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Signature Assignment Paper: Culminating Argument on Surgical Abortion
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Abstract
In the contemporary world, surgical abortion continues to elicit different emotions and
discussion. This paper’s primary concern is evaluating this ongoing debate’s ethical dilemma.
This practice maintains a vital position within the ever-changing healthcare environment,
informed by medical technology advances and the complexity of ethical issues. To understand
the scope of the subject matter, it is necessary to adopt a historical point of view and follow its
development through legal conflicts, altering society’s views, and medical developments. The
researches address concerns about accessibility, within the delicate balance that must be
maintained between these factors, which may result in dangerous treatments. The value of
medical care lies in the fact that it sheds light on the ethical dilemmas that underlie people’s
understanding of reproductive rights and moral principles.
Surgical abortion continues to attract global debate, particularly concerning the ethical,
societal, and medical factors it entails. Because the subject is critical in health practice,
evaluating this issue using peer-reviewed articles is essential. This research investigates issues
surrounding medical surgery, namely pain management procedures, financial implications, and
quality of care. The articles evaluate various concepts and components surrounding surgical
abortion, which include socioeconomic and ethical dimensions. It provides insightful findings
to healthcare stakeholders, including patients, policymakers, and practitioners. The analysis’s
primary objective is to contribute to existing knowledge to improve the practice and
knowledge and improve patient services and outcomes. Also, the study aims at eliminating the
misconceptions surrounding the topic. Because the topic is controversial, this paper concludes
with information on how its findings can play a critical role in improving healthcare.
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Surgical Abortion
Introduction
In today’s society, the question of surgical abortion remains essential for debate and
conversation. Abortions performed surgically affect various domains, including law, ethics,
and public discourse (Czekajewska et al., 2022). Because of this, several medical implications
and consequences linked to abortion have been questioned, including autonomy, fetal rights,
and the broader social responsibility involved with reproductive decision-making. This
practice is pivotal in the larger context of the interaction between women’s rights, ethical
concerns, and the ever-changing panorama of medical operations. Because of this complex
problem, medical professionals must conduct further research into its complexities. This
situation arises and not only has the potential to affect the progression of reproductive
healthcare but also our understanding of ethics, autonomy, and societal conventions.
The ongoing discussions in this topic are one of the most critical aspects that pertains
to abortion via surgical methods. This sensitive subject matter has provoked many
conversations and discussions among people. It is important to understand the historical
evolution of this topic regarding legal fights, shifting societal standards, and advancements in
medical technology. Doing so will allow one to nurture an intellectually strong and fruitful
dialogue that recognizes and appreciates the diversity of perspectives surrounding this issue.
However, this research focuses primarily on the ethical dilemma at the core, which is a
complicated connection between a woman’s natural entitlement to reproductive autonomy and
the moral concerns and rights connected to the fetus.
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Relevance of Surgical Abortion in Today’s Landscape
In the contemporary healthcare landscape, the topic of surgical abortion stands as a
crucial and timely subject of inquiry. It reflects medical advancements while navigating
complex discussions on autonomy, fetus rights, and societal responsibilities. Shaping
healthcare and broader narratives prompts reflection on the evolving intersection of women’s
rights, ethics, and medicine (Czekajewska et al., 2022). In medicine, the relevance of surgical
abortion is intertwined with medical technology and practice advancements.
Although the word “surgery” is commonly employed, it is essential to note that the
majority of abortions are characterized by minimum invasiveness and do not necessitate the
use of general anesthesia. A surgical abortion is a medical intervention to terminate a
pregnancy (Tufa et al., 2021). Surgical procedures are a viable alternative for individuals
seeking to undergo abortion procedures inside the controlled environment of a clinical or
medical facility.
Medical abortions, a viable alternative for most individuals, are predominantly
conducted in the comfort of one’s residence.
The majority of surgical abortions are performed using a delicate suctioning method
referred to as vacuum aspiration. When visiting a clinic it may span many hours, the actual
surgery is usually completed within a timeframe of 5 to 10 minutes. This operation can be
quick and efficient, if no health issues occur during the procedure. This quick operation is one
of the things that makes it more appealing to people.
Surgical abortion is an alternative for terminating a pregnancy at later stages compared
to medical abortion, also known as “the abortion pill.” Obtaining an abortion throughout the
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later stages of pregnancy is contingent upon the legal framework established within one’s state
and guidelines.
Due to recent law modifications to abortion regulations in the United States, the
availability of surgical abortion procedures has been limited in certain states. However,
individuals still have alternatives, such as the possibility of receiving abortion drugs through
postal delivery and more.
Unsafe and Safe Abortion
The risk and issue of unsafe abortion continues to put a significant challenge to many
health factors. According to the WHO, an abortion is deemed safe when administered using a
method that adheres to the safety guidelines and is performed by a qualified individual who has
received appropriate training (Agula et al., 2021). The meaning of a safe procedure or a
qualified individual has undergone many changes over time, particularly about the involvement
of non-physician healthcare practitioners. These significant changes has been characterized by
the availability of medical abortion. The legislation and development holds the potential to
facilitate self-administration, particularly in regions where access to abortion services is
severely limited or prohibited by law. The nature of the healthcare and legal landscape
necessitates a understanding of abortions, precluding a simplistic categorization into binary
classifications of safety and being unsafe. The World Health Organization now has a
classification system consisting of three categories: safe, least safe abortions, and less safe.
These categories are designed to reflect varying levels of risk associated with factors such as the
abortion technique, the provider involved, and the stage of pregnancy.
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Epidemiology
The magnitude of complications associated with abortion are contingent upon the
gestational age during which the abortion is performed and the specific procedure used at the
time of the termination. According to available medical reports, the estimated rates of abortion
complications are approximately 2% for pharmaceutical abortions and 1.5% for those
conducted in the second trimester or beyond (Gebremariam et al., 2023). The mortality rate
associated with induced abortion in the United States was reported to be 0.6 deaths for every
100,000 abortions (Gebremariam et al., 2023). The regulations of abortions in the US led to a
significant decrease in mortality rates associated with septic abortion. The likelihood of
mortality resulting from bacterial abortion escalates as gestation advances.
Etiology
Complications are a common occurrence when it comes to abortion. Infection may occur
due to a lack of adherence to universal precautions before the procedure, including inadequate
hand hygiene, failure to use surgical gloves, improper sterilization and use of non-sterile
instruments, and underlying conditions in the patient, such as endometritis. Incorrect removal
may cause accumulation of blood in the uterus, leading to excessive stretching and loss of
muscle tone, ultimately resulting in hemorrhaging, It may also result in infection and potentially
sepsis. The occurrence of injury resulting from the surgical process is contingent upon the
specific method employed, encompassing cervical or vaginal lacerations and potential harm to
the uterus.
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Unveiling Complexity: Controversy and Ethical Dilemmas
Internationally, a broad spectrum of legal classifications exists about abortion. Certain
nations grant women the right to request an abortion without justification. Conversely, other
countries impose specific criteria for abortion eligibility, while some have ambiguous laws that
prohibit illegal abortions without explicitly stating lawful grounds. Additionally, many
countries prohibit abortion, regardless of circumstances (Williams et al., 2023). Throughout
history, there has been ongoing debate and modification of laws, driven by many underlying
causes that dictate their intended scope of regulation. In jurisdictions with comparatively
permissive abortion legislation, such as the United States and South Africa, several women
may have difficulty accessing abortion services (Tadele et al., 2019). Access obstacles to
abortion services can arise due to several factors, including the distance individuals must travel
to reach healthcare facilities, the stringent rules governing these institutions, concerns
regarding privacy at clinics, the financial implications associated with the procedure, and the
limited number of health workers who are ready to provide abortion services. The significance
of the latter aspect lies in the observation made by the WHO regarding the substantial
hindrance to women’s accessibility to safe abortion caused by the insufficient presence of
healthcare professionals offering abortion services. Obtaining the services of healthcare
professionals willing to offer abortion care can pose challenges, particularly in environments
characterized by stringent abortion legislation and a cultural climate that stigmatizes the
profession. Consequently, abortion service providers often encounter social stigma and
prejudice.
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Abortion, especially involving surgical methods, remains contentious and evokes solid
opinions and discussions. Comprehending this topic’s complexities is imperative for fostering
well-informed and productive dialogues that respect diverse perspectives. The historical
trajectory of surgical abortion is marked by legal battles, shifting societal values, and
advancements in medical technology. What particularly interests me is the ethical dilemma
inherent in this topic. This dilemma encompasses a woman’s right to reproductive autonomy
juxtaposed with the ethical considerations and rights attributed to the fetus.
Ethical and Religious Justifications
Ethical problems involve conflicting ethical principles or values, leading to
disagreements on balancing these principles effectively and arriving at a conclusion. Moral
dilemmas frequently emerge when healthcare practitioners are compelled to employ broad
conceptions of the law due to the intersection of professional ethics and personal beliefs
(Broussard et al., 2019). The activation of fundamental beliefs and values was observed among
the study participants concerning the availability of abortion services. Some individuals
perceive abortion as malicious, while others perceive it as assisting vulnerable women,
aligning with the concept of doing good or beneficence (Thornborg, 2023). The last point was
frequently prioritized, with most healthcare professionals expressing willingness to support
women seeking abortion, particularly when women did not meet the strictest legal criteria
(Broussard et al., 2019). These judgments arise as instances of situations where individuals
desire to act in a morally positive manner. In their endeavor to uphold the ethical ideals of
beneficence and nonmaleficence, healthcare providers navigated morally ambiguous
situations, leading them to accept what they perceived as falsehoods and consequently engage
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in legal flexibility. The obligation of health practitioners to accept a woman’s testimony,
irrespective of their perspectives, placed significant demands on them.
Instead of framing abortion solely within the context of women’s autonomy and bodily
agency, the narratives of healthcare professionals highlight its significance as a public health
concern. These accounts underscore the role of abortion in mitigating the considerable health
risks associated with unsafe procedures, preventing childbirth among young and economically
disadvantaged unmarried women, and enabling young women to pursue their education
without interruption.
Balancing Autonomy and Societal Norms
A critical perspective that has caught my consideration is the multifaceted harmony
expected between an individual’s independence in pursuing personal decisions and the cultural
standards and values that can impact these choices. It raises a central issue: Is it morally
satisfactory for a lady to wield full command over her body, even when it means discontinuing
a potential life? Conversely, how do society’s moral principles and responsibilities intermingle
with an individual’s autonomy, mainly when a potential conflict exists between personal
choices and broader values? Adding another layer to this complex issue is the accessibility of
surgical abortion. This element is concerning because it may lead to women seeking risky
operations, threatening their health and the fetus’s development.
Accessibility and Health Concerns
Adding another layer to this complexity is the issue of accessibility to surgical
abortion. The accessibility aspect is concerning due to its potential to drive women towards
unsafe procedures, jeopardizing their health and the development of the fetus. This assertion
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emphasizes the need for comprehensive reproductive healthcare that ensures safe and ethical
options for women while respecting their autonomy. By exploring this problem, I aim to foster
a nuanced understanding of the ethical landscape surrounding surgical abortion and contribute
to developing balanced solutions that respect women’s autonomy while addressing broader
societal and moral considerations.
Despite being considered safe, both therapeutic abortions and spontaneous
miscarriages can result in a range of problems. Approximately one million abortions are
conducted annually in the United States exclusively (Guendelman et al., 2020). Most problems
are minor, encompassing discomfort, infection, bleeding, and post-anesthesia difficulties.
Several other complications might arise, including uterine atony and subsequent hemorrhage,
uterine perforation, damage to nearby organs such as the bowels or bladder, and septic
abortion. The estimated overall rate of complications connected to abortion, encompassing
various sources of care such as emergency rooms and the initial abortion clinic, is
approximately 2% (Williams et al., 2023). The user’s text is already academic and does not
require any rewriting. Approximately 40% of individuals who undergo an abortion experience
needing emergency medical care within six weeks following the first surgery (Williams et al.,
2023). These rates are alarming. Few people can access safe abortion.
Investigating further into this topic, my problem statement could be;
“How can we navigate the intricate ethical landscape surrounding surgical abortion to
ensure comprehensive reproductive healthcare, all while considering the concerns of
autonomy, fetal rights, and accessibility?”
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I invite you to share your unique perspectives on these concepts. I am particularly
interested in whether a woman’s autonomy should be the primary consideration or other ethical
and moral factors should hold a more significant influence. I am also keen to explore how we
can find a harmonious middle ground that respects women’s reproductive rights while
addressing the ethical complexities and dilemmas that this topic poses.
The overarching goal of this Assignment is to lay the groundwork for our final papers.
As we embark on this journey, our objective is to identify a specific area of focus and develop
a topic that centers on a pressing issue or challenge within that domain. Let us always
remember that our endeavors aim to propose and present practical solutions to the healthcare
issue we choose to address. Women seeking reproductive choices and comprehensive
healthcare would benefit from a solution to the ethical complexities surrounding surgical
abortion.
Literature Review
Article 1: Pain Control in Surgical Abortion
Cansino et al. (2021) explore pain management options during surgical abortion. Their
article focuses on moderate sedation, profound sedation, and general anesthesia. It offers
clinicalrecommendations and protocols for anesthesia, considering patient factors and safety
measures. It is an integral area that requires significant comprehension for increased efficiency
among the practitioners to provide quality care to their clients. The source is credible, as it is a
peer-reviewed article published in the journal “Contraception.” It is a reputable scientific
journal. The authors of the material are also experts in family planning and healthcare—a
component providing further credibility to the article. The article is a recent publication, which
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implies it contains relevant data and information by borrowing from past accounts to make
informed decisions. This document will be invaluable for understanding the scientific aspects
of anesthesiain surgical abortions—a factor that directly contributes to considerations about
comprehensive reproductive healthcare and improving patient experience.
Article 2: Quality of Care and Abortion
According to Darney et al. (2018), quality of care is substantial in all areas. In their
article, they stress the prominence of quality of care in abortion services. Abortion is a
potentially sensitive area that requires increased efficiency to increase outcomes. The authors
argue for a broader focus beyond safety, outlining the need for effective, efficient, patientcentered care. This research module is published in the peer-reviewed journal “BMJ Sexual &
Reproductive Health.” The authors are also reproductive health and healthcare policy experts,
making the source credible. Technically, this is a scientific article and directly correlates with
theissue discussed at hand. It offers a look into the quality of abortion services, which will be
critical in addressing the ethical and practical complexities surrounding the provision of
surgicalabortion services.
Article 3: The Mesoeconomics of Abortion
Lattof et al. (2020) provide a scoping review of the economic aspects of abortion. The
focus on the economic consequences of abortion on health systems and communities is an area
that takes up most of the article. It appears in “PLOS ONE,” a peer-reviewed journal. The
multi-disciplinary team of authors lends further credibility to the research. It is also a recent
documentpublished in 2020, making it valid for this research topic. Comprehending the
economic effects of abortion is crucial for policymakers and healthcare providers. The study
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material will help address the issue of abortion from an economic perspective. It is a factor that
will influence discussions on accessibility and affordability.
Improving Healthcare Outcomes
Although the majority of abortions are uncomplicated, there exists a subset of cases that
are accompanied by difficulties, posing a potential risk to the individual’s life. The
recommendation is to assemble an interdisciplinary team consisting of health and nursing
practitioners due to the elevated mortality associated with complications arising from abortion
procedures.
A considerable proportion of individuals experiencing post-abortion problems seek
medical attention at the emergency department, where the screening nurse initially assesses
them. The triage nurse must possess knowledge of potential difficulties that may arise following
an abortion procedure, enabling them to admit the patient and notify the interprofessional
healthcare team promptly. Also, to severe hemorrhage, post-abortion consequences encompass
septic shock, perforation of the bladder or colon, and potential ectopic pregnancy. Failure to
promptly diagnose these diseases can result in significant fatality rates. While coordinating the
imaging investigations, the nursing staff must verify the presence of two large-bore intravenous
catheters, administer oxygen, and guarantee that a typical blood work routine, particularly a
cross-match, has been dispatched for the patient. Continuous monitoring by a devoted nurse,
who promptly reports any irregularities to the clinician, is crucial for managing
hemodynamically unstable patients.
It is imperative to promptly conduct a comprehensive physical examination
encompassing the pelvic region to ascertain the absence of any overlooked injuries. If the
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patient needs expeditious surgical intervention, it is imperative to promptly inform the
anesthetic team and the surgical facility nursing staff. Close monitoring is necessary for stable
individuals due to the potential presence of internal bleeding that may not be readily apparent.
During monitoring period, it is considered proper care when the nurse promptly communicates
with the team of specialists in the event of any alterations in vital signs or abdominal pain.
With the growing number of self-induced procedures, there is expected to be a decrease
in abortion-related deaths. The significance of understanding women’s care requirements
persists, and the utilization of morbidity as a health outcome metric will continue to be pivotal.
To enhance the rigor and comparability of future facility-based research studies, it is
recommended that standardized definitions, such as the WHO near-miss criteria, be consistently
employed. Additionally, it is advisable for researchers to explicitly outline the clinical criteria
utilized in their studies, preferably data collection in a prospective manner.
Conclusion
In summary, examining surgical abortion through a meticulous evaluation of scholarly
literature has shed light on the complex interplay of medical, sociological, and ethical factors
that include this essential healthcare topic. This research study examined three peer-reviewed
studies that focused on important aspects of surgical abortion, specifically pain management,
the provision of high-quality treatment, and the economic considerations related to abortion.
Throughout this academic exploration, it becomes clear that surgical abortion extends beyond
simple medical treatment. It involves profoundly examining patient welfare, ethical
ramifications, and economic outcomes.
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The significance of an exhaustive review of these peer-reviewed papers cannot be
emphasized. These resources provide significant perspectives on improving the
implementation of surgical abortion procedures, considering various patient considerations,
and ensuring the delivery of high-quality healthcare. Moreover, these findings add to a broader
and deeper understanding of the moral and sociological aspects that shape the discussion
surrounding this particular medical methodology. The insights derived from scholarly
publications are of great value to healthcare providers, policymakers, and researchers as they
strive to explore the complex surgical abortion practice. These technologies facilitate informed
dialogues, strengthen healthcare practices, and eventually contribute to improved patient
experiences. Surgical abortion continues to be the subject of significant debate and careful
consideration. However, by actively interacting with the academic literature, healthcare
stakeholders can progress toward understanding its complexity and approaching it with
enhanced awareness. These essential components evaluated in the study serve as a foundation
upon which healthcare stakeholders can construct knowledgeable dialogues, enhance
healthcare procedures, and strive to enhance the comprehensive welfare of those seeking
medical care. However, active involvement with scholarly sources can advance stakeholders’
understanding and approach to this issue by enhancing peace effectiveness, knowledge, and
empathy in tackling its complexities.
The significance of an exhaustive review of these peer-reviewed papers cannot be
emphasized. These resources provide significant perspectives on improving the
implementation of surgical abortion procedures, considering various patient considerations,
and ensuring the delivery of high-quality healthcare. Moreover, these findings add to a broader
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and deeper understanding of the moral and sociological aspects that shape the discussion
surrounding this particular medical methodology. The insights derived from scholarly
publications are of great value to healthcare providers, policymakers, and researchers as they
strive to explore the complex surgical abortion practice. These technologies facilitate informed
dialogues, strengthen healthcare practices, and eventually contribute to improved patient
experiences. Surgical abortion continues to be the subject of significant debate and careful
consideration. However, by actively interacting with the academic literature, healthcare
stakeholders can progress toward understanding its complexity and approaching it with
enhanced awareness. These essential components evaluated in the study serve as a foundation
upon which healthcare stakeholders can construct knowledgeable dialogues, enhance
healthcare procedures, and strive to enhance the comprehensive welfare of those seeking
medical care. However, active involvement with scholarly sources can advance stakeholders’
understanding and approach to this issue by enhancing peace effectiveness, knowledge, and
empathy in tackling its complexities.
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References
Agula, C., Henry, E. G., Asuming, P. O., Agyei-Asabere, C., Kushitor, M., Canning, D., … &
Bawah, A. A. (2021). Methods women use for induced abortion and sources of services:
insights from poor urban settlements of Accra, Ghana. BMC Women’s Health, 21(1), 1–12.
Andersen, M., Bryan, S., & Slusky, D. (2020). Covid-19 surgical abortion restriction did not
reduce visits to abortion clinics.
Broussard, G., Rubenstein, L. S., Robinson, C., Maziak, W., Gilbert, S. Z., & DeCamp, M.
(2019). Challenges to ethical obligations and humanitarian principles in conflict settings: a
systematic review. Journal of International Humanitarian Action, 4(1), 1-13.
Cansino, C., Denny, C., Carlisle, A. S., & Stubblefield, P. (2021). Society of Family Planning
clinical recommendations: pain control in surgical abortion part 2–moderate sedation, profound
sedation, and general anesthesia.
Czekajewska, J., Walkowiak, D., & Domaradzki, J. (2022). Attitudes of Polish physicians,
nurses, and pharmacists towards the ethical and legal aspects of the conscience clause. BMC
Medical Ethics, 23(1), 107. https://link.springer.com/article/10.1186/s12910-022-00846-0
Darney, B. G., Powell, B., Andersen, K., Baum, S. E., Blanchard, K., Gerdts, C., & Kapp, N.
(2018). Quality of care and abortion: beyond safety. BMJ sexual & reproductive health, 44(3),
159-160.
Gebremariam, F. A., Habtewold, E. M., Degife, D. T., Geneti, H. B., & Gebrekiros, D. H.
(2023). Health facilities readiness to provide comprehensive abortion care and factors
associated with client satisfaction in Central Oromia Region, Ethiopia: a multilevel modeling
approach. Reproductive Health, 20(1), 1-18. https://reproductive-health-
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journal.biomedcentral.com/articles/10.1186/s12978-023-01610-2
Guendelman, S., Yon, E., Pleasants, E., Hubbard, A., & Prata, N. (2020). Shining the light on
abortion: Drivers of online abortion searches across the United States in 2018. Plos one, 15(5),
e0231672.
Lattof, S. R., Coast, E., Rodgers, Y. V. D. M., Moore, B., & Poss, C. (2020). The mesoeconomics of abortion: A scoping review and analysis of the economic effects of abortionon
health systems. PloS one, 15(11), e0237227.
Roe, A. H., & Bartz, D. (2019). Society of Family Planning clinical recommendations:
contraception after surgical abortion. Contraception, 99(1), 2-9.
Tadele, G., Haukanes, H., Blystad, A., & Moland, K. M. (2019). ‘An uneasy compromise’:
strategies and dilemmas in realizing a permissive abortion law in Ethiopia. International
Journal for Equity in Health, 18, 1-13.
Thornburg, E. L. (2023). The Public Health Crisis of Media Misinformation, Disinformation,
and Conspiracy Theories: A Case for Bioethical Intervention (Doctoral dissertation, Temple
University).
Tufa, T. H., Prager, S., Wondafrash, M., Mohammed, S., Byl, N., & Bell, J. (2021). Comparison
of surgical versus medical termination of pregnancy between 13-20 weeks of gestation in
Ethiopia: A quasi-experimental study. Plos one, 16(4), e0249529. https://doi.org/10.1371/
journal.pone.0249529
Williams, C. R., Valeria Bahamondes, M., Gómez Ponce de León, R., da Costa Machado, H.,
Bahamondes, L., Caffe, S., & Serruya, S. J. (2023). Analyzing the context and characteristics
of legal abortion and comprehensive post-abortion care among adolescents aged 10–14 in a
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network of sentinel centers in Latin America: a retrospective cross-sectional study, 2016–
2020. Sexual and Reproductive Health Matters, 31(1), 2175442.
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