Evolution of adolescent fertility after decriminalization of abortion in Montevideo, Uruguay

Antón, José María Monsalvo; Ferre, Zuleika; Triunfo, Patricia

doi:10.1016/j.ijgo.2016.06.002

Cited by 8 publications

(13 citation statements)

References 19 publications

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“…The VTP law has produced neither significant changes in total births, nor significant changes  in the number of abortions among teenagers. 4 This legislation did produce a reduction in the number of unplanned pregnancies of about 8 percent, but did not produce any effect on adolescent fertility (López Gómez, Brunet, and Couto 2019;Antón, Ferre, andTriunfo 2018, 2016).…”

Section: Program Features and Contraceptive Methods In Uruguaymentioning

confidence: 99%

Birth Collapse and a Large‐Scale Access Intervention with Subdermal Contraceptive Implants

Ceni

Parada

Perazzo

et al. 2021

Studies in Family Planning

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Between  and , we observe in Uruguay a steep decline of almost  percent in the number of total births, leading to the collapse of the adolescent fertility rate after decades of relative stagnation. We estimate the quantitative contribution on birth rates, especially teen births, of a policy of expanded availability of subdermal contraceptive implants. We exploit the expansion schedule of a large-scale policy of free-of-charge access to subdermal implants in the country's public health system through an event study to capture causal effects. We use detailed birth administrative records for the past  years. We document an average reduction of  percent in the birth rate in public health facilities across the two years after the policy was implemented in each department. These reductions were notably higher among teens and first births. Although changes in women's fertility decisions are a multicausal phenomenon, we claim that the expanded availability of subdermal contraceptive implants accounted for one-third of the teen and young women's birth collapse.

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Section: Program Features and Contraceptive Methods In Uruguaymentioning

confidence: 99%

Birth Collapse and a Large‐Scale Access Intervention with Subdermal Contraceptive Implants

Ceni

Parada

Perazzo

et al. 2021

Studies in Family Planning

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“…The abortion articles focus largely on strategies for bringing the law more in line with human rights obligations and public health guidance and implementation of the law, including the legal advocacy process contributing to the passage of a new law, [27][28][29] the extent to which the law is realised or circumvented, reasons for this and/or how to improve implementation and whether the law seemingly led to the desired social outcomes. [63][64][65][66][67] Other abortion-related articles probe more specific reasons for lack of implementation, namely lack of knowledge among key stakeholders or ideological opposition among community members or providers 47 61 68-78 and/or law or practice related to conscientious objection. [79][80][81] Each of the five articles regarding Female Genital Cutting/Mutiliation (FGC/M) focuses on the implementation of the law, including whether it is implemented and why it is not fully implemented.…”

Section: Part 1: Description Of Search Term Results From Abstractearch Of Empirical Literaturementioning

confidence: 99%

“…98 A paper analysing the association between legal grounds for abortion in national law and unsafe abortion in 160 countries found a 'clear pattern' with countries where abortion is permitted on broad indications having lower incidence of unsafe abortion and lower mortality from unsafe abortion, 64 a finding confirmed by Henderson et al 108 On the other hand, Anton et al, Briozzo and Briozzo et al found that Uruguay may be an exception; the chief contributor to reduced unsafe abortion was the adoption BMJ Global Health of a harm reduction approach to abortion care, rather than the change in law that eventually followed the application of harm reduction. 63 65 Similarly, a socioecological study on SRH outcomes in Nigeria found that states where customary and religious law were codified had poorer SRH outcomes, customary and religious law essentially watered down the salience of statutory law. 94 Three papers explored the concept of 'alegality', finding that safe abortion services were being provided in certain contexts with some level of government tolerance, irrespective of the fact that it was not permitted by law.…”

Section: Part 1: Description Of Search Term Results From Abstractearch Of Empirical Literaturementioning

confidence: 99%

Necessary but not sufficient: a scoping review of legal accountability for sexual and reproductive health in low-income and middle-income countries

Schaaf

Khosla

2021

BMJ Glob Health

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BackgroundThis paper is a scoping review of the impact of legal accountability efforts for sexual and reproductive health and rights (SRHR), exploring the links between legal accountability strategies and changes in the desired SRHR outcomes.MethodsWe defined legal accountability as use of the judicial system following state failure to respect, protect or fulfil SRHR as enshrined in national law, as well as individuals’ or the state’s use of criminal law mechanisms to prevent unwanted behaviour and to provide remedy. We undertook a keyword search in PubMed, Scopus and LexisNexis and then consulted a group of experts to provide guidance regarding further peer-reviewed and grey literature, yielding a total of 191 articles.ResultsThe majority of the empirical, peer-reviewed articles identified were regarding abortion law and abortion care availability, followed by violence against women. Most of these articles explore the gaps between law and practice. We identified seven key factors that shape the efficacy of legal accountability efforts, including the ways a law or court decision is formulated, access to courts, the (dis)advantages of criminal law in the given context, cultural norms, politics, state capacity and resources and the potential for further litigation. Many articles explained that use of the judiciary may be necessary to effect change and that the act of claiming rights can empower, but that legal avenues for change can be imperfect tools for justice.ConclusionsLegal accountability can be effective as part of a broader, long-term strategy, with due attention to context.

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“…The Ministry of Health/National Health Service relied on NGOs and medical organizations for their expertise, resources, and stature within the respective professions. In the higher HDI countries (Portugal, Colombia, and Uruguay), key contributions also came from country‐based health‐oriented NGOs, such the Portuguese Family Planning Association, Iniciativas Sanitarias in Uruguay, and Oriéntame and Profamilia in Colombia . In South Africa and Latin America, civil society groups’ advocacy and monitoring of the rollout and subsequent performance of the abortion services exerted pressure on the Ministry of Health/National Health Service to refine and improve services.…”

Section: Facilitationmentioning

confidence: 99%

Implementing and expanding safe abortion care: An international comparative case study of six countries

Chavkin

Stifani

Bridgman-Packer

et al. 2018

Intl J Gynecology & Obste

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We conducted a comparative case study‐based investigation of health sector strategies that were useful in expanding or establishing new abortion services. We selected geographically diverse countries from across the human development index if they had implemented new abortion laws, or changed interpretations of existing laws or policies, within the past 15 years (Colombia, Ethiopia, Ghana, Portugal, South Africa, and Uruguay). Factors facilitating the expansion of services include use of a public health frame, situating abortion as one component of a comprehensive reproductive health package, and including country‐based health and women's rights organizations, medical and other professional societies, and international agencies and nongovernment organizations in the design and rollout of services. Task sharing and the use of techniques that do not require much infrastructure, such as manual vacuum aspiration and medical abortion, are important for rapid establishment of services, especially in low‐resource settings. Political will emerged as the key factor in establishing or expanding access to safe abortion services.

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Evolution of adolescent fertility after decriminalization of abortion in Montevideo, Uruguay

Abstract: The normative change brought about by the law on the voluntary termination of pregnancy was not associated with any substantial change in the reproductive behavior of adolescents in Montevideo. We recommend that this analysis is taken further with impact evaluation methodologies.

Cited by 8 publications

References 19 publications

Birth Collapse and a Large‐Scale Access Intervention with Subdermal Contraceptive Implants

Birth Collapse and a Large‐Scale Access Intervention with Subdermal Contraceptive Implants

Necessary but not sufficient: a scoping review of legal accountability for sexual and reproductive health in low-income and middle-income countries

Implementing and expanding safe abortion care: An international comparative case study of six countries

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