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Abortion, many risks

By Raquel Sierra / Photo: Carmona

Havana.- Emma Peña, a 42-year-old professional, shudders every time she remembers that she can not have a baby after undergoing twelve abortions.

She recently underwent hysterectomy because she had three fibromas.

"You usually do things without thinking about the consequences. I was very fertile. My friends used to tell me that I got pregnant just looking at men's underwear", she said.

Her hair is now gray and she often reflects on her life. When you are young, you think you know everything and reject even medical advice. "If I had a daughter, I would tell her not to hurry and be aware of the need to protect from diseases and unwanted pregnancy", she added.

Like many other Cuban women, Emma did not pay close attention to the impact of abortion on reproductive health.

Experts say that infertility is one of the most serious long-term consequences of abortion. "I had always thought that abortion provided a safe alternative", she stressed.

Dr. Alejandro J. Velasco Boza, assistant professor at a Medical School in Havana, indicated that over 70 percent of infertile women resorted to abortion when they were young, he noted.

Considered a blind, though legal surgical procedure in Cuba, abortion poses many risks, even when it is performed under the best possible conditions, experts emphasized.

Talking to WFS, gynecologists Natacha Donate, Sara Laria and Juan C. Farrán highlighted the short-, mid- and long-term consequences of abortion.

Short-term problems include uterine cervix tearing, hemorrhage, perforation, anesthetic complications and death.

Mid-term difficulties cover endometrial inflammation, infection and bleeding.

Long-term sequels involve endometrial tissue misplacement, cervical incompetence (leading to spontaneous abortion and/or immature delivery), out-of-uterus pregnancy and infertility.

"We should stress that one single abortion can cause sterility", Donate noted.

Therefore, the best thing is prevention. This includes counseling services, especially for young people. At consultation, we provide information and recommend using both contraceptives and condom.

"This helps protect from sexually transmitted infections", Donate added.

Menstrual regulation has helped reduce hospital consultations and increase family planning services, 2003 studies showed.

This regulation, also known as menstrual extraction, endometrial aspiration or mini-suction, is a type of suction abortion method that is applied only in the first few weeks after menstruation has been interrupted.

Medically prescribed, such a method leads to abortion in over 70 percent of cases, but it is not risk-free either.

The number of unwanted pregnancy cases, however, has grown and makes it imperative to introduce sex education in curricula and specialized services, they also corroborated.

We should continue emphasizing how important it is for pregnant women to have the best possible social, physical and psychological conditions.

Not a way out

Hernán Rodríguez, first-degree specialist in obstetrics and head of the Abortion Service at the Ramón González Coro Hospital in Havana, highlighted the importance of prevention. "Abortion should not be seen as a contraceptive method", he said.

He announced that his institution had conducted 1,236 induced abortions in the first half of 2006.

This was five percent lower than in a similar period last year.

"Most patients were in the 20- to 34-year bracket. Out of the total, 22 percent of them were under 20 years (a period when more risks are involved)", he told WFS.

"We have recently taken a number of measures to schedule abortion in 24 hours and only perform basic complementary tests", he noted.

In his view, facilitating arrangements does not mean promoting abortion. "We try to complement prevention and planning activities at the primary-care level", he explained.

"Available contraceptive methods, counseling services, risk detection and sex education are indispensable to reducing the number of unwanted pregnancies that usually end up in abortions", he stressed.

He is now involved in a biological, psychological and social characterization project for teenagers who resort to abortion. Universal access to pregnancy tests can lead to early detection and a drop in the number of abortions, he commented.

Today, contraceptive drugs are available at some hospitals, polyclinics and convertible-peso pharmacies. The current government-fixed rates of exchange stand at 80 cents of a dollar to one convertible peso and 24 Cuban pesos to one convertible peso.

A different view

Bárbara, a Pentecostal Church pastor, said that youth affairs are a priority for them. "Sexuality and abortion rank high on our agenda", she added.

In her opinion, current television spots do not seek to delay sexual relations and highlight the need for love. "They merely recommend using condom for disease prevention purposes. This is an invitation to have sex", she noted.

"We usually tell young people about the Lord, explain to them that infidelity is a sin, and try to make them focus on issues other than sex", she added.

"We also tell them that abortion goes against life and that there is a need to follow the Lord precepts and promote values".

Some figures

In her book Voluntary abortion and contraception (Havana, 2005), Dr. Miriam A. Gran made a review of young, promiscuous women. More than one abortion, unstable relations and early pregnancy usually lead to this procedure and clearly show that sex education and family planning have not been successful.

Statistical data of the Ministry of Public Health reveal that the abortion rate moved from 19.9 in 2003 to 20.9 (67,277) in 2004.

Gran said that, although women have a lot of risk information available, they often resort to abortion.

World situation

- Estimates show that 40 to 60 million (legal / illegal) abortions are conducted every year.

- Most of them are carried out under risk conditions and some lead to serious injuries and death.

- Two to four million teenagers resort to abortion every year.

Non-Aligned Countries: A masculine summit

By Dalia Acosta

Havana.- Today's world is still masculine. This became evident at the presidential parade of the 14th Summit Conference of the Non-Aligned Movement (NAM), which was held last week in the Cuban capital.

With just a few exceptions like Chile, the Heads of State and Government and senior officials presiding over delegations and representing 118 countries of the South were men. In most cases, they made their first official appearance accompanied by their wives: men hold power while women are merely "first ladies".

Against this background, it was to be expected that topics related to women's rights would not rank high on the Summit agenda. Most media representatives, however, were women.

The specific demands of half of the world population were not discussed, but many of the questions raised and some of the most controversial issues discussed actually have a direct or indirect impact on women.

Participants in the Conference condemned the aggressions on Lebanon and Iraq and foreign interference with domestic affairs of Venezuela and Bolivia. They supported Cuba at a time when sanctions on the island have been intensified. They sought to boost South-South cooperation, especially in health care and AIDS coping strategies.

Trying to include issues like abortion and sexual-minority rights on the meeting agenda of such a heterogeneous organization would have certainly come like a bombshell. NAM was established in 1961 to deal with a bipolar world and help build international peace and security.

Everything seems to indicate that NAM member countries now need to reach a consensus and come up with a unified vote at the United Nations, and build upon the issues that unite rather than separate them. They make up two thirds of UN membership.

The Havana Summit 88-page draft Final Document that was made available to the press included some paragraphs on the advancement of women.

The text ratified NAM commitment to the implementation of the 1995 Beijing Summit Declaration and Plan of Action and the 2000 United Nations General Assembly document entitled Complementary measures and initiatives.

The Heads of State and Government expressed their determination to eliminate all forms of violence against girls and women, especially under armed conflicts and foreign occupation, including systematic kidnapping and rape as an instrument of war.

They also urged all States who have not done so to adhere to and/or ratify the International Convention to Eliminate All Forms of Discrimination against Women.

The draft welcomes the holding of the 2nd NAM Ministerial Meeting on the Advancement of Women next year and supports the establishment of a Center on Gender and Development in Kuala Lumpur (Malaysia).

We can only hope that the countries of the South will defend their right to be heard at international forums as strongly as women's voice and the demands of many civil society and minority groups within the Movement.

Ladies' nights

By Marta María Ramírez / Photo: Carmona

Havana.- Some promotional materials for nightclubs in Havana announce: Accompanied women do not pay.

This means women are given free access to artistic shows if they are accompanied by men.

The so-called Ladies' Nights seem to be well accepted, especially because cover charge for these nightclubs has to be paid in convertible pesos (CUCs).

Admission fees range from two to 10 CUCs. The current official exchange rate is one CUC to 24 Cuban pesos.

"My boyfriend and I think it is a good idea. We do not often go to these places because, in Cuba's tradition, men always pay, and he can not afford such a thing every week. There are not many other choices", Paula told WFS. She is a 20-year-old university student.

Similar initiatives also aim to "court" women at state-run discos and privately- or state-operated fiesta houses. They are given free access if they arrive before 12.00 p.m. At this time, the carriage turns into pumpkin, as in the fairy tale Cinderella.

Market wooing or 21st-century Cinderella?

Women are the most powerful consumers in the world, market researchers indicate. Women make 80 percent of decisions to buy, they estimate.

While the first rule to sell is understand the market, the second one is to understand consumers. Consequently, any action seeking to attract women in the island should take into account that they make up the population group most seriously hit by the economic crisis after the early 1990s.

When Fidel Castro's revolution triumphed in 1959, Cuban women were given the same opportunities as men, including free access to education and day-care centers for small children. They have also had contraceptive methods available.

Despite these achievements, women's share in the labor market dramatically fell in the 1990s. It dropped by 31.5 percent in the 1990-1994 period, data of the Federation of Cuban women showed.

Most of them got back home. Going out to work and looking after the family became all the more difficult due to transportation problems, food shortages and local-currency devaluation.

When the national economy started to get better and diversify in 1993, self-employment and the hospitality industry provided new alternatives.

Estimates by the National Office of Statistics showed that women's employment rate had grown by 4.4 percent in the 2000-2004 period. The gap between men and women's rate has widened, however, to reach 3.2 percent.

In her book The mystics of femininity, Betty Freidan says that income is something so important in society that the notions of equality and exclusion depend on it.

Against this background, women's marketing questions in Cuba today include: Does the end justify the means? How feasible is it to implement actions like Ladies' nights?

Sociologist Esther Suárez Durán believes that there should be a consistency between ends and means, a marketing ethics and a correspondence between marketing techniques and social contexts. In theory at least, these practices are unacceptable to our society, she added.

"Ladies' nights as a concept has never been approved by the Ministry of Tourism, although many facilities have asked for permits", said a Ministry official who asked not to be identified.

Skilful business people, however, have sought to present attractive ideas for women and please men. They are followers of Faith Popcorn and Lys Marigold's EVEolution and "women's marketing essential truths".

"I work hard all week long and I am always after these activities to take my wife. It is a pity that these facilities are not available everywhere", said Alfredo, a 47-year-old engineer.

While some women regret not to have had access to these promotional materials, others associate these messages with remakes of Cinderella and Snow White. Carmen, a 35-year-old domestic, is very happy about the offer.

This has to do with gentlemanliness, something that has, unfortunately, been lost. She wondered: "Why was there no protest when President Fidel Castro gave rice cookers to Cuban women on the International Women's Day? He presented us as house cooks. It is the same thing", she stressed.

"Perhaps, the idea behind this initiative is to encourage heterosexual couples to go together to these nightclubs", Suárez ironically commented.

Omissions

Other experts in gender issues think that the initiative goes far beyond giving free access to women. Most nightclubs in Havana admit only traditional (man-woman) couples.

Yvette, a 44-year-old painter, feels excluded. I am lesbian and most of my friends are homosexuals. We are not allowed in these places because we refuse to pretend we are heterosexuals, she noted.

The Ministry of Tourism official told WFS that all this is part of the struggle against prostitution.

Apparently, nightclub managers are flexible enough to allow men and women alone. If a couple separates after they are in, we reserve the right to ask them to leave, a provision stipulates.

Maité still remembers the day when a woman tried to snatch her boyfriend away. "She touched him and challenged me. Now I go to nightclubs where only couples are allowed", she indicated.

Juan, a young musician, hates these places after a man asked him to exchange partners one night.

Those who have been forgotten still have places where admission is not regulated. We have matinees with tape music, some discos with music of the 1960s, 1970s and 1970s, and specific shows at El gato Tuerto and La zorra y el Cuervo, the official said.

Caught off guard?

No public statement on Ladies' nights has so far been made by institutions or individuals.

According to Suárez, along with prostitution, drugs, gambling, corruption, nepotism, priority to foreigners over nationals, money power and individualistic attitudes, negative values affecting women's morale have been gaining momentum.

Some studies revealed that young people are not always aware of gender inequalities. They believe there is more equality now than in the past and see no threat in measures that can actually go against hard-fought equality.

We should never be caught off guard or rest on our laurels. We still have a long way to go, Suárez concluded.

Accidents at home: Living under threat

By Carlos Fioravanti

Rio de Janeiro.- Justina Nagato experienced an embarrassing situation while conducting some research during her fifth year at the Federal University of Rio de Janeiro’s School of Psychology.

She was interviewing a woman at a chalet where snacks were being prepared, in Icaraí (Niterói), a city close to Rio de Janeiro. While she was asking her about domestic accidents, her two children went up and down a winding staircase that had no railing or handrail.

The mother was quiet, but Justina was under constant stress: should she tell her they could easily break one bone if they fell? She waited and, at the end of the interview, asked the woman if it was not dangerous for the children to play in the staircase. She answered she had not thought about it and thanked her for the advice.

Justina and another seven Psychology students visited 96 women living in metropolitan Rio. They showed them six drawings (bedroom, living room, bathroom, kitchen, staircase and backyard) and asked the mothers about the type of accidents that could occur in those areas.

Published by Social Science & Medicine magazine, the survey findings may leave mothers with the hair standing on end. They usually find it difficult to believe that a child can get hurt if he/she grabs a knife carelessly left on a table, or get burned if he/she touches a hot iron.

Three every five respondents identified the threats on the illustrations, but only one every four provided solutions.

“Parents tend to believe that threats are outside rather than inside home”, said Rodolfo de Castro Ribas Jr., a professor at the Federal University’s School of Psychology and research team member.

For a small child, the risk of having an accident at home is greater than that of street violence, Ribas added. Neither Ribas nor his closest colleagues in this study – Alexander Tymchuk (Los Angeles-based University of California) and Adriana Ribas (Rio de Janeiro Estácio de Sá University) – had the slightest idea about how often and serious domestic accidents were.

They became aware as stories began to be told. One of them came from a researcher at the Federal University. She had to stay home on an examination day because one of her children had got burned with frying pan oil.

Statistical data show that mothers now think it twice before they let children enter the kitchen while they are cooking. Some 40 percent of deaths in children under 14 years of age, all over the world, are due to domestic accidents.

In Brazil, accidental wounds caused death in 35,000 children in the 1997-2002 period alone.

Another 30,000 got burned in liquid-alcohol accidents until the National Sanitary Surveillance Agency decided to allow alcohol sale only in gel form. This reduced accidents by half.

Injuries can be fatal sometimes. Three percent of those hospitalized due to burns in Brazil died because of accident-related injuries. Three percent of children cared for at emergency departments in the United Kingdom became physically disabled.

“Many epidemiological studies have been conducted, but just a few have actually focused on the reasons why so many accidents occur that can be prevented”, Ribas stressed.

Conscious mothers

A hypothesis the research team plans to verify in future works has to do with cuts, falls and burns in a living space (home) that seems to be so safe, and the way they are related to the emotional maturity of mothers.

“When they think they play an important role in children’s lives, they tend to look for further information and arrange the house in a way that helps prevent accidents”, Ribas noted.

Women experience much social pressure. That is why they promote education and guarantee health care and safety for their children. They usually lack support and have to manage it on their own.

The truth is they are no longer alone. Ribas and his team will begin a tour of Rio de Janeiro later this month. The idea is to meet teachers and parents at schools. “We want mothers to feel at ease and we will never promote a feeling of guilt. We will show them how to deal with domestic accident risks”, he emphasized.

It is advisable, for example, not to put pillows, especially soft ones, in the cradle because the baby can suffocate. It is also good not to leave toys and small objects on the floor because the baby can swallow them.

Most pieces of advice are the same as those given by mothers whose children say they are maniacs: lock cleaning products and medicines; keep matches, cutting objects, books and other heavy objects away from children; avoid having children in the kitchen while cooking; and never leave children alone in the bathtub.

“But, as women (mothers) should not bear all the burden in this world, the next stage of our research work will include interviews with fathers as well. We are very curious about male reactions to potential accidents at home”, he concluded.

Uruguay: Dissatisfaction with fertility

By Cristina Canoura

Montevideo.- Fertility is causing dissatisfaction in Uruguay, a country where the number of births is on the downswing and many people are not pleased with the number of children they actually have.

A study by researchers Ignacio Pardo and Andrés Peri at the Universidad de la República’s School of Social Sciences clearly showed the phenomenon.

Over 50 percent of Uruguayans do not want to have more than three children; middle-class mothers say they want to have more; and poor women are not happy with an offspring that is greater than the ideal one according to them.

Uruguay, with three million inhabitants, saw last year the same number of births as in 1953. The National Institute of Statistics indicated that there had been 47,600 births in the first five years of the 21^st century. This accounted for an 11,000-birth drop as compared to a decade ago.

The specialists prepared a report entitled New evidence on the double-dissatisfaction hypothesis. They revealed different views about fertility, all depending on socio-economic level, education, geographical region and age.

The work was presented at the 5^th Meeting on Scientific Research in late August in Montevideo and at the 2^nd Congress of the Latin American Population Association in early September in Guadalajara (Mexico).

The authors believe that identifying the highest levels of unwanted pregnancies would help put together sound population policies. “We should understand that the idea is to allow women to have the number of children they really want”, they stressed.

Their review was based on a 2004 national survey relative to social and biological reproduction in Uruguay. It involved 6,500 households. People in the 15- to 79-year bracket were asked how many children they would like to have or would have liked to have.

Ideal family

Argentina and Uruguay were the first two Latin American countries experiencing dropping fertility rates in the region. They remained the same (around three children per woman) in the 1950-1995 period, but they have exhibited sharp decline in the last ten years.

The rates have been well below generational replacement (birth-death ratio) in the last couple of years.

The average number of children dropped to two per woman in 1995.

The study corroborated that younger women tend to have smaller families. Those in the 55- to 59-year bracket feel that the ideal number of children would be three or more (they make up 60 percent of the total). Some 25 percent set the ideal number at two, and 41.7 percent at four.

On the other hand, those in the 15- to 19-year group having a similar aspiration make up less than 30 percent. Over 57 percent among the latter tend to believe the ideal thing would be to have two children.

The ideal number for all age groups was two children in the 1986-2004 period. While 15.3 percent of those in the 15- to 19-year bracket set such a number at four in 1986, they merely accounted for 7.9 percent of the total in 2004. In the 45- to 49-year bracket, those who wanted to have four children moved from 37 percent in 1986 to 25.6 percent in 2004.

The survey also showed that 44 percent decided to have two children; 23 percent, three; and 21 percent, four or more. While just a few said they would have no children, the number of families planning to have only one child (13.8 percent in the 15- to 19- year group and 7.1 percent in the 50- to 54-year bracket) is going up.

According to the researchers, the number of dissatisfied families by excess is not large in any group, but it ranges from 33.6 percent in the lowest social sectors to six percent in the highest quarters.

“We are witnessing the first signs of dropping fertility rates in the poorest sectors that had traditionally been responsible for the reproduction of the local population”, the experts stressed.

As there are limited opportunities to improve the socio-economic situation and implement individual projects, low-income people have decided to have fewer children.

If they finally have more, it is only due to difficult access to effective contraceptive methods, Pardo and Peri feel. Only high-income people say they are pleased with the number of children they have (two or three). Those who have completed formal education are usually pleased with the number of children they have. The average goes from three children for those who have taken three years of basic training to two children for those who have studied for 13 years.

The Women's News Service from Latin America and the Caribbean, International News Agency, offers this weekly service. No reproduction without authorization. Any comment o suggestion please contact us: semlac@redsemlac.net