Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2018;40(10):599-605
We have evaluated the prevalence of and the motivating factors behind the refusal to provide reproductive health services and the ethical knowledge of the subject among medical students from the Escola Bahiana de Medicina e Saúde Pública, in the state of Bahia, Brazil.
The present cross-sectional study involved 120 medical students. A questionnaire was utilized. The dependent variables were students’ objections (or not) regarding three clinical reproductive health cases: abortion provided by law, contraceptive guidance to an adolescent without parental consent, and prescription of emergency contraception. The independent variables were age, gender, religion, ethical value, degree of religiosity, and attendance at worship services. Ethical knowledge comprised an obligation to state the reasons for the objection, report possible alternatives, and referral to another professional. Data were analyzed with χ2 tests and t-tests with a significance level of 5%.
Abortion, contraception to adolescents, and emergency contraception were refused by 35.8%, 17.5%, and 5.8% of the students, respectively. High religiosity (p < 0.001) and higher attendance at worship services (p = 0.034) were predictors of refusing abortion. Refusal to provide contraception to adolescents was significantly higher among women than men (p = 0.037). Furthermore, 25% would not explain the reason for the refusal, 15% would not describe all the procedures used, and 25% would not refer the patient to another professional.
Abortion provided by law was the most objectionable situation. The motivating factors for this refusal were high commitment and religiosity. A reasonable portion of the students did not demonstrate ethical knowledge about the subject.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2014;36(1):5-9
DOI 10.1590/S0100-72032014000100003
To analyze and compare the knowledge, attitudes and opinions of medical students about abortion in Brazil during the progression of the course.
This was a cross-sectional study involving 174 medical students. A questionnaire was applied whose dependent variables were degree of information about abortion, including its legal aspects in Brazil, situations in which the students would agree with the expansion of permitted legal abortion, knowledge of someone undergoing abortion, and discomfort about performing the procedure legally. The independent variables were sociodemographic data, religion, and academic standing (first or second half of the course). For data analysis it was used χ2 and Fisher's exact tests, with the level of significance set at 5%.
Among the interviewees, 59.8 % considered themselves well informed about the topic. Students demonstrated knowledge about the complications of abortion, with no differences with the progression of the course. Knowledge about the legal aspects of abortion in Brazil was shown by 48.9% of the sample, being significantly higher among students in the second half of the course (34.0 and 68.9%, respectively; p<0.001). Experiencing situations of clandestine abortion was significantly higher among students in the final half of the course (3.05 and 59.4%, respectively; p<0.001), the same being observed about knowing someone who underwent the procedure illegally (5.0 and 18.9%, respectively; p<0.001). The expansion of permissive legal abortion in Brazil was agreed about by 86.2% students, although 54.6% of the students reported that they felt uncomfortable about performing the procedure even legally, without statistical significance with the evolution of the course regarding the two situations.
The experiences of abortion and the knowledge of legal aspects were significantly higher among students in the second half of the course, with no significant changes in attitudes or opinions about abortion being observed with the competences acquired during medical training.
Summary
Revista Brasileira de Ginecologia e Obstetrícia. 2007;29(5):230-234
DOI 10.1590/S0100-72032007000500002
PURPOSE: to analyze the factors associated with the reproductive future of patients wishing to become pregnant after having being submitted to tubal ligation (TL), attended at a public service. METHODS: a prospective study including 98 patients previously submitted to TL, who came to the Human Reproduction Center of the University Hospital of Brasilia (HUB), from January 1996 to January 2004, wishing to become pregnant again These patients were followed up from their first appointment till the end of the study, when they answered a structured questionnaire about the social demographic aspects at both the moment they asked for the TL and the reversion of the procedure. RESULTS: the patients’ average age at the TL procedure was 25 years old. Among them, 55.1% were younger than 25, 46.9% had three or more children, and ten of them had only one child. The most common reasons for the TL procedure were: contraception (48%), financial difficulties (25.5%) and marital problems (15.3%). The major causes for wishing a new pregnancy were: a new relationship/marriage (80.6%), the desire of having another child with the same partner (8.2%), and the death of a child (6.1%). The regret time informed by most of the patients was between two and four years, and the search for reversion was between six and ten years. About 83.6% of the sample referred lack of information about the procedure and the difficulties of reversion. Twenty patients were submitted to TL reversal procedure; from the ten who became pregnant, only six delivered babies, after a full-term pregnancy. Eight patients were referred to in vitro fertilization treatment, four of them became pregnant and two delivered healthy babies. CONCLUSIONS: TL in young vulnerable women, not informed about the definitive condition of the method, may increase the search for attended reproduction services and impair their reproductive future, as far as only 8.1% of the sample delivered babies and reached their goal.