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Medication abortion early in pregnancy

A Comprehensive abortion care program in Ethiopia

“There used to be a clinic in Mekele where an untrained provider was doing clandestine abortions; after our program began, the owner of the clinic closed it down because he couldn’t get any patients, since there was more awareness and services being provided in the local public sector facilities.”
-Doctor Tesfaye Endrias

 

Ethiopia’s maternal mortality ratio is one of the highest in the world, and abortion-related death is estimated to account for over 30% of maternal deaths in the country (Ministry of Health 2006). Prevention of unplanned pregnancies, which are the root cause of unsafe abortions, has not been addressed effectively at all levels of the health system.  On average Ethiopian woman bear more than five children and close to one third of these births are either mistimed or unwanted. 

As a strategy for preventing maternal deaths related to unsafe abortion, VSI is working with the Federal Ministry of Health and other non-governmental organization partners in Ethiopia to introduce misoprostol as a component of comprehensive abortion care (CAC) at multiple levels of the health system. By incorporating misoprostol into the existing package of technologies for abortion-related care, women will have more options for safe abortion early in pregnancy, especially if misoprostol is available for medication abortion in the communities where they seek and receive care.  Another key aspect of this introductory program is the strengthening of linkages between community-level health care providers and facility-based providers, a strategy VSI also employs in our efforts to improve management of postpartum hemorrhage.

The results of this CAC study will inform national policy on comprehensive abortion care in Ethiopia and potentially in other countries as the law permits.