"Regardless, you are not the first woman": an illustrative case study of contextual risk factors impacting sexual and reproductive health and rights in Nicaragua
"Regardless, you are not the first woman": an illustrative case study of contextual risk factors impacting sexual and reproductive health and rights in Nicaragua
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DOI：
10.1186/s12905-019-0771-9
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发表时间：
2019-06-14
影响因子：
2.5
通讯作者：
Rochat, Roger W.
中科院分区：
文献类型：
--
作者：
Luffy, Samantha M.;Evans, Dabney P.;Rochat, Roger W.
强奸、意外怀孕和堕胎是当今性与生殖健康研究人员、倡导者和公众面临的最具争议性和污名化的话题之一。在过去三十年中，公共卫生倡导者和人权倡导者在促进我们对性权利和生殖权利以及如何保护这些权利的理解方面取得了长足进步。这项研究的总体目标是了解在尼加拉瓜压制性的法律的和社会文化背景下年轻妇女的意外怀孕个人经历。2014年6月至7月，在尼加拉瓜中北部的一个城市，对16 - 23岁的妇女进行了10次深度访谈（IDI）。案例介绍本案例研究的重点是一名19岁的尼加拉瓜妇女被强奸，怀孕，几乎死于不安全堕胎引起的并发症。她的案件以化名Ana Maria详细介绍，由于尼加拉瓜限制性的性健康社会规范、普遍存在的暴力侵害妇女行为和全面禁止堕胎，在实现性权利和生殖权利方面面临独特的挑战。案件还提供了一个有用的透镜，通过它来检查个人的性健康和生殖健康（SRH）的经验，特别是强奸，意外怀孕和不安全堕胎;这种深入的分析确定了上下文的风险因素，促成了安娜玛丽亚的experience.ConclusionsFar太多的妇女经历他们的性行为的背景下，个人和结构性暴力。安娜·玛丽亚的案例为在性方面存在限制性法律的政策和保守文化规范的国家实现性健康和生殖健康及权利提供了几个重要的经验教训。安娜·玛丽亚的经历表明，个人的健康决定不是孤立作出的，不受社会规范和国家法律的影响。我们提出了一个概述的关键风险和背景因素，有助于安娜玛丽亚的暴力，意外怀孕和不安全堕胎的经验。
BackgroundRape, unintended pregnancy, and abortion are among the most controversial and stigmatized topics facing sexual and reproductive health researchers, advocates, and the public today. Over the past three decades, public health practicioners and human rights advocates have made great strides to advance our understanding of sexual and reproductive rights and how they should be protected. The overall aim of the study was to understand young women's personal experiences of unintended pregnancy in the context of Nicaragua's repressive legal and sociocultural landscape. Ten in-depth interviews (IDIs) were conducted with women ages 16-23 in a city in North Central Nicaragua, from June to July 2014.Case presentationThis case study focuses on the story of a 19-year-old Nicaraguan woman who was raped, became pregnant, and almost died from complications resultingfrom an unsafe abortion. Her case, detailed under the pseudonym Ana Maria, presents unique challenges related to the fulfillment of sexual and reproductive rights due to the restrictive social norms related to sexual health, ubiquitous violence against women (VAW) and the total ban on abortion in Nicaragua. The case also provides a useful lens through which to examine individual sexual and reproductive health (SRH) experiences, particularly those of rape, unintended pregnancy, and unsafe abortion; this in-depth analysis identifies the contextual risk factors that contributed to Ana Maria's experience.ConclusionsFar too many women experience their sexuality in the context of individual and structural violence. Ana Maria's case provides several important lessons for the realization of sexual and reproductive health and rights in countries with restrictive legal policies and conservative cultural norms around sexuality. Ana Maria's experience demonstrates that an individual's health decisions are not made in isolation, free from the influence of social norms and national laws. We present an overview of the key risk and contextual factors that contributed to Ana Maria's experienceof violence, unintended pregnancy, and unsafe abortion.