WHO issues new guidance on abortion (9 March 2022): Part 1

The World Health Organization (WHO) has recently issued new guidance on abortion. This article briefly presents the key messages from the guidelines.

Background Information:

Gestational age (duration of pregnancy): The number of days or weeks since the first day of the woman’s last normal menstrual period (LMP) in women with regular cycles. For women with irregular cycles or when LMP is unknown, gestational age is the size of the uterus, estimated in weeks, based on clinical examination or ultrasound, that corresponds to a pregnant uterus of the same gestational age dated by LMP.

Mandatory waiting period: A requirement imposed by law or policy, or in practice, to wait a specified amount of time between requesting and receiving abortion care.

Medical methods of abortion (medical abortion): Use of pharmacological agents to terminate a pregnancy.

Miscarriage (spontaneous abortion): Spontaneous loss of a pregnancy prior to 24 weeks’ gestation (before the fetus is usually viable outside the uterus).

Regulation of abortion: All formalized laws, policies and other instruments (e.g. facility level protocol) that regulate pregnancy and abortion.

Surgical methods of abortion (surgical abortion): Use of transcervical procedures for terminating pregnancy, including vacuum aspiration, and dilatation and evacuation (D&E).

Key Messages:

Abortion Regulation

  1. Criminalization

Recommend full decriminalization of abortion.

Decriminalization means removing abortion from all penal/criminal laws, not applying other criminal offences (e.g. murder, manslaughter) to abortion, and ensuring there are no criminal penalties for having, assisting with, providing information about, or providing abortion, for all relevant actors.

2. Grounds-based approaches

Recommend against laws and other regulations that restrict abortion by grounds.

Recommend that abortion be available on the request of the woman, girls or other pregnant person.

Grounds-based approaches to restricting access to abortion should be revised in favour of making abortion available on the request of the woman, girl or other pregnant person.

3. Gestational age limits

Recommend against laws and other regulations that prohibit abortion based on gestational age limits.

Pre-Abortion

  1. Mandatory waiting periods

Recommend against mandatory waiting periods for abortion.

2. Third-party authorization

Recommend that abortion be available on the request of the woman, girl or other pregnant person without the authorization of any other individual, body or institution.

3. Rh isoimmunization for abortion at gestational ages <12 weeks

For both medical and surgical abortion at <12 weeks Recommend against anti-D immunoglobulin administration.

4. Antibiotic prophylaxis for surgical and medical abortion

For surgical abortion, regardless of the individual’s risk of pelvic inflammatory infection: Recommend appropriate prophylactic antibiotics pre- or perioperatively.

For medical abortion: Recommend against the use of prophylactic antibiotics.

5. Determining gestational age of pregnancy: pre-abortion ultrasound scanning

For both medical and surgical abortion: Recommend against the use of ultrasound scanning as a prerequisite for providing abortion services.

6. Provider restrictions

Recommend against regulation on who can provide and manage abortion that is inconsistent with WHO guidance.

Useful Links:

Link to related WHO news release:

https://www.who.int/news/item/09-03-2022-access-to-safe-abortion-critical-for-health-of-women-and-girls

Link to the new guidance documents:

https://www.who.int/publications/i/item/9789240039483

2 thoughts on “WHO issues new guidance on abortion (9 March 2022): Part 1

  1. Pingback: WHO issues new guidance on abortion (9 March 2022): Part 2 | communitymedicine4all

  2. Pingback: WHO issues new guidance on abortion (9 March 2022): Part 3 | communitymedicine4all

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