What’s new

If you’ve previously worked with the WHO guidelines on abortion care (2012 Safe abortion guideline, 2015 Health worker roles in providing safe abortion care and post-abortion contraception and 2018 Medical management of abortion) , you may benefit from starting here for a quick glance at what’s additional (either entirely new recommendations; or recommendations that are now presented as separate recommendations, rather than as a composite recommendation), updated, and where the guidance has remained unchanged. On the left you have the sections, topic areas, and the specific recommendation or best practice statement number and type.

ABORTION REGULATION
Criminalization
1 (LAW & POLICY; LP)ADDITIONAL
Grounds-based approaches
2 (LP)ADDITIONAL 
Gestational age limits 
3 (LP)ADDITIONAL

SERVICES ACROSS THE CONTINUUM OF CARE
Provision of information on abortion care 
4 (SERVICE DELIVERY; SD)UNCHANGED
Provision of counselling
5 (SD)UPDATED

PRE-ABORTION
Mandatory waiting periods
6 (LP)ADDITIONAL
Third-party authorization
7 (LP)ADDITIONAL
Rh isoimmunization for abortion at gestational ages < 12 weeks
8 (CLINICAL SERVICES; CS) (NEW)ADDITIONAL
Antibiotic prophylaxis for surgical and medical abortion
9 (CS)UNCHANGED
Determining gestational age of pregnancy: pre-abortion ultrasound scanning
10 (CS)UNCHANGED
Pain management for abortion
11–14 (CS) for surgical abortion and for prior cervical priming ADDITIONAL
15 and 16 (CS) for medical abortionADDITIONAL
Cervical priming prior to surgical abortion
17 (CS) at < 12 weeksUPDATED
18 (CS) (NEW) at ≥ 12 weeksADDITIONAL
19 (SD) with medication, at any gestational ageUPDATED
20 (SD) with osmotic dilators, at ≥ 12 weeksUPDATED
Provider restrictions
21 (LP)ADDITIONAL
Conscientious objection
22 (LP)ADDITIONAL

ABORTION
Methods of surgical abortion
23 (CS) at < 14 weeksUNCHANGED
24 (SD) vacuum aspiration at < 14 weeksUPDATED
25 (CS) at ≥ 14 weeksUNCHANGED
26 (SD) D&E at ≥ 14 weeksUPDATED
Medical management of induced abortion
27 (CS) at < 12 weeksADDITIONAL
28 (SD) at < 12 weeks in whole or in part (i.e. performing all or some of the subtasks)UPDATED
29 (CS) at ≥ 12 weeksUPDATED
30 (SD) at ≥ 12 weeksUPDATED
Missed abortion
31 (CS) (NEW) Medical management at< 14 weeksADDITIONAL
Intrauterine fetal demise
32 (CS) Medical management at≥ 14 to ≤ 28 weeksUNCHANGED
33 (SD) Medical management at≥ 14 to ≤ 28 weeksADDITIONAL

POST-ABORTION
Follow-up care or additional services
34 (CS)UNCHANGED
Incomplete abortion
35 and 36 (CS)UNCHANGED 
37 (SD) Medical management with misoprostol at < 14 weeksUPDATED
38 (SD)Vacuum aspiration at < 14 weeksUPDATED
Management of non-life-threatening complications
39 (SD) InfectionUPDATED
40 (SD) HaemorrhageUPDATED
Timing of post-abortion contraception
41 (CS) Medical eligibility criteria (MEC) for contraceptive useUNCHANGED
42 (CS) Contraception and surgical abortionUNCHANGED
43 (CS) Contraception and medical abortionUNCHANGED
44 (SD) Intrauterine devices (IUDs)UNCHANGED
45 (SD) Contraceptive implantsUNCHANGED
46 (SD) Injectable contraceptivesUPDATED
47 (SD) Tubal ligationUNCHANGED

SERVICE-DELIVERY OPTIONS AND SELF-MANAGEMENT APPROACHES
Telemedicine approaches to delivering medical abortion care
48 (SD) (NEW)ADDITIONAL
Service-delivery approaches for provision of information, counselling and medical abortion
49 (SD) (NEW)ADDITIONAL
Self-management of medical abortion at < 12 weeks
50 (SELF-MANAGEMENT)UPDATED
Self-management approaches for post-abortion contraception (see also Timing of post-abortion contraception, Recommendations 41–47 above)
51 (SELF-MANAGEMENT) Injectable contraception (initiation and continuation)UPDATED
52 (SELF-MANAGEMENT) Over-the-counter oral contraceptive pillsUNCHANGED
53 (SELF-MANAGEMENT) Over-the-counter emergency contraceptive pillsUNCHANGED
54 (SELF-MANAGEMENT) Condom useUNCHANGED