Clinical Practice Handbook For Safe Abortion

The Clinical practice handbook for safe abortion care is intended to facilitate the practical application of the clinical recommendations from the second edition of Safe abortion: technical and policy guidance for health systems (World Health Organization [WHO] 2012). While legal, regulatory, policy and service-delivery contexts may vary from country to country, the recommendations and best practices described in both of these documents aim to enable evidence-based decision-making with respect to safe abortion care.

The Clinical practice handbook for quality abortion care is intended to facilitate the practical application of the clinical recommendations from the Abortion care guideline (World Health Organization [WHO] 2022). While legal, regulatory, policy and service-delivery contexts may vary from country to country, the recommendations and best practices described in both of these documents aim to enable evidence-based decision-making with respect to 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. We hope this handbook will be useful to a range of health workers in different settings and in varying legal and health service contexts.

At a UN General Assembly Special Session in 1999, governments recognised unsafe abortion as a major public health concern, and pledged their commitment to reduce the need for abortion through expanded and improved family planning services, as well as ensure abortion services should be safe and accessible. This technical and policy guidance provides a comprehensive overview of the many actions that can be taken in health systems to ensure that women have access to good quality abortion services as allowed by law.

Abortion is a legal medical procedure that has been provided to millions of American women. Since the Institute of Medicine first reviewed the health implications of national legalized abortion in 1975, there has been a plethora of related scientific research, including well-designed randomized clinical trials, systematic reviews, and epidemiological studies examining abortion care. This research has focused on examining the relative safety of abortion methods and the appropriateness of methods for different clinical circumstances. With this growing body of research, earlier abortion methods have been refined, discontinued, and new approaches have been developed. The Safety and Quality of Abortion Care in the United States offers a comprehensive review of the current state of the science related to the provision of safe, high-quality abortion services in the United States. This report considers 8 research questions and presents conclusions, including gaps in research.

The complex political, cultural and regulatory landscape surrounding abortion care in the United States requires that abortion providers develop a sophisticated understanding of the legal system. Words such as preliminary injunction, deposition and amicus curiae flow easily off the tongues of many abortion providers. Similarly, attorneys and reproductive health advocates increasingly are becoming “experts” in clinical terminology and scientific data related to abortion. Abortion in California: A Medical-Legal Handbook was created for clinicians and lawyers looking to navigate the bounds of California law in order to fully understand how the law interacts with clinical practice.

A practical, evidence-based resource for ensuring high standards of care in contraception and sexual and reproductive health that follows the curriculum of the joint EBCOG and ESCRH Certificate and Diploma Examination in Sexual and Reproductive Health. Text focuses on key information, providing advice on how to practice patient-centred care.

The objective of this guideline is to present the complete set of all WHO recommendations and best practice statements relating to abortion. While legal, regulatory, policy and service-delivery contexts may vary from country to country, the recommendations and best practices described in this document aim to enable evidence-based decision-making with respect to quality abortion care. This guideline updates and replaces the recommendations in all previous WHO guidelines on abortion care.

This multidisciplinary review of abortion is invaluable reading for clinicians and other care providers in the area of women's health.

Medical abortion care encompasses the management of various clinical conditions including spontaneous and induced abortion (both viable and non-viable pregnancies) incomplete abortion and intrauterine fetal demise as well as post-abortion contraception. Medical management of abortion generally involves either a combination regimen of mifepristone and misoprostol or a misoprostol-only regimen. Medical abortion care plays a crucial role in providing access to safe effective and acceptable abortion care. In both high- and low-resource settings the use of medical methods of abortion have contributed to task shifting and sharing and more efficient use of resources. Moreover many interventions in medical abortion care particularly those in early pregnancy can now be provided at the primary-care level and on an outpatient basis which further increases access to care. Medical abortion care reduces the need for skilled surgical abortion providers and offers a non-invasive and highly acceptable option to pregnant individuals.

Planned and regulated task shifting and task sharing can have a range of benefits. It can ensure a rational optimization of the available health workforce, address health system shortages of specialized health-care professionals, improve equity in access to health care and increase the acceptability of health services for those receiving them. This guideline provides a range of options for expanding of health worker roles in the provision of safe abortion care, the management of complications of abortion (also known as post-abortion care in some settings and provided as part of emergency obstetric care) and for post-abortion contraception provision.