Clinical Practice Handbook For Safe Abortion

The Clinical practice handbook for safe abortion care is intended to facilitate the practical application of the clinical recommendations from the second edition of Safe abortion: technical and policy guidance for health systems (World Health Organization [WHO] 2012). While legal, regulatory, policy and service-delivery contexts may vary from country to country, the recommendations and best practices described in both of these documents aim to enable evidence-based decision-making with respect to safe abortion care.

At a UN General Assembly Special Session in 1999, governments recognised unsafe abortion as a major public health concern, and pledged their commitment to reduce the need for abortion through expanded and improved family planning services, as well as ensure abortion services should be safe and accessible. This technical and policy guidance provides a comprehensive overview of the many actions that can be taken in health systems to ensure that women have access to good quality abortion services as allowed by law.

Abortion is a legal medical procedure that has been provided to millions of American women. Since the Institute of Medicine first reviewed the health implications of national legalized abortion in 1975, there has been a plethora of related scientific research, including well-designed randomized clinical trials, systematic reviews, and epidemiological studies examining abortion care. This research has focused on examining the relative safety of abortion methods and the appropriateness of methods for different clinical circumstances. With this growing body of research, earlier abortion methods have been refined, discontinued, and new approaches have been developed. The Safety and Quality of Abortion Care in the United States offers a comprehensive review of the current state of the science related to the provision of safe, high-quality abortion services in the United States. This report considers 8 research questions and presents conclusions, including gaps in research.

Planned and regulated task shifting and task sharing can have a range of benefits. It can ensure a rational optimization of the available health workforce, address health system shortages of specialized health-care professionals, improve equity in access to health care and increase the acceptability of health services for those receiving them. This guideline provides a range of options for expanding of health worker roles in the provision of safe abortion care, the management of complications of abortion (also known as post-abortion care in some settings and provided as part of emergency obstetric care) and for post-abortion contraception provision.

Twenty million unsafe abortions are performed each year, 90% of which occur in the developing world. Even in countries such as China, where abortion is fully accessible in practice as well as in theory, our understanding of the phenomenon is very partial. The result of a global research project commissioned by the World Health Organization, this book provides new information on abortion, why it happens and what happens when it does. There are sections detailing women' s perspectives and also chronicling the providers views and the effect they have on medical provision. Several essays focus on the relationship between contraception and abortion, while a section on adolescents addresses a newly emerging concern for program managers around the world. Including much previously unavailable material, this book is the most comprehensive and up-to-date picture of abortion globally.

Medical abortion care encompasses the management of various clinical conditions including spontaneous and induced abortion (both viable and non-viable pregnancies) incomplete abortion and intrauterine fetal demise as well as post-abortion contraception. Medical management of abortion generally involves either a combination regimen of mifepristone and misoprostol or a misoprostol-only regimen. Medical abortion care plays a crucial role in providing access to safe effective and acceptable abortion care. In both high- and low-resource settings the use of medical methods of abortion have contributed to task shifting and sharing and more efficient use of resources. Moreover many interventions in medical abortion care particularly those in early pregnancy can now be provided at the primary-care level and on an outpatient basis which further increases access to care. Medical abortion care reduces the need for skilled surgical abortion providers and offers a non-invasive and highly acceptable option to pregnant individuals.

What are the contemporary issues in abortion politics globally? What factors explain variations in access to abortion between and within different countries? This text provides a transnationally-focused, interdisciplinary analysis of trends in abortion politics using case studies from around the Global North and South. It considers how societal influences, such as religion, nationalism and culture, impact abortion law and access. It explores the impact of international human rights norms, the increasing displacement of people due to conflict and crisis and the role of activists on law reform and access. The book concludes by considering the future of abortion politics through the more holistic lens of reproductive justice. Utilising a unique interdisciplinary approach, this book provides a major contribution to the knowledge base on abortion politics globally. It provides an accessible, informative and engaging text for academics, policy makers and readers interested in abortion politics.

This multidisciplinary review of abortion is invaluable reading for clinicians and other care providers in the area of women's health.