Pregnancy Context and Health Outcomes

怀孕背景和健康结果

• 批准号: 10640130
• 负责人: Diana Greene Foster
• 金额: $ 47.88万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2019
• 资助国家: 美国
• 起止时间: 2019-09-10 至 2025-05-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10640130
• 关键词: Affect; Birth; Cessation of life; Child; Child Health; Childbirth; Country; Data; Developing Countries; Development; Economics; Family; Harm Reduction; Health; Health Services Accessibility; Improve Access; Incidence; Infection; Infertility; Interview; Legal; Legal system; Maternal Mortality; Measures; Mental Health; Methods; Mission; Morbidity - disease rate; National Institute of Child Health and Human Development; Nepal; Nutritional; Outcome; Persons; Policies; Poverty; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Prevalence; Prevention; Procedures; Productivity; Program Development; Prospective cohort; Reproductive Process; Research Design; Risk; Sampling; Services; Termination of pregnancy; Time; United States; Unwanted Birth; Unwanted pregnancy; Woman; Women' s Group; Women' s Health; World Health Organization; design; economic outcome; experience; feasibility testing; gaps in access; health assessment; health economics; improved; longitudinal, prospective study; mortality; physical conditioning; prevent; primary outcome; prospective; recruit; sex; social; social stigma; socioeconomics; unintended pregnancy

Project summary The objective of this project is to examine the health consequences of unintended pregnancy and denial of legal pregnancy termination services in Nepal on women and their children. Births following unwanted pregnancies can be associated with negative physical, social and economic consequences for both the woman and child. Half of all unintended pregnancies are terminated before they are carried to term and, when performed in unsafe or illegal conditions, the consequences can include infection, infertility, and death. The incidence of mortality and morbidity from termination are notoriously difficult to measure. Widespread stigma associated with unwanted pregnancy – even in settings in which termination is legally available – contribute to misreporting, concealment, and misattribution of termination-related morbidity and mortality. In addition, many women seek illegal methods—both safe and unsafe—which further confounds efforts to measure the prevalence of mortality and morbidity from terminations. The effects of unwanted pregnancy on children, including children born prior to and subsequent to the unwanted pregnancy, are also not well established. A prospective longitudinal study of women with unwanted pregnancies is required to validly investigate the health consequences for women and their families of termination outside of the legal system and delivery of an unwanted pregnancy, as compared to legal termination. Such a study is only possible in places like Nepal, where termination is legal but barriers prevent some women from receiving the service. Aim 1: To investigate the predictors of denial of legal pregnancy termination services. Aim 2: To assess the health consequences of childbirth and illegal termination for women after denial of legal termination Aim 3: To measure the effects of legal and illegal termination compared to birth on the health and development of women’s existing and subsequent children Prospective longitudinal data from women in a less developed country would provide valuable evidence for the development of programs and policies globally to improve access to and utilization of safe termination services where they are legal, and harm reduction services for women who are unable to access services.

项目摘要 该项目的目的是检查意外怀孕的健康后果和拒绝 尼泊尔妇女及其子女的合法怀孕终止服务。不需要的出生 怀孕可能会给妇女带来负面的身体，社会和经济后果 和孩子。在所有意外怀孕中，一半是在将其带到学期之前终止的，当 在不安全或非法条件下进行的后果可能包括感染，不育症和死亡。 众所周知，终止死亡率和发病率的发病率很难衡量。广泛的污名 与不需要的怀孕有关 - 即使在法律上可用的情况下，也有助于 对终止相关的发病率和死亡率的报告，隐藏和错误归因。此外，许多 妇女寻求非法方法 - 安全和不安全 - 这进一步混淆了衡量的努力 死亡率和终止的发病率的患病率。不需要怀孕对儿童的影响， 包括在不必要的怀孕之前出生的孩子，也没有很好地确定。一个 需要对不需要怀孕的妇女进行的前瞻性纵向研究有效地调查健康 在法律制度之外的妇女及其终止的后果和交付 与法律终止相比，不必要的怀孕。这样的研究只有在尼泊尔等地方才有可能 终止是合法的，但障碍阻止某些妇女获得服务。 目的1：调查拒绝合法怀孕终止服务的预测因素。 目的2：评估拒绝法律后，妇女的儿童外生和非法终止的健康后果 终止 目标3：与出生对健康和发展相比，衡量法律和非法终止的影响 妇女现有的和后来的孩子 来自较不发达国家的妇女的前瞻性纵向数据将为 在全球制定计划和政策，以改善安全终止服务的获取和利用 他们是合法的，并为无法获得服务的妇女造成减少服务。

项目成果

Denial of legal abortion in Nepal.

• DOI: 10.1371/journal.pone.0282886
• 发表时间: 2023
• 期刊: PloS one
• 影响因子: 3.7

Predictors of prior unsuccessful pharmacy abortion attempts among women presenting for abortion in government certified clinics in Nepal.

• DOI: 10.1002/ijgo.14141
• 发表时间: 2022-10
• 期刊: INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
• 影响因子: 3.8
• 作者: Ahlbach, Chris;Puri, Mahesh C.;Daniel, Sara;Rocca, Corinne H.;Karki, Sunita;Foster, Diana Greene
• 通讯作者: Foster, Diana Greene