Research Division, Faculty of Medicine, National Autonomous University of Mexico, Mexico.
Faculty of Law, National Autonomous University of Mexico, Mexico.
Best Pract Res Clin Obstet Gynaecol. 2020 Jan;62:63-78. doi: 10.1016/j.bpobgyn.2019.07.009. Epub 2019 Aug 1.
Latin America hosts the most restrictive abortion legislation globally. In 2007, Mexico, the second largest Catholic country in the world, decriminalized elective abortion within the first twelve weeks of pregnancy in the capital: Mexico City (also known as Federal District of Mexico). Following the reform, the Mexico City Ministry of Health (MX-MOH) implemented safe and legal services. Free services are provided to Mexico City residents and a sliding fee of up to $100 is applied to women from other Mexican states. Conscientious objection (CO) was addressed and included in service provision guidelines. Since 2007, 18 of 32 states amended their penal codes to restrict abortion. The road toward increasing access to abortion services at the MX-MOH included a shift from dilation and curettage (D&C) to medical abortion (MA), first with the misoprostol-alone regimen, followed by the combined mifepristone-misoprostol regimen. Manual vacuum aspiration is offered to out-of-state-women or to those beyond the gestational age where MA is less effective. Contraceptive uptake among abortion seekers is high (up to 95% of them prefer a free method of their choice). The Legal Interruption of Pregnancy program at the MX-MOH continues to provide effective, safe, reliable, and free services. However, women from indigenous groups residing in rural areas, those with low schooling, and adolescents with an unintended pregnancy who live in rural, urban, peri-urban districts, and at the state level are underserved despite being legally eligible to receive abortion services. Therefore, information and services for the disadvantaged groups need to be strengthened.
拉丁美洲拥有全球最严格的堕胎立法。2007 年，作为全球第二大天主教国家的墨西哥，在首都墨西哥城（也被称为墨西哥联邦区）将怀孕头 12 周内的选择性堕胎合法化。改革后，墨西哥城卫生部（MX-MOH）实施了安全合法的服务。墨西哥城居民可享受免费服务，而来自其他墨西哥州的女性则收取最高 100 美元的费用。医疗人员的良心反对（CO）被纳入服务提供准则。自 2007 年以来，32 个州中有 18 个修改了刑法典，以限制堕胎。MX-MOH 增加堕胎服务的途径包括从扩张和刮宫（D&C）转为药物流产（MA），最初采用米索前列醇单药疗法，然后是米非司酮-米索前列醇联合疗法。对于来自其他州的女性或 MA 效果不佳的超过妊娠年龄的女性，提供手动真空抽吸术。堕胎寻求者中避孕药具的使用率很高（高达 95%的人更喜欢选择免费的方法）。MX-MOH 的妊娠合法中断计划继续提供有效、安全、可靠和免费的服务。然而，尽管符合法律规定可以获得堕胎服务，但居住在农村地区的土著群体、受教育程度较低的妇女以及农村、城市、城乡结合部和州一级意外怀孕的青少年仍然得不到充分服务。因此，需要加强对弱势群体的信息和服务。
