Beyond safety: WHO Abortion care guideline

On 8 March 2022, the World Health Organization (WHO) published a new guideline for abortion. The guideline brings together the latest evidence, best practices and recommendations to around abortion care.

Quality of abortion

It is well established that abortion restrictions do not prevent abortions from happening, they rather render them less safe or unsafe. The WHO estimates that around 45% of all abortions are unsafe, of which 97% take place in developing countries. The prevalence of unsafe abortions has long informed a focus on the safety of abortion, sometimes overlooking aspects related to the quality of care. With this guideline, WHO shifts the focus to quality of abortion, defined as “care that is: effective, efficient, accessible, acceptable/patient centered, equitable and safe.” WHO suggests that abortions laws and policies and health systems should uphold quality of care and shall be in compliance with human rights.

Self-management of medical abortion

Previously, the WHO has endorsed self-care interventions in healthcare including in abortion care. Self-care interventions are often designed to involve patients and individuals in preventing disease and promoting and maintaining health with or without the support of a health worker. The guideline recognizes that self-managed medical abortion in part or as a whole can be a safe and effective option for individuals seeking to terminate a pregnancy up to 12 weeks. Self-management of medical abortion can be cost-effective for health systems and empowering for individuals.

Telemedicine as an alternative to in-person care

In addition to the recommendations around self-management of abortion, the WHO also recommends telemedicine as an alternative to in-person care. Telemedicine involves using technology, such as phones or computers, to provide healthcare services remotely, allowing individuals to consult with healthcare providers without needing to be physically present at a medical facility. The WHO guideline proposes that communication between an individual seeking abortion and a healthcare provider can occur in-person or remotely, with the integration of telemedicine being an option for delivering abortion care.

The guideline notes that diversifying service-delivery methods to include telemedicine may facilitate access to abortion. Telemedicine abortion can be particularly valuable in situations where geographical, logistical, or social barriers restrict individuals’ ability to access abortion services.