Update on medical abortion

Whaley, Natalie; Burke, Anne E.

doi:10.1097/gco.0000000000000215

Cited by 5 publications

(1 citation statement)

References 31 publications

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“…Functional equipment for abortion care, sterilization, maintenance, and resupply are essential to enable facilities to deliver PAC at all times [ 24 , 25 ]. The use of appropriate technology rather than outdated techniques such as sharp curettage (Dilation and Curettage) improves quality PAC [ 26 , 27 ] and patient satisfaction with these services [ 28 , 29 ]. Adopting appropriate technologies can also reduce hospital stay, the cost of treatment and strain on resources, and increase the safety of PAC services [ 30 ].…”

Section: Introductionmentioning

confidence: 99%

Policy, law and post-abortion care services in Kenya

et al. 2018

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BackgroundUnsafe abortion is still a leading cause of maternal death in most Sub-Saharan African countries. Post-abortion care (PAC) aims to minimize morbidity and mortality following unsafe abortion, addressing incomplete abortion by treating complications, and reducing possible future unwanted pregnancies by providing contraceptive advice. In this article, we draw on data from PAC service providers and patients in Kenya to illustrate how the quality of PAC in healthcare facilities is impacted by law and government policy.MethodsA cross-sectional design was used for this study, with in-depth interviews conducted to collect qualitative data from PAC service providers and seekers in healthcare facilities. Data were analyzed both deductively and inductively, with diverse sub-themes related to specific components of PAC quality.ResultsThe provision of quality PAC in healthcare facilities in Kenya is still low, with access hindered by restrictions on abortion. Negative attitudes towards abortion result in the continued undirected self-administration of abortifacients. Intermittent service interruptions through industrial strikes and inequitable access to care also drive unsafe terminations. Poor PAC service availability and lack of capacity to manage complications in primary care facilities result in multiple referrals and delays in care following abortion, leading to further complications. Inefficient infection control exposes patients and caregivers to unrelated infections within facilities, and the adequate provision of contraception is a continued challenge.DiscussionLegal, policy and cultural restrictions to access PAC increase the level of complications. In Kenya, there is limited policy focus on PAC, especially at primary care level, and no guidelines for health providers to provide legal, safe abortion. Discrimination at the point of care discourages women from presenting for care, and discourages providers from freely offering post-abortion contraceptive guidance and services. Poor communication between facilities and communities continues to result in delayed care and access-related discrimination.ConclusionGreater emphasis should be placed on the prevention of unsafe abortion and improved access to post-abortion care services in healthcare facilities. There is a definite need for service guidelines for this to occur.

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Section: Introductionmentioning

confidence: 99%

Policy, law and post-abortion care services in Kenya

et al. 2018

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Self-management of medical abortion: a qualitative evidence synthesis

Wainwright¹,

Swartz

Leon

2016

Reproductive Health Matters

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Medical abortion is a method of pregnancy termination that by its nature enables more active involvement of women in the process of managing, and sometimes even administering the medications for, their abortions. This qualitative evidence synthesis reviewed the global evidence on experiences with, preferences for, and concerns about greater self-management of medical abortion with lesser health professional involvement. We focused on qualitative research from multiple perspectives on women's experiences of self-management of first trimester medical abortion (< 12 weeks gestation). We included research from both legal and legally-restricted contexts whether medical abortion was accessed through formal or informal systems. A review team of four identified 36 studies meeting inclusion criteria, extracted data from these studies, and synthesized review findings. Review findings were organized under the following themes: general perceptions of self-management, preparation for self-management, logistical considerations, issues of choice and control, and meaning and experience. The synthesis highlights that the qualitative evidence base is still small, but that the available evidence points to the overall acceptability of self-administration of medical abortion. We highlight particular considerations when offering self-management options, and identify key areas for future research. Further qualitative research is needed to strengthen this important evidence base.

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Distance Traveled for an Abortion and Source of Care After Abortion

Upadhyay

Johns

Meckstroth

et al. 2017

Obstetrics &Amp; Gynecology

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For most patients, greater distance traveled for abortion was associated with increased likelihood of seeking subsequent care at an ED. Increasing the number of rural Medicaid abortion providers and reimbursing providers for telemedicine and alternatives to routine follow-up would likely improve continuity of care and reduce state costs by shifting the location of follow-up from EDs back to abortion providers.

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Update on medical abortion

Cited by 5 publications

References 31 publications

Policy, law and post-abortion care services in Kenya

Policy, law and post-abortion care services in Kenya

Self-management of medical abortion: a qualitative evidence synthesis

Distance Traveled for an Abortion and Source of Care After Abortion

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