Gynecology & Obstetrics
İÇİNDEKİLERWomen's PerspectivesS. Kabir Dhaka, Bangladesh Causes and consequences of unwanted pregnancy from Asian women's perspectives......................................9 Women's multiple reproductive health needs and their relationship to unwanted pregnancy in Asia are reviewed. Policy and program modifications are suggested. N.N. Mashalaba Gaborone, Botswana Commentary on the causes and consequences of unwanted pregnancy from an African perspective................15 The causes of unwanted pregnancy and the consequences of illegal abortion, especially for adolescents in sub-Saharan Africa, are reviewed. Specific solutions to the problems are outlined. Physician's Perspectives O.A. Ladipo Ibadan, Nigeria Preventing and managing complications of induced abortion in Third World countries....................21 Specific complications of clandestine abortion are described and modes of treatment discussed. Policy, program and training strategies are recommended. R.S. Samil Jakarta, Indonesia Commentary on menstrual regulation as a health service:challenges in Indonesia................ 29 The legal status, epidemiology, and causes of abortion in Indonesia are reviewed. The necessary components of safe, high quality abortion services are outlined. R.J.I. Leke Yaoundé, Cameroun Commentary on unwanted pregnancy and abortion complications in Cameroun ..............................33 Strategies for improving access to reproductive health care, especially for high risk adolescents, in urban and rural areas of Cameroun are described. R. Macklin New York, USA Liberty utility, and justice: an ethical approach to unwanted pregnancy........................... 37 The case for women's right to reproductive freedom and to contraceptive and abortion services is derived from the fundamental ethical principles of liberty, utility and justice. J. Villarreal Bogota, Colombia Commentary on unwanted pregnancy. induced abortion, and professional ethics: a concerned physician's point of view ...........................51 Reflections on the medical ethics and moral dilemmas posed by abortion provide guidance for medical professionals in making conscientious decisions about serving women with unwanted pregnancies. L.M. Mair Kingston, Jamaica Commentary on the ethics of induced abortion from a feminist perspective ..............57 An argument for reproductive freedom is elaborated, based on fundamentalrights of equality, self-determination, and human dignity. Law R.J. Cook Ontario, Canada Abortion laws and policies: challenges and opportunities.............. 61 Abortion laws of several types are described. Strategies to provide services under existing laws and to reform laws are discussed. A.F. Tadiar Quezon City, Philippines Commentary on the law and abortion in the Philippines........89 Recent drastic restrictions of reproductive rights in the are Phiıippines described. The potential for change through the women's movement, through legal reform and other channels is assessed. C. Alvarez-Laionchere Havana, Cuba Commentary on abortion law and practice in Cuba............... 93 Lessons for other countries are drawn from Cuba's experience in liberalizing abortion laws. The Need for Comprehensive Reproductive Health Services A Policy Perspective J.A. Pinotti, A. Faündes Sao Paolo, Brazil Unwanted pregnancy: challenges for health policy..... 97 Leading health policymakers examine the need for government policies to improve women's health. Specific programs and strategies, including the involvement of women in policymaking, are discussed. Comprehensive Services F.T. Sai, J. Nassim Washington, DC, USA The need for a reproductive health approach .........103 To reduce mortality and morbidity associated with sexuality, reproduction and clandestine abortion, comprehensive reproductive health programs are proposed. A. Faûndes, E. Hardy, J.A. Pinotti Sao Paulo, Brazil Commentary on women's reproductive health: means or end?..........115 The reasons for 'ınattention to women's reproductive health are discussed and strategies for improving women's health are described. O.L. Toro Bogoté, Colombia Commentary on women-centered reproductive health services......119 Strategies to ensure respect for women's basic rights and dignity in reproductive health programs are suggested. Examples are drawn from clinic experiences in Latin America. R. Bang, A. Bang, SEARCH Team Gadchiroli, India Commentary on a community-based approach to reproductive health care...............125 The components of a comprehensive approach to rural women's reproductive health in India are described. Recommendations for research, services and policy are outlined. Clinical Challenges Pain P.G. Stubblefield Vermont and Maine, USA Control of pain for women undergoing abortion .......131 Multiple strategies for reducing pain are reviewed, including psychological support for the patient, modified abortion techniques, improved techniques for paracervical block, analgesics, and avoidance of general anesthesia. J. Nasser Cali, Colombia Commentary on pain management during abortion from a Latin American physician's perspective ......141 Clinical experience is assessed, highlighting the importance of counseling and doctor-patient interaction, not just medical techniques, in pain management. Reproductive Tract Infections J. Wasserheit Maryland, USA The significance and scope of reproductive tract infections among Third World women..........145 Existing literature on the prevalence and consequences of reproductive tract infections is reviewed. Recommendations are made for research, services and policy. Counseling M.L. Londono Cali, Colombia Abortion counseling: attention to the whole woman .....169 The concept and personal and social significance of unwanted pregnancy are analyzed and redefined, as the basis for improved approaches to counseling. Appendix: Statement of the Christopher Tietze International Symposium on Women's Health in the Third World: The Impact of Unwanted Pregnancy............175 Subject Index 177  |
