Instituto de Saúde Coletiva, Universidade Federal Fluminense, Rio de Janeiro, Brasil.
Instituto Nacional de Infectologia Evandro Chagas, Fundação Oswaldo Cruz, Rio de Janeiro, Brasil.
Cad Saude Publica. 2020 Feb 10;36Suppl 1(Suppl 1):e00189718. doi: 10.1590/0102-311X00189718. eCollection 2020.
Previous reviews on the subject of abortion in Brazil have estimated one million procedures per year but did not address legal abortion. This systematic review sought to update knowledge regarding legal abortion in terms of service and women's profile, student and doctor knowledge, situations of anencephaly and severe malformations. We searched MEDLINE and LILACS for articles published in all languages between 2008 and 2018. Article quality was assessed using the Joanna Briggs Institute instruments. Search, selection, quality assessment and data extraction were carried out independently by two researchers. We selected 20 articles, 11 on the knowledge and opinion of medical professionals (4 articles) and students (7 articles) revealing a less-than-ideal level of knowledge and a high degree of objection of conscience. Six studies on women who use legal abortion services found that they are young, single and that the main demand was for pregnancy resulting from rape. When women were younger and single and when the aggressor was someone close to them, there were delays in seeking care. Three studies on severe malformation found around 40% of court authorizations. In cases for which no authorization was given, the evolution of pregnancies was complicated and deliveries were done through cesarean sections. Only one article addressed legal abortion services, showing that 37 of the 68 that had been registered were active, lack of services in seven states and concentration in capitals. Knowledge regarding legal abortion is still scarce, the demand for the procedure is repressed and medical training is deficient with regard to this subject.
以往关于巴西堕胎问题的综述估计每年有 100 万例，但没有涉及合法堕胎。本系统综述旨在更新关于合法堕胎服务和妇女特征、学生和医生知识、无脑畸形和严重畸形情况方面的知识。我们在 MEDLINE 和 LILACS 中检索了 2008 年至 2018 年发表的所有语言的文章。使用 Joanna Briggs 研究所工具评估文章质量。搜索、选择、质量评估和数据提取由两名研究人员独立进行。我们选择了 20 篇文章，其中 11 篇是关于医疗专业人员（4 篇）和学生（7 篇）的知识和意见的，这些文章显示出知识水平不理想和强烈的良心反对。六项关于使用合法堕胎服务的妇女的研究发现，她们年轻，单身，主要需求是因强奸而怀孕。当妇女更年轻、单身，而施害者是亲近的人时，寻求治疗就会出现延误。三项关于严重畸形的研究发现，约有 40%的法院批准了堕胎。在未获得授权的情况下，妊娠的进展变得复杂，分娩通过剖腹产进行。只有一篇文章涉及合法堕胎服务，显示已登记的 68 个服务中有 37 个是活跃的，7 个州缺乏服务，且服务集中在首府。关于合法堕胎的知识仍然匮乏，对该程序的需求受到压抑，而且医学培训在这方面也存在不足。
