Most tragic deaths resulting from unsafe abortions take place in lower-income African and Asian countries, the World Health Organisation (WHO) has said.
It stated that more than 60 per cent of such deaths occur in Africa, while 30 per cent occur in Asia and among those living in the most vulnerable situations.
Unsafe abortions, WHO stated cause around 39,000 deaths every year and result in millions more women hospitalised with complications.
Geneva-based WHO says its new guidelines on abortion released on Wednesday aimed at protecting women and girls.
The abortion care guideline updates the former edition, released in 2012, and consolidates existing and new recommendations.
Quality abortion care is effective care – delivered by health workers with the right skills, resources, and information, the WHO declared.
It added that quality abortion is also safe; accessible to all those that need it; timely, and respectful of women and girls’ needs and rights.
Craig Lissner, Acting Director, Sexual and Reproductive Health and Research at the WHO, stated that the new guidelines would help to prevent more than 25 million unsafe abortions that currently occur every year.
“Nearly every death and injury that results from unsafe abortion is entirely preventable.
“That’s why we recommend women and girls to access abortion and family planning services when they need them,’’ he stated.
He noted that the consolidated guidelines in the new edition brought together more than 50 recommendations spanning clinical practice, health service delivery, legal and policy interventions.
The guidelines, he stressed¸ were based on the latest scientific evidence and would improve access to high-quality, person-centred services.
“When abortion is carried out using a method recommended by the WHO, appropriate to the duration of pregnancy and assisted by someone with the necessary information, it is a simple and extremely safe procedure.
“Tragically, however, only around half of all abortions take place under such conditions,’’ he noted.
According to him, the new guideline includes recommendations on many simple primary care level interventions that improve the quality of abortion care provided to women and girls.
“These include task sharing by a wider range of health workers and ensuring access to medical abortion pills.
“It means more women can obtain safe abortion services and be sure that accurate information on care is available to all those who need it,’’ Lissner stated.
He added that for the first time, the guidelines included recommendations for use where appropriate of telemedicine, which helped support access to abortion and family planning services during the COVID-19 pandemic.
He stated that alongside the clinical and service delivery recommendations, the guidelines recommend removing medically unnecessary policy barriers to safe abortion.
Lissner listed such barriers as criminalisation, mandatory waiting times, the requirement that approval must be given by other people or institutions, and limits on when an abortion can take place.
He stated that such barriers could lead to critical delays in accessing treatment and put women and girls at greater risk of unsafe abortion stigmatisation, and health complications.
“While most countries permit abortion under specified circumstances, about 20 countries provide no legal grounds for abortion.
“More than three in four countries have legal penalties for abortion, which can include lengthy prison sentences or heavy fines for people having or assisting with the procedure,’’ Lissner observed.
Dr. Bela Ganatra, Head of WHO’s Prevention of Unsafe Abortion Unit in a contribution stated that “It’s vital that abortion is safe in medical terms, but that’s not enough on its own.
“As with any other health services, abortion care needs to respect the decisions and needs of women and girls, ensuring that they are treated with dignity and without stigma or judgement,’’ Ganatra said.
Ganatra stressed that no one should be exposed to abuse or harm like being reported to the police or put in jail because they have sought or provided abortion care.
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According to her, evidence shows that restricting access to abortions does not reduce the number of abortions that take place.
“In fact, restrictions are more likely to drive women and girls towards unsafe procedures.
“In countries where abortion is most restricted, only one in four abortions are safe, compared to nearly nine in 10 in countries where the procedure is broadly legal.
“The evidence is clear; if you want to prevent unintended pregnancies and unsafe abortions, you need to provide women and girls with a comprehensive package of sexuality education.
“Accurate family planning information and services, and access to quality abortion care are also essential,” Ganatra said.
She noted that following the launch of the guidelines, WHO would support interested countries to implement the new guidelines and strengthen national policies and programmes related to contraception.
Ganatra added that the WHO would also help counties on issues of family planning and abortion services, helping them to provide the highest standard of care for women and girls.
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