Sexual and reproductive health

Q&A: WHO guidance on safe abortion

Q1. What is the “Safe abortion: Technical and Policy Guidance for Health Systems”?

WHO published the first global guidance on abortion-related care and policy issues (Safe abortion: technical and policy guidance for health systems) in 2003. Updated guidance issued in June 2012 provides policy-makers, programme managers and health-service providers with the latest evidence-based guidance on clinical care. It also includes information on how to establish and strengthen services, and outlines a human-rights-based approach to laws and policies on safe, comprehensive abortion care.

Q2. Why is this guidance needed?

Abortion is legal in most countries, provided certain conditions are met, for instance, to save a woman’s life. In countries where abortion is highly restricted by law and/or unavailable, many women have little choice but to resort to unsafe means. Some 47 000 women are estimated to die as a result of unsafe abortions every year, a further 5 million suffer temporary or permanent injuries, and there are huge financial costs to women, their families, communities, and health systems. Injuries from unsafe abortion include severe bleeding, infection, injury to the uterus or genitals, and infertility.

Q3. How is the new edition of the guidance different from the earlier one?

The updated WHO guidance reflects changes in methods of abortion and related care, service delivery as it applies to the availability and use of new methods, and information on human rights and how they relate to policy-making and legislation related to abortion. It also includes the latest data on the scale of the problem of unsafe abortion.

Q4. How was the guidance developed?

To develop the guidance, WHO brought together a panel of international experts—health-service providers, health-programme managers, researchers, methodologists, human rights lawyers, and women’s health and human rights advocates—to review and prioritize draft questions and outcomes, which included clinical, technical and programmatic topics. All available scientific findings on clinical care of women before, during and after abortions were analysed. A technical consultation was then convened to review the evidence and make recommendations. Estimates of abortion and information about laws and service delivery were also updated.

Q5. What are the next steps?

The guidance document is being widely disseminated, including through a series of regional workshops on using the guidance to strengthen policies and programmes for safe abortion.

WHO will review the guidance again in four years’ time, to assess whether revision is necessary, based on the latest available evidence and feedback from users.

A clinical handbook on safe abortion services which provides more detailed information for service providers will be published shortly.

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