Physician, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Diego, La Jolla, San Diego, CA, USA.
PhD Candidate, Center on Gender Equity on Health, School of Medicine, University of California San Diego, La Jolla, San Diego, CA, USA.
Sex Reprod Health Matters. 2022;29(2):2107078. doi: 10.1080/26410397.2022.2107078.
In Bangladesh, abortion is illegal, except to save a woman's life. However, menstrual regulation (MR) to induce menstruation up to 12 weeks from the last menstrual period is permitted. Although safe and legal MR services are available, many women choose to self-manage their abortions. The prevalence of intimate partner violence (IPV) in Bangladesh is high. Whether IPV is associated with self-managed abortion is unknown. Between January and December 2019 we administered cross-sectional surveys to women presenting for MR or post-abortion care (PAC) services at facilities in six cities in Bangladesh assessing if women had ever experienced IPV and if they attempted to self-manage their abortion. We used multivariable logistic regression to assess the association between IPV and self-managed abortion and multinomial logistic regression to the association between IPV by type: (none, any physical, any sexual, or both) and self-managed abortion. Among 2679 women who presented for MR or PAC care and participated in the survey, 473 (17.7%) had previously attempted to self-manage abortion. Women who had ever experienced any IPV were more likely to attempt self-managed abortion prior to presenting for MR or PAC (adjusted odds ratio (aOR) = 1.52, 95% CI 1.24, 1.87). Women who ever experienced physical IPV were more likely to attempt self-managed abortion (adjusted relative risk ratio (aRRR) = 1.62, 95% CI 1.30, 2.03). Women who have ever experienced physical IPV may be more likely to attempt a self-managed abortion because they seek more covert ways of ending a pregnancy out of fear for their safety, or because of limited mobility or lack of resources. Interventions to support women to safely self-manage abortion should focus on populations with higher rates of IPV.
在孟加拉国,除了挽救妇女生命外,堕胎是非法的。然而,允许进行经期调节(MR),即在末次月经后 12 周内诱导月经。尽管有安全和合法的 MR 服务,但许多妇女选择自行堕胎。孟加拉国共暴力(IPV)的发生率很高。IPV 是否与自行堕胎有关尚不清楚。我们在 2019 年 1 月至 12 月期间,在孟加拉国六个城市的设施中对进行 MR 或堕胎后护理(PAC)服务的妇女进行了横断面调查,以评估妇女是否曾经经历过 IPV,以及她们是否试图自行堕胎。我们使用多变量逻辑回归来评估 IPV 与自行堕胎之间的关联,以及按类型(无、任何身体、任何性或两者兼有)的 IPV 与自行堕胎之间的关联。在 2679 名接受 MR 或 PAC 护理并参加调查的妇女中,有 473 名(17.7%)曾试图自行堕胎。曾经历过任何 IPV 的妇女在接受 MR 或 PAC 护理之前更有可能尝试自行堕胎(调整后的优势比(aOR)=1.52,95%置信区间 1.24-1.87)。曾经历过身体 IPV 的妇女更有可能尝试自行堕胎(调整后的相对风险比(aRRR)=1.62,95%置信区间 1.30-2.03)。曾经历过身体 IPV 的妇女可能更有可能尝试自行堕胎,因为她们出于对自身安全的担忧,或者因为行动不便或缺乏资源,而寻求更隐蔽的方式终止妊娠。支持妇女安全自行堕胎的干预措施应针对 IPV 发生率较高的人群。
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