The abortion paradox in Uganda: fertility regulator or cause of maternal mortality.
The abortion paradox in Uganda: fertility regulator or cause of maternal mortality.
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DOI：
10.1080/01443610500328074
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发表时间：
2005-11-01
期刊：
影响因子：
--
通讯作者：
Salihu, Hamisu M
中科院分区：
文献类型：
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作者：
Gorrette, Nalwadda;Nabukera, Sarah;Salihu, Hamisu M
乌干达母亲的生育率和产妇死亡率都很高。由于避孕普及率的提高低于使总的生育率和产妇死亡率发生任何有意义变化所需的临界水平，因此该国避孕普及率的提高（从1991年的5%提高到2000年的23%）在降低生育率和产妇死亡率方面的预期效益并未出现。夫妇之间限制家庭规模的强烈愿望，加上许多妇女，特别是该国农村地区的妇女无法获得现代避孕方法，导致越来越多地使用堕胎作为避免计划外或不合时宜的生育的手段。然而，与典型的生育调节器的预期结果相反，堕胎似乎上调而不是下调孕产妇死亡率。这种矛盾的关系主要是由于该程序的非法性，使其成为一种秘密活动，由缺乏训练的个人进行，在许多情况下，在脓毒症环境中进行。一个实际的解决方案是广泛提供现代有效的避孕方法，特别是在农村居民中。通过这一点，再加上人员培训，以及通过消除与堕胎有关的“非法”污名来消除堕胎的神秘性，可以在乌干达这样的国家实现生育率和产妇死亡率的下降，在乌干达，产妇死亡率高使人口爆炸更加复杂。
Both fertility and maternal mortality indices are high among Ugandan mothers. The expected benefits in fertility and maternal mortality reduction from a rising contraceptive uptake in the country (from 5% in 1991 to 23% by the year 2000) have not been forthcoming because the increase in contraceptive prevalence rate (CPR) was below the critical level required to cause any meaningful change in overall fertility and maternal mortality. The strong desire among couples to limit family size coupled with the lack of access to modern methods of contraception by many women, especially in the rural areas of the country, have contributed to the increasing use of abortion as a means of averting unplanned or mistimed motherhood. In contrast to the expected results of a typical fertility regulator, however, abortion seems to up-regulate instead of down-regulate the occurrence of maternal mortality. This paradoxical relationship is explained mainly by the illegality of the procedure, which converts it to a clandestine activity performed by poorly trained individuals operating, in many instances, in septic settings. A practical solution is to make modern and effective methods of contraception widely available, especially among rural-dwellers. Through this and coupled with training of personnel, as well as demystification of abortion by dismantling the stigma of "illegality" associated with it, down-regulation of fertility and maternal mortality can both be achieved in a country like Uganda where population explosion is further complicated by a high incidence of maternal demise.