Post-abortion care (PAC) is treatment and counseling for post-abortion women. It includes

curative care Curative care or curative medicine is the health care given for medical conditions where a cure is considered achievable, or even possibly so, and directed to this end. Curative care differs from preventive care, which aims at preventing the appear ...

, such as treating abortion complications, as well as preventative care, such as providing

birth control Birth control, also known as contraception, anticonception, and fertility control, is the use of methods or devices to prevent unwanted pregnancy. Birth control has been used since ancient times, but effective and safe methods of birth contr ...

to prevent future unwanted pregnancies. Post-abortion care reduces morbidity and mortality associated with abortion.

Prevalence

Approximately 75 million women require post-abortion care annually following induced and

spontaneous abortion Miscarriage, also known in medical terms as a spontaneous abortion and pregnancy loss, is the death of an embryo or fetus before it is able to survive independently. Miscarriage before 6 weeks of gestation is defined by ESHRE as biochemical lo ...

(miscarriage). All countries have committed to reducing pregnancy-related mortality by providing treatment for abortion complications, regardless if the abortion was illegally obtained. However, an analysis of ten countries (Bangladesh, Haiti, Kenya, Malawi, Namibia, Nepal, Rwanda, Senegal, Tanzania, and Uganda) found that in seven of ten, less than 10% of primary facilities could provide basic post-abortion care. No primary healthcare facilities in Namibia provided post-abortion care; Malawi, with greatest prevalence, offered post-abortion care at 29% of primary facilities.

Elements

The

aspect of PAC includes treating incomplete abortions by removing any fetal or maternal tissues remaining in the uterus. This can include using

vacuum aspiration Vacuum or suction aspiration is a procedure that uses a vacuum source to remove an embryo or fetus through the cervix. The procedure is performed to induce abortion, as a treatment for incomplete spontaneous abortion (otherwise commonly known as ...

(suction) or

curettage Curettage ( or ), in medical procedures, is the use of a curette (French, meaning scoop Mosby's Medical, Nursing & Allied Health Dictionary, Fourth Edition, Mosby-Year Book 1994, p. 422) to remove tissue by scraping or scooping. Curettages ar ...

(scraping). Aspiration results in shorter procedure times, less pain, and less blood loss than curettage. The drug

misoprostol Misoprostol is a synthetic prostaglandin medication used to prevent and treat stomach and duodenal ulcers, induce labor, cause an abortion, and treat postpartum bleeding due to poor contraction of the uterus. Misoprostol is taken by mouth wh ...

is an alternative to manual removal and is another option for treating incomplete abortion. For preventative care, women are provided family planning counseling and services, as most women seeking PAC were not using modern contraceptives at the time of conception. A study in Zimbabwe found that family planning counseling was associated with a significant reduction in unwanted pregnancies and repeat abortions in the year after they received post-abortion care. Infrequently, sexual health screenings such as

HIV testing HIV tests are used to detect the presence of the human immunodeficiency virus (HIV), the virus that causes acquired immunodeficiency syndrome (AIDS), in serum, saliva, or urine. Such tests may detect antibodies, antigens, or RNA. AIDS diagn ...

are provided as part of post-abortion care, though

sexually transmitted infection Sexually transmitted infections (STIs), also referred to as sexually transmitted diseases (STDs) and the older term venereal diseases, are infections that are spread by sexual activity, especially vaginal intercourse, anal sex, and oral s ...

screening is low and has been identified as an unmet need of PAC.

History

The term "post-abortion care" was first defined in the 1991 by the non-governmental organization (NGO) Ipas. In 1993, Ipas joined Jhpiego,

EngenderHealth EngenderHealth is a 501(c)(3) nonprofit organization based in Washington, D.C. active in sexual and reproductive health (SRH) operating in nearly 20 countries throughout Africa, Asia, and the Americas. The organization was established in 1943 an ...

Pathfinder International Pathfinder International, based in Watertown, Massachusetts, US, is a global non-profit organization 501(c)(3) that focuses on reproductive health, family planning, HIV/AIDS prevention and care, and maternal health. The organization operates in m ...

, and

International Planned Parenthood Federation The International Planned Parenthood Federation (IPPF) is a global non-governmental organisation with the broad aims of promoting sexual and reproductive health, and advocating the right of individuals to make their own choices in family p ...

, in creating the Postabortion Care Consortium. In 1994, a post-abortion care model was articulated by the Postabortion Care Consortium, with three key elements, regardless of the legality of abortion in a given country: 1) emergency treatment for abortion-related complications; 2) postabortion family planning counseling and services; and 3) linkage between emergency care and other reproductive health services, such as management of sexually transmitted diseases. The PAC model was adopted by

United States Agency for International Development The United States Agency for International Development (USAID) is an independent agency of the U.S. federal government that is primarily responsible for administering civilian foreign aid and development assistance. With a budget of over $27 bi ...

(USAID) in 1994. In 2002, two elements were added relating to counseling and community involvement. The first research compendium on post-abortion care was published in 2007 by USAID, ''What Works, A Policy and Program Guide to the Evidence on Postabortion Care''.

References

{{Abortion Abortion