To know the experiences of women who suffered sexual violence (SV), got pregnant and underwent legal abortion (LA) in a referral service in Brazil, a country with restrictive abortion laws. An exploratory qualitative study based on semistructured interviews was conducted with women selected through purposeful sampling. The interviews were recorded, transcribed and thematic analysis of content was performed. Women aged 18-38 years old, schooling ≥ 8 years, were interviewed 1-5 years after LA. Participants reported that the pregnancy discover was despairing, the desire of abortion was immediate and the possibility of LA brought expectation and hope. Having Catholic religion, seeing the fetus or fetal parts at the moment of the expulsion and the negative reactions from some health professionals were pointed as hindering elements of this experience that hampered their emotional recovery. In the long term, they reported no regret, however, feelings of guilt and difficulties in resuming their religious practices appeared. women undergoing LA of pregnancy suffer emotional impacts and revealed moral and religious sanctions. Health services should be sensitized and implement practices to ensure women's right to legal abortion in restrictive law countries.

The situation of abortion varies according to the laws and cultural context of society; and its implications for women's lives are quite linked to the social, cultural and religious representations of each country. The experiences of unwanted pregnancy, abortion and its consequences on women's mental health have motivated studies with controversial results. Most countries in Latin America have restrictive abortion laws except in some situations. In Brazil, abortion is a crime, except for situations of risk to a woman's life, rape and/or incest permitted since the Constitution of 1940 and, more recently, in pregnancies with anencephalic fetuses. The Brazilian public health sector has standardized emergency care for victims of sexual violence (SV) since 1998 in order to, within the first 72 hours, provide emergency contraception and prophylaxis for viral and bacterial STDs. Public health services should also provide services that perform legal abortion (LA) for women who become pregnant as a result of the SV. However, although required by law, women's access to abortion is still difficult. According to a research that sought to describe the care services for SV offer at 874 public hospitals with conditions to perform termination of pregnancy procedures, showed that 30.6% declared to provide the service for pregnancies resulting from sexual abuse and only 5.6% had received at least one procedure in a period of 14 months. The restrictive laws and the sociocultural characteristics of the Latin America population, marked by religious perspectives with a Christian majority and differences in gender relations, contribute to a negative view of society on the issue of abortion and hamper the search for institutional help for women, as well as maximizing their suffering during and after the decision for the LA. Considering the scarcity of studies in countries with restrictive laws to abortion and the necessity for information that may contribute to the care of women who are seeking institutional help for LA, this study aimed to know the experiences of women that underwent LA, and their fellings and difficulties through the process. The study was conducted at the Department of Obstetrics and Gynaecology, School of Medical Sciences, University of Campinas (UNICAMP), Campinas, Brazil. The project was approved by the University’s Institutional Review Board, and all the women enrolled signed an informed consent form. The Woman's Hospital Prof. Dr. Jose Aristodemo Pinotti is public and university teaching service located in southeastern São Paulo State, Brazil. The Division of Gynaecology has been dispensing care to women who became pregnant after sexual violence for 20 years with an average of 30 requests of LA annually. A qualitative exploratory study based on semi-structured interviews was conducted. Participants were selected according to the logic of purposeful sampling and the strategy was maximum variation sampling. Women who were ≥18 years of age, requested and performed LA of a pregnancy resulting from SV, with a minimum of 12 months and maximum 60 months after the procedure, were invited to participate. Women with cognitive disabilities and/or severe psychiatric history were excluded. Sample size was determined by the criteria of saturation of information. For the selection of participants, 63 medical records of women who requested termination of pregnancy between 2006 and 2011 were evaluated, and 28 women met the inclusion criteria. Telephone contact was made with 17 women, of whom 14 agreed to participate. They were provided with information on the objectives of the study and on the voluntary nature of participation. The criterion of saturation of information was achieved in the first ten interviews.

With Regards,
Sara Giselle
Associate Managing Editor
Journal of Critical Care Obsestrics & Gynocology