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Open Access Research article

Brazilian adolescents’ knowledge and beliefs about abortion methods: a school-based internet inquiry

Ellen MH Mitchell1*, Silke Heumann2, Ana Araujo3, Leila Adesse4 and Carolyn Tucker Halpern5

Author Affiliations

1 Amsterdam Institute for Global Health & Development, Amsterdam, Netherlands

2 International Institute of Social Studies, Erasmus University Rotterdam, The Hague, The Netherlands

3 Anthropology Department, Amherst College, Amherst, USA

4 University of Rio de Janeiro School of Public Health, Rio de Janeiro, Brazil

5 Carolina Population Center, University of North Carolina, Chapel Hill, USA

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BMC Women's Health 2014, 14:27  doi:10.1186/1472-6874-14-27

Published: 13 February 2014

Abstract

Background

Internet surveys that draw from traditionally generated samples provide the unique conditions to engage adolescents in exploration of sensitive health topics.

Methods

We examined awareness of unwanted pregnancy, abortion behaviour, methods, and attitudes toward specific legal indications for abortion via a school-based internet survey among 378 adolescents aged 12–21 years in three Rio de Janeiro public schools.

Results

Forty-five percent knew peers who had undergone an abortion. Most students (66.0%) did not disclose abortion method knowledge. However, girls (aOR 4.2, 95% CI 2.4-7.2), those who had experienced their sexual debut (aOR1.76, 95% CI 1.1-3.0), and those attending a prestigious magnet school (aOR 2.7 95% CI 1.4-6.3) were more likely to report methods. Most abortion methods (79.3%) reported were ineffective, obsolete, and/or unsafe. Herbs (e.g. marijuana tea), over-the-counter medications, surgical procedures, foreign objects and blunt trauma were reported. Most techniques (85.2%) were perceived to be dangerous, including methods recommended by the World Health Organization. A majority (61.4%) supported Brazil’s existing law permitting abortion in the case of rape. There was no association between gender, age, sexual debut, parental education or socioeconomic status and attitudes toward legal abortion. However, students at the magnet school supported twice as many legal indications (2.7, SE.27) suggesting a likely role of peers and/or educators in shaping abortion views.

Conclusions

Abortion knowledge and attitudes are not driven simply by age, religion or class, but rather a complex interplay that includes both social spaces and gender. Prevention of abortion morbidity and mortality among adolescents requires comprehensive sexuality and reproductive health education that includes factual distinctions between safe and unsafe abortion methods.

Keywords:
Abortion; Adolescents; Brazil; Internet; Emergency contraception; Reproductive health; Pregnancy; Misoprostol