Simplifying access for patients
Termination of pregnancy is a safe and effective medical act, usually managed with tablets (medication abortion) or a minor intervention under local anesthesia (manual vacuum aspiration, or MVA). Both of these abortion methods are less risky than an injection of penicillin.
Medication abortion involves two drugs, mifepristone and misoprostol, and a total of only five pills. It is often the preferred method for women, as it is less invasive and can be started as an outpatient and completed in the privacy of one’s own home.
Doctors are not necessary to provide these services; midwives and nurses can provide both of these abortion methods in hospitals and health centers alike, as long as they have the skills.
Even so, in places where health services are stretched, providers can benefit greatly from additional support—further training, institutional backing, mentoring, and guidance. In Rustenburg, South Africa, this is an important component of nurse Kgaladi Mphahlele’s work as a Choice of Termination of Pregnancy Manager on behalf of MSF. The district health service is committed to providing safe abortion care, but staff can be unsure of correct methods and protocol.
Some staff also need moral support in the face of judgment and stigma from colleagues in the workplace. Even knowing the importance of safe abortion care, many health providers—including MSF— must confront their personal attitudes toward providing this care. Peer support is important.