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Seventeen-year-old Barnali Ghorai, a student at Bankura Sammilani College in West Bengal, underwent an unsafe abortion in an illegal clinic in a medicine shop. In the process, her womb was punctured, and she bled to death. Barnali's boyfriend, aided by his friends, put her body in a gunny bag and disposed of it in a forest eight kilometers away. The police arrested the boyfriend, the owner of the medicine shop and the doctor. |
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Abortion is the termination of pregnancy. Whether it is caused spontaneously (miscarriage) or whether a woman chooses to induce an abortion, it is second only to childbirth as the most common obstetric experience in the world.
When induced abortion is provided by qualified personnel in an adequate clinical setting, it is one of the safest of all medical procedures. Yet, lack of access to safe, legal abortion services results in a tremendous loss of women’s lives each year. Abortion-related maternal deaths are almost totally preventable when existing safe-abortion methods are made accessible to all women in their communities.
- In developing countries, where abortion is often illegal or highly restricted, deaths from abortion are hundreds of times higher than where abortion is legal.
- Almost 70,000 women around the world die each year and many times that number suffer injuries from unsafe-abortion procedures.
- About 20 million of the abortions performed around the world each year are clandestine and generally unsafe.
Ipas works to reduce maternal deaths from unsafe abortion and advance women’s reproductive health and rights. We promote a woman-centered comprehensive abortion care approach that takes into account the various factors that influence a woman’s individual health needs—both physical and mental—as well as her personal circumstances and her ability to access services. The goals of the woman-centered comprehensive abortion care program are:
- To provide safe, high-quality services
- To decentralize services to the most local level possible
- To ensure that services are affordable and acceptable to women
- To understand each woman’s particular social circumstances and individual needs and to tailor her care accordingly
- To reduce the number of unplanned pregnancies and abortions
- To identify and serve women's other sexual and reproductive health needs
- To ensure that services are affordable and sustainable for health systems
Women have the right to determine if and when to become pregnant; to continue or to terminate a pregnancy; and to select among available abortion procedures, contraceptives, providers and facilities. Women’s choices must be informed by complete and accurate information and they must have the opportunity to ask questions of, and express concerns to, knowledgeable health-care personnel. Women’s options for safe abortion include:
Vacuum aspiration is a method by which the contents of the uterus are evacuated through a plastic or metal cannula that is attached to a vacuum source. The primary difference between vacuum-aspiration options is the source of the vacuum. Manual vacuum aspiration (MVA) uses a hand-held, portable aspirator, whereas electric vacuum aspiration (EVA) employs an electric pump.
Other terms for vacuum aspiration include: suction abortion, vacuum curettage, suction curettage, menstrual regulation (MR) and mini-suction.
Who can have an abortion with vacuum aspiration? Women who have reviewed their options through counseling and are choosing abortion in the first trimester can terminate pregnancy with vacuum aspiration. Vacuum aspiration can also be used for second-trimester uterine evacuation through 15 weeks since the last menstrual period.
Is vacuum aspiration safe and effective? Studies show that vacuum aspiration is approximately 99 percent effective and carries very low risk of complications.
Medication abortion (also known as medical abortion or pharmaceutical abortion) involves the use of pharmaceuticals to expel the contents of the uterus.
Who can have a medication abortion? Women who have reviewed their options through counseling and are choosing abortion within the first nine weeks of pregnancy can terminate pregnancy with medication abortion. Although less common, medication abortion can also be used in terminations of pregnancies longer than 12 weeks’ duration.
Is medication abortion safe and effective? Medication abortion has been safely used by millions of women in many countries. Studies have shown that medication abortion has success rates up to 98 percent.
Dilatation and Evacuation (D&E) is a procedure by which the cervix is dilated, and then the uterine contents are removed by using electric vacuum aspiration.
Who can have a D&E procedure? Women who have reviewed their options and are choosing an abortion in the second trimester can have a D&E procedure.
Is D&E safe and effective? This procedure is very safe and effective when performed by trained, experienced health-care providers.
In settings where abortion is legally restricted or access to safe services is limited, women with unwanted pregnancies often resort to unsafe abortions and subsequently require urgent medical attention to remove the remaining products of conception from the uterus and to treat complications such as bleeding or infection. Women can also suffer incomplete spontaneous abortions (miscarriages), which require uterine evacuation.
A term originated by Ipas in the early 1990s, postabortion care (PAC) is an approach for reducing deaths and injuries from incomplete and unsafe abortions and their related complications.
The Postabortion Care Consortium — a group of organizations working internationally to inform health-care providers, policymakers and communities about unsafe abortion and its impact, and to promote PAC as an effective strategy for reducing women's abortion-related deaths and injuries — has updated and expanded the PAC model to include five essential elements:
- Community and service provider partnerships
To prevent unwanted pregnancies and unsafe abortions, to mobilize resources (to help women receive appropriate and timely care for abortion complications), and to ensure that health services reflect and meet community expectations and needs. - Counseling
To identify and respond to women's emotional and physical health needs and other concerns. - Treatment
Of incomplete and unsafe abortion and complications that are potentially life-threatening. - Contraceptive and family-planning services
To help women prevent unwanted pregnancy or practice birth spacing. - Reproductive and other health services
That are preferably provided on-site or via referrals to other accessible facilities in providers' networks.
The international community recognizes unsafe abortion as a serious public-health problem and endorses the need to ensure women's access to PAC. Numerous global agreements call on governments and health systems to take action to support the timely provision of PAC services, including the United Nations International Conference on Population and Development (ICPD), held in Cairo in 1994; the Fourth World Conference on Women, held in Beijing, China in 1995; and the United Nations follow-up meeting to the ICPD in 1999, commonly known as ICPD+5.