Ensuring healthy outcomes: Access to quality abortion care for the health and rights of women and girls

28 September 2022

Access to the highest attainable standard of health, including sexual and reproductive health, is a core human right. The ability to decide if and when to have children, and access to safe, timely, respectful and person-centred abortion care, and post-abortion care, when needed, helps to safeguard the health and well-being of women, girls, their families and their communities. 

The World Health Organization (WHO) Abortion care guideline promotes an enabling environment in which people are active participants in their health and care. As people move through the abortion care pathway (pre-abortion, abortion, post-abortion) — health services must be integrated within the health sector to ensure that service delivery meets the needs of women and girls — equitably and without discrimination. 

When abortion is carried out using a method recommended by WHO, appropriate to the duration of the pregnancy and assisted by someone with the necessary information or skills, it is a simple and safe procedure. 

The guideline also recommends many simple primary care level interventions that improve the quality of abortion care provided to women and girls. These include task sharing by a wider range of health workers, ensuring access to medical abortion pills, which mean more women can obtain safe abortion services and making sure that accurate information on care, including self-care, is available to all those who need it.  

WHO is proud to share these photos, taken in partnership with Regional Offices, Country Offices and their partners, and with the full, informed consent of all participants, though names have been changed to protect privacy. With this exhibition, we celebrate the role people play in their own health, as well as the life-saving, life-changing impact of healthcare workers committed to delivering quality abortion care, including post-abortion care. 

This photo exhibition is launching on International Safe Abortion Day, 2022, the theme of which is “Abortion in uncertain times.” While rights continue to come under attack, what is not uncertain is that heath is a human right, and abortion care is health care. Promoting and protecting access to quality abortion care is essential to achieve a world where everyone is able to access the highest standards of sexual and reproductive health services, and reach their full potential.

Raising awareness

WHO / SRHR / Uma Bista
Dhriti, mother of two, recovers in a hospital in Nepal. She arrived in a critical condition, following an unsafe abortion.
© Credits

Recovering thanks to post-abortion care

Dhriti, mother of two, recovers in a hospital in Nepal. She arrived in a critical condition, following an unsafe abortion. 

Abortion can be safely provided through a simple facility-based procedure or through tablets. When taking tablets, it is important to ensure that the woman is supported with accurate information, good quality medicines, and access to back up care in a facility if she needs or wants it, as well as to family planning options.  

Around 73 million induced abortions take place worldwide each year. Nearly half of all abortions in the world are unsafe, a leading – but preventable – cause of maternal deaths and morbidities. Most abortion related deaths occur in developing countries – 60% in Africa and 30% in Asia.  

Delivering care at home

WHO / SRHR / Uma Bista
Kopisha, youth mobilizer, (left) and Chimini, a nurse and midwife (right), walk across a suspension bridge to their clients’ homes in rural Nepal.
© Credits

Going the distance

Kopisha, youth mobilizer, (left) and Chimini, a nurse and midwife (right), walk across a suspension bridge to their clients’ homes in rural Nepal. They cover huge distances, often on foot, committed to providing sexual and reproductive health services in rural areas, including comprehensive abortion care, cervical cancer screening, and family planning. 

They cover huge distances, often on foot, committed to providing sexual and reproductive health services in rural areas, including comprehensive abortion care, cervical cancer screening, and family planning. 

Home visits ensure medical services reach those in remote areas. The services provided are private, quality, and include follow-up appointments – elements that are not guaranteed when clients are left to seek out care through health posts, which can be unreliable in terms of staffing. 

Accessing choices and rights

WHO / SRHR / Uma Bista
Sreva (right), with her mother-in-law, at their home in rural Nepal. Two years ago, Sreva had a safe abortion with the help of a nurse/midwife.
© Credits

Thriving

Sreva (right), with her mother-in-law, at their home in rural Nepal. Two years ago, Sreva had a safe abortion with the help of a nurse/midwife. She continues to receive sexual and reproductive health services from the same nurse who travels great distances to deliver quality care.

Health workers are crucial to providing quality abortion care and post-abortion contraception.

WHO / Blink media - Uma Bista
A nurse and midwife inserts a contraceptive for a client in rural Nepal.
© Credits

Preventing unwanted pregnancy

A nurse and midwife inserts a contraceptive for a client in rural Nepal.  

Access to contraceptive information and services are fundamental to the health and human rights of all individuals. The prevention of unintended pregnancies leads to fewer unsafe abortions. 

Ensuring the right to health

WHO / SRHR / Uma Bista
A midwifery student, practices inserting an Intrauterine Device on a postpartum uterus trainer with the guidance of her teacher (right) at Kathmandu University School of Medical Sciences in Nepal.
© Credits

Building skills

A midwifery student, practices inserting an Intrauterine Device on a postpartum uterus trainer with the guidance of her teacher (right) at Kathmandu University School of Medical Sciences in Nepal. 

According to human rights law, governments must ensure access to necessary, up-to-date scientific technologies, in particular contraception and medicines for abortion, without discrimination. 

WHO / SRHR
A gynecologist in Moldova consults a woman about an unintended pregnancy of six weeks.
© Credits

Providing respectful care

A gynecologist in Moldova consults a woman about an unintended pregnancy of six weeks. 

Abortion care needs to respect the decisions and needs of women and girls, ensuring that they are treated with dignity and without stigma or judgement.

WHO/SRHR/Saiyna Bashir
Health workers gather for their monthly meeting in Islamabad, Pakistan at a primary healthcare facility.
© Credits

Connecting with the community

Health workers gather for their monthly meeting in Islamabad, Pakistan at a primary healthcare facility. Each facility has 20 to 25 health workers who provide sexual and reproductive health services to their community, across the continuum of care. 

WHO provided the workers with individual touchscreen tablets. These tools are part of an Electronic Data Management system, brought to Islamabad in 2020, which has focused on tracking patient history, as well as collecting data for a digitally integrated, centralized health center. The electronic system has connected the community to the health system, has made medical data easier to record and has elevated the status of the health workers in the community. 

WHO/SRHR/Saiyna Bashir
A health worker goes door-to-door to speak about sexual and reproductive health (SRH) with young girls and women, and to refer them to health clinics.
© Credits

Opening doors

A health worker goes door-to-door to speak about sexual and reproductive health (SRH) with young girls and women, and to refer them to health clinics.

Facility-based and community-based health workers play essential roles in delivering safe and effective SRH care, especially when it comes to support in evidence-based, quality abortion care. 

WHO/SRHR/Saiyna Bashir
A health worker, visits a woman and her 14-month-old son in Pakistan to provide postnatal care, information on contraception and abortion.
© Credits

Sharing knowledge and resources

A health worker, visits a woman and her 14-month-old son in Pakistan to provide postnatal care, and information on contraception and abortion. 

Community-based health workers play essential roles in delivering safe, effective and rights-based sexual and reproductive health care.

WHO/SRHR/Saiyna Bashir
A health worker consults with a mother on various forms of contraceptives
© Credits

Reaching everyone

A health worker consults with a mother on various forms of contraceptives while she waits to see the doctor, along with her children, aged 4-years and 9-months.  

Health centers have been established in Pakistan to provide services to communities who are uninsured.  

WHO / SRHR / Hickmatu Leigh
A nurse administers a contraceptive injection for a client at the Princess Christian Maternity hospital in Freetown, Sierra Leone
© Credits

Providing personalized care

A health worker gives a young woman birth control pills upon request during a home visit in Islamabad, Pakistan.  

A growing body of evidence supports provision of information on safety and efficacy of each contraceptive method available, but leaving the personal decision about which method to use up to the patient.

WHO / SRHR / Hickmatu Leigh
A nurse administers a contraceptive injection for a client at the Princess Christian Maternity hospital in Freetown, Sierra Leone
© Credits

Planning for the future

A nurse administers a contraceptive injection to a client at the Princess Christian Maternity hospital in Freetown, Sierra Leone. 

Each year, almost half of all pregnancies – 121 million – are unintended; 6 out of 10 unintended pregnancies and 3 out of 10 of all pregnancies end in induced abortion. 

It is important for every woman to have access to desired contraception to prevent unintended pregnancies, as well as access to post-abortion contraception.

WHO/SRHR/Hickmatu Leigh
In Sierra Leone, a nurse provides post-abortion care, an important stage in the continuum of abortion care
© Credits

Ensuring health after an abortion

In Sierra Leone, a nurse provides post-abortion care, an important stage in the continuum of abortion care, which can include management of complications from abortion and contraception services. 

States are required to ensure access to post-abortion care, regardless of whether abortion is legal or restricted.

WHO/SRHR/Hickmatu Leigh
A nurse manages the stock of emergency contraception at a dispensary in Sierra Leone.
© Credits

Taking stock

A nurse manages the stock of emergency contraception at a dispensary in Sierra Leone.  

WHO recommends making over-the-counter emergency contraceptive pills available without a prescription to individuals who wish to use them. Such access can decrease unintended pregnancies and, in turn, decrease unsafe abortions. 

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