EXECUTIVE SUMMARY
Post-abortion care (PAC) — the treatment of complications from both safe and unsafe abortions, combined with family planning counselling and provision — is an essential component of SRHR services that UNFPA supports regardless of the legal status of abortion in a given country. An estimated 45 per cent of all abortions globally are unsafe (approximately 25 million annually), with the vast majority occurring in LMICs with restrictive abortion laws. Unsafe abortion causes approximately 4.7–13.2 per cent of maternal deaths and is a leading cause of maternal morbidity (haemorrhage, infection, infertility).
PAC is less politically contested than abortion provision itself because it treats the consequences of abortion that has already occurred. WHO, UNFPA, and the broader SRHR community have advocated for PAC as a minimum standard that should be available in all health systems, regardless of abortion law. The PAC model includes five elements: treatment of complications, family planning counselling and services, community partnerships for prevention, evaluation of sexual violence, and referral for other reproductive health services.
UNFPA supports PAC through health worker training (use of manual vacuum aspiration and misoprostol for incomplete abortion), commodity procurement, integration into EmONC and SRHR services, and advocacy for PAC as part of the MISP in humanitarian settings.
KEY FACTS
- Unsafe abortions globally: Approximately 25 million annually; 97% in LMICs (Lancet/WHO 2017)
- Maternal deaths from unsafe abortion: Approximately 4.7–13.2% of all maternal deaths (WHO)
- PAC five elements: (1) Treatment of incomplete/unsafe abortion complications; (2) FP counselling and services; (3) Community partnerships; (4) Evaluation of other RH conditions; (5) Assessment for sexual violence
- Treatment methods: Manual vacuum aspiration (MVA) and misoprostol are WHO-recommended for treatment of incomplete abortion; sharp curettage is outdated but still used in some settings
- FP after PAC: Women presenting for PAC have immediate contraceptive need; providing FP at the same visit prevents repeat unintended pregnancy
- Legal context: PAC is legal everywhere — it is treatment of complications, not provision of abortion
- MISP inclusion: PAC is an explicit component of the MISP for reproductive health in emergencies
- Misoprostol: Heat-stable, inexpensive medicine for treatment of incomplete abortion and postpartum haemorrhage; UNFPA procures and distributes
DETAIL
UNFPA's PAC work operates within its broader maternal health and SRHR framework. Training health workers in MVA and medical management of incomplete abortion (misoprostol) ensures that women experiencing complications receive timely, evidence-based care rather than delayed referral or inappropriate surgical intervention.
The integration of FP into PAC visits is a critical quality indicator — women who receive contraception at the time of PAC are significantly less likely to experience repeat unintended pregnancy. PAC visits therefore serve as both a treatment opportunity and an FP access point.
In humanitarian settings, PAC is included in the MISP — ensuring that women experiencing complications from abortion have access to life-saving care even in emergencies.
SOURCES
- WHO: "Safe abortion: technical and policy guidance for health systems" (2012, updated 2022)
- Ganatra, B. et al.: "Global, regional, and subregional classification of abortions by safety" (Lancet, 2017)
- PAC Consortium: Post-Abortion Care model documentation
- UNFPA: MISP technical guidance — PAC component
RELATED DOCUMENTS
- UNFPA-C-02 (UNFPA and Abortion)
- UNFPA-W-01 (Maternal Health)
- UNFPA-W-04 (MISP)
- UNFPA-W-14 (EmONC)
- UNFPA-E-05 (Guttmacher-Lancet Commission)