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Atenas Program: Pioneer Brazilian service of outpatient care by telemedicine for women with miscarriage or incomplete abortion

2024; Centro Brasileiro de Estudos de Saúde; Volume: 48; Issue: 141 Linguagem: Inglês

10.1590/2358-289820241418414i

2358-2898

Ana Gabriela Lima Bispo de Victa, Cecília McCallum, Greice Maria de Souza Menezes,

Maternal and fetal healthcare

ABSTRACT The criminalization of abortion and restricted access to misoprostol in Brazil force women to seek unsafe methods to terminate a pregnancy. Hospital care for miscarriage or abortion is standard. In contrast, telemedicine for the medical management of miscarriage and abortion is the gold standard of care internationally. This article presents the Atenas Program – an unprecedented initiative for first trimester abortion/miscarriage care, aiming at a humanized out-of-hospital service based on telephone monitoring by nurses, allowing women to choose the method of uterine evacuation (expectant, medical or surgical). For this purpose, ethnographic research was carried out in a northeastern public maternity hospital, between 2014 and 2021. In the context of structural and conjunctural difficulties, among the 723 Atenas participants, 73,6% dispensed with hospital admission for miscarriage and abortion resolution: 58,4% occurred spontaneously and 15,2% through hospital misoprostol. No complications were registered. Telephone monitoring by nurses provided the basis for continuity of individualized care for this invisibilized public. Atenas Program, initiative of a SUS institution run without external financial support, represents an advance in humanized care for women with miscarriage and abortion. It should be extended to the entire public health network, to expand access to rounded and humanized care for abortion and miscarriage.