Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #103372

Heathe Luz McNaughton, MPH¹, Ellen M. H. Mitchell, PhD², Karen Padilla, MD¹, and Emilia Gudelia Hernandez, MD³. (1) Ipas Central America, 300 Market St, Suite 200, Chapel Hill, NC 27516, 9195936961, luzipasca@cablenet.com.ni, (2) Research & Evaluation Unit, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC 27516, (3) Maestria en Salud Sexual y Reproductiva, University of El Salvador, Boulevard de los Heroes, San Salvador, El Salvador

In 1998 Salvadoran legislators passed measures that criminalize all indications for abortion, including abortion to save a woman's life. The law change preceded an immediate increase in the number of women criminally charged with illegal abortion based on information disclosed by their health care providers. The purpose of this study was to; (i) analyze the legal and ethical safeguards of patient-provider confidentiality in postabortion care through a review of human rights treaties and national laws (ii) describe the number of women charged with illegal abortion from 1998-2003 (iii) identify the factors that influence providers to report women (iv) assess the consequences of confidentiality disclosures on women's help seeking behavior. Methodology includes a review of international and national law, court records, a cross-sectional survey of obstetrician gynecologists (n=110) and a case study interview. While international human rights instruments and Salvadoran law protect patient-provider confidentiality, most obstetrician-gynecologists surveyed believe the law requires them to notify legal authorities when they suspect an induced abortion (80%) and are unaware of national laws that protect patient-provider confidentiality (76%). The majority of obstetrician-gynecologists have had direct or indirect experience in reporting illegal abortion (61%). Despite widespread acknowledgement that Salvadoran women are delaying or avoiding seeking postabortion care for fear of prosecution (86%), some obstetrician-gynecologists fear reprisals if they fail to report (25%). Preservation of confidentiality is essential to ensuring women's access to postabortion care. Providers who breach confidentiality endanger women's health, violate human rights, national law and professional ethical standards.

Learning Objectives:

1.Describe the impact of Salvadoran legislation (199
• that criminalized all indications for abortion on the prosecution of women for illegal abortion. 2.Discuss the international human rights instruments and national legislation relevant to the issue of patient-provider confidentiality and postabortion care services. 3.List the exceptions to health care providers' duty to strictly observe professional secrecy and analyze those exceptions in the context of postabortion care. 4.Identify the reported motivations for confidentiality violations by postabortion care providers and discuss the consequences of this practice for women's reproductive health.

Keywords: Human Rights, Abortion

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.