Decreasing the risk of unsafe abortion in Peru through harm reduction

In Peru, abortion is illegal unless the life or health of the woman is at risk. This leads some women to seek care from clandestine providers or attempt to self-induce abortion in ways that may be unsafe or ineffective. Throughout Latin America, it’s estimated that unsafe abortion is responsible for up to 20% of maternal deaths. A new study from ANSIRH, Ibis Reproductive Health, International Planned Parenthood Federation and Instituto Peruano de Paternidad Responsable (INPPARES) tested a way to guide women to safer abortion options within restrictive legal limits.

INPPARES is a non-profit clinic that began offering a harm-reduction model for women seeking to terminate a pregnancy. Trained counselors informed patients that misoprostol – a drug that is relatively accessible in Peru – can be used safely to induce abortion. Counsellors asked patients if they wanted a follow-up appointment and would schedule one either in-person or over the phone.

The vast majority of the women in this study took misoprostol correctly and terminated their pregnancies. Only two women interviewed reported a serious complication, in this case being hospitalized to treat an infection. INPPARES began offering telephone follow-up to make it easy and accessible for women, and women who received either kind of follow-up reported high levels of satisfaction. The most common challenge was difficulty obtaining the drug, most often because a pharmacy wouldn’t sell it or required a physician’s prescription.

Medical professionals in countries with highly restrictive abortion laws can use this type of harm-reduction approach to better serve their patients and decrease the risks associated with unsafe abortion.

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