with controls. Similar significant findings were evident among control participants after they participated in the treatment. Maintenance of psychological benefits among the 1st set of participants was demonstrated at a 3-month follow-up.

Abortion, Induced↗
PubMed1981

Total prevention of Rh hemolytic disease: possible or impossible?

Rh immune globulin prophylaxis has reduced the incidence of Rh immunization in Manitoba from 10.6 per 1000 births in 1964 to 1.8 per 1000 births in 1979. With total physician, patient compliance, and universal antenatal, postnatal postabortion, postamniocentesis Rh prophylaxis programs and Kleihauer fetal red cell screening, the incidence of Rh immunization will be reduced even further. However, since there is a 0.106% incidence of Rh immunization appearing before antenatal Rh prophylaxis is given and a 0.085% incidence of Rh immunization occurring in which the cause of the immunization is unknown, total prevention of Rh immunization is impossible. Assuming a family size of 2.2 to 2.5 children, reduction of the incidence of Rh immunization to 0.4 per 1000 births is possible and should be our goal.

Abortion, Spontaneous↗
PubMed1990

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.

Abortion, Induced↗
PubMed1992

The psychosocial sequelae of a second-trimester termination of pregnancy for fetal abnormality.

A retrospective study to investigate the psychosocial sequelae of a second-trimester termination of pregnancy (TOP) for fetal abnormality (FA) is described. After appropriate consent was obtained, 84 women and 68 spouses were visited 2 years after the event and asked to complete an extensive questionnaire. Most couples reported a state of emotional turmoil after the TOP. There were differences in the way couples coped with this confusion of feelings. After 2 years about 20 per cent of the women still complained of regular bouts of crying, sadness, and irritability. Husbands reported increased listlessness, loss of concentration, and irritability for up to 12 months after the TOP. In the same period, there was increased marital disharmony in which 12 per cent of the couples separated for a while and one couple obtained a divorce. These problems could be attributed to a lack of synchrony in the grieving process. Confusing and conflicting feelings led to social isolation and lack of communication. Difficulties in coming to terms with the fetal loss were not found to be linked to the type of fetal abnormality or religious beliefs but were related to parental immaturity, inability to communicate needs, a deep-rooted lack of self-esteem before the pregnancy, lack of supporting relationships, and secondary infertility. Suggestions for improved management are given.

Abortion, Therapeutic↗
PubMedDate not supplied

[Postpartum contraceptive practice in hospitals of the Federal District].

For many women living in developing areas, childbirth is the only time when they receive medical care in a clinical setting. These women may not return until they are ready to deliver their next baby. Without access to family planning counseling and effective contraceptive methods, they are likely to become pregnant again within a year or two. Where contraceptive information and services are available to women receiving maternity care, many choose to begin using contraception in the postpartum period. Some elect to have an IUD inserted immediately after delivery or to undergo sterilization while still in the hospital. Under a postpartum contraceptive program administered by the IMSS in one hospital and the same program established in another hospital of the SSA, more than half of postpartum and postabortion women began using contraception or underwent sterilization before they left the hospital. In contrast, the other hospitals under the analysis showed a wide range of contraception coverage from 7 to 55 percent. A formal postpartum contraception program is necessary to establish in all the hospitals in order to improve coverage. Counseling is an important component for all women who must have adequate information before they choose a contraceptive method.

Contraception↗
PubMed2002

Reducing abortion-related mortality in South Asia: a review of constraints and a road map for change.

South Asia (Bangladesh, India, Nepal, Pakistan, and Sri Lanka) is home to 28% of the world's people and accounts for about a third (30%) of the world's maternal deaths. Thirteen percent of all maternal deaths in South Asia are attributed to complications of unsafe abortion and are almost entirely preventable. This article reviews the legal, health system, and sociocultural barriers to safe abortion and suggests strategies to reduce abortion-related morbidity and mortality. Restrictive laws hamper safe abortion in most of the region, but even where laws are more liberal, limited awareness of the law has been a barrier to access. Such health system barriers as an insufficient number of trained providers, inequitable distribution of services, and excessive costs have contributed to death from unsafe abortion. Sociocultural attitudes, including the right of male relatives to make reproductive decisions, the emphasis on male heirs, and the strong social stigma against extramarital pregnancy also put women at risk. Government and other institutions must strive to prevent abortion-related death and disability by making safe abortion services accessible to the fullest extent of the law. Health systems need to provide emergency care for complications and postabortion contraceptive counseling, use appropriate technology, and allow nonphysician providers to deliver care. Safe abortion care programs need to address the needs of the local community, particularly the needs of socially and economically vulnerable subgroups, such as the unmarried and adolescents.

Abortion, Induced↗
PubMed1996

Detailed analysis of menstrual bleeding patterns after postmenstrual and postabortal insertion of a copper IUD or a levonorgestrel-releasing intrauterine system.

Detailed information on the menstrual bleeding patterns in users of copper-releasing intrauterine devices (IUDs) and levonorgestrel-releasing intrauterine systems (IUSs) is lacking. Even less is known about the menstrual bleeding patterns associated with postabortal insertion of IUDs. We postulated that the scarcity of IUD studies including detailed analysis of bleeding could be a result of the lack of an easy-to-use computer program designed for this purpose. We therefore developed a set of graphical user interface (Windows) programs for entering, editing, and analyzing menstrual diary data. With these programs, we reanalyzed the menstrual diaries of the subjects of one of the hospital clinics that participated in a previous multicenter study comparing copper IUDs and LNg IUSs. The group included patients who had the IUD inserted postabortally. Copper IUD users had patterns of bleeding that were stable over time, and clearly more bleeding than LNg IUS users, many of whom had either infrequent bleeding, bleeding completely replaced by regularly occurring spotting, or amenorrhea. Postabortal insertion of LNg IUSs was associated with slightly better patterns of bleeding than postmenstrual insertion. Detailed statistics on bleeding help clinicians in counseling patients regarding these methods. The statistics permit assumptions to be made about the probabilities of specific menstrual disturbances and their changes over time.

Abortion, Induced↗
PubMed1984

Urban black adolescents who obtain contraceptive services before or after their first pregnancy. Psychosocial factors and contraceptive use.

This paper compares three groups of urban black teenagers at their enrollment in a contraceptive program and at a one-year follow-up. The groups comprise 263 never-pregnant, postabortion, and postpartum teens ages less than or equal to 17 years at their initial family planning visit. Self-report questionnaires examined attitudes and information about pregnancy and contraceptive use, sources of contraceptive information, sexual and contraceptive experience, family and partner support for contraceptive use, and demographic background factors. Emotional, personality, and psychosocial factors were assessed with standard measures. Age, partner relationships, and items relating to the mother's communication about contraception and pregnancy were significant variables in the outcome of never-pregnant and delivery of pregnancy. Self-esteem was highest in the never-pregnant group. Personality factors, emotional distress, and social adjustment scores were in the normal ranges and did not differ between the groups. Contraceptive use at follow-up was most consistent in the never-pregnant group. These data suggest the need for earlier family involvement in educating and guiding teens together with access to contraceptive services in preventing unwanted adolescent pregnancies.

Abortion, Induced↗