Safe & Unsafe. abortion

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1 Safe & Unsafe Facts About abortion

2 WHAT IS THE DIFFERENCE BETWEEN UNSAFE AND SAFE ABORTION? What is unsafe abortion? Unsafe abortion is a procedure for terminating an unplanned pregnancy either by a person lacking the necessary skills or in an environment lacking the minimal medical standards or both. Unsafe abortion is one of the leading causes of maternal death. Unsafe abortion also leads to complications that lead in long term and disabling complications. 2

3 Unsafe abortion is performed by: Inserting unhygienic materials (metallic or plastic) into the uterus Drug overdose Inserting herbs into the vagina and different other dangerous techniques Unsafe abortion leads to the following complications: Severe bleeding Perforation of the uterus and damage to the genital tract (vagina, bladder, cervix, intestines) Infection Infertility Death 3

4 Use contraceptive methods to avoid unplanned pregnancy. If you have unplanned pregnancies go to health facilities and seek for advice, don t go to unregistered providers and non professionals. What is safe abortion? Safe abortion is performed by skilled professionals in a suitable environment to terminate pregnancy. Safe abortion prevents deaths and complications that could have resulted from unsafe abortion. In case of unplanned pregnancy talk to qualified providers if you are eligible to receive safe abortion care. Don t go to people who are not professionals. When performed by trained health care providers with proper equipment, correct technique and sanitary standards, abortion is one of the safest medical procedures. 4

5 If you find someone with unwanted pregnancy Encourage her to visit nearby health facility to get advice and appropriate care Strongly advise her not to go to unqualified/ traditional providers Tell her all the consequences of unsafe abortion POSTABORTION CONTRACEPTION AND FOLLOW-UP Importance of contraception Contraception is critical to women s health and wellbeing for several reasons. Contraceptive use can: Promote women s health by limiting births to the healthiest childbearing years 5

6 Allow mothers a safe means to achieve desired spacing between births and a small family size, which evidence shows improves infant health and saves infant lives Allow women the freedom to improve their quality of life, pursue an education or establish a career Reduce maternal mortality and morbidity by helping women avoid future unwanted pregnancies and the possibility of an unsafe abortion that might end in injury or death POST ABORTION CONTRACEPTIVE COUNSELLING AND METHOD PROVISION In general, all methods of contraception, including intrauterine devices (IUDs) and hormonal methods, can be considered after a first trimester abortion. However, when providing contraception to a woman, her medical eligibility for each method needs to be considered. 6

7 Providers Should: Use visual aids to explain human reproduction if necessary Encourage the client to ask questions and answer all questions clearly Provide information about the risk of becoming pregnant again before her next menses and return to fertility as early as 10 days after the abortion Explain that there are safe contraceptive methods to prevent or delay pregnancy or space children, including emergency contraception Ask if the client desires to delay or prevent future pregnancy If she desires to delay or prevent future pregnancy, explain that all modern contraceptive methods can be used 7

8 immediately after abortion care with appropriate client screening and informed choice. Provide accurate information on available contraceptive methods that are appropriate for her medical condition (see section below on methods) Educate on risk of STI transmission and recommend dual protection (use of methods that both prevent pregnancy and STI transmission, such as barrier methods) In centre s where family planning counseling and methods are not available, ensure that appointments are arranged for the client to visit the nearest family planning services or that counselor will visit clients after the procedure Make linkage to other health services if necessary(support counseling/social welfare, medical care, HIV counseling and testing) Inform client of the need for follow up family planning visits and schedule next visit. 8

9 Contraceptive methods and medical eligibility after abortion Combined oral contraceptives may be started immediately after both first and second trimester abortion, including septic abortion Progestin-only pill (Minipill) may be started immediately after both first and second abortion, including septic abortion Combined injectables may be started immediately after both first and second trimester abortion, including septic abortion Progestin-only injectables may be started immediately after both first and second trimester abortion, including septic abortion 9

10 Implants may be started immediately after both first and second trimester abortion, including septic abortion. IUD may be inserted immediately after first trimester abortion. May also be inserted immediately after second trimester abortion, but chances of expulsion are slightly higher than insertions which follow first trimester abortions. IUD SHOULD NOT BE USED IMMEDIATELY after septic abortion. Condom use may start with first act of intercourse, after first and second trimester abortion, including septic abortion. Diaphragm or cervical cap use may start with first act of intercourse, after first trimester abortion, including septic abortion. Use should be postponed for 6 weeks following second trimester abortion Fertility-awareness based methods should be delayed till regular menstrual cycles return. 10

11 Tubal ligation can be done immediately after uncomplicated first and second abortion. Should be delayed if abortion is complicated with infection, severe haemorrage, trauma, acute hematometra. In cases where the woman has experienced uterine perforation or injuries to intra-abdominal organs, tubal ligation can be carried out only at facilities with sufficient infrastructure. Special attention should be given in cases where women request sterilization to ensure their choice is not influenced by the crisis nature of the moment and to avoid later regret. Vasectomy: when chosen by partner, vasectomy can be done at any time 11

12 If client is practicing traditional family planning, counsel as follows: Withdrawal use may start with first act of intercourse, after first and second trimester abortion. You can become pregnant again before your next menstruation There are safe methods to prevent or delay pregnancy Get information on how or where you can obtain contraceptives Get information on how soon after abortion you should start using a contraceptive method 12

13 POST ABORTION ADVICE AND INSTRUCTIONS Please remember: You have the right to ask for and receive information from health workers. Feel free to talk to the providers. You can call your provider by using the telephone number provided in this brochure. You can become pregnant again before your next monthly bleeding. Use a family planning method immediately or when you decide to have sex. Your provider talks to you about contraceptives, if not please feel free to ask for information. Condoms will protect you from pregnancy and sexually transmitted infections, including HIV. You should return to the clinic immediately or call your service provider and seek medical attention immediately if you experience any of the following: 13

14 Heavier bleeding than your normal monthly menstrual bleeding Fever Dizziness or fainting Severe abdominal pains Bad smelling discharge from the uterus If you don t generally feel well Be sure to follow guidelines as well as any additional guidelines given to you by your service provider: If you have been prescribed antibiotics, take them completely as directed until you have finished them. You can start sexual relations two to three days after you stop bleeding and when you feel comfortable. 14

15 These are some common signs and symptoms after an abortion: Mild abdominal pain and cramping Nausea Vomiting Spotting and bleeding 15

16 For further enquiries, please contact: PPAG Nasia Road Laterbiokoshie (Blacksmith) P.O. Box AN 5756 Accra-North Tel: +233 (0302) , Fax: +233 (0302)

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