Boersma Adriana, Alberts Jantina, Bruijn Jeanne De, Meyboom Betty-de Jong, Kleiverda Gunilla
Glob J Health Sci. 2012 Apr 28;4(3):30-8. doi: 10.5539/gjhs.v4n3p30.
In Curaçao Termination of Pregnancy (TOP) is still forbidden by law, although a policy of tolerance has been stipulated since 1999. This paper is about the prevalence of TOP and about its health complications. These data on TOP are officially unknown but are suspected to be rather high.
One year registration of illegal performed termination of pregnancy cases by all general physicians (GPs) practicing TOP in Curaçao. The registration included patient characteristics according to the model of the National Abortion Registration in The Netherlands, adjusted to the local Curaçao situation. Socio demographic characteristics, number of previous pregnancies and TOPs, pregnancy duration, contraception methods and reason for failure were registered. The comparative part of the research compares TOP rates of Curaçao with those of Antillean women in the Netherlands. The gynaecologists in the referral hospital registered complications requiring hospital admission after TOP.
All GPs performing TOP participated and the majority registered extensively. The total number of registered TOP was 1126. 666 of the 1126 were registered using the local adjusted Abortion Registration Model. With 30.000 women aged between 15 and 45 living in Curaçao, the TOP rate was at least 38 (per 1000 in that age category), comparable to rates for Antillean women in the Netherlands. Mean age was 26.9 years. Nearly half (47%) had one or more TOPs before; the majority (53%) was less than 7 weeks pregnant and two third (67%) had one or more children. Two third of the women did not use contraception (63%). For those using contraception, main reason for failure was inconsistent use (50%). There were 14 hospital admissions due to complications of TOP.
The number of TOP is high in Curaçao and comparable to (first generation) Antillean women living abroad in the Netherlands. Most unintended pregnancies originated from no or inconsistent use of reliable contraception. Improvement of sex education is necessary in order to bring down the number of TOP, as well as realizing accessible and affordable contraception, including sterilization. The number of complications around TOPs was equal to other countries where TOP is illegal.
在库拉索岛，尽管自1999年起就规定了宽容政策，但法律上仍然禁止终止妊娠（TOP）。本文探讨了TOP的发生率及其健康并发症。这些关于TOP的数据官方并不知晓，但据推测相当高。
对库拉索岛所有实施TOP的全科医生（GP）进行为期一年的非法终止妊娠病例登记。登记内容包括根据荷兰国家堕胎登记模式并结合库拉索岛当地情况调整后的患者特征。登记了社会人口统计学特征、既往怀孕和TOP次数、怀孕时长、避孕方法及失败原因。研究的对比部分将库拉索岛的TOP发生率与荷兰的荷属安的列斯群岛女性的发生率进行了比较。转诊医院的妇科医生登记了TOP后需要住院治疗的并发症。
所有实施TOP的GP都参与了，且大多数进行了详细登记。登记的TOP总数为1126例。1126例中有666例是使用当地调整后的堕胎登记模式登记的。库拉索岛有30000名年龄在15至45岁之间的女性，TOP发生率至少为38（每1000名该年龄段女性中），与荷兰的荷属安的列斯群岛女性的发生率相当。平均年龄为26.9岁。近一半（47%）的女性之前有过一次或多次TOP；大多数（53%）怀孕不到7周，三分之二（67%）育有一个或多个孩子。三分之二的女性未采取避孕措施（63%）。对于采取避孕措施的女性，失败的主要原因是未持续使用（50%）。因TOP并发症而住院的有14例。
库拉索岛的TOP数量很高，与居住在荷兰境外的（第一代）荷属安的列斯群岛女性相当。大多数意外怀孕源于未采取或未持续使用可靠的避孕措施。为了降低TOP数量，有必要改善性教育，同时实现可及且负担得起的避孕措施，包括绝育。TOP相关并发症的数量与TOP为非法行为的其他国家相当。
