Women’s rescuers network: Community support for self-managed abortion in Argentina

Gabriela Luchetti; Valeria Albardonedo; María Victoria Alfonso

doi:10.18294/sc.2024.4810

Women’s rescuers network: Community support for self-managed abortion in Argentina

https://doi.org/10.18294/sc.2024.4810

Published 20 June 2024

Gabriela Luchetti Physician, obstetrician-gynecologist. Master in Gender, Society and Politics. Assistant Professor, School of Medicine, Universidad Nacional del Comahue, Neuquén, Argentina. , Valeria Albardonedo Bachelor of Social Communication. Master in Social Sciences. Teaching Assistant, School of Medicine, Universidad Nacional del Comahue, Neuquén, Argentina. , María Victoria Alfonso Bachelor of Social Communication. Master in Science and Technology Policy and Management. Secretary, Superior Council, Universidad Nacional del Comahue, Neuquén, Argentina.

PDF (Español)

Abstract views

260

Metrics Loading ...

Funding

Ministerio de Salud de la Nación | Grant numbers Nro. de registro IS002702 RENIS

Keywords:

Legal Abortion, Induced Abortion, Misoprostol, Community Networks, Feminism, Argentina

Abstract

The availability of medications to induce abortion, especially in contexts of restricted access, has transformed practices and allowed women and/or their community organizations to assist other women in obtaining abortions, whether or not they interact with the healthcare system. This study recovers the experience of a feminist community organization that, from the province of Neuquén, extends throughout the country, creating a network of community care. An exploratory descriptive study with a qualitative approach was conducted to analyze the experiences of women who facilitate access to permitted abortion in Argentina. Through in-depth interviews with three leaders of the feminist collective La Revuelta and semi-structured interviews with 33 members of the socorrista groups, conducted between November 2019 and December 2020, we describe their history and processes of work and growth; we explore their motivations and feelings and characterize the interactions of these organizations with public and private health systems. The results of this work align with the international conversation and bibliographic production about these organizations and their particularities, and with the need to incorporate these forms of care into institutional health systems.

References

1. Organización Mundial de la Salud. Aborto sin riesgos [Internet]. 2012 [citado 10 oct 2023]. Disponible en: https://tinyurl.com/bttcumnd.

2. Ganatra B, Gerdts C, Rossier C, Johnson BR, Tunçalp Ö, Assifi A, et al. Global, regional, and subregional classification of abortions by safety, 2010–14: estimates from a Bayesian hierarchical model. Lancet. 2017;390(10110):2372-2381. DOI: https://doi.org/10.1016/S0140-6736(17)31794-4

3. Calvert C, Owolabi OO, Yeung F, Pittrof R, Ganatra B, Tunçalp Ö, et al. The magnitude and severity of abortionrelated morbidity in settings with limited access to abortion services: A systematic review and meta-regression. BMJ Global Health. 2018;3:e000692. DOI: https://doi.org/10.1136/bmjgh-2017-000692

4. Bearak J, Popinchalk A, Ganatra B, Moller AB, Tunçalp Ö, Beavin C, et al. Unintended pregnancy and abortion by income, region, and the legal status of abortion: estimates from a comprehensive model for 1990–2019. Lancet Global Health. 2020;8(9):e1152-e1161. DOI: https://doi.org/10.1016/S2214-109X(20)30315-6

5. Starrs AM, Ezeh AC, Barker G, Basu A, Bertrand JT, Blum R, et al. Accelerate progress—sexual and reproductive health and rights for all: report of the Guttmacher–Lancet Commission. The Lancet. 2018;391(10140):2642-2692. DOI: https://doi.org/10.1016/S0140-6736(18)30293-9

6. Anzorena CC. El derecho al aborto legal, seguro y gratuito en Argentina: obstáculos y desafíos de la política en acto a 18 meses de su implementación (2021-2022). Salud Colectiva. 2023;19:e4613. DOI: https://doi.org/10.18294/sc.2023.4613

7. Tiseyra MV, Vila Ortiz M, Romero M, Abalos E, Ramos S. Barreras de acceso al aborto legal en el sistema público de salud de dos jurisdicciones de Argentina: Rosario y Ciudad Autónoma de Buenos Aires, 2019-2020. Salud Colectiva. 2022;18:e4059. DOI: https://doi.org/10.18294/sc.2022.4059

8. Ramos S, Romero M, Aizenberg L, Ramos S, Romero M. Women’s experiences with the use of medical abortion in a legally restricted context: the case of Argentina. Reproductive Health Matters. 2015;22(Supl 1):4-15. DOI: https://doi.org/10.1016/S0968-8080(14)43786-8

9. Zamberlin N, Romero M, Ramos S. Latin American women’s experiences with medical abortion in settings where abortion is legally restricted. Reproductive Health. 2012;9:34. DOI: https://doi.org/10.1186/1742-4755-9-34

10. Robson SC, Kelly T, Howel D, Deverill M, Hewison J, Lie MLS, et al. Randomised preference trial of medical versus surgical termination of pregnancy less than 14 weeks’ gestation (TOPS). Health Technology Assessment. 2009;13(53):1–124. DOI: https://doi.org/10.3310/hta13530

11. Winikoff B, Dzuba IG, Chong E, Goldberg AB, Steve Lichtenberg E, Ball C, et al. Extending outpatient medical abortion services through 70 days of gestational age. Obstetrics and Gynecology. 2012;120(5):1070-1076. DOI: https://doi.org/10.1097/AOG.0b013e31826c315f

12. Zurbriggen R, Keefe-Oates B, Gerdts C. Accompaniment of second-trimester abortions: the model of the feminist Socorrista network of Argentina. Contraception. 2018;97(2):108-115. DOI: https://doi.org/10.1016/j.contraception.2017.07.170

13. Berro Pizzarossa L, Nandagiri R. Self-managed abortion: a constellation of actors, a cacophony of laws? Sexual and Reproductive Health Matters. 2021;29(1):1899764. DOI: https://doi.org/10.1080/26410397.2021.1899764

14. Argentina. Decreto 297/2020 Aislamiento Social Preventivo y Obligatorio [Internet]. 2020 [citado 10 oct 2023]. Disponible en: https://tinyurl.com/7pn2tx5m.

15. Lesbianas y Feministas por la Descriminalización del Aborto. Todo lo que querés saber sobre cómo hacerse un aborto con pastillas. Buenos Aires: Editorial El Colectivo; 2010.

16. Socorristas en Red. Sistematización de acompañamientos a abortar. [Internet]. 2022 [citado 10 oct 2023]. Disponible en: https://tinyurl.com/2n229a68.

17. World Health Organization. Abortion care guideline [Internet]. 2022 [citado 10 oct 2023]. Disponible en: https://tinyurl.com/ysykufkm.

18. Gambir K, Kim C, Ka N, Ganatra B, Td N, Gambir K, et al. Self-administered versus provider-administered medical abortion. The Cochrane database of systematic reviews. 2020;3(3):CD013181. DOI: https://doi.org/10.1002/14651858.CD013181.pub2

19. Hyland P, Raymond EG, Chong E. A direct-to-patient telemedicine abortion service in Australia: Retrospective analysis of the first 18 months. Australian & New Zealand Journal of Obstetrics & Gynaecology. 2018;58(3):335-340. DOI: https://doi.org/10.1111/ajo.12800

20. Hyman A, Blanchard K, Coeytaux F, Grossman D, Teixeira A. Misoprostol in women’s hands: A harm reduction strategy for unsafe abortion. Contraception. 2013;87(2):128-130. DOI: https://doi.org/10.1016/j.contraception.2012.10.020

21. Kero A, Wulff M, Lalos A. Home abortion implies radical changes for women. European Journal of Contraception and Reproductive Health Care. 2009;14(5):324-333. DOI: https://doi.org/10.3109/13625180903128609

22. Song LP, Tang SY, Li CL, Zhou LJGYK, Mo XT. Early medical abortion with self-administered low-dose mifepristone in combination with misoprostol. Journal of Obstetrics and Gynaecology Research. 2018;44(9):1705-1711. DOI: https://doi.org/10.1111/jog.13716

23. Tan YL, Singh K, Tan KH, Gosavi A, Koh D, Abbas D, et al. Acceptability and feasibility of outpatient medical abortion with mifepristone and misoprostol up to 70 days gestation in Singapore. European Journal of Obstetrics, Gynecology, and Reproductive Biology. 2018;229:144-147. 10.1016/j.ejogrb.2018.08.014. DOI: https://doi.org/10.1016/j.ejogrb.2018.08.014

24. Braine N. Autonomous health movements: Criminalization, de-medicalization, and community-based direct action. Health and Human Rights. 2020;22(2):85-97.

25. Jelinska K, Yanow S. Putting abortion pills into women’s hands: realizing the full potential of medical abortion. Contraception. 2018;97(2):86-89. DOI: https://doi.org/10.1016/j.contraception.2017.05.019

26. Gerdts C, Jayaweera RT, Kristianingrum IA, Khan Z, Hudaya I. Effect of a smartphone intervention on self-managed medication abortion experiences among safe-abortion hotline clients in Indonesia: A randomized controlled trial. International Journal of Gynaecology and Obstetrics. 2020;149(1):48–55. DOI: https://doi.org/10.1002/ijgo.13086

27. Harries J, Daskilewicz K, Bessenaar T, Gerdts C. Understanding abortion seeking care outside of formal health care settings in Cape Town, South Africa: a qualitative study. Reproductive Health. 2021;18:190. DOI: https://doi.org/10.1186/s12978-021-01243-3

28. Organización Mundial de la Salud. Directrices unificadas sobre intervenciones de autoasistencia sanitaria [Ïnternet]. 2019 [citado 10 oct 2023]. Disponible en: https://tinyurl.com/bdd98ja2.

29. Chemlal S, Russo G. Why do they take the risk? A systematic review of the qualitative literature on informal sector abortions in settings where abortion is legal. BMC Womens Health. 2019;19(1):55. DOI: https://doi.org/10.1186/s12905-019-0751-0

30. Baum SE, Ramirez AM, Larrea S, Filippa S, Egwuatu I, Wydrzynska J, et al. “It’s not a seven-headed beast”: abortion experience among women that received support from helplines for medication abortion in restrictive settings. Health Care for Women International. 2020;41(10):1128-1146. DOI: https://doi.org/10.1080/07399332.2020.1823981

31. Aiken ARA, Lohr PA, Lord J, Ghosh N, Starling J. Effectiveness, safety and acceptability of no-test medical abortion (termination of pregnancy) provided via telemedicine: a national cohort study. BJOG. 2021;128(9):1464-1474. DOI: https://doi.org/10.1111/1471-0528.16668

32. Grossman D, Baum SE, Andjelic D, Tatum C, Torres G, Fuentes L, et al. A harm-reduction model of abortion counseling about misoprostol use in Peru with telephone and in-person follow-up : A cohort study. Plos One. 2018;13(1):e0189195. DOI: https://doi.org/10.1371/journal.pone.0189195

33. Moseson H, Keefe-Oates B, Jayaweera RT, Filippa S, Motana R, Bercu C, et al. Studying Accompaniment model Feasibility and Effectiveness (SAFE) Study: Study protocol for a prospective observational cohort study of the effectiveness of self-managed medication abortion. BMJ Open. 2020;10:e036800. DOI: https://doi.org/10.1136/bmjopen-2020-036800

34. Moseson H, Herold S, Filippa S, Barr-Walker J, Baum SE, Gerdts C. Self-managed abortion: A systematic scoping review. Best Practice & Research, Clinical Obstetrics & Gynaecology. 2020;63:87-110. DOI: https://doi.org/10.1016/j.bpobgyn.2019.08.002

35. Moseson H, Jayaweera R, Egwuatu I, Grosso B, Kristianingrum IA, Nmezi S, et al. Effectiveness of self-managed medication abortion with accompaniment support in Argentina and Nigeria (SAFE): a prospective, observational cohort study and non-inferiority analysis with historical controls. Lancet Global Health. 2022;10(1):e105-e113. DOI: https://doi.org/10.1016/S2214-109X(21)00461-7

36. Atienzo EE, Zurbriggen R, Gerdts C, Zambrano D, Keefe-oates B, Wollum A. Characterizing two models for abortion. Revista de Saúde Pública. 2023;57:36. DOI: https://doi.org/10.11606/s1518-8787.2023057004993

37. Yanow S, Pizzarossa LB, Jelinska K. Self-managed abortion: Exploring synergies between institutional medical systems and autonomous health movements. Contraception. 2021;104(3):219-221. DOI: https://doi.org/10.1016/j.contraception.2021.06.006

38. Pizzarossa LB, Skuster P. Toward human rights and evidence-based legal frameworks for (self-managed) abortion: A review of the last decade of legal reform. Health and Human Rights. 2021;23(1):199–212.

39. Socorristas en Red. Sistematizacion de acompañamientos a abortar: Realizados en el año 2019 por Socorristas en Red (feministas que abortamos) [Internet]. 2020 [citado 10 oct 2023]. Disponible en: https://tinyurl.com/3r5jjcfh.

40. Burton J. Você precisa abortar? Onde quer que você esteja, nós te acompanhamos: pandemia e acompanhamento de abortos em Neuquén, Argentina, durante 2020. Cadernos Ibero-Americanos de Direito Sanitário. 2023:12(4). DOI: https://doi.org/10.17566/ciads.v12i4.1200

41. Gudiño Bessone P, Drovetta RI, Rúa A. Ações para o aborto seguro durante a pandemia: o caso das práticas de duas organizações na Argentina. Ações para o aborto seguro durante a pandemia: o caso das práticas de duas organizações na Argentina. 2023;12(4). DOI: https://doi.org/10.17566/ciads.v12i4.1199