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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Quick links

What is new in the 2022 guidelines 

If you've previously worked with the 2012 Safe abortion guideline, benefit from starting here for a quick glance at what's new, updated, or unchanged.


Incomplete abortion management recommendations

Incomplete abortion is defined by clinical presence of an open cervical os and bleeding.


Medical management of induced abortion

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


Background and context

Sexual and reproductive health is fundamental to individuals, couples and families, and to the social and economic development of communities and nations.


Abortion regulation

One element of an enabling environment is that law and policy promote and protect sexual and reproductive health and rights (SRHR).


Medical management of missed abortion

Missed abortion is when a pregnancy stops developing and the cervical os is closed. Symptoms may include pain, bleeding or no symptoms at all.


Conceptual structure of the guideline


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.

Related materials

Clinical practice handbook for quality abortion care

This handbook is oriented to health workers who already have the requisite skills and training necessary to provide safe abortion and/or treat complications of unsafe abortion. It is neither a substitute for formal training, nor a training manual.

Download here.

Towards a supportive law and policy environment for quality abortion care: evidence brief

This brief provides illustrations of and insights into steps that can be taken at the national, local and health-care facility level to create an enabling environment for quality abortion care.

Download here.