BACKGROUND The abortion law in Uruguay changed in 2012 to allow first trimester abortion on request. Implementation of the law in Uruguay has been lauded, but barriers to care, including abortion stigma, remain. This study aimed to assess women's experiences seeking abortion services and related attitudes and knowledge following implementation of the law in Uruguay. METHODS We interviewed 207 eligible women seeking abortion services at a high-volume public hospital in Montevideo in 2014. We generated univariate frequencies to describe women's experiences in care. We conducted regression analysis to examine variations in experiences of stigma by women's age and number of abortions. RESULTS Most of the women felt that abortion was a right, were satisfied with the services they received, and agreed with the abortion law. However, 70% found the five-day waiting period unnecessary. Women experienced greater self-judgement than worries about being judged by others. Younger women in the sample (ages 18-21) reported being more worried about judgment than women 22 years or older (1.02 vs. 0.71 on the ILAS sub-scale). One quarter of participants reported feeling judged while obtaining services. Women with more than one abortion had nearly three times the odds of reporting feeling judged. CONCLUSIONS These findings highlight the need to address abortion stigma even after the law is changed. Some considerations from Uruguay that may be relevant to other jurisdictions reforming abortion laws include: the need for strategies to reduce judgmental behavior from staff and clinicians towards women seeking abortions, including training in counseling skills and empathic communication; addressing stigmatizing attitudes about abortion through community outreach or communications campaigns; mitigating the potential stigma that may be perpetuated through policies to prevent "repeat" abortions; ensuring that younger women and those with more than one abortion feel welcome and are not mistreated during care; and assessing the necessity of a waiting period. The rapid implementation of legal, voluntary abortion services in Uruguay can serve in many ways as an exemplar, and these findings may inform the process of abortion law reform in other countries.

中文翻译：

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在乌拉圭获得合法堕胎的经验：堕胎客户的知识、态度和耻辱。


背景 乌拉圭的堕胎法于 2012 年进行了修改，允许根据要求进行妊娠早期堕胎。乌拉圭法律的实施受到赞扬，但护理方面的障碍，包括堕胎耻辱，仍然存在。本研究旨在评估乌拉圭法律实施后妇女寻求堕胎服务的经历以及相关态度和知识。方法 2014 年，我们采访了 207 名在蒙得维的亚一家高流量公立医院寻求堕胎服务的合格女性。我们生成了单变量频率来描述女性的护理经历。我们进行了回归分析，以研究女性年龄和堕胎次数对耻辱经历的影响。结果 大多数妇女认为堕胎是一项权利，对她们获得的服务感到满意，并同意堕胎法。然而，70% 的人认为五天的等待期没有必要。与担心被他人评判相比，女性经历了更多的自我评判。样本中的年轻女性（18-21 岁）报告比 22 岁或以上的女性更担心判断力（ILAS 子量表上的 1.02 比 0.71）。四分之一的参与者表示在获得服务时感到受到评判。堕胎不止一次的女性感到受到评判的几率几乎是其三倍。结论 这些发现凸显了即使在法律修改后也需要解决堕胎耻辱问题。 乌拉圭的一些考虑因素可能与其他改革堕胎法的司法管辖区相关，包括：需要制定战略，减少工作人员和临床医生对寻求堕胎的妇女的评判行为，包括咨询技能和同理心沟通方面的培训；通过社区外展或宣传活动解决对堕胎的污名化态度；通过防止"重复"堕胎的政策，减轻可能长期存在的潜在耻辱；确保年轻妇女和多次堕胎的妇女感到受欢迎，并且在护理期间不会受到虐待；并评估等待期的必要性。乌拉圭快速实施合法、自愿堕胎服务在很多方面都可以作为典范，这些发现可以为其他国家的堕胎法改革进程提供参考。