REPRODUCTIVE HEALTH
Postabortion Care

Complications arising from miscarriage and incomplete abortion are recognized by governments, researchers, and health care providers worldwide as a major public health concern, even in countries where abortion is legal but restricted, or in the few countries where it is illegal in all cases.

Poor quality of medical care, substandard provider–client communication, and lack of counseling on medical procedures and recuperation are just some of the problems experienced by women with complications from miscarriage and incomplete abortion. In addition, scant attention too often is paid to patients' other health concerns—including their desire for effective and affordable contraception.

Postabortion care (PAC) is defined as a service-delivery strategy that includes:

• emergency health services (treatment of complications of spontaneous or unsafely induced abortion);
• postabortion counseling and family planning services; and
• links to other reproductive health care services.

The Population Council has collaborated with other international organizations to conduct research aimed at improving PAC. The Council's Frontiers in Reproductive Health Program (FRONTIERS) conducts operations research (OR) interventions in Africa, Asia, and Latin America to test the effectiveness and cost-effectiveness of introducing or improving PAC. Other research is conducted by the Council’s Ebert Program, including clinical studies aimed at reducing morbidity and mortality as well as work on policy-related aspects of PAC through involvement in the Postabortion Care Consortium. Ebert Program staff members have conducted several clinical trials of misoprostol to help identify regimens useful for effective treatment of early pregnancy failure and other indications. More research is needed to provide conclusive data on the best regimens, as anecdotal evidence and several qualitative studies indicate that there is considerable variation in the ways providers currently use misoprostol for a range of gynecologic and postabortion indications.

In addition, the ability of reproductive health services to provide high-quality care relies on effective supervision and monitoring, yet supervisors frequently do not know what constitutes high-quality care and how to evaluate services. To address this problem, Council researchers have developed innovative computerized, self-analyzing monitoring and evaluation tools to improve assessment and quality of PAC services. A user-friendly computer program can be loaded onto hand-held computers to analyze data immediately and provide instant feedback. The PAC Guide and other simple monitoring and evaluation tools are available in English, French, and Spanish, and can be downloaded free of charge (computer-based tools).

Projects

• Research on Unwanted Pregnancies and Postabortion Complications in Pakistan
• FRONTIERS projects

  • Bolivia, Guatemala, Mexico: Developing and Testing a Supervision Instrument of Postabortion Care (PAC) Services in Bolivia, Guatemala, and Mexico

  • Bolivia: Technical Assistance to Pathfinder for Postabortion Care Operations Research

  • Egypt: Using Operations Research to Enhance Delivery of Postpartum/Postabortion Family Planning Services in the Arab Region

  • Egypt: Linking Family Planning with Postabortion Services in Egypt: Testing Feasibility, Acceptability, and Effectiveness of Two Models of Integration

  • Guatemala: Scaling Up a Successful Counseling Model

  • Haiti: Situational Analysis of the Use of Contraception in Postpartum, Postabortion, and Prevention of Mother-to-Child HIV Transmission

  • Honduras: Expansion of Postpartum/Postabortion Contraceptive Services in Honduras

  • Peru: Sustainability of Postabortion Care

  • Russia: Testing Two Models of Postabortion Family Planning in Russia

  • Senegal: Assessing Management Sciences for Health's Postabortion Care Decentralization Program

  • Senegal: Introducing Postabortion Care (PAC) Services in Rural Senegal
  • Tanzania: Assessing the Introduction of Comprehensive Postabortion Care in Rural Tanzania
  • Sub-Saharan Africa: Dissemination of Results on Postabortion Care (PAC) Initiative for Francophone Africa
  • Additional FRONTIERS projects in Latin America and the Caribbean, Asia and the Near East, sub-Saharan Africa, Europe and Eurasia, and across countries

Publications/Resources on this issue

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See Also

• Operations Research
• Reducing Unsafe Abortion

Offsite Link

• Postabortion Care Consortium

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This page updated 14 March 2008

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