Meeting women's needs for post-abortion family planning: Framing the questions

Abstract

Although women who undergo abortion are at risk of subsequent unwanted pregnancies abortion services in developing countries are rarely linked to family planning services. This neglect of post-abortion contraceptive services reflects both the low priority allotted to womens reproductive health needs and national and international policies that restrict abortion-related programming. Even when abortion providers refer women to a family planning center the clinic is often inaccessible or insufficiently supplied with modern contraceptives. preferable is a model involving on-site delivery of initial counseling and contraceptive provision after abortion coupled with referral to and contraceptive provision after abortion coupled with referral to community sources for continuity of care and resupply. Since women who are not adequately counseled are at high risk of method discontinuation all family planning options must be clearly presented. In all cases respectful treatment of abortion patients and understanding of the situation that led them to seek abortion will improve the acceptability of services. In the majority of cases unwanted pregnancies occur because family planning services are unavailable inaccessible ineffective or culturally unacceptable to women. The inclusion of women in the design of post-abortion services can help to identify the obstacles to family planning use. Fortunately there is growing concern about the effects of unsafe clandestine abortion (up to 200000 maternal deaths each year) and the momentum for change exists. Ways must be found however to reach women who induce abortions clandestinely and never enter the health care system.