All women should have access to safe abortion in their communities and should be able to benefit equally from new and improved technologies. Medical abortion, a proven but underutilized method, is truly transformative. Medical abortion has the potential to enable women, even in remote communities with little access to health services, to end unwanted pregnancies safely, confidentially and affordably.

Making this a reality requires more than working with doctors and policymakers. It requires collaborating with women, as well as with the community members that women turn to and trust.

When a woman’s best option is to take medication to end her pregnancy without assistance from a health-care provider, she needs accurate, appropriate information on how to do so safely, no matter how, where or from whom she obtains the pills. Ipas is using innovative approaches to inform women and men about access to and safe use of medical abortion.

Our community work also focuses on the needs of young people, who face particular challenges in accessing reproductive health care and information. When faced with unwanted pregnancies, young women are often at a greater risk of resorting to dangerous abortion methods. For them, medical abortion can be especially promising. Medical abortion has the potential to empower women of all ages and around the world to take their reproductive rights into their own hands.

Our strategies include:

Ipas creates and tests locally relevant tools for pregnancy identification, decision making, finding safe health services, using medical abortion and family planning. We have created materials for women in Vietnam, Nepal, India, Mexico and in the U.S.

With local partners, Ipas conducts community interventions to raise women’s and men’s awareness of local laws and women’s rights, pregnancy options, and where safe abortion and family planning services are available. Our activities have included street dramas, harm-reduction models and facilitated conversations with groups of women. Through mutual partnership with community groups, we ensure that materials and approaches are appropriate for the communities where we work.

Although abortion has been legal in India on broad grounds since 1972, for many women, safe services are still out of reach. Many people do not know that abortion is legal, and many women, particularly poor women, seek healthcare from informal and untrained providers. Complications from unsafe abortions remain common.

In Jharkhand, a predominately rural state in east India, health services are few and far between, and women often lack information about the health services that are available. To reach these women with information about medical abortion, in 2008 Ipas developed a comprehensive community education strategy using wall signs, street dramatizations and interpersonal communication approaches. Based on the needs and interests identified in the community assessment that Ipas conducted in 253 of the state’s villages, more than 500 wall signs and 350 street performances informed community members about safe medical abortion services. Many of the women and men surveyed reported that they often rely on other community members for information on health-related issues. The research identified people in the villages – such as traditional birth attendants and nurse midwives – who could potentially serve as intermediaries, providing women with information, support and referral to safe services. Ipas had trained more than 300 of these community resource people by early 2009, and expects them to reach more than 70 percent of women in the project area through this approach. Ipas also trains public and private health-care providers in medical abortion care in the state. (read more)

In Uruguay, Ipas and long-time partner Iniciativas Sanitarias have engaged in a harm-reduction approach to reduce the number of abortion-related deaths and injuries. Ipas and Iniciativas Sanitarias are working with El Abrojo, a local NGO, on a community engagement project to address sexual and reproductive health and connect women with health services. In 2008, El Abrojo led a community diagnosis in the Jardines del Hipodromo neighborhood of Montevideo and in Florida City to identify the needs, challenges, and opportunities related to women’s access to reproductive health services. They used the results of the assessment to design interventions to strengthen local coordination among health facilities and community organizations, to promote discussion about sexual and reproductive health issues, enhance outreach efforts, and improve sexual and reproductive health services and information. (read more)

Around the world, women turn to trusted people in their communities for information about medical abortion, referrals to health-care providers or for the medications themselves. Ipas works with women’s groups and community members, providing them with accurate information and training them to share knowledge effectively and assess the needs of women in their communities.

In Vietnam, Ipas and leaders from the Vietnam Women’s Union (VWU), a women’s organization with nearly 11 million members, organized trainings to increase awareness of medical abortion in communities. The VWU is a diverse women’s group that strives for the equality and advancement of all women. Ipas held training workshops for more than 90 VWU leaders from two provinces, addressing contraceptive methods and safe abortion options, including medical abortion. Ipas also provided these women with information about how to share knowledge effectively with others, thereby strengthening social networks within the community. After the trainings, Ipas and local women’s union leaders convened several community meetings in the two provinces, reaching hundreds of women with reproductive health information. Ipas and the VWU also developed and distributed client-oriented health-education pamphlets focused on abortion options, contraception and the needs of young women. 

Although the women’s union had held information sessions on family planning in the past, this effort marked the first time participants had the opportunity to raise their questions and concerns. Many of the women said that they did not fully understand the advantages and disadvantages of the contraceptives they were using, and participants were happy to have their questions clearly answered by the facilitator. The women’s union leaders committed to using this more interactive format for future activities. In addition to collaborating with the women’s union, Ipas initiated changes to services in local health centers in the provinces, after which provider attitudes and behaviors improved. These efforts also focused on linking abortion with contraceptive service, providing abortion and contraception counseling, improving infection prevention practice, rearranging the service rooms, making them more comfortable, adjusting the flow of services, and reallocating staff appropriately.