RESUMO
PIP: Sociocultural and psychological investigations were conducted to determine why lower class Chilean women undergo abortions despite strong social, religious, and legal sanctions. According to various estimates, there are 2 undetected illegal abortions in Chile for each abortion leading to hospitalization of the woman. Some 120,000-150,000 abortions are estimated to occur each year, compared to perhaps 300,000 live births. Illegal abortion is the principal cause of maternal mortality in Chile, carrying 4 times greater risk of death than term pregnancy. Because of the extreme difficulty of obtaining systematic information on abortion in the society at large, the studies were conducted in hospital wards treating women for septic abortions. Qualitative studies were 1st conducted using intensive methods such as life histories and a test of body image to assess knowledge of reproductive anatomy and physiology. A more extensive study was then done 2 of the 6 health services in metropolitan Santiago and a health service in Valparaiso. The sample of 357 women represented almost all of the women treated for abortion in the services during the time of the study. The women were lower class, primarily of urban origin, and 16-34 years old for the most part. 60% were single and 10% were separated or widowed. 75% had some secondary education but only 20% had finished secondary school. 1/2 of the sample had no gainful employment and 60% of the rest lacked any type of social insurance. 1/2 of the abortions were in single women abandoned by their partners or who lived with their parents and feared their reactions. 15% were single women who feared loss of employment. 30% were married with children and gave economic reasons for seeking abortion. The women were found to have erroneous ideas about the reproductive cycle, believing pregnancy to be possible only around the time of menstruation. Their beliefs were part of a coherent system passed down by oral tradition and not challenged by any scientific teaching imparted in the educational process. Very few used modern contraception. They relied instead on periodic abstinence during the days they erroneously believed to be fertile. They were not strongly motivated to seek modern contraception and many believed they lacked access or did not meet qualifications for family planning programs. The products of conception were not viewed as a truly living thing until after the 1st months of gestation. They believed that once the lesser abortifacient actions such as drinking concoctions were undertaken the child would inevitably be deformed. They were thus motivated for the 2nd stage, traumatic introduction of foreign objects into the uterus to provoke abortion usually at the hands of unskilled person under septic conditions. Most of the women knew of safer means of abortion but were unable to pay for them.^ieng