Guideline Highlights

Quality of abortion

Abortion care must be safe, timely, affordable, non-discriminatory and respectful. Quality of abortion care is foundational to this abortion care guideline. Quality of care is defined as care that is: effective, efficient, accessible, acceptable/patient centered, equitable and safe.

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The abortion care pathway

Comprehensive abortion care includes provision of information, abortion management (including induced abortion and care related to pregnancy loss), and post-abortion care. This guideline includes recommendations for different abortion indications, and for different stages of the continuum of care (the “who”, “what”, “where” and “how”).

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Enabling environment

Quality abortion care is supported by an enabling environment. The three cornerstones of an enabling environment are: (1) respect for human rights including a supportive framework of law and policy; (2) the availability and accessibility of information; and (3) a supportive, universally accessible, affordable and well functioning health system.

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Human rights including a supportive framework of law and policy

An enabling environment is one in which the human rights of individuals are respected, protected and fulfilled.

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Common approaches to abortion regulation

Almost all countries where abortion is lawfully available regulate abortion differently to other forms of health care.

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Service-delivery options and self-management approaches

Abortion care services can be provided by a range of health workers and some tasks can be managed by individuals themselves.

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Medical management of induced abortion

Medical management of spontaneous and induced abortion at early or later gestational ages.

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Post-abortion contraception recommendations

All contraceptive options may be considered after an abortion.

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Telemedicine approaches to delivering medical abortion care

This is a mode of health service delivery where providers and clients are separated by distance.

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Conceptual structure of the guideline

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As illustrated above, this guideline is centred on the values and preferences of abortion seekers, and considers them as active participants in as well as beneficiaries of health services. This guidance emphasizes that – as a woman, girl or other pregnant person moves through the abortion care pathway (pre-abortion, abortion, post-abortion) – health services must be integrated within the health sector to ensure that service delivery meets their needs equitably and without discrimination. As each individual moves through this pathway, the guideline provides specific recommendations on the interventions needed (i.e. the “what”), and guidance on the individuals who may safely carry them out (i.e. the “who”). The guideline also provides information on the locations where services can be provided (i.e. the “where”) and outlines service-delivery models that can be used (i.e. the “how”). The enabling environment provides the context for the effective implementation of these interventions.