9 March 2022
Access to safe abortion critical for health of women and girls: WHO
The World Health Organization (WHO) has today released new guidelines on abortion care in support of the health of women and girls around the world and to help prevent over 25 million unsafe abortions that are still occurring each year in countries with restrictive laws, poor or non-existent safe abortion services and outdated, risky and dangerous practices.
Safe abortion is essential healthcare. Nearly every death and injury that results from an unsafe abortion is preventable, and need not have happened.
Based on the latest scientific and policy evidence, these guidelines consolidate and update all previous WHO guidelines. Theybring together over 50 recommendations spanning clinical practice, health service delivery, and legal and policy interventions to support good quality abortion care.
The new recommendations aim to improve access
When abortion is carried out using a method recommended by WHO, appropriate to the duration of the pregnancy and assisted by someone with the necessary information and/or skills, it is a simple and extremely safe procedure. However, in spite of decades of scientific advance to reach this point, only around half of all abortions worldwide take place under such good conditions.
Unsafe abortions still cause around 39,000 deaths every year and result in millions of women being hospitalized with complications. These cases are almost all concentrated in lower-income countries – e.g. over 60% in Africa and 30% in Asia – and among those living in poverty and other vulnerable situations.
The new guidelines include recommendations on making most abortions, especially early abortions, a simple primary care level intervention that improves the quality of and reflects the simplicity of abortion care. These include allowing a wide range of trained health workers to provide services, ensuring access to medical abortion pills, and making sure that accurate information is available to everyone who needs it.
For the first time, the guidelines also includes recommendations for use of telemedicine to arrange direct access to abortion pills, e.g. via pharmacists. Telemedicine has helped to support access not only to abortion and family planning services during the Covid-19 pandemic, but many other health services as well, and remains relevant for the ongoing delivery of services in the future. Indeed, telemedicine has altered the provision of many aspects of health care, and with abortion with pills, has made abortions earlier and more accessible, e.g. in Great Britain.
The guidelines call for removing unnecessary and outdated legal and policy barriers
Alongside the clinical and service delivery recommendations, the guidelines recommend removing medically unnecessary policy barriers to safe abortion, such as criminalization, mandatory waiting times between requesting abortion and receiving it, requirements of third-party approval (e.g. by several doctors, or a partner, family member or judge), and limits on when during pregnancy an abortion can take place.
Such barriers can lead to critical delays in accessing care and put women and girls at greater risk of seeking unsafe abortions and experiencing health complications, while increasing disruptions to education or missing work.
Most countries still permit abortion only under specified circumstances. While only about 20 countries permit no legal grounds for abortion, more than 75% of countries have legal penalties for abortion, which can include lengthy prison sentences or heavy fines for those having or assisting with the procedure.
“It’s vital that an abortion is safe in medical terms,” said Dr Bela Ganatra, Head of WHO’s Prevention of Unsafe Abortion Unit. “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 judgment. No one should be exposed to abuse or harms such as being reported to the police or put in jail because they have sought or provided safe abortion care.”
Evidence shows that restricting access to abortions does not reduce the number of abortions that take place. Instead, restrictions are more likely to drive women and girls towards unsafe procedures. “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 good quality abortion care,” added Dr Ganatra.
Following the launch of the guidelines, WHO will support interested countries to implement these new guidelines and strengthen national policies and programmes related to contraception, family planning and abortion services, helping them provide the highest standard of care for women and girls.
The WHO abortion care guideline updates the former edition, released in 2012, and consolidates other existing and new recommendations. The digital version is available at: https://srhr.org/abortioncare
An interactive online database containing comprehensive information on the abortion laws, policies, health standards and guidelines for all countries is available at https://abortion-policies.srhr.org.
This press release is a slightly revised version of the WHO Human Reproduction Programme press release.
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