Berer Marge
International Consortium for Medical Abortion, London, UK.
Reprod Health Matters. 2004 Nov;12(24 Suppl):1-8. doi: 10.1016/s0968-8080(04)24024-1.
Unsafe abortion and associated morbidity and mortality in women are completely avoidable. This paper reports on an analysis of the association between legal grounds for abortion in national laws and unsafe abortion, drawing on an unpublished study and using estimates of the incidence of and mortality from unsafe abortion using information from the sources used to estimate the incidence of unsafe abortion and associated mortality in 2000. Although legal grounds alone may not reflect the way in which the law is applied, nor the quality of services offered, a clear pattern was found in more than 160 countries indicating that where legislation allows abortion on broad indications, there is a lower incidence of unsafe abortion and much lower mortality from unsafe abortions, as compared to legislation that greatly restricts abortion. The data also show that most abortions become safe mainly or only where women's reasons for abortion, and the legal grounds for abortion coincide. This is a compelling public health argument for making abortion legal on the broadest possible grounds. A wide range of actions have formed part of national campaigns for safe, legal abortion over the past century, covering law reform, provision of safe services, ensuring quality of care, training for providers and information and support for women. Safe abortion is an essential health service for women, as essential for sexual and reproductive health as safe contraception, and safe pregnancy and delivery care. In spite of sometimes powerful opposition and terrible setbacks, the public health imperative is gaining ground in many parts of the globe.
妇女不安全堕胎及相关发病和死亡情况是完全可以避免的。本文基于一项未发表的研究进行分析，利用2000年用于估计不安全堕胎发生率及相关死亡率的信息来源所提供的不安全堕胎发生率和死亡率估计值，报告各国法律中堕胎合法理由与不安全堕胎之间的关联。尽管仅法律理由可能无法反映法律的实施方式，也不能体现所提供服务的质量，但在160多个国家发现了一个明显的模式，即与严格限制堕胎的法律相比，立法允许在广泛指征下堕胎的地方，不安全堕胎发生率较低，不安全堕胎导致的死亡率也低得多。数据还表明，大多数堕胎主要或仅在妇女的堕胎理由与堕胎合法理由相符时才会变得安全。这是一个令人信服的公共卫生论据，支持尽可能广泛地将堕胎合法化。在过去一个世纪里，一系列行动构成了各国安全、合法堕胎运动的一部分，包括法律改革、提供安全服务、确保护理质量、培训服务提供者以及为妇女提供信息和支持。安全堕胎是妇女必不可少的一项卫生服务，对性与生殖健康而言，其重要性等同于安全避孕、安全妊娠及分娩护理。尽管有时面临强大的反对和严重的挫折，但公共卫生的迫切需求在全球许多地方正逐渐占据上风。
