Post-abortion care: a women's health initiative to combat unsafe abortion.
Improving postabortion care can reduce the negative impact of unsafe abortion. Of the 53 million estimated induced abortions occurring annually about two out of five involve unsafe procedures. About one abortion occurs for every three births annually. 96% of abortions in Africa and 85% of abortions in Latin America are unsafe. About 100,000 to 200,000 women die every year from unsafe abortion, or 1 out of 400 women. Family planning is unavailable to over 120 million women in developing countries who desire contraception. Past moral and political controversies divert attention away from death and injury. The international community can take the opportunity to change affairs by adopting a women's health initiative globally. Improvements are needed in quality of care and accessibility of emergency treatment services. Emergency treatment services are usually only available at the tertiary level of care in urban areas. Poor transportation systems limit access. Access is also impaired by women's attitudes toward treatment centers. Availability of services needs to increased through decentralized centers. Clear protocols and comprehensive, systematic training must be accomplished in tandem with improvements in quality. Provision of technology such as manual vacuum aspiration is cost effective and an easy way to improve quality in primary care or outpatient settings. Unsafe abortion is a byproduct of the failure to provide adequate family planning for prevention of unwanted pregnancy. The obstacles, that interfere with provision of family planning to abortion users, should be removed. These obstacles include providers' lack of understanding of women's needs and motivations, separation between abortion and family planning services, misinformation about contraception following abortion, lack of acknowledgement about unsafe abortion, and women's low status. National and international policies also interfere with provision of contraception. Complete reproductive health care is a necessity for improvement in maternal health and mortality.
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