Abstract

PIP: This article discusses issues related to improving postpartum and postabortion quality of care for women in developing countries. Health workers and health care providers have a responsibility to provide high-quality care to postpartum and postabortion women that includes family planning counseling. Postabortion and postpartum women may have different needs. Quality of care means "helping women to identify their individual reproductive health needs and helping them make choices that will meet those needs." Choice belongs to the family planning client. Clients may view family planning quality as the ability to maintain reproductive health and satisfaction in sexual relations. Providers may view quality as prevention of unplanned pregnancies. Quality outcome measures are more than effectiveness and avoidance of complications. Quality means satisfaction of clients' personal preferences and lack of interference with women's everyday life. Clients need accurate information, empathetic counseling, and accessible services. Health workers need to consider how service delivery systems, providers' attitudes, and clients' views can affect women's access to postpartum and postabortion contraception and other reproductive health services. Providers must know that postpartum women need information about breast feeding, infant care, and nutrition. Women who were treated for incomplete abortions need emergency treatment for complications and information about symptoms that would warrant a return to the medical setting. The need for family planning is immediate for postabortion women, but providers should not offer women family planning information while women are under stress. Privacy is key to quality services. The Pan American Health Organization and the Judith Bruce framework identify essential features of quality services.