WHO: New guidance on treating complications due to unsafe abortion

Around 45 per cent of all abortions are unsafe, 97 per cent of which take place in developing countries.

New insights into quality of care for girls and women facing medical complications due to unsafe abortion were published on Wednesday by the UN health agency and partners.

Although too many girls and women continue to die and face both the short and long-term repercussions of unsafe abortions, potentially life-saving information on receiving quality care for abortion-related complications, remains in short supply.

To address this gap, the UN system for human reproduction research, HRP, the World Health Organization (WHO) and partners, published new data on the issue, in the latest edition of the International Journal of Gynecology and Obstetrics.

Strengthening research

The WHO and HRP multi-country survey on abortion (MCS-A) gathered evidence on the provision, experience and quality of care, based on a study conducted across 17 countries in the African, Latin American and Caribbean regions.

And in a special supplement, it highlights work covering 11 sub-Saharan African countries.

“This supplement shows how far we still have to go in ensuring quality, respectful post-abortion care for all; it also proves how much we can learn when we commit to working together”, said Özge Tunçalp, Medical Officer at WHO and HRP.

“Across 11 countries, knowledge has been gained and research capacity has been strengthened”.

Raising standards

To ensure the health and well-being of girls and women who face abortion-related complications, it is crucial to understand what works in their clinical management and care.

In addition to providing this, the newly published papers also explore the experiences of adolescents and women in accessing support in insecure environments.

“A stronger research community is better able to listen, ask and answer questions, working together for a future where every woman and girl achieves the highest standard of sexual and reproductive health and rights”, said Dr. Tunçalp.

Safeguarding bodily autonomy

Through the WHO and HRP multi-country study on abortion, data was collected on over 23,000 women attending health facilities with abortion-related complications.

While most had mild or moderate abortion-related complications, there were many who had severe or even life-threatening difficulties, particularly in sub-Saharan Africa.

A comprehensive approach to abortion and post-abortion care includes clinical-care, self-care, task-sharing for providing care, and legal frameworks that supports health systems.

These are all critical to delivering high quality care, which also incorporates access to a range of affordable and acceptable contraception options – key for safeguarding human rights to health and bodily autonomy.

The papers in the supplement show that countries need to move fast to ensure that healthcare providers and systems can improve the standard of quality care for girls and women.

Sub-Saharan Africa

An editorial that’s part of the study, highlights important actions that decision-makers in the sub-Saharan Africa region can take to make a difference, such as increasing access to high-quality abortion services at all levels of healthcare.

Other steps include improving the quality of evidence-based post-abortion care in which healthcare providers use recommended practices; auditing the availability of equipment and supplies; and conducting clinical audits to better understand why health complications arise.

Identifying and using interventions that go beyond the health system are also recommended, such as addressing harmful beliefs held by healthcare providers; recognizing and addressing constraints of health systems; and ensuring that girls and women are empowered.

‘Important step forward’

“While we still face many challenges and obstacles to ensuring access to high-quality abortion and post-abortion care for all women, we believe that efforts such as the MCS-A in Sub-Saharan Africa and Latin America and the Caribbean represent an important step forward”, said Seni Kouanda and Zahida Qureshi, authors of the supplement’s editorial.

They also shared their hopes that the work presented throughout the supplement “will help inspire innovations and insights to help fulfil women’s reproductive rights”.