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Objective: To evaluate the implementation of the law that liberalizes voluntary abortion in Uruguay and enables health services to offer these services to the population., Methods: The legal and regulatory provisions are described and the national data-provided by the Ministry of Public Health's National Information System (SINADI)-on the number of voluntary terminations of pregnancy, the abortion method (medical or surgical), and whether it was performed as an outpatient or inpatient are analyzed. To determine complications, the number of maternal deaths and admissions to intensive care units for pregnant women was used. The study period ran from December 1, 2012, to December 31, 2014., Results: A total of 15 996 abortions were performed during the study period; only 1.2% were surgical and 98.8% were medical. Of the latter, only 3.4% required hospitalization. Less than half of the pregnancies were terminated up to 9 weeks of gestation and 54% were at 10 to 12 weeks in a sample from the Pereira Rossell Hospital., Conclusion: The rapid nationwide rollout of voluntary termination of pregnancy services to all women was possible to a large degree thanks to the availability and broad acceptance of medical abortion, facilitated by the prior experience in applying the risk and harm reduction strategy., (© 2016 The Authors. Published by International Federation of Gynecology and Obstetrics and John Wiley & Sons Ltd.)

Objective: To analyze the attitudes and behavior of gynecologists in Uruguay with respect to the right to conscientious objection that is included in the law concerning voluntary termination of pregnancy., Methods: The relevant laws and decrees, academic articles, legal or administrative claims, and the positions published by the institutions representing physicians or by groups of gynecologists were analyzed., Results: In general, the institutions positioned themselves in favor of correct application of conscientious objection and the immense majority of gynecologists followed this conduct. Small groups mounted a strong opposition and in one department (province) all gynecologists declared themselves to be objectors., Conclusion: Most gynecologists, whether or not they are objectors, proved to have a "loyalty to duty," fulfilling their primary obligation to abide by the ethical duty to give treatment to the persons who need it. A small group used conscientious objection to impede the provision of care to the women who needed the service, some group members being genuine objectors and others pseudo-objectors., (© 2016 The Authors. Published by International Federation of Gynecology and Obstetrics and John Wiley & Sons Ltd.)

Objective: To describe the initial stages of the implementation of a risk-reduction model designed by Iniciativas Sanitarias to shield women from unsafe abortion in a traditional community on the Uruguay-Brazil border., Methods: This mixed-design study was conducted first between 22 and 26 March 2010, and then between 2 and 7 May 2011, in Rivera, Uruguay, to gather information from women seen at health centers, healthcare providers, and local policy makers before the project started and midway through the project., Results: At baseline most women and providers considered abortion justifiable only on narrow grounds, yet favored the implementation of a risk-reduction model that would include preabortion as well as postabortion counseling, the former providing information on different abortion methods and their risks. By the midterm assessment, the counseling service had assisted 87 women with unwanted pregnancies. Of the 52 who came for a postabortion visit, 50 had self-administered misoprostol, with no complications. Women were highly satisfied with the counseling. At baseline, misoprostol seemed to be available from both pharmacists and informal sellers. At midterm, it was still available from informal vendors but pharmacists said they did not provide misoprostol. The risk-reduction initiative heightened public attention to the abortion issue but the controversy it generated did not seriously impede its implementation., Conclusion: It is feasible to implement the proposed risk-reduction model in a traditional community such as Rivera, not only in Uruguay but in any country irrespective of its abortion laws., (Copyright © 2012 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.)