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Abortion is common,
life-saving healthcare

What MSI has learned from providing abortion and how we can work together to end unsafe abortion by 2030.

3 out of 10 pregnancies end in abortion.

And, yet, it remains stigmatized, inaccessible and legally restricted all around the world. If we do nothing, we estimate there will be 48 million unsafe abortions in the year 2030.

If we act now, the year 2030 could be the first where no one needs to resort to an unsafe abortion – a year in which there are 94,000 fewer maternal deaths and 12 million fewer potentially life-long injuries from medical complications.

A world free of unsafe
abortion is within reach.

In MSI Reproductive Choices 2024 report Abortion Care: Frontline to Future, we share on-the-ground experiences, reflect on best practices and promising models, and shed light on how we can move forward together in partnership to save lives and protect the right to reproductive choice. We delve further into:

1. Reducing inequality

Stark inequality in abortion access is growing, with low- and middle-income countries bearing the burden of 97% of unsafe abortions. Young women and people in rural and poorer areas are disproportionately affected, forced to resort to desperate, unsafe measures.

Sleepovers for services

Free mobile outreach programs—where our teams travel into remote and underserved communities to provide reproductive choice—have provided abortion services to over 100,000 women in the past five years, in areas where services have previously been limited or non-existent. We’ve been adapting, testing, and scaling different outreach models, and one successful approach has been implementing ‘sleepovers’. A team of healthcare providers remains at the service delivery site overnight so women who are unable to come for a service during regular daytime hours (for example, because they cannot leave work, have daytime childcare obligations, or they don’t want to be seen) can access the care they need.

Read the full report

2. Ensuring a choice of medical or surgical abortion

Everyone should have a choice of how they have an abortion—whether that’s a surgical or medical abortion. Where both options are available in our centers, we find there’s a consistent 50/50 split in which method our clients choose.

Maternity hospitals

Private maternity hospitals can fill a major gap in access to surgical abortions, including second trimester procedures. Because maternity hospitals have surgical capacity, abortion and any complications can be safely managed with 24/7 support. And integrating abortion services with other healthcare like maternity care can help normalize abortion and reduce stigma. The demand is there: MSI’s maternity hospitals deliver almost twice the number of abortion and post-abortion care services than MSI’s outpatient clinics do. This requires thoughtful consideration of how services are designed to ensure a good client experience, with separate areas for maternity care and abortion care.

Read the full report

3. Innovating to expand abortion access

Working with partners, our country teams have developed, implemented, and advocated for new models and approaches, from telemedicine to revising burdensome clinical requirements. With new approaches, we can put care within reach of more women.

Quality-assuring products

Providing information is not enough—women need quality-assured products. In recent years, there’s been an increase in sub-standard and unregulated medical abortion products sold in markets worldwide, and our teams continue to respond with life-saving post-abortion care when these go wrong. In Nepal, almost 80% of medical abortion pills are low quality. Our team are crowding out these dangerous products by expanding access to WHO-approved medical abortion products, with nationwide distribution, by leveraging digital communications to raise awareness of quality products, and by advocating for better regulations. Governments increasingly need to take accountability as a watchdog for unregulated abortion products to keep people safe.

Read the full report

4. Making abortion care client-centered

Abortion care must be high-quality. That includes effectiveness, accessibility, equity, and safety—and increasingly, the health sector is acknowledging that quality is about valuing the clients’ perspectives, too.

Feedback direct from clients

Abortion providers must be accountable to clients. By integrating routine client feedback forms into our processes, we hear directly from our clients on their experiences, including the support they received from providers, stigma and pain management. Capturing our clients’ voices helps us improve and adapt our approach. For example, based on direct client feedback via a new digital feedback tool, MSI Ghana increased communication on wait times—and saw clients’ satisfaction scores increase. And following client feedback in Sierra Leone, the team rearranged waiting areas to provide more space for loved ones accompanying clients.

Read the full report

5. Advocating for abortion

Law reform is expanding abortion access, creating significant global progress—more than 60 countries have liberalized their abortion laws in the past 30 years. But many unnecessary legal, clinical, policy and cultural barriers remain.

Nurses & midwives’ curriculums

DRC has a high rate of maternal mortality, and unsafe abortion is the second leading cause. Two thirds of an estimated 593,000 annual abortions end in health complications because of dangerous methods and the lack of training of healthcare providers. By engaging with the Ministry of Health, the MSI DRC team successfully integrated two new training modules into the curriculum for university students of nursing and midwifery. Already in the pilot phase, this fundamental change to the DRC healthcare curriculum has seen more than 2200 midwives and nurses trained on providing safe abortion.

Read the full report

6. Protecting frontline providers

Frontline abortion providers face increasing discrimination, stigma, threats, and attacks just for doing their work—and it’s having a silencing and stigmatizing effect.

‘Providers Share’ workshops

We have found that one of the best ways to support frontline team members is through ‘Providers Share’ workshops. These are peer-to-peer support sessions where providers can ask questions about how to deal with stress, share their experiences, and understand how they can be prepared for challenging situations. Many report they find it easier to share their emotions, difficulties and concerns with others who can relate to their experiences. The MSI Zimbabwe team introduced these sessions at the end of 2018 and post-abortion care providers have reported that they’ve helped to lift the emotional burden of not disclosing their work to those around them, and helped them to discuss challenging post-abortion care cases—in the process building peer-to-peer support and teambuilding.

Read the full report

Until no one dies from unsafe abortion.
Until no one is left behind.

The world has all the knowledge and tools we need to end unsafe abortion by 2030. We have global guidelines, protocols, technology, and evidence of best practices to ensure that all people can receive confidential, respectful, and high-quality abortion care services. What we lack is political will and resources.

We need to decide that women’s autonomy and lives are worth protecting. We need resources to implement effective approaches at scale. We need to integrate abortion as part of a comprehensive approach to health and we need to focus efforts on reaching the most vulnerable and marginalized group.

This is an unfinished revolution, and we need you with us.

MSI’s local teams across the globe have an
unmatched ability to deliver world-leading,
cost-effective programs.

Urgent investment is needed to protect women’s access to healthcare.
Support global reproductive choice with a donation or partner with us to transform futures.

 

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