Ipas > Postabortion care in Latin America saves women’s lives

Postabortion care in Latin America saves women’s lives

April 21, 2005

Given the prevalence and tragic consequences of unsafe abortion, there is a critical need for prompt, high-quality postabortion care to be available to all women in Latin America.

Photo courtesy of Betty Press, Panos Pictures.

Modest measures can have a major impact when it comes to improving the treatment provided to women suffering from postabortion complications, according to a report just released in the journal Health Policy and Planning.

The report, Postabortion Care in Latin America: Policy and Service Recommendations from a Decade of Operations Research, reviews results from 10 major operations research studies conducted in public-sector hospitals in seven Latin American countries between 1991 and 2002.

“Overall, the studies show that incorporating the use of appropriate technologies, such as manual vacuum aspiration (MVA), and a woman-centered approach can save women’s lives and improve their reproductive health, while at the same time reducing costs to the health-care system,” said Deborah Billings, Ipas Senior Research and Evaluation Associate and the report’s coauthor.

Throughout Latin America, where abortion laws are generally highly restrictive, an estimated 3.7 million clandestine and unsafe abortions take place every year. This equals almost one unsafe abortion for every three live births in the region. Approximately 3,700 women die from related complications annually and, for every death, countless others experience injuries and long-term disabilities.

Given the prevalence and tragic consequences of unsafe abortion, there is a critical need for prompt, high-quality postabortion care (PAC) to be available to all women in Latin America. PAC also presents an opportunity to help women prevent future unwanted pregnancies through contraceptive counseling and services.

The PAC model includes five main components: prompt treatment of life-threatening abortion complications; counseling to identify and respond to women’s emotional and physical health needs and other concerns; contraceptive and family-planning services; reproductive and other health services provided onsite or by referral; and community and service-provider partnerships to address the problems of unwanted pregnancies and unsafe abortion.

The report, coauthored by Billings and Ipas Vice President and Director of Research and Evaluation Janie Benson, shows that prior to PAC improvements, many women arriving at health facilities with abortion complications in Latin America did not receive the highest quality care possible. Those presenting with incomplete abortion were generally treated with sharp curettage in an operating theater under general anesthesia or heavy sedation and often required to wait for the procedure and stay overnight afterward. Additionally, few women received postabortion contraceptive services.

Following relatively modest interventions, the majority of women were treated instead with MVA, a method recommended by the World Health Organization over sharp curettage as an effective and safer method of uterine evacuation. In most settings, services were reorganized to make PAC an outpatient procedure, substantially reducing costs and the average length of women’s stay in the hospital. Furthermore, women’s acceptance of contraceptives improved substantially after contraceptive counseling and services were integrated with PAC clinical treatment.

“The studies showed that small changes in PAC delivery yield significant results,” said Billings. “Even greater progress will be made, however, through addressing the other components of PAC, such as by linking women to other reproductive-health services they might need.”

“Finally, the report recommends that such efforts should be coupled with work to improve primary prevention, including better contraceptive services to prevent unwanted pregnancy and safe, legal abortion services to reduce the number of clandestine and unsafe abortions,” she concluded.

For more information, contact:
Kirsten Sherk
Senior Associate, Media Relations
e-mail: sherkk@ipas.org
phone: 919.960.5612
fax: 919.929.0258