Labandera Ana, Gorgoroso Monica, Briozzo Leonel
Gynecology and Obstetrics Clinic A, Pereira Rossell Hospital, School of Medicine, University of the Republic, Montevideo, Uruguay.
Int J Gynaecol Obstet. 2016 Aug;134(S1):S7-S11. doi: 10.1016/j.ijgo.2016.06.007.
The history of the creation of the risk and harm reduction model applied to unsafe abortion is reviewed, from its initial implementation by a small group of gynecologists at the Pereira Rossell Hospital Center in Uruguay to its spread to the rest of the country. Its ethical rationale, its successful application in the hospital, the decision to disseminate it with the cooperation of the International Federation of Gynecology and Obstetrics (FIGO), and the intervention procedures are explained. It was evaluated from the epidemiological and anthropological viewpoints, from the changes in professionals' and users' perception of the care offered and its impact on complications and maternal deaths. A very favorable change was seen in the number and quality of the services, the providers' attitude, and maternal morbidity and mortality were reduced. It also brought visibility to women with unplanned and unwanted pregnancies and an improved understanding of their problems, which contributed to the legislative changes that were made subsequently.
回顾了应用于不安全堕胎的风险与伤害降低模式的创建历程，从乌拉圭佩雷拉·罗塞尔医院中心的一小群妇科医生最初实施该模式，到其在该国其他地区的推广。文中解释了该模式的伦理依据、在医院的成功应用、在国际妇产科联合会（FIGO）合作下进行推广的决定以及干预程序。从流行病学和人类学角度进行了评估，涉及专业人员和使用者对所提供护理的认知变化及其对并发症和孕产妇死亡的影响。在服务数量和质量、提供者态度方面出现了非常积极的变化，孕产妇发病率和死亡率有所降低。它还让意外怀孕和非意愿怀孕的女性受到关注，并增进了对她们问题的理解，这为随后的立法变革做出了贡献。
