"This book... arises out of a concern that the steadily growing body of information about the harmful complications of abortion for women and their subsequent children should become widely known. These complications are physical, psychological, social, and spiritual." --

Abortion is a legal medical procedure that has been provided to millions of American women. Since the Institute of Medicine first reviewed the health implications of national legalized abortion in 1975, there has been a plethora of related scientific research, including well-designed randomized clinical trials, systematic reviews, and epidemiological studies examining abortion care. This research has focused on examining the relative safety of abortion methods and the appropriateness of methods for different clinical circumstances. With this growing body of research, earlier abortion methods have been refined, discontinued, and new approaches have been developed. The Safety and Quality of Abortion Care in the United States offers a comprehensive review of the current state of the science related to the provision of safe, high-quality abortion services in the United States. This report considers 8 research questions and presents conclusions, including gaps in research.

The Clinical practice handbook for safe abortion care is intended to facilitate the practical application of the clinical recommendations from the second edition of Safe abortion: technical and policy guidance for health systems (World Health Organization [WHO] 2012). While legal, regulatory, policy and service-delivery contexts may vary from country to country, the recommendations and best practices described in both of these documents aim to enable evidence-based decision-making with respect to safe abortion care.

Sets out guidelines that can help reduce the high levels of maternal morbidity and mortality associated with abortion whether spontaneous or induced. Recommendations and advice are backed by extensive practical experience and rooted in the principle that emergency care for the complications of abortion should be available 24 hours a day in every health care system. In view of the need to prevent life-threatening complications the book also establishes standards of safe abortion practice for use in those countries where abortion is permitted by law. Prevention of abortion through education and family planning is likewise discussed. Addressed to health managers administrators and care providers the book follows a step-by-step approach to the provision of emergency and preventive care. The first three chapters describe the magnitude of mortality and morbidity caused by unsafe abortions define the essential components of abortion care at each level in the health system and discuss the ways in which legal and societal factors affect abortion behaviour and care. Against this background the remaining eleven chapters provide technical and managerial guidelines for each component of service at each level of the health system needed to ensure that all women have access to care 24 hours a day. A chapter on planning is followed by three chapters outlining the clinical elements of emergency abortion care. Of particular value is a chapter on patient information and counselling which emphasizes the importance of providing information in a supportive manner. Other chapters offer detailed guidance on the facilities equipment and drugs needed for abortion care on the training and supervision of staff and on ways to overcome several obstacles that make it difficult for women in remote rural areas to receive timely care.

"Now with a new afterword by the author"--Back cover.

At a UN General Assembly Special Session in 1999, governments recognised unsafe abortion as a major public health concern, and pledged their commitment to reduce the need for abortion through expanded and improved family planning services, as well as ensure abortion services should be safe and accessible. This technical and policy guidance provides a comprehensive overview of the many actions that can be taken in health systems to ensure that women have access to good quality abortion services as allowed by law.