Comprehensive Post-Abortion Care: Framework and Essential Elements
Post abortion care is the care given to the woman following an abortion. This includes medical and nursing care and is done at all hospital levels. The term "post abortion care" was first articulated as a critical element of women's health initiatives in the early 1990s, and the message was to integrate it in the developing world. The concept of post abortion care provides the basis for reducing mortality and morbidity from incomplete abortion, whether spontaneous or induced.
The Essential Elements of Post-Abortion Care
Comprehensive post abortion care services should include both medical and preventive health care. In order to realize this, five elements of post abortion care were developed, that reflects, from a provider and a consumer perspective, an enhanced vision of high-quality, sustainable services. The essential elements of postabortal care shift the focus from facility-based medical treatment to a public health approach that responds to women's broader sexual and reproductive health needs. The key elements include:
- Community and service provider partnerships
- Counseling
- Treatment
- Family Planning and Contraceptive Services
- Reproductive and other health services
In the same period a model was developed which comprised of three elements: emergency treatment services for complications of spontaneous or unsafely induced abortion; post abortion family planning counseling and services; and links between emergency abortion treatment services and comprehensive reproductive health care.
| Element | Description and Purpose |
|---|---|
| Counseling | This is the process of helping and supporting a person to resolve personal, social, or psychological challenges and difficulties. |
| Treatment | Emergency treatment services for complications of spontaneous or unsafely induced abortion. |
| Family Planning | Counseling and services to help women prevent unwanted pregnancy, space births and reduce unsafe abortion. |
Community and Service Provider Partnerships
At this level, Community health education and mobilization have been identified as key strategies to combat unsafe abortion, increase access to and quality of post abortion care programs, and improve women's reproductive health and lives. In order to achieve this, community leaders and advocacy groups, lay health workers, traditional healers and formally trained service providers have been identified as major key partners of nurses and other health personnel in fulfilling the following tasks:
- Providing Education – On contraceptive usage and thereby help women prevent unwanted pregnancy, space births and reduce unsafe abortion.
- Education about obstetric emergencies and appropriate care-seeking behaviours.
Clinical Considerations and Health Systems
Prevention of abortion related illness and mortality is dependent on the availability of emergency post abortion care throughout the health care system. In order to reduce the risk of long term illness or disability, and death, to women presenting with the complications of incomplete abortion, health care systems must provide easily accessible, quality post abortion care at all service levels. When done safely, abortion complications are rare, but they can include:
- Incomplete abortion
- Haemorrhage
- Infection
- Uterine perforation
- Anaesthesia-related complications
- Uterine rupture
Post-abortion care includes any or all of the following, as needed or desired: optional follow-up check-up, management of residual side-effects or complications, and contraception services. Clinical services recommendations include medical management of missed abortion at gestational ages < 14 weeks and medical management of induced abortion.