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Family planning: a key component of post abortion care. Consensus statement: International Federation of Gynecology and Obstetrics (FIGO), International Confederation of Midwives (ICM), International Council of Nurses (ICN), and the United States Agency for International Development (USAID).
[London, United Kingdom], FIGO, 2009 Sep 25. 4 p.The International Federation of OB/Gyn (FIGO,) the International Confederation of Midwives (ICM) the International Council of Nurses (ICN) and USAID have recently issued this joint statement that makes a compelling case for the provision of voluntary family planning along with post abortion care. A key message is “The provision of universal access to post abortion family planning should be a standard of practice for doctors, nurses, and midwives in public and private health care.” It also provides some insight on organizing services to make it more practical, including providing FP at the point of service delivery. This document can be used as an advocacy tool at a variety of levels including national, district and facility level.
Nairobi, Kenya, IPPF, 1994. , 36 p.In March 1994, more than 100 specialists from family planning associations (FPAs) and ministries of health participated in the IPPF-supported Conference on Unsafe Abortion and Post-Abortion Family Planning in Africa (sub-Saharan Africa) in Gran' Baie, Mauritius. It was designed to help FPAs and governments confront the public health and social problems caused by unsafe abortion. Topics discussed in the working groups were abortion and postabortion family planning services, role of support services in abortion and postabortion family planning services, counseling and contraceptive needs, and reducing the number of unsafe abortions. Working groups developed strategies and action plans to reduce the incidence of unsafe abortion in Africa. The estimated unsafe abortion rate in Africa is 23/1000 women aged 15-49, ranging from 12 in Middle Africa to 31 in Eastern Africa. In Nigeria, 50% of all maternal deaths are related to abortion. In Kenya, insertion of foreign bodies/instruments is the most common abortion method. In Benin, most abortion patients are married (70.5%) and Catholic (58.7%). No African country provides abortion on demand. Botswana, Ghana, and Zambia have the most liberal abortion laws (abortion allowed for social and sociomedical reasons). In countries where abortion services are legal, FPAs can produce a list of sympathetic health personnel, conduct a follow-up on women who have been denied safe abortion services, document where safe abortion services are withheld from some population groups, promote the use of newer abortion techniques, and provide training in safe abortion techniques. Many donor and technical cooperating agencies have made commitments and implemented initiatives to bring about safe abortion and postabortion family planning services in Africa, such as Family Health International and Johns Hopkins University's Center for Communication Programs.
In: Workshop proceedings, 20-21 May 1999. Issues in establishing postabortion care services in low-resource settings, edited by Anita Ghosh, Dana Lewison, Enriquito R. Lu. Baltimore, Maryland, JHPIEGO, 1999 Oct. 31-41. (USAID Award No. HRN-A-00-98-00041-00)This document presents a global update on postabortion care (PAC) programs, which is a summary of the workshop proceedings on issues in the establishment of PAC services in low-resource settings. The PAC programs, which were initially implemented and designed in 1993, include emergency treatment of complications of spontaneous and unsafely induced abortion, provision of postabortion family planning, and other reproductive health services. Conclusions gathered at the meeting include: the need to build a common framework for PAC, a strategic plan on PAC services, better coordination of PAC programs, and collaboration on common advocacy strategies that emphasize the missions, country leaders, other donors and PAC programs. Several steps have been identified as the key elements of a comprehensive approach to PAC services involving the organization of services, communication, providers, policy and management. Various steps were emphasized as critical in the development of PAC program such as the development of common strategic approach, sharing of lessons learned, focus on fewer countries, address on sustainability and measurement of impact, increase success awareness, mobilization of human and financial resources, clarification of PAC roles and leadership, and collaboration with other donors.
Determinants of induced abortion: the role of perceived and experienced contraceptive side effects and lack of counseling.
[Unpublished] . , 30,  p.In 1989, the World Health Organization (WHO) Task Force for Social Science Research on Reproductive Health initiated 27 projects in 20 developing countries to identify the determinants and consequences of induced abortion. A significant proportion of women in these studies had used a modern contraceptive method (generally the pill) in the past, but had recently discontinued method use or switched to a less effective method. This finding appears consistent with Luker's postulate that women who have both knowledge of and access to modern methods but are not contracepting at the time of abortion have calculated the risk and found the cost of contraception-related side effects too high. Further analysis of the WHO studies suggests that a woman's day to day health is a more proximate concern for her than more distal concerns with the health consequences of unintended pregnancy and abortion. Women's negative perceptions of modern contraceptive methods--based on either personal experience or rumor--appear to be the most significant determinant of their contraceptive practice. The 1993 Turkish Demographic and Health Survey, which provided the first nationally representative evidence on abortion, confirmed these postulates. 47% of reported abortions were preceded by use of withdrawal or periodic abstinence, 34% by no method use, and 17% by failure of a modern method. 26% of one-time pill and IUD users had discontinued method use because of side effects. Persistence of the belief that pill use causes sterility or cancer indicates that women lack access to reliable information, while the high frequency of repeat abortion attests to the need for postabortion family planning counseling. On the other hand, more attention must be given to women's perceptions of the cultural significance of contraceptive side effects, especially those related to disruption of the menstrual cycle. A user perspective to family planning demands that every woman should have access to a method that maximizes her opportunity to avoid unwanted pregnancy while minimizing psychological or physiologic distress.