Baum Sarah, DePiñeres Teresa, Grossman Daniel
Ibis Reproductive Health, Oakland, CA, USA.
Fundación Oriéntame, Bogotá, Colombia.
Int J Gynaecol Obstet. 2015 Dec;131(3):285-8. doi: 10.1016/j.ijgo.2015.06.036. Epub 2015 Sep 9.
To evaluate delays before first- or second-trimester legal abortion and barriers to care in Colombia.
A secondary analysis was undertaken of data from a prospective cohort study of women undergoing first-trimester (<12 weeks) and second-trimester (12-15 weeks) abortion between February and July 2012. Participants (aged ≥18 years with access to a telephone) reported key dates in their abortion process and barriers to care. Univariate and multivariate analyses were performed.
Overall, 100 women in the first trimester and 200 in the second trimester were included. Second-trimester clients experienced longer delays in each step of the abortion process than did first-trimester clients (P<0.001 for all three intervals examined), with the largest delay being time to suspicion of pregnancy (37 days vs 17 days). Difficulty accessing care was associated with the second trimester (odds ratio 5.1, 95% CI 2.9-9.1) and low socioeconomic status (odds ratio 2.3, 95% CI 1.2-4.3). Financial barriers were the most common (30 [30.0%] first-trimester clients; 86 [43.0%] second-trimester clients).
Despite partial decriminalization of abortion in 2006, Colombian women still face barriers to legal services that probably contribute to late presentation. Interventions promoting early pregnancy recognition and information about how to access legal abortion could reduce the need for second-trimester services.
评估哥伦比亚早期或中期合法堕胎前的延迟情况以及护理障碍。
对2012年2月至7月间进行早期（<12周）和中期（12 - 15周）堕胎的女性前瞻性队列研究数据进行二次分析。参与者（年龄≥18岁且可使用电话）报告了她们堕胎过程中的关键日期及护理障碍。进行了单变量和多变量分析。
总体而言，纳入了100名早期堕胎女性和200名中期堕胎女性。与早期堕胎女性相比，中期堕胎女性在堕胎过程的每个步骤都经历了更长的延迟（在所检查的所有三个时间段中P<0.001），最大的延迟是怀疑怀孕的时间（37天对17天）。获得护理困难与中期堕胎（比值比5.1，95%可信区间2.9 - 9.1）和低社会经济地位（比值比2.3，95%可信区间1.2 - 4.3）相关。经济障碍最为常见（30名[30.0%]早期堕胎女性；86名[43.0%]中期堕胎女性）。
尽管2006年堕胎部分合法化，但哥伦比亚女性在获得法律服务方面仍面临障碍，这可能导致就诊延迟。促进早期妊娠识别以及提供有关如何获得合法堕胎信息的干预措施，可能会减少对中期堕胎服务的需求。
