Postabortion Care: Objectives, Importance, and Global Challenges
Postabortion care (PAC) is the management of a medical emergency. It is care for women with complications of abortion. The document outlines the importance and objectives of Postabortion Care (PAC), highlighting its role in providing life-saving treatment for women suffering from complications due to abortions, particularly in developing countries. Our aim is to improve the quality and expand the services available.
Key Elements of Quality PAC Services
Quality PAC involves several critical components to ensure survivor health and safety:
- Emergency Treatment
- FP Counseling & Services
- Other Reproductive Health Services
Importance of PAC Programs
PAC is a life-saving service. Death from abortion complications is preventable. We have the technology to make quality PAC services much more accessible. Most unwanted pregnancies, and therefore abortions, are preventable. While many hospitals manage patients with complications of abortions, quality, accessible PAC services are currently only available in a few hospitals.
The Scope of the Global Problem
The scale of abortion-related complications is a significant public health issue, as shown in the following data:
| Category | Statistics |
| Unwanted pregnancies yearly | 70 million |
| Abortions performed every year | 40-60 million |
| Abortions occurring in unsafe conditions | 20 million |
| Abortions in developing countries | 99% |
| Abortions among teenagers | 25-50% |
| Annual deaths from abortion | 70,000 |
| MMR due to complications of abortion | 13-50% |
| Gynaecological beds occupied by postabortion cases | 15-60% |
Plus, 15% of all pregnancies result in spontaneous abortions, and many clients seeking PAC services have had a miscarriage. 600,000 women die annually in the world from pregnancy related causes.
Challenges and Service Delivery in Africa
Why is the risk so high in Africa? Emergency services are not accessible and few paramedical staff are trained in PAC. Patients arrive in late and in poor condition. Services are not available on an emergency, immediate basis. D&C is the primary clinical management, which results in added delays waiting for OT time and staff, and an added risk of complications. Community understanding is poor and cultural barriers are a reality.
In Zambia, the PAC caseload doubled in less than 10 years. There were 16,000 PAC Admissions in UTH in 1993, and 16,000+ in the first half of 2002. Reported maternal mortality reached 1,000-2,000/100,000 in some districts.
Rationale for Using Manual Vacuum Aspiration (MVA)
MVA is the preferred treatment of incomplete abortion. The document emphasizes the need for improved healthcare systems and stronger linkages to family planning. A phased action plan is required to expand PAC services within the healthcare framework, promoting training and resources to strengthen service delivery.