At the request of the pregnant woman, the doctor must address the request to the head of the obstetrics and gynecology department of the health institution, who in turn informs the hospital management. Then a panel must decide whether the abortion takes place or not. In March 2018, the March for Life was held in Peru to draw society`s attention to a very sensitive issue such as abortion. During Pro-Life Day, a group of feminist activists also demonstrated and demanded the decriminalization of abortion in Peru. “Therapeutic abortion has been legal in Peru since 1924,” says María Ysabel Cedano, executive director of the feminist organization DEMUS. Therapeutic abortion can be requested in hospitals and clinics in the country if there is a permanent threat and harm to the woman`s health. [16] VII. MANAGEMENT BY COMPLEXITY AND SOLVENCY 1. General and therapeutic measuresPrimary obstetric and neonatal facility – FONP (categories I-1, I-2, I-3)• Identification of warning signs and related factors.• Establishment of a safe VE pathway with 9% ClNa. • Timely referral with the following measures: (see reference protocol)- Safe route with intravenous catheter N°18. – Permeable respiratory tract. Oxygen with nasal catheter up to 3 liters.
per minute.- Position of dorsal bedsores.- Sufficient peeling.- Strict monitoring of vital functions by trained professionals.- Transfer with companion, potential blood donor.- Communicate with the reference site.• In cases where you have a qualified doctor and bleeding is heavy, perform the following:- Speculum examination.- Remove the remains of the vaginal and cervical canal with Foerster tweezers.Configuration with basic obstetric functions and neonatal – FONB (category I-4)The same as in establishments with FONP plus:• Perform a vaginal examination and an examination with speculum. • Complete blood count (haemoglobin or hematocrit), blood type and Rh factor, urine test, RPR, Elisa test for HIV or rapid test.• If there are signs of decompensation, see hemorrhagic shock protocol.• If you have a qualified doctor, supplies and infrastructure, go for curettage or AVM for an incomplete and uncomplicated abortion. Otherwise, stabilize and refer.• Refer if the patient has: – fever, peritoneal reaction, pain when mobilizing the cervix or purulent or foul-smelling discharge. – Severe anemia and requires blood transfusion. Establishment with essential obstetric and neonatal functions – FONE (categories II-1, II-2)a) Incomplete abortion.• Hospitalization.• Install a safe EV pathway with 9% ClNa.• Request:- Ultrasound. – Complete blood count (hemoglobin or hematocrit). – Blood group and rhesus factor.- Urine test.- RPR or VDRL.- Elisa HIV test or rapid test. • Procedure: If the uterine size is less than 12 cm: uterine curettage or MVA, after dilation of the cervix, if necessary. If the uterine size is greater than 12 cm:- If the cervix is open, there are uterine contractions and metrorrhagia is not abundant, request expulsion of the remains with oxytocic infusion 30 IU in 500 cc ClNa 9% o. Then perform uterine curettage.- If the cervix is closed and there are no uterine contractions and metrorrhagia is not abundant, ripen the throat with prostaglandins: 200 micrograms of misoprostol in the bottom of the vaginal sac every 6 hours, maximum 4 doses. Then perform uterine curettage with a safe intravenous route.- If metrorrhagia is abundant, put a safe route with oxytocin and immediately evacuate the uterine contents.
When the cervix is closed, perform instrumental dilation, followed by uterine curettage or, in the latter case, abdominal hysterotomy. It stipulates that abortion will be criminalized in all circumstances. Articles 133 to 137 provide for penalties for abortions or abortions. Anyone who arranges an abortion with the consent of the woman who induces her own abortion shall be punished by imprisonment for 2 to 8 years; If this is done without the woman`s consent, it is punishable by imprisonment for 4 to 10 years. If the abortion is committed by a doctor, it is punishable by imprisonment for 5 to 12 years, in addition to the penalty of prohibition from exercising the profession or activity for the same period. Anyone who induces a woman or gives her the means to perform an abortion is liable to imprisonment for 2 to 5 years, in the case of parenthood the penalty is increased by one third of the penalty, in the case of a guilty abortion it is punishable by imprisonment from 6 months to 2 years. A culpable abortion caused by the pregnant woman herself and her attempt to induce her abortion are not punishable. In Peru, a woman who arranges her abortion or consents to it being performed by another person is liable to imprisonment for up to two years or community service, in accordance with the Penal Code. does not apply to cases of therapeutic abortion) notes that abortion is criminalized in all circumstances, unless there is a danger to the woman`s life. Articles 432 to 435 describe the penalties for those who commit or perform an abortion. A woman who intentionally performs an abortion is liable to imprisonment from six months to two years; Whoever arranges abortion with the consent of the woman shall be punished by imprisonment of twelve to thirty months, in case of death of the woman, the penalty shall be imprisonment of three to five years.
If the abortion is performed without consent or against the will of the woman, is punishable by imprisonment from fifteen months to three years, in case of causing the death of the woman, the penalty is imprisonment of six to twelve years, if the offender is a doctor, the penalty increases in addition to suspending the exercise of his career for the duration of the sentence imposed, On the other hand, the doctor who organizes abortion as an indispensable means to save a woman`s life should not be punished. Article 436 provides that the penalty shall be reduced from one to two thirds and that the custodial sentence shall be commuted to imprisonment if the perpetrator of the abortion committed it for reasons of honour.
