{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,25]],"date-time":"2026-06-25T15:21:45Z","timestamp":1782400905235,"version":"3.54.5"},"reference-count":46,"publisher":"FapUNIFESP (SciELO)","issue":"4","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cad. Sa\u00fade P\u00fablica"],"abstract":"<jats:p>El objetivo de esta investigaci\u00f3n fue la identificaci\u00f3n de las barreras m\u00e1s recurrentes de acceso a abortos en contextos cl\u00ednicos (clandestinos o legales), desde la perspectiva de acompa\u00f1antes, activistas feministas que acompa\u00f1an a mujeres que optaron por abortos autogestionados con medicamentos. Realizamos 14 entrevistas semiestructuradas con acompa\u00f1antes en tres regiones mexicanas: Baja California y Chiapas, ambos contextos restrictivos, y la Ciudad de M\u00e9xico, donde el aborto por voluntad es legal hasta las 12 semanas. Identificamos cuatro categor\u00edas en las cuales se entretejen las vulnerabilidades sociales de las mujeres que deciden abortar, la falta de informaci\u00f3n, persistencia de estigma, y la influencia del marco legal, los fallos en la atenci\u00f3n del aborto, incluso en las cl\u00ednicas de interrupci\u00f3n legal de embarazo (en la Ciudad de M\u00e9xico), y mala calidad de los servicios prestados -maltrato, objeci\u00f3n de conciencia y denuncia de los proveedores de salud-, y, por \u00faltimo, los grupos anti-derechos y sus estrategias. En las tres regiones, el acceso a abortos cl\u00ednicos sigue siendo un privilegio reservado para las mujeres que cuentan con los recursos econ\u00f3micos, log\u00edsticos y sociales indispensables para realizarlo en esos espacios. La existencia de un programa Interrupci\u00f3n Legal de Embarazo en solamente una entidad denota la existencia de una desigualdad jur\u00eddica y sanitaria. Los hallazgos de este estudio sobre mujeres acompa\u00f1antes de abortos aportan elementos para que el Estado mexicano mejore el acceso a abortos seguros para todas las mujeres, sobre todo ahora que la Suprema Corte de la Justicia de la Naci\u00f3n decret\u00f3 la despenalizaci\u00f3n, y la legalizaci\u00f3n inminente en todo el pa\u00eds.<\/jats:p>","DOI":"10.1590\/0102-311xes124221","type":"journal-article","created":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T21:04:00Z","timestamp":1651266240000},"source":"Crossref","is-referenced-by-count":5,"title":["\u201cSigue siendo un sistema precario\u201d. Barreras de acceso a abortos cl\u00ednicos: la experiencia de acompa\u00f1antes en tres regiones mexicanas"],"prefix":"10.1590","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6253-9325","authenticated-orcid":false,"given":"Suzanne","family":"Veldhuis","sequence":"first","affiliation":[{"name":"El Colegio de la Frontera Sur,  Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7916-5753","authenticated-orcid":false,"given":"Georgina","family":"S\u00e1nchez-Ram\u00edrez","sequence":"additional","affiliation":[{"name":"El Colegio de la Frontera Sur,  Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8120-028X","authenticated-orcid":false,"given":"Blair G.","family":"Darney","sequence":"additional","affiliation":[{"name":"Oregon Health & Science University,  USA; Instituto Nacional de Salud Publica,  Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2022]]},"reference":[{"key":"ref1","series-title":"Abortion worldwide 2017: uneven progress and unequal access","author":"Singh S","year":"2018"},{"key":"ref2","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12905-019-0751-0","article-title":"Why do they take the risk A systematic review of the qualitative literature on informal sector abortions in settings where abortion is legal","volume":"19","author":"Chemlal S","year":"2019","journal-title":"BMC Womens Health"},{"key":"ref3","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1136\/jfprhc-2013-100862","article-title":"Barriers and facilitators of access to first-trimester abortion services for women in the developed world a systematic review","volume":"41","author":"Doran F","year":"2015","journal-title":"J Fam Plann Reprod Health Care"},{"key":"ref4","series-title":"Causales de aborto legal."},{"key":"ref5","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1016\/j.bpobgyn.2019.07.009","article-title":"Twelve years after abortion decriminalization in Mexico City can we still remain an island of liberties?","volume":"62","author":"D\u00edaz Olavarrieta C","year":"2020","journal-title":"Best Pract Res Clin Obstet Gynaecol"},{"key":"ref6","doi-asserted-by":"crossref","first-page":"e81","DOI":"10.1136\/bmjsrh-2021-201079","article-title":"Travelling for abortion services in Mexico 2016-2019: community-level contexts of Mexico City public abortion clients.","volume":"48","author":"Jacobson LE","year":"2021","journal-title":"BMJ Sex Reprod Health"},{"key":"ref7","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1002\/ijgo.13077","article-title":"Con la ley y sin la ley\/With and without the law utilization of abortion services and case fatality in Mexico, 2000-2016","volume":"148","author":"Darney BG","year":"2020","journal-title":"Int J Gynecol Obstet"},{"key":"ref8","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1016\/j.contraception.2018.11.012","article-title":"Quantifying disparities in access to public-sector abortion based on legislative differences within the Mexico City Metropolitan Area","volume":"99","author":"Friedman J","year":"2019","journal-title":"Contraception"},{"key":"ref9","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0192547","article-title":"Who presents past the gestational age limit for first trimester abortion in the public sector in Mexico City","volume":"13","author":"Saavedra-Avenda\u00f1o B","year":"2018","journal-title":"PLoS One"},{"key":"ref10","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1016\/S0968-8080(13)41708-1","article-title":"Evolving capacity and decision-making in practice adolescents' access to legal abortion services in Mexico City","volume":"21","author":"Clyde J","year":"2013","journal-title":"Reprod Health Matters"},{"key":"ref11","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0226522","article-title":"Women's abortion seeking behavior under restrictive abortion laws in Mexico","volume":"14","author":"Ju\u00e1rez F","year":"2019","journal-title":"PLoS One"},{"key":"ref12","series-title":"Violencia sin interrupci\u00f3n","year":"2017"},{"key":"ref13","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1186\/s12978-018-0548-x","article-title":"Access to abortion under the health exception a comparative analysis in three countries","volume":"15","author":"K\u00fcng SA","year":"2018","journal-title":"Reprod Health"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1136\/bmjsrh-2018-200300","article-title":"Utilisation of second-trimester spontaneous and induced abortion services in public hospitals in Mexico, 2007-2015","volume":"45","author":"Alexander LT","year":"2019","journal-title":"BMJ Sex Reprod 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cl\u00ednica para un aborto seguro","year":"2014"},{"key":"ref19","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1016\/S0968-8080(10)36530-X","article-title":"Characteristics of private abortion services in Mexico City after legalization","volume":"18","author":"Schiavon R","year":"2010","journal-title":"Reprod Health Matters"},{"key":"ref20","doi-asserted-by":"crossref","DOI":"10.1590\/0102-311x00004815","article-title":"Experi\u00eancias de abortos provocados em cl\u00ednicas privadas no Nordeste brasileiro","volume":"32","author":"Silveira P","year":"2016","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"ref21","series-title":"Sangrias.","first-page":"40","volume-title":"Legaliza\u00e7\u00e3o do aborto com enfrentamento ao racismo: as mulheres negras querem justi\u00e7a reprodutiva.","author":"Goes EA","year":"2019"},{"key":"ref22","doi-asserted-by":"crossref","first-page":"300","DOI":"10.1093\/heapol\/czp061","article-title":"Exploring the determinants of unsafe abortion improving the evidence base in Mexico","volume":"25","author":"Sousa A","year":"2010","journal-title":"Health Policy Plan"},{"key":"ref23","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1080\/03630242.2014.919983","article-title":"Qualitative evidence on abortion stigma from Mexico City and five states in Mexico","volume":"54","author":"Sorhaindo AM","year":"2014","journal-title":"Women Health"},{"key":"ref24","first-page":"153","article-title":"Disputa social y disputa subjetiva Religi\u00f3n, g\u00e9nero y discursos sociales en la legalizaci\u00f3n del aborto en M\u00e9xico","volume":"41","author":"Amuch\u00e1stegui A","year":"2015","journal-title":"La Ventana"},{"key":"ref25","doi-asserted-by":"crossref","first-page":"S111","DOI":"10.1080\/17441692.2011.594072","article-title":"Social stigma and disclosure about induced abortion results from an exploratory study","volume":"6","author":"Shellenberg KM","year":"2011","journal-title":"Glob Public 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F","year":"2012","journal-title":"Int Perspect Sex Reprod Health"},{"key":"ref29","series-title":"WHO recommendations on self-care interventions: self-management of medical abortion","year":"2020"},{"key":"ref30","series-title":"Realidades y retos del aborto con medicamentos en M\u00e9xico.","first-page":"116","volume-title":"\"Velamos por su seguridad\": acompa\u00f1antes de abortos seguros y seguridad de las acompa\u00f1antes en M\u00e9xico.","author":"Veldhuis S","year":"2021"},{"key":"ref31","first-page":"4","article-title":"Aborto aut\u00f4nomo, feminista e acompanhado redes feministas de acompanhamento \u00e0s mulheres que abortam","volume":"2","author":"Lauterbach G","year":"2018","journal-title":"Pra\u00e7a"},{"key":"ref32","series-title":"M\u00e9dici\u00f3n de pobreza 2008-2018."},{"key":"ref33","series-title":"Programa de las Naciones Unidas para el Desarrollo. IDH para las entidades federativas, M\u00e9xico - 2015","year":"2015"},{"key":"ref34","series-title":"Maternidad o castigo. La criminalizaci\u00f3n del aborto en M\u00e9xico","year":"2018"},{"key":"ref35","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1111\/j.1467-9531.2011.01243.x","article-title":"Comment on the concept of snowball sampling","volume":"41","author":"Handcock MS","year":"2011","journal-title":"Sociol Methodol"},{"key":"ref36","series-title":"Bases de la investigaci\u00f3n cualitativa: t\u00e9cnicas y procedimientos para desarrollar la teor\u00eda fundamentada","author":"Strauss A","year":"2002"},{"key":"ref37","doi-asserted-by":"crossref","first-page":"379","DOI":"10.18002\/cg.v0i5.3794","article-title":"De c\u00f3mo occidente diluy\u00f3 los conocimientos en salud de las mujeres Repercusiones en el caso de M\u00e9xico","volume":"5","author":"S\u00e1nchez-Ram\u00edrez G","year":"2010","journal-title":"Cuestiones de G\u00e9nero: de la Igualdad y la Diferencia"},{"key":"ref38","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.socscimed.2018.01.035","article-title":"Trajectories of women's abortion-related care a conceptual framework","volume":"200","author":"Coast E","year":"2018","journal-title":"Soc Sci Med"},{"key":"ref39","series-title":"Resumen ejecutivo - encuestas con acompa\u00f1antes","author":"Reyes Y","year":"2018"},{"key":"ref40","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1016\/j.contraception.2021.10.005","article-title":"'Becoming the woman she wishes you to be': a qualitative study exploring the experiences of medication abortion acompa\u00f1antes in thre regions in Mexico.","volume":"106","author":"Veldhuis S","year":"2022","journal-title":"Contraception"},{"key":"ref41","series-title":"Requisitos para solicitar la interrupci\u00f3n legal del embarazo (ILE)."},{"issue":"3","key":"ref42","doi-asserted-by":"crossref","first-page":"S16","DOI":"10.1016\/j.whi.2011.02.009","article-title":"Sociodemographic factors associated with obstacles to abortion care: findings from a survey of abortion patients in Mexico City.","volume":"21","author":"Becker D","year":"2011","journal-title":"Womens Health Issues"},{"key":"ref43","doi-asserted-by":"crossref","DOI":"10.1590\/0102-311x00192717","article-title":"Actitudes hacia la interrupci\u00f3n voluntaria del embarazo en j\u00f3venes mexicanos, y su opini\u00f3n acerca del aborto inseguro como problema de salud p\u00fablica","volume":"34","author":"Marv\u00e1n ML","year":"2018","journal-title":"Cad Sa\u00fade P\u00fablica"},{"key":"ref44","doi-asserted-by":"crossref","first-page":"104","DOI":"10.1016\/j.ijgo.2015.11.017","article-title":"Insights from an expert group meeting on the definition and measurement of unsafe abortion","volume":"134","author":"Sedgh G","year":"2016","journal-title":"Int J Gynaecol Obstet"},{"key":"ref45","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1136\/bmjsrh-2018-200060","article-title":"Quality of care and abortion beyond safety","volume":"44","author":"Darney BG","year":"2018","journal-title":"BMJ Sex Reprod Health"},{"key":"ref46","first-page":"45","article-title":"Avances y retos de los servicios de interrupci\u00f3n legal del embarazo en la Ciudad de M\u00e9xico.","volume":"11","author":"Schiavon R","year":"2017","journal-title":"Coyuntura Demogr\u00e1fica"}],"container-title":["Cadernos de Sa\u00fade P\u00fablica"],"original-title":["\u201cThe system is still precarious\u201d. Barriers in access to medical abortion: the experience of accompanying persons in three regions of Mexico"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S0102-311X2022000405009&tlng=es","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,4,29]],"date-time":"2022-04-29T21:04:48Z","timestamp":1651266288000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0102-311X2022000405009&tlng=es"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":46,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2022]]}},"alternative-id":["S0102-311X2022000405009"],"URL":"https:\/\/doi.org\/10.1590\/0102-311xes124221","relation":{},"ISSN":["1678-4464","0102-311X"],"issn-type":[{"value":"1678-4464","type":"electronic"},{"value":"0102-311X","type":"print"}],"subject":[],"published":{"date-parts":[[2022]]},"article-number":"ES124221"}}