Development & Aid, Headlines, Health, Latin America & the Caribbean

HEALTH-CUBA: Sex Education Needed to Fight Overuse of Abortion

Dalia Acosta

HAVANA, Dec 6 2002 (IPS) - The legalisation of abortion in Cuba was successful in reducing the maternal mortality rate to a minimum. But the heavy reliance on abortion, virtually as a form of birth control, by many women reveals the ineffectiveness of sex education and family planning programmes in this socialist Caribbean island nation.

Government research and statistics demonstrate that women in Cuba often turn to abortion, which has been legal since 1965, as just another form of birth control, ignoring the health risks and ethical questions involved.

”This is my third abortion, and I’ve never had any problem,” Rosa Martínez, 32, remarked to IPS. ”I’m always scared when I come in, but in the end everything turns out ok, I’m fine, and as time goes by I just forget about the difficult experience, and end up coming back.”

Martínez has been taking the pill for over five years. But sometimes she forgets. In addition, she says, ”my husband doesn’t like to use a condom, and since we’re not used to thinking about the problem, I almost always realize what’s happening when it’s too late.”

A study by obstetrician-gynecologist Ignacio González and pediatrician Emilia Miyar, who are specialists in sexology, called for more comprehensive sex education programmes and a more effective family planning policy to reduce the ”indiscriminate use of abortion.”

The doctors pointed out that it is common to see pregnant adolescents as young as 12 or 13 in the maternity clinics, as well as young and adult women who come back for repeat abortions, sometimes more than one a year.

Nearly all of the women are familiar with birth control, but many simply do not use any method – a problem in which the widespread prejudice against condoms in Cuba, seen as reducing pleasure, is a key factor.

Last year, 69,563 abortions were practiced in this country of 11.2 million, equivalent to 20.6 for every 1,000 women between the ages of 12 and 49, and 49.8 for every 100 births, according to the Statistical Health Yearbook published by the Ministry of Public Health.

Although that represents a significant drop with respect to 1986, when 160,926 abortions were registered, the 2001 statistics did not include cases in which menstruation is induced by doctors, an estimated 70 percent of which could actually involve voluntary interruptions of pregnancy.

The procedure is used to induce menstruation generally before six weeks have gone by since the last menstrual cycle, and usually without a pregnancy test.

Since abortion was legalised in Cuba in 1965, maternal deaths resulting from abortion fell from 120 for every 100,000 live births to seven per 100,000 in 2000, according to preliminary data.

The World Health Organisation (WHO) estimates that at least 80,000 women die annually worldwide and many more suffer permanent physical or mental damages as a result of unsafe abortions.

Around 20 million of the estimated 40 to 60 million abortions carried out globally every year are ”back alley” abortions practiced by individuals lacking the proper training and without even minimal conditions of hygiene.

But in Cuba, all abortions are carried out on demand free of charge in public hospitals.

However, the overuse of abortions is of concern to health professionals and authorities.

The Statistical Profile of the Cuban Woman, a report released in 2000 by the governmental National Office of Statistics, showed that 5.6 million live births and 3.2 million abortions took place between 1968 and 1996.

Some social sectors in Cuba see abortion as a method of birth control, an attitude that is even passed down from one generation to another, said the study.

That is the only way to explain the repeated use of abortion by adult women, who already have several children, as well as by their young adolescent daughters, who are repeating a family pattern, it pointed out.

Birth control demands day-to-day discipline, while abortion is seen as a solution to an intangible future problem that many women, at a subconscious level, believe will not happen to them, the National Office of Statistics report added.

In their own study, meanwhile, González and Miyar insisted that ”We must design sex education programmes in which the approach taken to birth control is not the same for adults in stable relationships, who need contraceptives to plan their families and space out the births of their children, as for young people.”

The specialists said more comprehensive plans are needed for the youngest generations, which must include information that enables them to optimise their enjoyment of sex while protecting themselves from unwanted pregnancies and sexually transmitted diseases.

For several years, the United Nations Population Fund (UNFPA) has provided support for the Education Ministry’s sex education programme in high schools throughout the country.

But the efforts are opposed by many families, who blame ”excessive information” for the early age at which their sons and daughters become sexually active.

The report by González and Miyar states that society expects youngsters to ”abstain” from sex, even though adults do not do so. ”The important thing is to accept the fact that youngsters have sex lives, and that it is our role to act and to educate.”

In the authors’ view, optimal sex education should help bring about ”better use of contraceptives and a reduction in the use of abortion.”

 
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Development & Aid, Headlines, Health, Latin America & the Caribbean

HEALTH-CUBA: Sex Education Needed to Fight Overuse of Abortion

Dalia Acosta

HAVANA, Dec 6 2002 (IPS) - The legalisation of abortion in Cuba was successful in reducing the maternal mortality rate to a minimum. But the heavy reliance on abortion, virtually as a form of birth control, by many women reveals the ineffectiveness of sex education and family planning programmes in this socialist Caribbean island nation.
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