Novembro de 2021 – Vol. 26 – Nº 11
Monique Leite Sampaio1,
Modesto Leite Rolim Neto2.
1 Obstetrician Gynecoligist, Preceptor of the Federal University of Campina Grande – UFCA, Campus Cajazeiras-PB / HUJB
2Faculty of Medicine, Federal University of Cariri – UFCA
OBJECTIVE: Analyze what are the psychiatric repercussions on abortion in the daily life of children and adolescents who were victims of sexual violence.
METHODS: Studies were identified using large-circulation international journals found in two electronic databases: Scopus and Embase.
RESULTS: Women experience high levels of post-traumatic stress, anxiety, and depression after early pregnancy loss. One out of six women go though post-traumatic stress. Although the sorrow may eventually decrease with time, it still significantly remains. The trigger involving the development of harms is pulled especially due to the prejudice of society as well as the guilt of having committed a crime according to the Brazilian law. The stigmatizing connotation on the illegalization of abortion puts women in an embarrassing situation because they access a sentiment of guilt, which is mostly irreversible, leading these women to self-condemnation.
CONCLUSION: The chaos of today reclaim new mains of imagination so that we can understand how these children and adolescents bear experiencing the mourning. There would not be death, bleeding or suffering whether abortion was recognized as a health necessity as it is supposed to be. These girls and adolescents are in social and mental emergency. They suffer and their pain surpass the unimaginable. They live on the margins of society and fall into oblivion and anonymity.
Key-words: Psychiatric Repercussions; Children; Adolescents; Sexual Violence; Abortion.
Official data revealed that every day roughly six hospital admissions are registered due to abortion involving girls aged from 10 to 14 years old who got pregnant after having been raped in Brazil1. Has this sort of violence been normalized? Girls up to 13 years old have been raped in the country2. The body becomes mature and the silence of rape turns into the pregnancy scandal3. They arrive at the hospital baffled and terrified due to all the traumatic events they went through4. In this context, what are the psychiatric repercussions on abortion in the daily life of children and adolescents who were victims of sexual violence?
It is necessary to observe that the main victims of abortion and sexual violence in Brazil are the black, poor, and indigenous women as well as women who inhabit regions where they generally live under extreme vulnerability and social marginalization as well as are minors and inhabitants of the periphery due to complications in clandestine procedures 5,6,7. Still related to trauma caused by sexual abuse, those who got pregnant also live with the risk of pregnancy itself as well as its psychological repercussions. Also, studies claim that pregnancy in girls up to 15 years old are riskier than in older women. The younger you are, the riskier the gestation is4.
According to Diniz5 they died of the insecurity imposed by the criminality, in the most fragile conditions of access to safe methods. That is, every time a new forbidding regulation comes against practices that belong to one’s life, which is the case of abortion, there is the rise of a clandestine market. In addition, the clandestine market makes the already imposed insecurity by criminalization even more insecure because at this point women are not even sure whether they are taking the right medication5, 7, 8,9,10. The poorer the country is, the bigger the risk of death cause by unsafe abortion, taking into account that the handful of illegal abortions are bound to black young ladies who were provided with little income and education as well as live in the peripheries11.
The use of sharp instruments and other methods that derailed unacceptable sequels and complications caused bleeding, infection, septic shock as well as long-term complications and death12, carrying very serious psychological complications because of abortion. Based on what Farren et al.,13 say, women experience high levels of post-traumatic stress, anxiety, and depression after early pregnancy loss. One out of six women go though post-traumatic stress. During the fist month after the quoted loss, 29% of these individuals fill up the criteria required to suffer from post-traumatic stress while 24% range from mild to severe anxiety and 11% experience either mild or severe depression as well. Although the sorrow may eventually decrease with time, it still significantly remains.
This scenario prompts certain reflection on the psychic pain felt by these children and adolescents, especially on the effects of race inequality. The poor – indeed, the “black poor” – seek unsafe solutions and wind up finding complications, suffering, death, and pain12.
Restrictive rules regarding the pandemic and gender inequality tend to crash one another, derailing into domestic violence and abortion criminalization, therefore more women die or have witnessed life risk. From China to Equator, the patterns of social isolation increased the vulnerability of girls and women when it comes to domestic violence. As a matter of fact, São Paulo have registered a growth in numbers of women who were killed in their own houses compared to the very same period in 2019 9.
These girls and adolescents are in social and mental emergency. There is an ethic call on why normality is suspended due to the pandemic and the response cannot be to submit to rules that intend to govern our bodies or resignation regarding our privileges that save us, but the consciousness on what is fair10. They suffer and their pain surpass the unimaginable. They live on the margins of society and fall into oblivion and anonymity.
Women – girls and adolescents – are plundered by patriarchy that perceive their bodies as a moral persecution to impose the necropolitic as an extermination tactic of vulnerable women. There would not be death, bleeding or suffering whether abortion was recognized as a health necessity as it is supposed to be13.
Abortion must be decriminalized because women possess the right of deciding what to do with their bodies. The State is abuse for taking control over the body of a woman. The abortion dilemma is no longer a conversation about religion or customs, it is indeed a matter of health 14,15, and given the current situation, it turns to be a matter of mental health, too.
Specialists claim that angst, high depression and mental disorder are such as spiked marks in one’s soul and these marks may show up either immediately or as time goes by. The trigger involving the development of harms is pulled especially due to the prejudice of society as well as the guilt of having committed a crime according to the Brazilian law. The stigmatizing connotation on the illegalization of abortion puts women in an embarrassing situation because they accede a sentiment of guilt, which is mostly irreversible, leading these women to self-condemnation. This position is related to a broad incidence of depressing symptoms as well as alcohol and drug abuses14.
The chaos of today reclaim new mains of imagination so that we can understand how these children and adolescents bear experiencing the mourning3,8,9,10,15. Finally, we end by calling the attention of professionals in the mental health field to the pain of these women, hiccups and gagging of hidden tears and silence, source of a forgotten childhood as well as stolen adolescences due to the raw truths permeated by abortion.
1. Brasil de Fato. (2020). Aborto é a quarta causa de morte materna no Brasil. https://www.brasildefato.com.br/2018/07/31/aborto-e-a-quarta-causa-de-morte-materna-no-brasil-afirma-pesquisadora
2. BBC New Brasil. (2020). Brasil registra 6 abortos por dia em meninas entre 10 e 14 anos estupradas. https://noticias.uol.com.br/ultimas-noticias/bbc/2020/08/17/brasil-registra-6-abortos-por-dia-em-meninas-entre-10-e-14-anos-estupradas.htm
3. Fórum Brasileiro de Segurança Pública. (2019). Anuário Brasileiro de Segurança Pública. http://www.forumseguranca.org.br/wp-content/uploads/2019/09/Anuario-2019-FINAL-v3.pdf
4. El Pais. (2020). Uma menina de dez anos aborta e é nosso dever nos unir à dor dela. https://brasil.elpais.com/opiniao/2020-08-17/uma-menina-de-dez-anos-aborta-e-e-nosso-dever-nos-unir-a-dor-dela.html
5. Diniz D, Medeiros M, Madeiro A. (2017). Pesquisa Nacional de Aborto 2016. Ciênc Saúde Colet; 22:653-60.
6. Cardoso, Bruno Baptista, Vieira, Fernanda Morena dos Santos Barbeiro, & Saraceni, Valeria. (2020). Aborto no Brasil: o que dizem os dados oficiais?. Cadernos de Saúde Pública, 36(Suppl. 1), e00188718. Epub February 21.
7. UOL. (2020). As maiores vítimas do aborto no Brasil. https://noticias.uol.com.br/ultimas-noticias/deutschewelle/2020/02/21/as-maiores-vitimas-do-aborto-no-brasil.htm?cmpid=copiaecola
8. Época.(2020). Acompanhei gestantes de 10 anos em estado grave na UTI: médica detalha os riscos de uma criança grávida. https://epoca.globo.com/sociedade/acompanhei-gestantes-de-10-anos-em-estado-grave-na-uti-medica-detalha-os-riscos-de-uma-crianca-gravida-24592014
9. Supremo Tribunal Federal – STF. (2020). Médica diz que descriminalização de aborto reduziria mortalidade materna. http://www.stf.jus.br/portal/cms/verNoticiaDetalhe.asp?idConteudo=385631
10. Farren,J., Jalmbrant,M., Falconieri, N., Mitchell-Jones, N., Bobdiwala, S., Al-Memar,M., Tapp, S., Van Calster, B., Wynants, L., Timmerman,D., Bourne,T. (2020). Posttraumatic stress, anxiety and depression following miscarriage and ectopic pregnancy: a multicenter, prospective, cohort study. American Journal of Obstetrics & Gynecology 367.e11. https://www.ajog.org/action/showPdf?pii=S0002-9378%2819%2931369-9
11.El Pais. (2020b). Prisão aos médicos justos. https://brasil.elpais.com/opiniao/2020-04-29/prisao-aos-medicos-justos.html
12. El Pais. (2020c). Covid-19 e a ferida no útero. https://brasil.elpais.com/opiniao/2020-06-27/covid-19-e-a-ferida-no-utero.html
13. El Pais. (2020d). O relicário de uma Pandemia. https://brasil.elpais.com/brasil/2020-08-08/o-relicario-de-uma-pandemia.html
14. Estado de Minas. (2013). Aborto deixa sequelas psicológicas. https://www.em.com.br/app/noticia/tecnologia/2013/04/16/interna_tecnologia,372063/aborto-deixa-sequelas-psicologicas.shtml
15. O Beltrano. (2020). É pela vida das mulheres. https://www.obeltrano.com.br/portfolio/especial-aborto/
Modesto Leite Rolim Neto, Faculty of Medicine, Federal University of Cariri (UFCA), 284, Divine Savior Street, Downtown, Barbalha, Ceará 63180000, Brazil
Tel +5588 999042979
Email: [email protected]