Ipas Senior Advocacy Advisor, Ipas, Chapel Hill, North Carolina, USA.
Independent consultant, Ipas, Chapel Hill, North Carolina, USA.
Sex Reprod Health Matters. 2020 Dec;28(1):1744225. doi: 10.1080/26410397.2020.1744225.
Adolescent girls comprise a considerable proportion of annual abortion deaths, worldwide, with 15% of all unsafe abortions taking place among girls under 20 years of age. Despite recent global attention to the health and welfare of adolescent girls, little is known about their abortion experience, particularly of those under the age of 15 years. This review examines existing peer-reviewed and grey literature on abortion-related experiences of adolescent girls, paying particular attention to girls ages 10-14. In December 2019, the authors conducted a comprehensive search of five major online resource databases, using a two-part keyword search strategy for articles from 2003 to 2019. Of the original 3,100+ articles, 1,228 were individually screened and 35 retained for inclusion in the analysis. Findings show that while adolescent girls may have knowledge of abortion in general, they lack specific knowledge of sources of care and delay care-seeking due to the fear of stigma, lack of resources and provider bias. Adolescent girls do not experience higher rates of physical complications compared to older cohorts, but they are at risk of psychosocial harm. For girls ages 10-14, abortion experience may be compounded by pregnancy due to sexual abuse or transactional sex, and they face even more barriers to care than older adolescents in terms of provider bias and lack of agency. Adolescents have unique needs and experiences around abortion, which should be accounted for in programming and advocacy. Adolescent girls need information about safe abortion at an early age and a responsive and stigma-free health system.
全球范围内，每年少女在堕胎死亡中占相当大的比例，所有不安全堕胎中有 15%发生在 20 岁以下的少女中。尽管最近全球关注少女的健康和福利，但对她们的堕胎经历知之甚少，尤其是 15 岁以下的少女。本综述审查了现有的同行评议和灰色文献中关于少女堕胎相关经历的研究，特别关注 10-14 岁的少女。2019 年 12 月，作者对五个主要在线资源数据库进行了全面搜索，使用了 2003 年至 2019 年期间的两部分关键词搜索策略来搜索文章。在最初的 3100 多篇文章中，有 1228 篇文章被单独筛选，35 篇文章被保留进行分析。研究结果表明，尽管少女可能对堕胎有一般的了解，但由于害怕耻辱、缺乏资源和提供者偏见，她们缺乏关于护理来源和延迟护理的具体知识。少女与年龄较大的群体相比，没有更高的身体并发症发生率，但她们面临着心理社会伤害的风险。对于 10-14 岁的少女来说，由于性虐待或交易性性行为导致的怀孕，她们的堕胎经历可能会更加复杂，而且由于提供者的偏见和缺乏代理权，她们在获得护理方面比年龄较大的青少年面临更多的障碍。青少年在堕胎方面有独特的需求和经历，这应该在规划和宣传中得到考虑。少女需要在早期获得关于安全堕胎的信息，以及一个有回应和无耻辱感的卫生系统。
