Post-abortion family planning

Abstract

In many countries, reproductive health services do not actively include post-abortion family planning services for women who are treated for complications of unsafe abortion. This greatly increases the risk of further unintended pregnancies and unsafe abortions. The authors, drawing on the recommendations of a meeting of experts, make a plea for bridging the gap and dealing more realistically with this urgent need.

PIP: 24 international experts on reproductive health met in Italy in February 1993 to explore ways of making family planning (FP) services available to postabortion women. They agreed that a range of contraceptive methods, accurate information, sensitive counseling, and referral for ongoing care should be available to all women postabortion. Furthermore, policy-makers and health care providers should be responsible for ensuring that women have access to such services. Thus, abortion care facilities and FP programs need to work closely, and safe abortion care and postabortion Fp should be an integral part of all safe motherhood initiatives. Finally, postabortion contraceptive protocols should take into account the psychological and social needs of the clients. It was recommended that 1) all abortion-care facilities offer FP services or referral to FP services and counseling; 2) abortion services be offered as part of comprehensive reproductive health care; 3) abortion services be offered on an outpatient level in primary health care settings; and 4) protocols on postabortion FP be developed and a supply of contraceptives be available at abortion facilities. FP programs should likewise either offer or refer women to abortion services to the fullest extent permissible by law. Issues of safety, counseling, respecting the rights of clients, and confidentiality were also found to be important. Finally, the group recommended that further research be performed on 1) incorporating women's perspectives into program design, 2) attitudes and interactions of users and providers of abortion care, 3) programs for adolescents and for women with HIV, and 4) ways of linking abortion and FP services. Efforts to reduce the deaths, disability, and poor health caused by unsafe abortion and poorly timed childbearing should be forwarded without delay.