Küretaj sebepli damgalanma, kadın sağlığını olumsuz etkileyen durumlardandır. Bu çalışma, küretaj deneyimlemiş kadınların, toplumun ve sağlık profesyonellerinin küretaja yönelik görüş ve tutumlarını içeren çalışmaların sonuçlarını derleyerek, değerlendirmek amacıyla yapılmış bir sistematik derlemedir. Derlemeye dâhil etme kriterlerini sağlayan 19 çalışmanın 5'i tanımlayıcı, 13'ü nitel ve 1'i hem tanımlayıcı hem nitel tasarım tipindedir. Çalışmaların örneklemini, toplum ve spesifik olarak küretaj deneyimleyen kadınlar, sağlık çalışanları ve üniversite öğrencileri oluşturmaktadır. Çalışmalar incelendiğinde; küretaj sebepli damgalanmanın kadınlarda anksiyete, korku, keder ve depresyona sebep olabileceği belirlenmiştir. Kadınların küretaj damgalanması yaşamalarında, toplumun ve sağlık bakım vericilerinin küretaja yönelik görüş ve tutumları önemlidir. Toplumun, küretaja karşı olumsuz tutum sergilemesinde toplumun dini görüşünün, kadının medeni hâlinin, birden fazla küretaj deneyimleme durumunun, gebe ve fetüsün genel sağlık durumunun önemli olduğu görülmüştür. Küretajın kirli bir iş ve sorgulanabilir ahlaki ölçüt olarak görülmesi, sağlık bakım vericilerinin ve küretaj uygulayıcılarının, küretaja yönelik görüşünü ve tutumunu etkilemektedir. Küretajın yasal olma durumunun ise hem toplumun hem de sağlık profesyonellerinin küretaja yönelik görüş ve tutumunu etkilediği belirlenmiştir. Küretaj damgalanması deneyimlemekten sakınan kadınların, güvenli olmayan gebelik sonlandırma yollarına başvurduğu görülmüştür. Bu sebeple kadın sağlığının korunup geliştirilmesinde küretaj sebepli damgalanmaların önlenmesi ya da en aza indirilmeye çalışılması hedeflenmelidir. Küretaja yönelik damgalanma toplumdan topluma farklılık gösterdiğinden, sağlık bakım vericileri kendi toplumlarına uygun bu konuda farkındalık oluşturacak eğitim ve destek programlarının yürütülmesinde aktif rol almalıdır.
Anahtar Kelimeler: Damgalanma; küretaj; gebeliğin sonlandırılması
Stigmatization due to abortion is one of the conditions adversely affecting women's health. This study is a systematic review to review and evaluate the results of studies including opinions and attitudes of women, community and health professionals who have experienced abortion. Five of the nineteen studies that met the inclusion criteria were descriptive, thirteen were qualitative and one was both descriptive and qualitative. The sample of the study consists of women who experience abortion in society and specifically, health workers and university students. When the studies were examined; it has been determined that stigmatization due to abortion may cause anxiety, fear, grief and depression in women. The opinions and attitudes of the community and health care providers towards abortion are important for women to experience stigmatization of abortion. It was observed that the religious opinion of the society, the marital status of the woman, the experience of multiple abortions, and the general health status of the pregnant and fetus were important in the society's negative attitude towards abortion. The fact that abortion is seen as a dirty job and as a questionable moral criterion affects the opinion and attitude of health care providers and abortion practitioners towards abortion. It was determined that the legal status of abortion affects the opinions and attitudes of both the society and health professionals towards abortion. It was found that women who avoided experiencing abortion stigmatization resort to unsafe pregnancy termination methods. For this reason, it should be aimed to prevent or minimize the stigma due to abortion in the protection and promotion of women's health. Since stigma on abortion differs from community to community, health care providers should take an active role in conducting training and support programs that will raise awareness of this issue in their respective communities.
Keywords: Stigma; abortion; pregnancy termination
- Mosley EA, King EJ, Schulz AJ, Harris LH, De Wet N, Anderson BA. Abortion attitudes among South Africans: findings from the 2013 social attitudes survey. Cult Health Sex. 2017;19(8):918-33. [Crossref] [PubMed]
- Loi UR, Otieno B, Oguttu, M, Gemzell-Danielsson K, Klingberg-Allvin M, Faxelid E, et al. Abortion and contraceptive use stigma: a cross-sectional study of attitudes and beliefs in secondary school students in western Kenya. Sex Reprod Health Matters. 2019;27(3):1652028. [Crossref] [PubMed]
- Gelman A, Rosenfeld EA, Nikolajski C, Freedman LR, Steinberg JR, Borrero S. Abortion stigma among low-income women obtaining abortions in western Pennsylvania: a qualitative assessment. Perspect Sex Reprod Health. 2017;49(1):29-36. [Crossref] [PubMed]
- Esia-Donkoh K, Darteh EKM, Blemano H, Asare H. Who cares? Pre and post abortion experiences among young females in Cape Coast Metropolis, Ghana. Afr J Reprod Health. 2015;19(2):43-51. [PubMed]
- Martin LA, Debbink M, Hassinger J, Youatt E, Harris LH. Abortion providers, stigma and professional quality of life. Contraception. 2014;90(6):581-7. [Crossref] [PubMed]
- Hulme-Chambers A, Temple-Smith M, Davidson A, Coelli L, Orr C, Tomnay JE. Australian women's experiences of a rural medical termination of pregnancy service: a qualitative study. Sex Reprod Healthc. 2018;15:23-7. [Crossref] [PubMed]
- Cockrill K, Biggs A. Can stories reduce abortion stigma? Findings from a longitudinal cohort study. Cult Health Sex. 2018;20(3):335-50. [Crossref] [PubMed]
- Shellenberg KM, Tsui AO. Correlates of perceived and internalized stigma among abortion patients in the USA: an exploration by race and Hispanic ethnicity. Int J Gynaecol Obstet. 2012;118 Suppl 2:S152-9. [Crossref] [PubMed]
- Rocca CH, Kimport K, Roberts SCM, Gould H, Neuhaus J, Foster DG. Decision rightness and emotional responses to abortion in the United States: a longitudinal study. PLoS One. 2015;10(7):e0128832. [Crossref] [PubMed]
- Aiken ARA, Johnson DM, Broussard K, Padron E. Experiences of women in Ireland who accessed abortion by travelling abroad or by using abortion medication at home: a qualitative study. BMJ Sex Reprod Health. 2018;bmjsrh-2018-200113. [PubMed]
- Oginni A, Ahmadu SK, Okwesa N, Adejo I, Shekerau H. Correlates of individual-level abortion stigma among women seeking elective abortion in Nigeria. Int J Womens Health. 2018;10:361-6. [Crossref] [PubMed]
- Holcombe SJ, Berhe A, Cherie A. Personal beliefs and professional responsibilities: Ethiopian midwives' attitudes toward providing abortion services after legal reform. Stud Fam Plann. 2015;46(1):73-95. [Crossref] [PubMed]
- Makleff S, Wilkins R, Wachsmann H, Gupta D, Wachira M, Bunde W, et al. Exploring stigma and social norms in women's abortion experiences and their expectations of care. Sex Reprod Health Matters. 2019;27(3):1661753. [Crossref] [PubMed]
- Martin LA, Hassinger JA, Seewald M, Harris LH. Evaluation of abortion stigma in the workforce: development of the revised Abortion Providers Stigma Scale. Womens Health Issues. 2018;28(1):59-67. [Crossref] [PubMed]
- Ahman E, Shah IH. New estimates and trends regarding unsafe abortion mortality. Int J Gynecol Obstet. 2011;115(2):121-6. [Crossref] [PubMed]
- Jewkes R, Rees H, Dickson K, Brown H, Levin J. The impact of age on the epidemiology of incomplete abortions in South Africa after legislative change. BJOG. 2005;112(3):355-9. [Crossref] [PubMed]
- Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, 2014. 2013 Türkiye Nüfus ve Sağlık Araştırması. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Kalkınma Bakanlığı ve TÜBİTAK, Ankara, Türkiye.
- Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, 2019. 2018 Türkiye Nüfus ve Sağlık Araştırması, Temel Bulgular. Hacettepe Üniversitesi Nüfus Etütleri Enstitüsü, T.C. Cumhurbaşkanlığı Strateji ve Bütçe Başkanlığı ve TÜBİTAK, Ankara, Türkiye.
- Bommaraju A, Kavanaugh ML, Hou MY, Bessett D. Situating stigma in stratified reproduction: abortion stigma and miscarriage stigma as barriers to reproductive healthcare. Sex Reprod Healthc. 2016;10:62-9. [Crossref] [PubMed]
- Smith W, Turan JM, White K, Stringer KL, Helova A, Simpson T, et al. Social norms and stigma regarding unintended pregnancy and pregnancy decisions: a qualitative study of young women in Alabama. Perspect Sex Reprod Health. 2016;48(2):73-81. [Crossref] [PubMed]
- Kebede MT, Middelthon AL, Hilden PK. Negotiating the social and medical dangers of abortion in Addis Ababa: an exploration of young, unmarried women's abortion-seeking journeys. Health Care Women Int. 2018;39(2):186-207. [Crossref] [PubMed]
- Kpolovie PJ, Oguwike A. Female students' attitude towards abortion. Int J Humanit Soc Sci Educ. 2017;4(11):98-120. [Crossref]
- Yegon EK, Kabanya, PM, Echoka E, Osur J. Understanding abortion-related stigma and incidence of unsafe abortion: experiences from community members in Machakos and Trans Nzoia counties Kenya. Pan Afr Med J. 2016;24:258. [Crossref] [PubMed]
- Grindlay K, Seymour JW, Fix L, Reiger S, Keefe-Oates B, Grossman D. Abortion knowledge and experiences among U.S. servicewomen: a qualitative study. Perspect Sex Reprod Health. 2017;49(4):245-52. [Crossref] [PubMed]
- Hanschmidt F, Treml J, Klingner J, Stepan H, Kersting A. Stigma in the context of pregnancy termination after diagnosis of fetal anomaly: associations with grief, trauma, and depression. Arch Womens Ment Health. 2018;21(4):391-9. [Crossref] [PubMed]
- Steinberg JR, Tschann JM, Furgerson D, Harper CC. Psychosocial factors and pre-abortion psychological health: the significance of stigma. Soc Sci Med. 2016;150:67-75. [Crossref] [PubMed]
- Hoggart L, Newton VL, Bury L. 'Repeat abortion', a phrase to be avoided? Qualitative insights into labelling and stigma. J Fam Plann Reprod Health Care. 2017;43(1):26-30. [Crossref] [PubMed]
- Cárdenas R, Labandera A, Baum SE, Chiribao F, Leus I, Avondet S, et al. "It's something that marks you": abortion stigma after decriminalization in Uruguay. Reprod Health. 2018;15(1):150. [Crossref] [PubMed]
- Jayaweera RT, Ngui FM, Hall KS, Gerdts C. Women's experiences with unplanned pregnancy and abortion in Kenya: a qualitative study. PloS One. 2018;13(1):e0191412. [Crossref] [PubMed]
- Mohamed D, Diamond-Smith N, Njunguru J. Stigma and agency: exploring young Kenyan women's experiences with abortion stigma and individual agency. Reprod Health Matters. 2018;26(52):1492285. [Crossref] [PubMed]
- Begun S, Combs KM, Schwan K, Torrie M, Bender K. "I know they would kill me": abortion attitudes and experiences among youth experiencing homelessness. Youth Soc. 2018;52(8):1457-78. [Crossref]
- Zordo SD. From women's 'irresponsibility' to foetal 'patienthood': obstetricians-gynaecologists' perspectives on abortion and its stigmatisation in Italy and Catalu-a. Glob Public Health. 2018;13(6):711-23. [Crossref] [PubMed]
- Aniteye P, O'Brien B, Mayhew SH. Stigmatized by association: challenges for abortion service providers in Ghana. BMC Health Serv Res. 2016;16(1):486. [Crossref] [PubMed]
- Kavanagh A, Wielding S, Cochrane R, Sim J, Johnstone A, Cameron S. 'Abortion' or 'termination of pregnancy'? Views from abortion care providers in Scotland, UK. BMJ Sex Reprod Health. 2018;44(2):122-7. [Crossref] [PubMed]
- Sonalkar S, Gurney EP, McAllister A, Schreiber CA. A randomized pilot evaluation of individual-level abortion stigma resulting from Pennsylvania mandated abortion counseling. Contraception. 2017;96(4):227-32. [Crossref] [PubMed]
- Moseson H, Massaquoi M, Dehlendorf C, Bawo L, Dahn B, Zolia Y, et al. Reducing under-reporting of stigmatized health events using the List Experiment: results from a randomized, population-based study of abortion in Liberia. Int J Epidemiol. 2015;44(6):1951-8. [Crossref] [PubMed]
- Norup M. Attitudes towards abortion in the Danish population. Bioethics. 1997;11(5):439-49. [Crossref] [PubMed]
- Astbury-Ward E, Parry O, Carnwell R. Stigma, abortion, and disclosure--findings from a qualitative study. J Sex Med. 2012;9(12):3137-47. [Crossref] [PubMed]
- Levandowski BA, Kalilani-Phiri L, Kachale F, Awah P, Kangaude G, Mhango C. Investigating social consequences of unwanted pregnancy and unsafe abortion in Malawi: the role of stigma. Int J Gynaecol Obstet. 2012;118 Suppl 2:S167-71. [Crossref] [PubMed]
.: İşlem Listesi