In many countries, women treated for complications from spontaneous or unsafely induced abortion lack access to contraceptive services. As a result, many of them soon have a subsequent unplanned pregnancy or a repeat abortion, placing their health at increased risk. This report presents the results of a prospective intervention study on postabortion family planning conducted in the two largest public hospitals in Zimbabwe. Women at Harare Central Hospital, in the capital, received a postabortion family planning intervention, and Mpilo Central Hospital, in Bulawayo, served as the control site. The study cohort was 982 women, 527 of whom were followed for a 12-month period. During the follow-up period, significantly more women used highly effective methods of contraception, significantly fewer unplanned pregnancies occurred, and fewer repeat abortions were performed at the intervention site than at the control site. These results offer compelling evidence that ward-based contraceptive services provided to women treated for incomplete abortion can significantly reduce subsequent unplanned pregnancies. The results also suggest that postabortion family planning services can reduce the incidence of repeat abortion.

Reducing unplanned pregnancy and abortion in Zimbabwe through postabortion contraception.

Unsafe abortion is a significant yet preventable cause of maternal mortality and morbidity in developing countries. This report contains the papers submitted to an interdisciplinary consultation convened by WHO to assess the problem of unsafe abortion globally and to identify a research agenda aimed at reducing unintended pregnancy unsafe abortion and the resultant burden on women their families and public health systems. Experts at the consultation reviewed the available evidence on unsafe abortion examined the factors that perpetuate the problem and identified both opportunities for preventing unsafe abortion and constraints on prevention. Participants addressed the theoretical and medical issues relating to research on unsafe abortion and outlined regional priorities for the prevention of unsafe abortion. Both long-standing and emerging issues relating to research on unsafe abortion were discussed. (authors)

Preventing Unsafe Abortion and its Consequences : Priorities for Research and Action

The Asian-Pacific Resource and Research Centre for Women is a member of the Asian Women's Resource Exchange, a network of women's information and resource centers in Asia which promotes the use of electronic networking for resource and information sharing.

Asian-Pacific Resource and Research Centre for Women

This research project explores doctors' views regarding induced abortion. Abortion's penalization in Mexico greatly conditions its relevance as a social and public health problem. Physicians constitute a professional sector that can play an important role in reforming current laws on abortion. As a professional group, they have taken a conservative stance towards abortion. Their attitudes are to a great extent influenced by the medical training they receive. In this article we present results from a survey of 96 medical students from the Universidad Autonoma Metropolitana Xochimilco, in Mexico City. Data were processed with the SPSS program. Simple frequencies show that students have limited knowledge concerning the legal status of abortion and that they tolerate it with restrictions and in limited situations. Women students apparently take a more conservative stance, but statistical analysis with the c-square test did not show significant differences by gender. The article poses the need to modify doctors' training in the reproductive health field, allowing future doctors to acquire a broader view of health problems related to sexuality and reproduction. In the long run, this should also promote a kind of comprehensive health care practice in medical services, thus responding more satisfactorily to women's needs.

Los médicos en formación y el aborto: opinión de estudiantes de medicina en la Ciudad de México

Effective linkage between postabortion evacuation services and family planning is essential to reduce the incidence of repeat unwanted pregnancy and unsafe abortion. This collaborative operations research study between FRONTIERS Program TAHSEEN/Catalyst Project and the Egyptian Ministry of Health and Population (MOHP) with funds from USAID was undertaken to test the feasibility acceptability and effectiveness of two models of integrating family planning services with postabortion services. The first model involves provision of family planning counseling to postabortion patients and referral to a clinic near their residence to receive a method. The second model involves in addition offering family planning methods to postabortion patients who are interested in immediate initiation of contraception. A companion study investigated pain management perceptions and practices of Egyptian patients and providers in relation to postabortion care in different types hospitals; the research methodologyand results are provided in Appendix I of this report. The study was conducted in six MOHP hospitals in Fayoum and Beni Suef governorates where staff received training on improved PAC (including FP counseling and method provision) a PAC brochure was provided to postabortion patients before discharge and FP methods were placed on the Ob/Gyn ward. The two models were implemented in tandem over a three month period followed by an assessment using provider interviews supervisor interviews patient exit interviews patient follow-up interviews at home three months after discharge and customized spreadsheets to collect information on incremental costs. (excerpt)

Linking family planning with postabortion services in Egypt: Testing the feasibility acceptability and effectiveness of two models of integration.

Although women who undergo abortion are at risk of subsequent unwanted pregnancies abortion services in developing countries are rarely linked to family planning services. This neglect of post-abortion contraceptive services reflects both the low priority allotted to womens reproductive health needs and national and international policies that restrict abortion-related programming. Even when abortion providers refer women to a family planning center the clinic is often inaccessible or insufficiently supplied with modern contraceptives. preferable is a model involving on-site delivery of initial counseling and contraceptive provision after abortion coupled with referral to and contraceptive provision after abortion coupled with referral to community sources for continuity of care and resupply. Since women who are not adequately counseled are at high risk of method discontinuation all family planning options must be clearly presented. In all cases respectful treatment of abortion patients and understanding of the situation that led them to seek abortion will improve the acceptability of services. In the majority of cases unwanted pregnancies occur because family planning services are unavailable inaccessible ineffective or culturally unacceptable to women. The inclusion of women in the design of post-abortion services can help to identify the obstacles to family planning use. Fortunately there is growing concern about the effects of unsafe clandestine abortion (up to 200000 maternal deaths each year) and the momentum for change exists. Ways must be found however to reach women who induce abortions clandestinely and never enter the health care system.

Meeting womens needs for post-abortion family planning: framing the questions.

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Meeting womens needs for post-abortion family planning: framing the questions.