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Objective: 26% of all pregnancies end in miscarriage, and up to 10% of clinically diagnosed pregnancies, and recurrent pregnancy loss is 5% among couples of childbearing ages. Although there are several known causes of pregnancy loss in the first half, including recurrent pregnancy loss, including parental chromosomal abnormalities, uterine malformations, endocrinological disorders, and immunological abnormalities, about half of the cases of pregnancy loss in its first half remain unexplained. Methods: The review includes observational controlled studies (case-control or cohort, longitudinal studies, reviews, meta-analyses), which include the study of biochemical factors for predicting pregnancy losses in the first half, in singlet pregnancy. The Newcastle-Ottawa Scale (NOS) was used to assess the research quality. Results: Finally, 27 studies were included in the review, which has 134904 examined patients. The results of the review include estimates of ß-human chorionic gonadotropin, progesterone, pregnancy-associated protein - A, angiogenic vascular factors, estradiol, α-fetoprotein, homocysteine and CA-125 as a predictors or markers of the first half pregnancy losses. Conclusion: It may be concluded that to date, research data indicate the unavailability of any reliable biochemical marker for predicting pregnancy losses in its first half and require either a combination of them or comparison with clinical evidence. A fairly new model shall be considered for the assessment of α-fetoprotein in vaginal blood, which may have great prospects in predicting spontaneous miscarriages.

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In December 2020, Argentina approved a new abortion law following decades of feminist and social advocacy. This paper presents qualitative findings from interviews and focus group discussions with people in local communities focusing on how individuals of reproductive age access and communicate sexual and reproductive health information, particularly regarding abortion. Sixteen in-depth interviews were conducted with key informants working in the field of SRHR and four focus group discussions took place with cisgender women and girls, transmasculine people and non-binary people of reproductive age. We found that information exchange and communication about sexual and reproductive health issues, particularly abortion, took place mainly through informal social networks engaging with activists and feminist grass-root organisations. These informal social networks were built on trust as a collective affect that enabled open communication about abortion. Information sharing through word of mouth, in person and via digital means using different social media platforms, is an important means of information sharing and communication in Argentina. Monitoring the implementation of abortion policies in this country should include investigating the impact of people accessing abortion through informal social networks in terms of abortion pathways and intersections with the formal health system.

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BACKGROUND: Abortion is a public health problem in Latin America and is more common among women living with HIV. OBJECTIVE: to verify the incidence and factors associated with induced abortion in a cohort of women living with HIV assisted in a reference service for care for individuals with HIV/AIDS in Rio de Janeiro/Brazil. METHODS: Prospective cohort during the period 1996-2016. We estimated the incidence of induced abortions during follow-up in the cohort by calculating person-time incidence rates [per 100 persons-years (PY)] and investigated the factors associated with the outcome "induced abortion" using a generalized linear mixed model. RESULTS: 753 women and 210 pregnancies were included in the present analysis. We estimated an induced abortion incidence rate of 0.68/100 persons-years (95% confidence interval [CI]: 0.47; 0.94) in the study period, with a significant reduction after 2006. The main factors associated with an induced abortion were currently living with a partner (adjusted OR [AdjOR] 0.32 95% CI: 0.10-0.98), number of children (2 children AdjOR 0.12, 95% CI: 0.02-0.95) and the type of antiretroviral treatment used (regimen without Efavirenz: AdjOR: 0.11, 95% CI 0.02-0.70). CONCLUSIONS: We showed a significant reduction in the incidence of induced abortions in a cohort of women living with HIV in Rio de Janeiro, Brazil, probably due to a decrease in the incidence of pregnancies observed in the same period. The factors associated with a lower occurrence of induced abortion suggest a good integration between the clinical and reproductive assistance offered to those women.

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BACKGROUND: Telemedicine represents an important strategy to facilitate access to medication abortion (MAB) procedures, reduces distance barriers and expands coverage to underserved communities. The aim is evaluating the self-managed MAB (provided through telemedicine as the sole intervention or in comparison to in-person care) in pregnant people at up to 12 weeks of pregnancy. METHODS: A literature search was conducted using electronic databases: MEDLINE, Embase, Cochrane (Central Register of Controlled Trials and Database of Systematic Reviews), LILACS, SciELO, and Google Scholar. The search was based on the Population, Intervention, Comparison, Outcome, and Study Design (PICOS) framework, and was not restricted to any years of publication, and studies could be published in English or Spanish. Study screening and selection, risk of bias assessment, and data extraction were performed by peer reviewers. Risk of bias was evaluated with RoB 2.0 and ROBIS-I. A narrative and descriptive synthesis of the results was conducted. Meta-analyses with random-effects models were performed using Review Manager version 5.4 to calculate pooled risk differences, along with their individual 95% confidence intervals. The rate of evidence certainty was based on GRADE recommendations. RESULTS: 21 articles published between 2011 and 2022 met the inclusion criteria. Among them, 20 were observational studies, and 1 was a randomized clinical trial. Regarding the risk of bias, 5 studies had a serious risk, 15 had a moderate risk, and 1 had an undetermined risk. In terms of the type of intervention, 7 compared telemedicine to standard care. The meta-analysis of effectiveness revealed no statistically significant differences between the two modalities of care (RD = 0.01; 95%CI 0.00, 0.02). Our meta-analyses show that there were no significant differences in the occurrence of adverse events or in patient satisfaction when comparing the two methods of healthcare delivery. CONCLUSION: Telemedicine is an effective and viable alternative for MAB, similar to standard care. The occurrence of complications was low in both forms of healthcare delivery. Telemedicine services are an opportunity to expand access to safe abortion services.

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Previous studies have determined that Chloroluma gonocarpa (Sapotaceae), is a species that has cryptic dioecy. This type of sexual system is characterized by flowers that are morphologically perfect (both sexual whorls are present) but functionally pistillate or staminate (in each type of flower one of the sexual whorls is non-functional). In C. gonocarpa the pistillate flowers present well-developed stigma, functional ovules, and staminodes, while the staminate flowers present a poorly developed stigma, collapsed ovules, and pollen-producing anthers. In angiosperms, the abortion of sexual organs can occur at different stages of development (from pre-meiosis to post-meiosis), that is why we conducted an anatomical analysis of both flower types at various developmental stages. Using light microscopy, we described the processes of sporogenesis and gametogenesis to establish when the staminate flowers lose their pistillate function. To achieve this, we collected, fixed, and processed the flowers following conventional anatomical techniques for observation under a light microscope. Our findings reveal that pollen development occurs only in staminate flowers, while ovule development begins in both types of flowers but ceases in staminate flowers due to post-meiosis abortion. In contrast, normal development continues in pistillate flowers. These results suggest that dioecy in C. gonocarpa may have arisen from a gynodioecious pathway.

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Background and Aim: In the Caribbean region of Colombia, the concomitance of endemic infectious agents is a common problem, and coinfections are possible, increasing the complexity of cattle herds' sanitary, reproductive, and productive problems. This study aimed to estimate the seroprevalence of bovine leukemia virus and its association with bovine infectious abortion in grazing Creole breeds from tropical herds in the Colombian Caribbean. Materials and Methods: For the determination of bovine leukemia virus (BLV), bovine viral diarrhea virus (BVDV), bovine herpes virus-1 (BoHV-1), and Neospora Caninum (NC), the enzyme-linked immunosorbent assay technique was used. Matrix analysis was performed to represent multiple seroprevalence in the same cow. To explore the association between the seroprevalence of BLV and bovine infectious abortion agents, a multivariate logistic regression model was used. Results: The seroprevalence was as follows: BLV 30.78%, BVDV 33.01%, BoHV-1 12.85%, and NC 8.96%. In the multivariate logistic regression model, seroprevalence of BVDV (OR 10.8; 95% CI: 7.5-15.6) and seroprevalence of BoHV-1 (OR 1.8; 95% CI: 1.1-3.0) were associated with the seroprevalence of BLV. Conclusion: Animals infected with BLV are more susceptible to coinfections with BVDV and BoHV-1. Implementing healthy measures against these two immunosuppressive infections could enhance the hygiene of numerous cattle herds. This study was designed as a retrospective cross-sectional study, which limits the ability to confirm that BLV is the primary infection. Further studies to confirm the primary infection of BLV with an active viral coinfection are necessary and the factors associated with these phenomena.

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Background: Following the decriminalization of abortion in Colombia and amidst a global health crisis due to COVID-19, Profamilia implemented a telemedicine-assisted first-trimester Medication Abortion (MAB) program. This is an opportunity to reduce inequalities in access and to promote empowerment and sexual and reproductive rights. This study aims to describe socio-demographic and clinical characteristics of users and to assess its effectiveness and safety. Study design: A retrospective cohort study. Methods: The study analyzed data from users who received Profamilia's telemedicine abortion services between August 2021 and August 2022 (n = 3073). A descriptive analysis of their sociodemographic and clinical characteristics was performed, grouping, and comparing them according to follow-up status and abortion outcome. Effectiveness was assessed by the percentage of complete abortions without surgical intervention, and safety by the incidence of complications, potential adverse events, and potentially dangerous signs. Results: Most of the users were less than 8 weeks gestation at the start of treatment (88.3 %), from low socioeconomic strata (84.8 %), affiliated to the subsidized healthcare system (87.6 %), with educational levels up to secondary school (81.6 %), between 18 and 35 years (87.4 %), from urban areas (97.8 %) and singles (90,8 %). 94.9 % of users had a complete abortion using medication, and 0.3 % of cases reported complications. Conclusions: First-trimester MAB through telemedicine in the Latin American context is an effective and safe choice. Telehealth is an important strategy to expand access to safe abortion care, especially for those with limited financial means or educational backgrounds. Rural and marginalized populations need more attention to improve access.

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Objective: This study aimed to investigate the effects of the presence of subchorionic hematoma (SH) in early pregnancies with threatened miscarriage (TM) on levels of first-trimester maternal serum markers, pregnancy-associated plasma protein-A (PAPP-A), and free ß-human chorionic gonadotropin (ß-hCG) levels. Methods: The data of TM cases with SH in the first trimester between 2015 and 2021 were evaluated retrospectively. The data of age and gestational age-matched TM cases without SH were also assessed to constitute a control group. Demographic characteristics, obstetric histories, ultrasonographic findings, and free ß-hCG and PAPP-A levels of the groups were compared. Results: There were 119 cases in the study group and 153 cases in the control group. The median vertical and longitudinal lengths of the SH were 31 mm and 16 mm. The median age of both groups was similar (p=0.422). The MoM value of PAPP-A was 0.088 (.93) in the study group and 0.9 (0.63) in the control group (p=0.519). Similarly, the MoM value of free ß-hCG was 1.04 (0.78) in the study group and 0.99 (0.86) in the control group (p=0.66). No significant relationship was found in the multivariate analysis between free ß-hCG MoM, PAPP-A MoM, age, gravida, and vertical and longitudinal lengths of the hematoma (p>0.05). Conclusion: The level of PAPP-A and free ß-hCG were not affected by the SH. Therefore, these markers can be used reliably in TM cases with SH for the first-trimester fetal aneuploidy screening test.

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Costa Rica prohibits abortion except under narrow circumstances to save the pregnant person's life. The country boasts historically strong support for social policy and human rights, while also presenting a complex and restrictive abortion access landscape. From September 2021 to March 2022, we conducted 23 interviews with obstetrician-gynecologist (OB/GYN) physicians, OB/GYN medical residents, and policy stakeholders to explore the socio-ecological influences on abortion access in Costa Rica. We sampled clinicians and policy stakeholders from the Universidad de Ciencias Médicas listserv through snowball sampling and conducted semi-structured in-depth interviews in Spanish. We identified limited access to comprehensive sexual health education, lack of support from interpersonal networks, inadequate provider knowledge and training, financial and migratory status, and both provider and community stigma as substantial barriers to abortion access. This study addresses a gap in published research around the social determinants of abortion in Costa Rica and sheds light on the attitudes and opinions of the medical and policy stakeholder communities about abortion access. The results highlight the need for expanded access to comprehensive sexual health education, abortion-related training for healthcare providers, and increased programming efforts, such as funding, outreach, and implementation, to ensure comprehensive reproductive health services are available and accessible, especially for vulnerable populations in Costa Rica.

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This article is a systematic review (SR) and meta-analysis (MA) whose objective was to identify the association between induced abortion and the development of depression, based on the Cochrane guidelines for SRs. A systematic search was carried out in the WoS, PubMed and Scopus databases. Retrospective and prospective cohort studies, carried out until November 2020, that evaluated a population of women in childbearing age (12 to 46 years) with at least 1 induced and/or provoked abortion, including pharma-cological and surgical abortion. Only studies with healthy women at the beginning of the research were included, i.e., with absence of psychiatric pathology prior to induced abor-tion. The quality of the included studies was measured with the Newcastle-Ottawa Scale (NOS), and for the MA random-effects models were specified using the DerSimonian & Laird method, grouping them into follow-up after abortion before and after one year. The results of the SR were measured with relative risk (RR), hazard ratio (HR), odds ratio (OR), and the chi-square test, which assessed the intensity of the statistical relationship between population and exposure. Systematic review demonstrated an OR of 1.38 (95% CI 1.14-1.68) of depression after induced abortion. Meta-analysis demonstrated a statis-tically significant association between depression and induced abortion when the as-sessment after one year was performed OR: 1.37 (95% CI 1.09-1.71). The risks, harms and mental health consequences of induced abortion, such as depression, should be in-vestigated and warned.

El presente artículo es una revisión sistemática (RS) y metaanálisis (MA) cuyo objetivo fue identificar la asociación entre el aborto inducido y el desarrollo de depresión, con base en los lineamientos Cochrane para RS. Se hizo la búsqueda sistemática en las bases de datos WoS, PubMed y Scopus. Se incluyeron estudios de cohorte retrospectivos y prospectivos, hasta noviembre de 2020, que evaluaron una población de mujeres en edad fértil (12 a 46 años) con al menos un aborto inducido o provocado, incluido el aborto farmacológico y el quirúrgico. Solo se incluyeron estudios con mujeres sanas al inicio de la investigación, es decir, con ausencia de patología psiquiátrica previa al aborto inducido. La calidad de los estudios incluidos se midió con la Newcastle-Ottawa Scale (NOS) y para el MA se especificaron modelos de efectos aleatorios con el método de DerSimonian & Laird y se agruparon en seguimiento posterior al aborto antes y después de un año. Los resultados de la RS fueron medidos con riesgo relativo (RR), hazard ratio (HR), odds ratio (OR) y la prueba de chi cuadrado, que valoraron la intensidad de la relación estadística entre la población y la exposición. La RS demostró un OR 1.38 (IC 95% 1.14-1.68) de depresión tras el aborto inducido. El MA demostró una asociación estadísticamente significativa entre la depresión y el aborto inducido cuando se hizo la evaluación posterior a un año OR: 1.37 (IC 95% 1.09-1.71). Se deberían investigar y advertir los riesgos, daños y consecuencias en la salud mental, como la depresión, tras el aborto inducido.

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BACKGROUND: We describe clients in Mexico City's public abortion programme, Interrupción Legal de Embarazo (ILE), during the COVID-19 pandemic and test whether the pandemic exacerbated inequities in access. METHODS: We conducted a cohort study of all abortions in the ILE programme from 1 January 2019 to 30 June 2022. We compared patients from within and outside the Mexico City Metropolitan area (ZMVM) by pandemic stage (pre-, acute-, mid- and late-COVID periods) and assessed changes in client characteristics (adolescent age, education, weeks' gestation) by place of residence (ZMVM vs outside the ZMVM) using linear probability models clustered on state. RESULTS: We included 45 031 abortions. The proportion of abortions to women who travelled from outside the ZMVM decreased from 6.5% pre-COVID to 4.4%-4.8% in in the acute, mid- and late-COVID periods. The adjusted probability of being an adolescent who travelled from outside the ZMVM dropped between pre-COVID (14.4%, 95% CI 12.7% to 16.1%) and mid-COVID (9.3%, 95% CI 7.9% to 10.7%). The proportion of abortions to women with a high school education stayed fairly flat among those travelling, while it rose among those residing in the ZMVM. The adjusted probability of presenting at 11 gestational weeks or greater was higher among women residing in the ZMVM in the pre-pandemic period; this flipped during all pandemic stages, with a higher probability of presenting at 11 weeks or greater among those who travelled from outside the ZMVM. CONCLUSIONS: The COVID-19 pandemic exacerbated existing disparities in who can access ILE services. To reduce inequities in access to essential health services, public sector abortion services should be made available in all Mexican states.

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South American camelids (SAC) are gaining popularity for various purposes, including fiber production, trekking, and companionship. High abortion rates pose a significant health issue in SAC herds, leading to substantial economic losses for breeders. Often, the causes of these abortions remain unidentified. This review provides a comprehensive summary of the known infectious and non-infectious causes of abortions in SAC.

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Introduction: HIV heavily affects sub-Saharan African women living in France and can impact reproductive decisions. It was investigated whether HIV was associated with induced abortion in pregnancies held after migration by women from sub-Saharan Africa living in Île-de-France. Methods: We used data on ANRS Parcours, a retrospective life event survey conducted in health facilities in the metropolitan region of Paris, between February 2012 and May 2013, with migrants from sub-Saharan Africa. Data on the history of pregnancies were collected among women living with HIV (HIV group) and those attending primary care centers (reference group). We investigated 242 women in the reference group, who had 729 pregnancies, and the 277 women in the HIV group, who had 580 pregnancies. The association between abortion and HIV was evaluated using clustered logistic models, successively adjusted for women and pregnancy characteristics, for the whole sample, and stratified by pregnancy intendedness. Results: In the reference group, 11.0 % of pregnancies were terminated in abortion, the same situation as 14.1 % in the HIV group (p = 0.124). HIV was not associated with abortion in the crude and adjusted models. However, after adjustments, HIV exhibited a non-significant trend towards reducing the likelihood of abortion, particularly when considering the intendedness of pregnancy variable. Conclusions: Factors that shape the overall context of women's lives and pregnancies, which are shared with the reference group, may have a more significant impact on reproductive decision-making than HIV alone. Health services must pay attention to the intendedness of pregnancies, providing advice and support on the prevention of mother-to-child transmission to women living with HIV who intend to become pregnant, in addition to strengthening the provision of family planning and the prevention of unintended pregnancies.

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Objective: To assess the prevalence and type of chromosomal abnormalities in Brazilian couples with recurrent pregnancy loss (RPL) and compare the clinical characteristics of couples with and without chromosome abnormalities. Methods: We assessed the medical records of 127 couples with a history of two or more miscarriages, referred to a tertiary academic hospital in Belo Horizonte, Brazil, from January 2014 to May 2023. Karyotype was generated from peripheral blood lymphocyte cultures, and cytogenetic analysis was performed according to standard protocols by heat-denatured Giemsa (RHG) banding. Results: Abnormal karyotypes were detected in 10 couples (7.8%). The prevalence of chromosomal abnormalities was higher among females (6.3%) compared to males (2.0%), but this difference was not statistically significant (p=0.192). The mean number of miscarriages was. 3.3 ± 1.1 in couples with chromosome abnormalities and 3.1 ± 1.5 in couples without chromosome abnormalities (p=0.681). Numerical chromosomal anomalies (6 cases) were more frequent than structural anomalies. Four women presented low-grade Turner mosaicism. No differences were found between couples with and without karyotype alterations, except for maternal age, which was higher in the group with chromosome alterations. Conclusion: The prevalence of parental chromosomal alterations in our study was higher than in most series described in the literature and was associated with increased maternal age. These findings suggest that karyotyping should be part of the investigation for Brazilian couples with RPL, as identifying the genetic etiology may have implications for subsequent pregnancies.

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OBJECTIVES: Describe the characteristics and changes in the profile of women who sought care after experiencing sexual violence (SV) during the first six months of the COVID-19 pandemic in a Brazilian city. METHODS: This is a cross-sectional retrospective study. Data from emergency care and legal abortion requests of women assisted at the Women's Health Care Center Hospital (School of Medical Sciences, University of Campinas, Brazil) due to SV experienced between March 23 and August 23, 2020 (Quarantine Group, QG), were collected and compared with data from the same period of the previous biennium (Comparison Group, CG). χ2 and Fisher's exact tests were used to compare groups; the significance level was 5%. RESULTS: Data for 236 women were analyzed; 70 women were included in the QG and 166 in the CG. In the QG, there was a restriction in the area of origin of women, with a higher proportion of women who lived in Campinas (P = 0.0007) and a higher frequency of chronic SV (P = 0,035). There were no rapes associated with the use of social media or apps in the QG, but 9.8% of women in the CG experienced rape associated with the use of social media or apps. There were higher rates of domestic violence (P = 0.022) and intimidation through physical force (P = 0.011) in the first two months. CONCLUSION: The COVID-19 quarantine affected the profile of women who sought care after experiencing SV. The quarantine resulted in changes in the area of origin of patients, hindering access to health services and leading to higher rates of chronic and domestic SV, particularly in the first 2 months of the pandemic.

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The availability of medications to induce abortion, especially in contexts of restricted access, has transformed practices and allowed women and/or their community organizations to assist other women in obtaining abortions, whether or not they interact with the healthcare system. This study recovers the experience of a feminist community organization that, from the province of Neuquén, extends throughout the country, creating a network of community care. An exploratory descriptive study with a qualitative approach was conducted to analyze the experiences of women who facilitate access to permitted abortion in Argentina. Through in-depth interviews with three leaders of the feminist collective La Revuelta and semi-structured interviews with 33 members of the socorrista groups, conducted between November 2019 and December 2020, we describe their history and processes of work and growth; we explore their motivations and feelings and characterize the interactions of these organizations with public and private health systems. The results of this work align with the international conversation and bibliographic production about these organizations and their particularities, and with the need to incorporate these forms of care into institutional health systems.

La disponibilidad de medicamentos para producir un aborto, sobre todo en contextos de acceso restringido, transformó las prácticas y permitió que las propias mujeres y/o sus organizaciones comunitarias ayuden a otras mujeres a abortar, interactuando o no con el sistema de salud. Este estudio recupera la experiencia de una organización feminista de la comunidad que, desde la provincia de Neuquén, se extiende a todo el país, generando una red de cuidados comunitarios. Se realizó un estudio exploratorio descriptivo, con enfoque cualitativo con el propósito de analizar las experiencias de las mujeres que facilitan el acceso al aborto permitido en Argentina. A través de entrevistas en profundidad a tres líderes de la colectiva feminista La Revuelta y de entrevistas semiestructuradas a 33 integrantes de las grupas socorristas, realizadas entre noviembre de 2019 y diciembre de 2020, describimos su historia y los procesos de trabajo y crecimiento; exploramos sus motivaciones y sentimientos y caracterizamos las interacciones de dichas organizaciones con los sistemas de salud público y privado. Los resultados de este trabajo coinciden con la conversación y la producción bibliográfica internacional acerca de estas organizaciones y sus particularidades y con la necesidad de incorporar estos cuidados a los sistemas de salud institucionales.

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The reproductive efficiency and milk yield of cows are crucial factors in a dairy farm's profitability. However, abortions can have a negative impact on these factors. While the morbidity of abortion has been estimated in many countries, information on the burden on dairy cattle in tropical conditions is limited, and Costa Rica is a good example. This study aims to assess the incidence and recurrence of bovine abortion in dairy cattle from Costa Rica. The study analysed the morbidity of abortion in Costa Rican dairy herds between 2010 and 2022. The incidence rate (IR) and the recurrence rate (ReR) were calculated per 100 cow-months at risk using data from the Veterinary Automated Management and Production Control Programme (VAMPP). The dataset comprised 1032,457 lactations from 330,265 cows in 1134 specialized dairy herds. Abortions were classified either as early foetal mortality (EFM) or late foetal mortality (LFM). Rates were estimated based on cow breed, lactation number, and ecological zone to which the farm belongs. The IR of general abortion, EFM, and LFM cases were 0.98, 0.41, and 0.57 per 100 cow-months at risk, respectively. No statistically significant differences were found in the IR between cow breed, lactation number, and ecological zone, nor for the trend of abortions over calving years. The first ReR (for cows that had one previous abortion during the lactation) was 0.95, and the second ReR (for cows that had two previous abortions during the lactation) was 1.41 per 100 cow-months at risk. These results suggest that bovine abortions are an important ongoing problem in dairy farms in Costa Rica with potentially detrimental effects on the reproductive and productive performance of cows and may be representative of other specialized tropical dairy systems in Latin America.

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RESUMO A criminalização do aborto no Brasil e o acesso restrito ao misoprostol obrigam mulheres a buscarem métodos inseguros para sua indução. Atenção hospitalar ao aborto induzido ou espontâneo é padrão. Na contracorrente, no cenário internacional, a telessaúde no aborto medicamentoso é padrão ouro da atenção às perdas gestacionais, espontâneas ou induzidas. Este artigo apresenta o Programa Atenas iniciativa inédita de atenção ao aborto no primeiro trimestre gestacional - com foco no atendimento extra-hospitalar, através de monitoramento telefônico por enfermeiras, facultando às mulheres escolher o método de esvaziamento uterino (expectante, medicamentoso ou cirúrgico), com vistas à humanização da atenção. Foi realizada pesquisa etnográfica, em maternidade pública nordestina, entre 2014 e 2021. No contexto de dificuldades estruturais e conjunturais, 723 participantes foram atendidas; 73,6% prescindiram de hospitalização para resolução do aborto: 58,4% ocorreram de forma espontânea e 15,2% através do misoprostol hospitalar. Não houve registro de complicações. O monitoramento telefônico promoveu vínculo e cuidado individualizado a este público invisibilizado. Esta iniciativa orgânica do SUS, sem apoio financeiro de órgãos externos, representa um avanço na atenção humanizada às mulheres com aborto. Recomenda-se estender a toda rede pública de saúde, visando ampliação do acesso a um cuidado integral e humanizado no aborto.

ABSTRACT The criminalization of abortion and restricted access to misoprostol in Brazil force women to seek unsafe methods to terminate a pregnancy. Hospital care for miscarriage or abortion is standard. In contrast, telemedicine for the medical management of miscarriage and abortion is the gold standard of care internationally. This article presents the Atenas Program - an unprecedented initiative for first trimester abortion/miscarriage care, aiming at a humanized out-of-hospital service based on telephone monitoring by nurses, allowing women to choose the method of uterine evacuation (expectant, medical or surgical). For this purpose, ethnographic research was carried out in a northeastern public maternity hospital, between 2014 and 2021. In the context of structural and conjunctural difficulties, among the 723 Atenas participants, 73,6% dispensed with hospital admission for miscarriage and abortion resolution: 58,4% occurred spontaneously and 15,2% through hospital misoprostol. No complications were registered. Telephone monitoring by nurses provided the basis for continuity of individualized care for this invisibilized public. Atenas Program, initiative of a SUS institution run without external financial support, represents an advance in humanized care for women with miscarriage and abortion. It should be extended to the entire public health network, to expand access to rounded and humanized care for abortion and miscarriage.

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Objetivo: Analisar, a partir da perspectiva crítica e interseccional, a organização, composição e atuação legislativa de comissão voltada aos direitos sexuais e reprodutivos de mulheres, denominada Frente Parlamentar de Combate ao Aborto ­ Pró-Vida. Metodologia: Foi realizada leitura interseccional acerca da constituição de Frente Parlamentar de Combate ao Aborto - "Pró-Vida", da Assembleia Legislativa do Estado de Goiás (ALEGO), e o perfil sociodemográfico de seus integrantes foi traçado, discutido a luz dos marcadores sociais gênero, raça/etnia, classe social e religião, e problematizado acerca de um tema que implica diretamente na saúde e na vida das mulheres, o aborto. Resultados e Discussão: a análise dos resultados aponta a sub-representividade feminina, a prevalência de pessoas brancas e o predomínio de ideologia conservadora nos costumes e religião no perfil sociodemográfico dos membros integrantes da frente parlamentar estudada. Em contraponto, a literatura, ao discutir os marcadores sociais em investigação, traz o retrato daquelas que optam por realizar o aborto como sendo o de mulheres negras, de baixa renda e escolaridade, e que procuram em partidos de viés progressista advocacia para suas causas. Conclusão: A estrutura tradicional, presente na frente parlamentar investigada, enfrenta desafios na construção de um debate representativo e capaz de reproduzir nas políticas públicas as complexas identidades, necessidades e experiências das mulheres em risco de abortamento. Nessa argumentação, a construção de práticas políticas e tratos legislativos devem, prioritariamente, considerar as complexidades identitárias e as intersecções e opressões que levam as mulheres ao aborto para, enfim, construir-se uma democracia inclusiva, equitativa e representativa.

Objective: Analyze, from a critical and intersectional perspective, the organization, composition and legislative performance of a commission focused on women's sexual and reproductive rights, called the Parliamentary Front to Combat Abortion ­ Pró-Vida. Methodology: An intersectional reading was carried out regarding the constitution of the Parliamentary Front to Combat Abortion - "Pró-Vida", of the Legislative Assembly of the State of Goiás (ALEGO), and the sociodemographic profile of its members was outlined, discussed in light of social markers, gender, race/ethnicity, social class and religion and problematized about a topic that directly affects women's health and lives, abortion. Results and discussion: analysis of the results points to female underrepresentation, the prevalence of white people and the predominance of conservative ideology in customs and religion in the sociodemographic profile considered. In contrast, the literature, when discussing the social markers under investigation, portrays those who choose to have an abortion as black women, with low income and education, and who look to parties with a progressive bias to advocate for their causes. Conclusion: The traditional structure present in the Parliamentary Front investigated faces challenges in building a representative debate capable of reproducing in public policies the complex identities, needs and experiences of women at risk of miscarriage. In this argument, the construction of political practices and legislative approaches must primarily consider the complexities of identity and the intersections and oppressions that lead women to abortion in order to, ultimately, build an inclusive, equitable and representative democracy.

Objetivo: Analizar, desde una perspectiva crítica e interseccional, la organización, composición y desempeño legislativo de una comisión enfocada en los derechos sexuales y reproductivos de las mujeres, denominada Frente Parlamentario de Lucha contra el Aborto ­ Pró-Vida. Metodología: Se realizó una lectura interseccional sobre la constitución del Frente Parlamentario de Lucha contra el Aborto - "Pró-Vida", de la Asamblea Legislativa del Estado de Goiás (ALEGO), y se delineó el perfil sociodemográfico de sus integrantes, discutido a la luz de marcadores sociales, género, raza/etnia, clase social y religión y problematizados sobre un tema que afecta directamente la salud y la vida de las mujeres, el aborto. Resultados y discusión: el análisis de los resultados apunta a la subrepresentación femenina, el predominio de personas blancas y el predominio de la ideología conservadora en las costumbres y la religión en el perfil sociodemográfico considerado. En contraste, la literatura, al discutir los marcadores sociales bajo investigación, retrata a quienes eligen abortar como mujeres negras, con bajos ingresos y educación, y que buscan partidos con un sesgo progresista para defender sus causas. Conclusión: La estructura tradicional presente en el Frente Parlamentario investigado enfrenta desafíos en la construcción de un debate representativo capaz de reproducir en políticas públicas las complejas identidades, necesidades y experiencias de las mujeres en riesgo de aborto espontáneo. En este argumento, la construcción de prácticas políticas y enfoques legislativos debe considerar principalmente las complejidades de la identidad y las intersecciones y opresiones que llevan a las mujeres al aborto para, en última instancia, construir una democracia inclusiva, equitativa y representativa.

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RESUMO

BACKGROUND: In 2006, a Constitutional Court ruling partially decriminalized abortion in Colombia, allowing the procedure in cases of rape, risk to the health or life of the woman, and fetal malformations incompatible with life. Despite this less prohibitive law, some women and pregnant people preferred self-managing their abortions outside the formal healthcare system, often without accurate information. In 2018, we undertook a study to understand what motivated women to self-manage using medications that they acquired informally. Colombia has since adopted a progressive law in 2022, permitting abortion on request through the 24th week of pregnancy. However, the implementation of this law is still underway. Examining the reasons why women chose to informally self-manage an abortion after 2006 may not only highlight how barriers to legal services persisted at that time, but also could inform strategies to increase knowledge of the current abortion law and improve access to services going forward. METHODS: In-depth interviews were conducted in 2018 with 47 women aged 18 and older who used misoprostol obtained outside of health facilities to induce an abortion, and who were receiving postabortion care in two private clinics. Interviews explored what women knew about the 2006 abortion law which was then in effect, and the reasons why they preferred informal channels for abortion care over formal healthcare services. RESULTS: Women's motivations to use misoprostol obtained outside the formal healthcare system were influenced by lack of trust in the healthcare system along with incomplete and inaccurate knowledge of the abortion law. Conversely, women considered misoprostol obtained outside the healthcare system to be effective, affordable, and easier to access. CONCLUSIONS: Obtaining misoprostol outside the formal healthcare system offered a more accessible and appealing prospect for some women given fears of legal repercussion and stigma toward abortion. Though this preference will likely continue despite the more liberal abortion law, strategies should be implemented to broaden knowledge of the recent change in law and to combat misinformation and stigma. This would support knowledge of and access to legal abortion for those who wish to avail themselves of these services.

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