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Seven things the world should know about abortion

23 Jan 20
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Seven things the world should know about abortion

A pharmacy in downtown Port-au-Prince where misoprostol - a drug used to induce abortions - is readily available without a prescription. Caption
A pharmacy in downtown Port-au-Prince where misoprostol - a drug used to induce abortions - is readily available without a prescription.

This week marks two years since Donald Trump signed the Global Gag Rule, restricting access to abortion information and care for women in many of the countries where we work. 

Dr Manisha Kumar busts some of the biggest myths about abortion and shares the facts she thinks everyone should know...

My name is Manisha Kumar. I’m a doctor and, for the past three years, I’ve travelled the world talking about abortion. 

Almost everywhere I go, it’s not a topic that is openly discussed – even with other healthcare workers.

Many of them tell me abortion wasn’t even mentioned during their training, despite how common it is. 

If everyone knew these basic facts about abortion, it would go a long way to combating stigma and increasing access to safe abortion care. 

That’s why MSF has teamed up with HowToUseAbortionPill.org to create a free, open-source, evidence-based online course about medical abortions.

Our goal is to ensure that everyone has access to factual, scientifically accurate information about abortion – no matter who you are, where you are, or where you are going. 

From everything I’ve experienced, I know that talking about abortion is the only way to break the cycle of stigma, shame, and misinformation that marginalizes people and puts their lives in danger.

For humanitarian workers and medics, and for all of us, as sisters and brothers, as friends, it is our duty to educate ourselves so we can educate others.

With that in mind, here are seven things the world should know about abortion...

At MSF's out-patient department in Batil refugee camp Gandhi Pant, a nurse, escorts a patient with a possible appendicitis to a waiting ambulance. 

Batil is one of three camps in South Sudan’s Upper Nile State sheltering at least 113,000 refugees who have crossed the border from Blue Nile state to escape fighting between the Sudanese Armed Forces and the SPLM-North armed group. Refugees arrive at the camp with harrowing stories of being bombed out of their homes, or having their villages burned. The camps into which they have poured are on a vast floodplain, leaving many tents flooded and refugees vulnerable to disease. Mortality rates in Batil camp are at emergency levels, malnutrition rates are more than five times above emergency thresholds, and diarrhea and malarial cases are rising.

Help us prepare for the next emergency

If everyone knew these basic facts about abortion, it would go a long way to combating stigma and increasing access to safe abortion care. 

Dr Manisha Kumar
MSF doctor and abortion expert

1. Safe abortion is healthcare

The fact is that one in four pregnancies ends in induced abortion. Which means that you probably know someone who’s had one. Maybe you’ve had one yourself.

But because there is so much stigma and shame around abortion, it can be difficult for people to talk about freely, let alone share their experiences and learn from each other. 

Despite the stigma, abortion is a part of people’s lives and a key component of reproductive healthcare. It’s essential that healthcare workers, humanitarian workers – and everyone for that matter – know the basics about abortion.

2. Unsafe abortion is one of the main causes of maternal death

According to the Guttmacher Institute, at least 22,800 women die every year from complications from unsafe abortion.  The World Health Organization reports that around 7 million women are admitted to hospitals every year as a result of unsafe abortion.

And, unlike the other causes of maternal death, unsafe abortion is almost entirely preventable – by providing access to safe, effective abortion care.

3. Ninety-seven percent of unsafe abortions take place in the Global South

Poor women, women of color, and women living in rural areas are disproportionately cut off from safe abortion services. They are the ones whose lives and dignity are most at risk.

Women and girls trapped in war, crisis, and conflicts often face additional barriers to accessing safe abortion care – our online course has special considerations for these humanitarian settings.

4. A safe, effective abortion can be done with pills

Having an abortion doesn’t necessarily mean going through a surgery or a medical procedure anymore.

An abortion can be provided safely with pills alone.

In this kind of medication abortion, a combination of pills causes the uterus to contract and push out the pregnancy in a process that is similar to miscarriage. This is effective at ending a pregnancy more than nine times out of 10

The chance of severe complication from a medication abortion is less than one percent.  An abortion with pills is so safe that, most of the time, women can take the medications at home – they only need to go to a hospital or clinic if they have a question or a problem.

Contrary to rumours, a medication abortion does not cause infertility, mental health problems, or problems with future pregnancies.

5. An abortion with pills is relatively simple to provide

You don’t need any advanced technology or specialized medical interventions in order to provide medication abortion safely. According to the World Health Organization, blood tests, ultrasound, and follow-up are not required. 

All you need to provide a medication abortion are: 1) accurate information, 2) quality medications, and 3) mutual respect and trust.

Because of this, medication abortion has increased access to safe abortion care for millions of women and girls around the world – and especially in low-resource and humanitarian settings.

6. The global gag rule is silencing healthcare workers

The Global Gag Rule – which President Donald Trump reinstated and expanded on January 23, 2017 – prohibits doctors, nurses, and other health workers around the world from even speaking about abortion. If they do, they could lose the funding from the US government which they use to provide vital health services.

Health workers are relied upon for thorough, evidence-based medical information, and now they’ve been silenced in the places where that information is needed the most.

7. The right information can make a huge difference

People living in crisis and conflict situations don’t commonly have access to computers, smartphones, or the internet. That’s why it’s essential for humanitarian workers to learn about medication abortion and spread the information. The more you know, the more you can help others.

After I gave a training on medication abortion in one of our field projects, a local doctor working with MSF came up to me to share her experience.

“Last year, when we did an emergency intervention in a refugee camp, women came to me asking for help with abortions. They really needed our help, but we didn’t know about this, so we had to turn them away,” she said.  She didn’t know what happened to those women afterward, she didn’t see them again. “But now,” she said, “with what we have just learned, I see how easy it is. I think we can do more.”

I asked her if she thought that during the next emergency intervention, with the information she has now, it would be possible to provide safe abortion care. She nodded her head, “Yes, I think we can. In fact, we must.”

Neither MSF nor HowToUseAbortionPill.org takes funding from the US government. This means we can't be silenced by the Global Gag Rule.

We will speak the truth.  An abortion with pills is simple, safe, and effective – even for those in the hardest to reach places.