中国未婚女青年妊娠及流产需要与实现

Access to Abortion among Unmarried Women Aged 15-24

本文利用全国青年生殖健康可及性调查数据对中国未婚女青年妊娠与流产进行现况研究;并对广东等地的公立医院妇产科医务工作者进行访谈,探讨影响未婚女青年流产需要实现的因素。研究发现,21.3%有性行为未婚女青年有妊娠经历;90.9%未婚妊娠者有人工流产经历;2.5%未婚女青年过去一年中有流产服务需要,其中38.9%由于害怕被嘲笑、自认为问题不严重或觉得费用太高而未去医疗机构寻求流产服务。公立医院"看病难看病贵"的刻板印象影响了未婚女青年流产服务利用,而选择了私立医疗机构的未婚女青年中有人遭遇流产失败,生命健康受到严重威胁。这需要高度重视未婚女青年妊娠和流产,进行未婚妊娠预防干预,扫除女青年发展障碍,进一步研究与推行女青年赋能机制,并以公立医院为主导,加强流产服务信息网络化建设,促进未婚女青年流产知情选择。

Using data from a survey on youth access to reproductive health in China and findings from interviews with health workers in Gynecology and Obstetrics Departments of public hospitals in Guangdong, this paper assesses the rates of pregnancy and abortion among unmarried women aged 15-24, and identifies factors influencing their access to abortion, so as to recommend to improve their reproductive health. There are 21.3% of the unmarried sexually active female youth who became pregnant, and 90.9% of the pregnant unmarried female youth had abortions. 2.5% of unmarried female youth reported the needs of abortion services last year, of which 38.9% did not go to public medical facilities for abortion services, for fear of being ridiculed, or not being taken serious, or regarding the services unaffordable. Of those who attempted abortions in private medical facilities based on an assumption that private facilities would be less costly and provide better protection of privacy, some suffered greatly from abortion failures. The findings appeal for greater attention to prevention of unmarried pregnancy, and efforts to address the unmet needs of abortion services of unmarried youth in China. The paper also shed lights on further research to empower youth and to enable them to adopt more desirable strategy to enhance development and their health status. It also recommends promoting the leading role of public hospitals in providing online access to abortion service information, and to encourage the unmarried female youth to make informed reproductive health choices.