UNFPAState of World Population 2004
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State of World Population
Population and Poverty
Population and the Environment
Migration and Urbanization
Gender Equality and Women's Empowerment
Reproductive Health and Family Planning
Maternal Health
Preventing HIV/AIDS
Adolescents and Young People
Reproductive Health for Communities in Crisis
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Maternal Health

New Approaches
Causes and Consequences
Maternal Morbidity
Obstetric Fistula
Reducing Maternal Mortality and Morbidity
Difficulties in Measurement
Holistic Responses
Antenatal Care
Skilled Attendance
Emergency Obstetric Care
Post-abortion Care
Quality of Maternal Health
Men and Maternal Health
UNFPA and Safe Motherhood

Post-abortion Care

About 19 million of the estimated 45 million induced abortions performed annually are unsafe (done by untrained people in less-than-hygienic circumstances); nearly 70,000 women die as a result, representing 13 per cent of pregnancy-related deaths.(47)

Many national health services dedicate a high percentage of beds in second- and third-level facilities to accommodate the large number of women who require post-abortion emergency treatment. In sub- Saharan Africa, up to 50 per cent of gynaecological beds are occupied by patients with abortion complications.(48)

The ICPD, in a groundbreaking consensus, called for all women to have access to treatment for abortionrelated complications, post-abortion counselling, education and family planning services, regardless of the legal status of abortion.(49)

Post-abortion care is cost-effective, reduces repeat abortions and helps individuals meet their reproductive intentions.(50) Many countries now recognize the contribution it can make to saving women’s lives. For example, Kenya’s 1997 reproductive health service guidelines state, “The prompt treatment of post-abortion complications is an important part of health care that should be available at every district-level hospital.” (51)

An international consortium has adopted a postabortion care model, which aims to help women avoid further unwanted pregnancies and other reproductive health problems in addition to providing for their emergency needs. First developed by the NGO Ipas, the model includes: emergency treatment for complications of miscarriage or induced abortion; family planning counselling and services; management of sexually transmitted infections; counselling tailored to each woman’s emotional and physical needs; and community and service provider partnerships.(52)

At least 40 countries have initiated post-abortion care programmes since the ICPD, including Honduras, Malawi, Mexico and Zimbabwe.(53) Facilities offering post-abortion care in Egypt increased significantly between 1999 and 2001,(54) and treatment of complications of incomplete abortion is now part of essential obstetric care protocols.(55)

Myanmar’s Department of Health integrated postabortion care and contraceptive services into existing health care at the township level. Midwives now make follow-up home visits to women with abortionrelated complications and provide family planning methods when requested.(56)

SERVICES FALL SHORT. Yet, lack of access to treatment for incomplete abortion remains a major problem. A study in Ethiopia found that only 16 of 120 health centres were able to respond with emergency transport to assist a woman needing post-abortion care.(57) Documenting the need for postabortion care is difficult. One hospital study in Kenya found abortion was an important cause of admission but was rarely recorded as the cause in the death register, “a fact likely due to the stigma attached to abortion-related mortality”. (58)

The social taboos surrounding abortion(59) and the penalties for both women who seek abortions and those who provide them are further challenges in many countries, even where post-abortion care is legal. A study in Zimbabwe found that the most common reason given for not seeking prompt medical attention for abortion complications was fear of being reported to the police.(60)

Adolescents undergo a major share of illegal abortions. For them, stigma, shame and disapproval from providers can be intense and may discourage many from seeking treatment.

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