Legal abortion in situations of pregnancy resulting from sexual violence in women and adolescents with intellectual disabilities

Abstract

Introduction: women with intellectual disabilities are particularly vulnerable to sexual violence and its consequences. However, little is known about the pregnancy resulting from this crime and outcomes for these women. Objective: to compare the characteristics of sexual crime and pregnancy outcomes resulting from sexual violence between women with and without intellectual disabilities. Methods: cross-sectional study with 1,478 pregnant women due to a sexual crime aged ≥14 years who requested a legal abortion, treated at Hospital Pérola Byington, São Paulo, Brazil, between 1994–2015. A total of 88 pregnancies of women with and 1,390 without intellectual disabilities were compared regarding sociodemographic variables, sexual crime, aggressor, pregnancy and abortion. For statistical analysis, Person’s chi-square, adjusted binary logistic regression and Student’s t test for independent samples were used, with significant p<0.05 and a 95% Confidence Interval. Research approved by the Pérola Byington Hospital Research Ethics Committee, opinion 1,396,893. Results: pregnant women with intellectual disabilities had less education than those without (84.1% versus 23.4%) (p<0.001), declared less religion (68.2% versus 85.0%) (p<0.001), and they were not married or in a relationship (96.6% versus 81.1%) (p<0.001). Domestic sexual crime was more frequent (57.8% versus 18.8%) (p<0.001), related aggressor (44.9% versus 11.2%) (p<0.001), referral by public security (80, 7% versus 50.4%) (p<0.001), police report (86.4% versus 65.3%) (p<0.001), and medical-legal examination (83.0% versus 61.5%) (p<0.001). There was no difference in abortion, but in pregnant women with intellectual disabilities, the medical method was more frequent (55.6% versus 34.2%) (p=0.03) due to higher gestational age. Conclusion: pregnant women with intellectual disorders are more vulnerable to domestic sexual violence perpetrated by related aggressors, with greater involvement of public security, and later seeking abortion.