The Postabortion Care (PAC) Consortium sounds an alarm within the reproductive health community about the need to effectively treat complications of miscarriage and incomplete abortion in order to reduce maternal mortality worldwide, and to promote PAC as an effective strategy for addressing this pressing global problem. The PAC Consortium promotes PAC as an effective strategy for addressing this global problem through a comprehensive public health model of the Five Essential Elements of Postabortion Care: community and service provider partnerships, counseling, treatment, contraceptive and family planning services, and reproductive and other health services. Join here.
According to the WHO, about 22 million unsafe abortions occur each year causing close to 50,000 maternal deaths - the vast majority of which, are developing countries. In addition, approximately 5 million women suffer short-term or lifelong disabilities due to complications resulting from unsafe abortion. Postabortion care is a strategy to address this problem by treating women with complications, providing family planning services to prevent future abortions, counseling and referring women for other needed services, and engaging communities.
Individually and in collaboration, the PAC Consortium agencies implement postabortion care programs around the world, and also encourage technical agencies, governments and donors to incorporate PAC into their own programs and policies as a critical step in reducing deaths and injuries of women from complications related to miscarriage and abortion-related consequences.
Thank you to those of you who were able to attend "Addressing Stigma and Quality of Care Issues in PAC Services" in November. A recording of the morning sessions is now available below along with the presentations. A short report summarizing discussions will be available soon.
The State and Future of Postabortion Care
Katherine Turner, Ipas and Maureen Corbett, IntraHealth International
Stigma, Discrimination and Human Rights: Making Connections for the PAC Context
Kati LeTourneau, inroads and Bia Galli, Ipas (begins around 24:30)
After Legalization of Abortion: The Continued Relevance of PAC in Nepal
Indira Basnett, Ipas (begins around 1:20:00)
A Tale of Two Abortion Contexts in One Country: Abortion Services and Stigma in Mexico
Patricio Sanhueza Smith, Secretariat of Health, Mexico City (begins around 1:42:30)
PAC in Rwanda: Program Highlights and Issues around Stigma
John Muganda, Rwanda Society of Obstetricians & Gynecologists (begins around 2:07:30)
APHA Conference Center, Washington, DC
Wednesday, November 19th, 2014 (9:00am-3:30pm EST)
Join the PAC Consortium (in-person or virtually) to explore the current state and future of postabortion care, country experiences, addressing stigma, and using a rights-based approach to improve PAC services.
Confirmed presenters include:
- Dr. Ominde Japhet Achola, Senior Clinical Advisor, EngenderHealth
- Dr. Indira Basnett, Ipas Country Director, Nepal
- Ms. Maureen Corbett, Vice President of Programs, IntraHealth International
- Ms. Bia Galli, Senior Regional Policy Advisor, Ipas
- Ms. Kati LeTourneau, Advisor, Inroads
- Dr. John Muganda, Rwanda Society of Obstetricians and Gynecologists
- Dr. Patricio Sanhueza, Reproductive Health Coordinator, Mexico City Secretariat of Health
- Ms. Katherine Turner, Senior Advisor, Health Systems, Ipas
- Dr. Defa Wane, Director of Technical Strategy and Innovation, EngenderHealth
Location: APHA Conference Center, 800 I Street, NW, Washington, DC 20001. The morning session (9:00-12:30) will be webcast for those who cannot attend in person.
When: Wednesday, November 19th, 2014 (9:00am-5:00pm EST)
Interviews with Young People Shed Light on Pressing Need for Youth-friendly Information and Services
Written by: Catherine Packer, Research Associate, FHI 360, and Co-Chair of the Youth-Friendly PAC Task Force
The following originally appeared on the K4Health blog. It is reposted here with permission.
Each year about 18 million adolescent girls under the age of 19 give birth, and about three million adolescents ages 15 to 19 undergo unsafe abortions worldwide. Childbirth and pregnancy-related complications are the number one cause of death among girls ages 15 to 19 in low- and middle-income countries. Early pregnancy increases the risk of anemia, postpartum hemorrhage, prolonged obstructed labor, obstetric fistula, and malnutrition for young mothers. Adolescents are more likely than women over the age of 20 to have stillbirths and give birth to infants with low birth weight. A girl who becomes pregnant also faces numerous societal consequences. She may be forced to drop out of school and confront discrimination in her community, and she is more likely to have a lower income and more children at shorter intervals over the course of her lifetime.
Healthy timing and spacing of pregnancy is critically important for adolescents’ health, education, and wellbeing; however, youth face many barriers to avoiding or delaying pregnancy. Social pressure to marry early and have children and lack of access to contraception impede adolescents’ ability to avoid pregnancies, which puts their lives and health at risk.
In countries where abortion is illegal, many adolescents and women end unwanted pregnancies by undergoing unsafe abortions and can die or become severely injured as a result. In some of these countries, women can obtain postabortion care (PAC) services, which, ideally, include treatment of abortion complications and provision of contraceptive counseling and methods. When adolescents access PAC services, it is sometimes their first interaction with the health care system. Thus, PAC services offer an opportunity to reach young people with information and contraception to help them avoid future unintended pregnancies and to achieve healthy timing and spacing of desired pregnancies.
Youth voices on postabortion care
To find out what youth think about access to contraception and postabortion care, the PAC Consortium’s Youth-Friendly Task Force recently produced a video of young people discussing these topics. Public health colleagues from Kenya, Nepal, Nigeria, Senegal, and Zambia used smart phones and video cameras to record interviews with young people, who brought up the following key issues:
- If young people try to obtain contraceptive methods, health care providers, parents, and communities judge them.
- Young women experiencing unwanted pregnancies often go to “quacks” or traditional healers who use unsafe methods to terminate the pregnancy. If they seek follow-up services in a health facility, health care providers treat them badly and are judgmental.
- Many young people knew someone who had been injured or who had died from complications of unsafe abortion.
- There is a lack of discussion about sexuality in homes, schools, and communities.
In the 14-minute video, young people express a desire for nonjudgmental services and access to quality reproductive health care and information. Unfortunately, because of stigma around youth sexuality, adolescents are often treated harshly by judgmental providers and community members. Therefore, we should advocate for increased access to youth-friendly, nonjudgmental reproductive health information and services.
Written by: PAC Consortium Community and Stigma Task Force
This year’s September 28th Global Day of Action, part of the campaign activities undertaken by the International Campaign for Women’s Right to Safe Abortion, imagines a world free of abortion stigma. The same factors that contribute to abortion-related stigma for women seeking services and health providers also lead to stigmatization of postabortion care (PAC) services (the treatment of complications from spontaneous and unsafely induced abortions).
Until there is universal access to safe and legal comprehensive abortion care, PAC for the treatment of incomplete and unsafe abortions remains an essential element for the reproductive health and rights of women and girls worldwide.
In solidarity with the International Campaign’s vision of a stigma free world, the Postabortion Care Consortium’s Community and Stigma Task Force calls for a world where women are able to access stigma-free, safe, and affordable PAC services from professional health providers – regardless of the legal status of abortion in their country – and a world where service providers are able to offer safe, respectful PAC services without facing stigma themselves. Moreover, all governments need to be held accountable to follow through on the international agreements they have committed to and provide PAC to those who need it.
The task force envisions a world where women and girls:
- Know where to access facilities that provide safe PAC services
- Are assured of receiving respectful, stigma-free, and confidential care from health providers
- Are able to access a full package of PAC services, including emergency obstetric treatment, counseling, contraception before discharge from the health facility, and other reproductive health services
- Are free from age and sexuality stigma when accessing PAC services
- Are free from stigma in their communities
- Are not refused PAC services as a result of narrow or incorrect interpretation of the law in contexts where abortion is highly restricted
- Do not die or suffer from disabilities as a result of spontaneous or unsafe abortion
Join us in this call to remove all barriers to PAC and to eliminate stigma, which is at the root of these barriers. Click here to learn how you can make your voice heard.
1. Barot, Sneha, “Implementing Postabortion Care Programs in the Developing World: Ongoing Challenges,” Guttmacher Policy Review 17, no. 1 (2014): 1, accessed September 5, 2014, http://www.guttmacher.org/pubs/gpr/17/1/gpr170122.html.
2. Guttmacher Institute, “Facts on Induced Abortion Worldwide,” In Brief (2012), accessed Feb. 16, 2014, http://www.guttmacher.org/pubs/fb_IAW.pdf.
3. Singh S, “Hospital Admissions Resulting from Unsafe Abortion: Estimates from 13 Developing Countries,” Lancet, 368, no. 9550 (2006): 1887-1892.