Are women really free to choose how to have an abortion?
Approach: Analysing why, despite the fact that Sexual and Reproductive Health international organizations, such as WHO, UN or Guttmacher Institute, recommend to explain in an impartial and enlightening way, the methods of safe abortion according to clinical features and daily life for women to choose. However there are places where a method is prioritized more than other and this may affects women.
There are instrumental methods, called surgical, although there is no surgery, with local anaesthesia or sedation, based on the use of instruments which are fast and comfortable, also chemical methods called pharmacological or medical, that create an intoxication, among other effects they may produce a long and painful abortive process.
- Ignorance: Lack of sanitary education especially in sexual and reproductive health international organizations and especially in induced abortion, which also suffers from a lack of cross-information between women who live abortion in silence because of moral and religious burden it has.
- Training: In Spain and other places, there is no regulated training in instrumental abortion, therefore the chemical is a professional refuge, because they believe that it does not need any special knowledge. Moreover, it could be perform by auxiliary personnel, even when it is at the expense of time and suffering of women.
- Ideology (politic):
- Thinking that the chemical “belongs to the women” (empower them) and demedicalizes.
- Conscientious objection: (the chemist) allows the professional to think that the woman does it alone or, in any case, does not have a direct action. It is something that “happens” and only intervenes if there are problems.
- Ownership in some professional sectors.
- Application on the territory: with the chemist, it is easier to transfer the whole process to the home and environment of the patient and her family, with occasional support of the local hospital.
- Economic: It seems that the chemical is cheaper to the payer, especially if it is public, although it depends on how the costs are understood.
All these aspects have particularities in each trimester of gestation. We will present a Website to disseminate the advantages of instrumental methods.
Santiago Barambio is an experienced obstetrician-gynaecologists who has been working for 41 years in the sexual and reproductive health domain in Catalunya (Spain). He is an abortion provider and the Medical Director of the “Ara” clinic (Agrupación Tutor Médica – Barcelona) that has provided more than 50.000 terminations over the last 22 years, including second trimester abortions. He is the founder and former President of the Spanish Association of Abortion clinics (ACAI) and the former President of the Catalan Society for Contraception (SCC) as well as of the Medical Sciences Academy of Catalunya and Balears (ACMCiB). He currently is a Board member of the Association of Family Planning of Catalunya and Balears, which is member of the International Planned Parenthood Federation. He is the authors of several scientific articles on abortion related issues, including a number of articles on misoprostol use for early abortions.