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Portugal young women report high rate of teenage births: Second highest in Europe
– Reported, February 04, 2012
In Portugal, the main issue of concern regarding reproductive health is certainly the high rate of teenage births, the second highest in Europe. In Portugal, abortion has been forbidden until very recently except under very restrictive conditions: when womenís health and life is at risk, when there is fetus malformation or when pregnancy results from rape. However, even within those cases, it was difficult to abort because of physicianís or hospitalís refusal to practice abortions. According to estimations, 3,861.4 per 100,000 women illegal abortions were practiced each year in Portugal (Dias et al., 2000). According to data from the Ministry of Health, around 5,000 women were hospitalized each year due to complications related to illegal abortions.
Family planning consultations have been organized in Portugal since the late 60s.However, its larger diffusion goes back to the early 80s. Access to family planning consultations to patients younger than 18 has been allowed in 1984. Nowadays, all health care centers have at least one family planning consultation available per week at low cost. Health care centers are also recommended to make contraceptive pills available for free when necessary.
The use of contraception methods has been increasing strongly in Portugal.According to data from the National Commission for Equality and Womenís Rights (CIDM, 2007), the percentage use of the contraceptive pill increased from 52.3 to 62.3% between 1993 and 1997, and the use of condoms from 9.3 to 14.6%.
Sexual education courses are compulsory at public schools (representing 82% children in 2002). However, although they are enforced by law since 2001, they are poorly organized in practice, mostly due to lack of skilled staff.As already mentioned, most women in Portugal have access to skilled attended delivery. However, the unequal distribution of hospital and quality of care certainly results in strong inequalities in the population. An international comparison of infant mortality ratio (IMR), e.g., indicates a high variation in Portugal with respect to other countries (Fantini et al., 2006). The discrepancies across regions in terms of infant, neonatal and perinatal mortality (the highest in Algarve and Madeira).
Comparing regions, the IMR goes from 3.8 to 7.9 death per 1,000 live births (a 4.1 range, while the comparable ranges for England, France, Germany and Italy are,respectively, 2.2, 1.8, 2.1 and 3.8). The same phenomenon is observed for postneonatal mortality rates. These preliminary results could be the sign that discrepancies in reproductive health reflect the large differences in the availability of health care facilities. Yet, further research is necessary to draw more definite conclusions.
Finally, in 1999, in Portugal, the rate of caesarean section was 27.9% in public hospitals and 53.1% in private ones, while the WHO recommends a 15% rate (Reynolds et al., 2004). Portugal is the second country with the highest rate of caesarean sections among the Eur-A group (Figure 8). Meanwhile, Reynolds et al.(2004) indicate that Norway, Finland, Sweden and Denmark achieved reductions in perinatal mortality similar to other developed countries while fulfilling WHO recommendations. Indeed, on Figure 9, we observe that those countries experience similar rates of perinatal deaths as Portugal, with much lower rates of caesarean sections.
Credits: Ana Alexandre Fernandes,Julian Perelman and CÈu Mateus
More Information at:
http://www.fcm.unl.pt/cv/Health%20and%20Health%20Care%20in%20Portugal.pdf
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