“Medical abortion can safely and effectively be provided by midlevel healthcare personnel and administered by women themselves when they are provided with the accurate information.” These are the outcomes of the recently published Ph.D. research, “Task Shifting in the Provision of Medical Abortion: Say Goodbye to Coat Hangers”, undertaken by Dr. Rebecca Gomperts (director of Women on Waves and Women on Web). The research presents four studies that investigate the use of telemedical information services, as well as midlevel health care providers, for women who are opting for abortion at up to 9 weeks of pregnancy.
Unsafe abortion and global maternal mortality
Unsafe abortion remains one of the most important causes of maternal mortality worldwide. Of the approximately 21.6 million unsafe abortions undergone each year, an estimated 47, 000 result in death. The main reasons for this are legal and administrative restrictions, insufficient services and limited access to services. The study looks into the administering of medical abortion. Different from surgical abortion, this form of abortion is performed using pills and has already been proven to be one of the safest medical options, with minimal risks of morbidity and mortality. The research shows that at up to 9 weeks of pregnancy, and provided with proper information, medical abortion can safely and effectively be done by midlevel healthcare personnel such as midwives, and even at home by women themselves.
A woman’s choice
Hivos welcomes the outcomes of this research. Hivos considers control over one’s sexual and reproductive health, including the choice to have an abortion, a crucial part of a world where people enjoy human dignity and self-determination. The choice whether or not to continue a pregnancy should be that of a woman herself and not impeded or restricted by the state – whether through legal restrictions or a lack of access to information and safe services. The use of telemedical information services, as well as shifting tasks from medical doctors to midlevel healthcare providers, has the potential to improve this access, even in countries where laws are restrictive. This also strengthens women’s control and autonomy over their bodies.
Hivos’ work on safe abortion
The outcomes also underline the approach that Hivos has taken towards safe abortion over the past years. ‘Women on Waves’ and ‘Women on Web’ are long-time Hivos partners. In East Africa, one of Hivos’ partners has opened a pharmacy providing the misoprostol pill, a legal medicine used to treat post-birth hemorrhage, but that can also be used to induce medical abortion. Another partner organisation runs a hotline providing information on how to perform a safe abortion, what is needed and where this can be found.
Currently, Hivos is in the process of developing a regional programme in East Africa to reduce maternal mortality rates – consistent with government’s commitment to UN Millennium Development Goal 5 – by improving access to modern contraceptive services, including to safe abortion, for every woman. Gomperts’ research provides an ideal entry point for the programme to explore home-based medical abortion, the use of telemedical services to provide information and task shifting.