Introduction

Ipas’s Clinical Updates in Reproductive Health contain up-to-date, evidence-based clinical recommendations on comprehensive abortion care, with new topics and resources added regularly. The Clinical Updates in Reproductive Health provide concise, easy-to-read information about abortion care, combining the latest evidence with lessons learned from health professionals globally to produce relevant clinical recommendations.

Who should use this resource

First published in 2013, the Clinical Updates in Reproductive Health were designed originally as an up-to-date, evidence-based clinical resource for Ipas staff. Over time, the publication has also been of use to:

• clinicians providing abortion care
• clinical and public health professionals working on patient care protocols in public health systems and the private sector
• safe abortion advocates and policymakers creating laws and policies that fulfill women’s and girls’ right to health

What’s new in this revision

In this edition of the Clinical Updates in Reproductive Health, you will find updated, evidence-based recommendations on more than 40 abortion care topics. During the 2021 update, we reviewed newly published literature related to the components of paracervical block prior to uterine manipulation, assessment of gestational age before the provision of abortion services, effectiveness and ongoing pregnancy rates following medical abortion between 10-13 weeks, complication rates following medical abortion at or after 13 weeks, surgical treatment of incomplete abortion, and client satisfaction with contraceptive services at the time of medical abortion.   We updated our recommendations accordingly. Additionally, we updated with supportive and informative data the sections on misoprostol quality, pain management, screening for ectopic pregnancy, recommended regimens for mifepristone and misoprostol, home use of medical abortion pills, inducing fetal demise prior to abortion at or after 13 weeks, cervical preparation prior to D&E, and managing postabortion hemorrhage.

The online Clinical Updates (www.ipas.org/clinicalupdates) contains the recommendations included in this manual along with easy-to-use drop-down menus to help readers navigate quickly to the information they need. Both online and print/PDF editions are also available in Spanish, French and Portuguese.

We have also updated a number of our clinical tools and job aids, which are drawn from the evidence and recommendations contained in the Clinical Updates in Reproductive Health, and these are also available online at www.ipas.org/clinicalupdates.