The midwife's role in abortion care

Clandestine or unhygienic abortion is one of the five primary causes of maternal mortality, causing up to 200,000 deaths annually. The medical complications of unsafe abortion are exacerbated by the standard use of sharp curettage for uterine evacuation and by the need to transfer women to the highest level of the health system for treatment. Three ways in which midwives can begin to reverse this trend and improve the quality and accessibility of abortion care are to perform vacuum aspiration to treat incomplete abortion or for early induced abortion; to recognise the warning signs of incomplete abortion, provide emergency stabilisation and resuscitation, and offer appropriate and timely referral for uterine evacuation; and to provide family planning counselling and services, particularly to women who have experienced abortion and may be at high risk for future unintended pregnancies but are otherwise not reached by family planning programmes.