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      Autonomy in the reproductive health of quilombolas women and associated factors Translated title: Autonomía en la salud reproductiva de mujeres cimarronas y factores relacionados Translated title: Autonomia na saúde reprodutiva de mulheres quilombolas e fatores associados

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          Abstract

          ABSTRACT Objective: Identify the level of reproductive autonomy of quilombola women and associate it with sociodemographic characteristics and aspects of sexual and reproductive health. Methods: Cross-sectional census study carried out in quilombola communities in a municipality in Bahia. Data was collected through questionnaires from the National Health Survey and the Reproductive Autonomy Scale, applied to quilombola women who agreed to participate. Descriptive statistics procedures were used and associations were made between reproductive autonomy scores and sociodemographic and reproductive characteristics. Results: The average total score for reproductive autonomy was 2.06. An association was found between the “decision-making” score and marital status. The score for “total reproductive autonomy” was associated with the use of contraceptive method. Conclusion: The reality of the study participants converges with the literature regarding the interference of sociodemographic and reproductive factors in the reproductive autonomy of black women.

          Translated abstract

          RESUMEN Objetivo: Identificar el nivel de autonomía reproductiva de mujeres cimarronas y relacionarlo a las características sociodemográficas y aspectos de la salud sexual y reproductiva. Métodos: Estudio censorio transversal realizado en comunidades cimarronas de un municipio baiano. Los datos han sido recogidos por medio de los cuestionarios de la Investigación Nacional de Salud y de la Escala de Autonomía Reproductiva, aplicados a las mujeres cimarronas que aceptaron participar. Se utilizaron procedimientos de la estadística descriptiva y se realizaron relaciones entre las calificaciones de autonomía reproductiva y las características sociodemográficas y reproductivas. Resultados: La calificación media total de autonomía reproductiva ha sido 2,06. Se verificó relación entre la calificación de “toma de decisión” y estado conyugal. La calificación de “autonomía reproductiva total” ha sido relacionada a la utilización de método contraceptivo. Conclusión: La realidad de las participantes del estudio converge con la literatura cuanto a la interferencia de factores sociodemográficos y reproductivos en la autonomía reproductiva de mujeres negras.

          Translated abstract

          RESUMO Objetivo: Identificar o nível de autonomia reprodutiva de mulheres quilombolas e associá-lo com características sociodemográficas e aspectos da saúde sexual e reprodutiva. Métodos: Estudo censitário transversal realizado em comunidades quilombolas de um município baiano. Os dados foram coletados por meio dos questionários da Pesquisa Nacional de Saúde e da Escala de Autonomia Reprodutiva, aplicados às mulheres quilombolas que aceitaram participar. Utilizaram-se procedimentos da estatística descritiva e realizaram-se associações entre os escores de autonomia reprodutiva e as características sociodemográficas e reprodutivas. Resultados: O escore médio total de autonomia reprodutiva foi 2,06. Verificou-se associação entre o escore de “tomada de decisão” e estado conjugal. O escore de “autonomia reprodutiva total” foi associado à utilização de método contraceptivo. Conclusão: A realidade das participantes do estudo converge com a literatura quanto à interferência de fatores sociodemográficos e reprodutivos na autonomia reprodutiva de mulheres negras.

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          Development and validation of a reproductive autonomy scale.

          No validated measures are currently available to assess women's ability to achieve their reproductive intentions, also referred to as "reproductive autonomy." We developed and validated a multidimensional instrument that can measure reproductive autonomy. We generated a pool of 26 items and included them in a survey that was conducted among 1,892 women at 13 family planning and 6 abortion facilities in the United States. Fourteen items were selected through factor analysis and grouped into 3 subscales to form a Reproductive Autonomy Scale: freedom from coercion; communication; and decision-making. Construct validity was demonstrated by a mixed-effects model in which the freedom from coercion subscale and the communication subscale were inversely associated with unprotected sex in the past three months. This new Reproductive Autonomy Scale offers researchers a reliable instrument with which to assess a woman's power to control matters regarding contraceptive use, pregnancy, and childbearing, and to evaluate interventions to increase women's autonomy domestically and globally.
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            A family planning clinic partner violence intervention to reduce risk associated with reproductive coercion.

            This study examined the efficacy of a family-planning-clinic-based intervention to address intimate partner violence (IPV) and reproductive coercion. Four free-standing urban family planning clinics in Northern California were randomized to intervention (trained family planning counselors) or standard of care. English-speaking and Spanish-speaking females ages 16-29 years (N = 906) completed audio computer-assisted surveys prior to a clinic visit and 12-24 weeks later (75% retention rate). Analyses included assessment of intervention effects on recent IPV, awareness of IPV services and reproductive coercion. Among women reporting past-3-months IPV at baseline, there was a 71% reduction in the odds of pregnancy coercion among participants in intervention clinics compared to participants in the control clinics that provided standard of care. Women in the intervention arm were more likely to report ending a relationship because the relationship was unhealthy or because they felt unsafe regardless of IPV status (adjusted odds ratio = 1.63; 95% confidence interval=1.01-2.63). Results of this pilot study suggest that this intervention may reduce the risk for reproductive coercion from abusive male partners among family planning clients and support such women to leave unsafe relationships. Copyright © 2011 Elsevier Inc. All rights reserved.
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              Investigating social consequences of unwanted pregnancy and unsafe abortion in Malawi: the role of stigma.

              Malawian women in all sectors of society are suffering from social implications of unwanted pregnancy and unsafe abortion. Unwanted pregnancies occur among women who have limited access to family planning and safe abortion. A legally restrictive setting for safe abortion services leads many women to unsafe abortion, which has consequences for them and their families. In-depth interviews were conducted with 485 Malawian stakeholders belonging to different political and social structures. Interviewees identified the impact of unwanted pregnancy and unsafe abortion to be the greatest on young women. Premarital and extramarital pregnancies were highly stigmatized; stigma directly related to abortion was also found. Community-level discussions need to focus on reduction of stigma. Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.
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                Author and article information

                Journal
                reben
                Revista Brasileira de Enfermagem
                Rev. Bras. Enferm.
                Associação Brasileira de Enfermagem (Brasília, DF, Brazil )
                0034-7167
                1984-0446
                2020
                : 73
                : suppl 4
                : e20190786
                Affiliations
                [3] Senhor do Bonfim Bahia orgnameUniversidade do Estado da Bahia Brazil
                [2] Salvador Bahia orgnameUniversidade Federal da Bahia Brazil
                [1] Guanambi Bahia orgnameUniversidade do Estado da Bahia Brazil
                Article
                S0034-71672020001600190 S0034-7167(20)07300000190
                10.1590/0034-7167-2019-0786
                6b58b4e5-7761-4ef2-b17c-9238e9a17369

                This work is licensed under a Creative Commons Attribution 4.0 International License.

                History
                : 24 May 2020
                : 05 November 2019
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 22, Pages: 0
                Categories
                Original Article

                Autonomia Pessoal,Women,Socioeconomic Factors,African Continental Ancestry Group,Personal Autonomy,Reproductive Health,Mulheres,Fatores Socioeconômicos,Grupo com Ancestrais do Continente Africano,Saúde Reprodutiva,Mujeres,Factores Socioeconómicos,Equipo con Ancestrales del Continente Africano,Autonomía Personal,Salud Reproductiva

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