Critical gaps in universal access to reproductive health: Contraception and prevention of unsafe abortion

Abstract

Unsafe abortion accounts for a significant proportion of maternal deaths, yet it is often forgotten in discussions around reducing maternal mortality. Prevention of unsafe abortion starts with prevention of unwanted pregnancies, most effectively through contraception. When unwanted pregnancies occur, provision of safe, legal abortion services can further prevent unsafe abortions. If complications arise from unsafe abortion, emergency treatment must be available. Recommendations made on this issue during the Precongress Workshop held prior to the 2009 FIGO World Congress in Cape Town, South Africa, were part of a report that was adopted by the FIGO General Assembly. These recommendations address prevention of unsafe abortion and its consequences and support access to safe abortion care to the full extent allowed by national laws, along with 6 strategies for implementation, including integration of family planning into other reproductive health services, adequate training for providers, task-sharing with mid-level providers, and using evidence to discuss this issue with key stakeholders.

Scaling Up Family Planning to Reduce Maternal and Child Mortality: The Potential Costs and Benefits of Modern Contraceptive Use in South Africa

“…There are many barriers to contraceptive use from both the demand and supply side [34, 35]. In South Africa, the leading reasons for not using contraceptives include concerns regarding side effects and opposition by partners [36, 37].…”

Provision of injectable contraceptives in Ethiopia through community-based reproductive health agents

“…[1][2][3] To address this critical shortage of health professionals, international health bodies and expert observers have advocated shifting specific health-care tasks from highly-trained medical staff to providers with minimal training, depending on the type of intervention. [4][5][6][7] This systematic delegation of tasks to less skilled providers, formerly referred to as substitution, is not new. 8 However, for such continued and expanded task shifting and sharing to be viable, these services must be delivered just as safely and effectively by less skilled providers as by medical staff.…”

Postabortion contraceptive use and method continuation in India

“…Often, the poor and socially excluded are deprived of essential abortion care in settings in which reproductive healthcare services are constrained [2][3][4][5][6]. In India, abortion is legal under medical and social conditions but most women lack sufficient knowledge about abortion care and services [7,8].…”