Unsafe abortion is one of the top five causes of maternal mortality, along with post-partum hemorrhage, sepsis, complications from delivery, and hypertensive disorder. Together these five causes are responsible for nearly 75 percent of maternal death worldwide.
The consequences of unsafe abortion are a medical issue. We have seen time and time again that many women resort to unsafe abortion methods when safe abortion care is not accessible, in spite of the considerable risks. Unsafe abortions often result in serious health problems and death.
According to the World Health Organization, about 22 million unsafe abortions are performed every year. This means they are performed by persons lacking the necessary skills or in an environment lacking the minimal medical standards. The WHO estimates that 47,000 women and girls die every year and another 5 million sustain disabilities due to unsafe abortion. However, the full picture of the consequences of unsafe abortion is unknown because many women and girls are unable to seek medical care afterward and no one knows how many die.
It is MSF's policy to provide contraceptives and safe abortion care as part of our response to women’s and girls' health needs.
Does MSF provide birth control and abortions as part of your programs? What are your criteria?
MSF policy includes the provision of contraceptives and safe abortion care as part of the response to women’s and girls' health needs. Unwanted pregnancy and unsafe abortion contribute significantly to ill health and mortality among girls and women. Unsafe abortion is one of the main causes of maternal mortality worldwide. Contraceptives are offered in all relevant projects and whenever local considerations allow it.
The treatment of abortion-related complications and the termination of pregnancy to save a woman from a life-threatening complication are part of all MSF obstetric care.
The decision on whether to provide termination of pregnancy on request at a specific project is taken very carefully — the safety of patients and staff is our first concern. The relevant laws, customs and perceptions have to be considered on a case by case basis.
What is your position on abortions?
MSF does not have a political position on abortions. We see the consequences of unsafe abortion as a medical issue: unsafe abortions cause suffering and death and contribute to the overall burden of ill health.
Do you provide abortions in all of your programs? What about in countries where abortion is illegal?
Our aim is to reduce suffering and death in places that are affected by conflict and crisis. If the life of the mother is threatened, the physician must come to a decision with the patient or her family.
If the life of the mother is not immediately in danger, but she wants to terminate her pregnancy for whatever reason, MSF weighs all the relevant factors and decides whether or not we can offer safe abortion care. This can be a difficult decision because we have seen time and time again that in the absence of safe abortion care women will seek to terminate an unwanted pregnancy by other means, and unsafe abortions very often lead to more suffering and even death. However, providing this service in some places can present a risk to patients and staff. We assess the risks to our patients and staff in order to make this decision. The relevant laws, customs and perceptions have to be considered on a case by case basis.
Do you have a policy on when you can perform an abortion (weeks into pregnancy)?
Termination of pregnancy on request in MSF projects is supported until the end of the first trimester. Termination of pregnancy at a later gestational age may be considered in exceptional cases.
Does MSF provide the morning after pill?
Yes. When a girl or woman approaches MSF with the fear of being pregnant, as result of forced sex, sexual violence, failure of a contraceptives or any other reason, MSF will assess if emergency contraception is an option and provide it if it is the choice of the patient.
Does MSF encourage abortion for any other reason that for the health of the woman?
MSF does not encourage abortion at all. The termination of pregnancy is solely the choice of the woman or girl. MSF does not have abortion as an objective; MSFs objective is to prevent the consequences of unsafe abortion. Given all evidence, women who decide that they cannot keep a pregnancy will find a way to terminate this pregnancy, even if this will put their life at risk. MSF aims to reduce the consequences of unsafe abortion.
To work with MSF do doctors in the field have to be willing to perform abortions?
MSF staff members have to understand and agree with the MSF policy for reproductive health, including the policy on abortion. It is, however, the personal choice of each medical professional to perform or not to perform an abortion. Medical staff who personally do not want to perform an abortion are not excluded from MSF - they are assigned to positions where it is not required for them to perform an abortion.