Safe abortion: technical and policy guidance for health systems
Over the past two decades, the health evidence, technologies and human rights rationale for providing safe, comprehensive abortion care have evolved greatly. Despite these advances, an estimated 22 million abortions continue to be performed unsafely each year, resulting in the death of an estimated 47 000 women and disabilities for an additional 5 million women (1). Almost every one of these deaths and disabilities could have been prevented through sexuality education, family planning, and the provision of safe, legal induced abortion and care for complications of abortion. In nearly all developed countries, safe abortions are legally available upon request or under broad social and economic grounds, and services are generally easily accessible and available. In countries where induced abortion is legally highly restricted and/or unavailable, safe abortion has frequently become the privilege of the rich, while poor women have little choice but to resort to unsafe providers, causing deaths and morbidities that become the social and financial responsibility of the public health system.
In view of the need for evidence-based best practices for providing safe abortion care in order to protect the health of women, the World Health Organization (WHO) has updated its 2003 publication Safe abortion: technical and policy guidance for health systems. In this process, the WHO standards for guideline development have been followed, including: identification of priority questions and outcomes; retrieval, assessment and synthesis of evidence; formulation of recommendations; and planning for dissemination, implementation, impact evaluation and updating.
The target audience for this guidance is policy-makers, programme managers and providers of abortion care. The use of the clinical recommendations should be individualized to each woman, with emphasis on her clinical status and the specific method of abortion to be used, while considering each woman’s preferences for care.