Delhi - New research just released by Marie Stopes International (MSI) concludes that replicating India’s approach to medical abortion could revolutionise access to abortion services around the world, helping to reduce the huge number of women who die or are disabled each year as a direct result of having unsafe surgical abortion*.The study also found that medical abortion, which involves a woman taking two drugs**, is a more cost effective alternative to surgical abortion. The research,
Medical Abortion in India: a Model for the World?, found that medical abortion is provided widely in India and that there is broad support – within clinical communities and the general public -- for further increasing access. Eighty percent of healthcare providers (medical practitioners and pharmacists) thought it is an effective method for ending a pregnancy and a similar percentage of women who had a medical abortion were satisfied with it as a method. The researchers also found that there were less serious complications and need for hospitalisation following medical abortion***. It was also up to five times cheaper than the surgical alternative.
Areas of concern However, the research did uncover some areas of concern. Very few women, for example, were provided with all the information they needed, including what side effects to expect, before having a medical abortion. In addition, only 46% then went on to use contraception after having a medical abortion, compared to 59% of those who had had a surgical abortion.
Interestingly, although medical abortion is widely used in India, approximately two thirds of women thought it was illegal as did three out of four pharmacists, indicating that more needs to be done to educate all communities about its legal status.
To help improve medical abortion services, the researchers recommended that:
- healthcare providers should be trained in: the number of pills required; the dosage and how and when to take the pills; common side effects; the need for family planning after an abortion; counselling; referral systems and follow-up
- women and men are educated about their reproductive health rights and family planning in general, and
- medical abortion products should always meet the highest standards of quality and efficacy.
Findings What the research found overall is that India’s model is a lesson to the many other countries that struggle with high rates of unsafe abortion and the unacceptably high levels of maternal morbidity and mortality linked with unsafe procedures.
The health and well-being of women, particularly those in low income and rural settings, would be greatly improved by rolling out this method of abortion more widely. Between 60% and 95% of unsafe abortions take place in developing countries, compared to eight percent in developed countries****. There are also huge opportunities for increasing access to medical abortion via out-of-clinic settings through the use of mid level providers like pharmacists.
Read the full report: Medical abortion in India, a model for the world? *Each year, 52 million abortions take place around the world; 19 million of those are unsafe resulting in the deaths of around 67,000 women and millions more suffering long term damage or disease.
The majority of abortions that take place each year are surgical abortions, and like any surgical procedure, surgical abortion carries with it a certain amount of risk.
**The WHO recommends using Mifepristone and Misoprostol as the standard regimen for early medical abortion.
*** Around the world, complications from unsafe abortion lead to the hospitalisation of more than five million women each year.
**** Alan Guttmacher Institute. Facts on Induced abortion worldwide. In Brief. New York: Alan Guttmacher Institute, 2008