POST ABORTION CARE (PAC

)
Definition Post abortion care is an approach for reducing morbidity and mortality from incomplete and unsafe abortion and its complications and for improving women's sexual and reproductive health and lives

Post abortion care and the international community
The international community recognizes unsafe abortion as a serious public-health problem Endorses the need to ensure women's access to PAC PAC can save women's lives and its an important part of any Safe Motherhood initiative. Numerous global agencies call on governments and health systems to take action to support the timely provision of PAC services, United Nations International Conference on Population and Development (ICPD), held in Cairo in 1994; Fourth World Conference on Women, in Beijing, China in 1995;

Components of post abortion care
first articulated by IPAS in 1991 The original PAC model had three components: Emergency treatment services for complications of spontaneous or unsafe abortion. Post abortion family planning counseling and services Links between emergency abortion treatment services and comprehensive reproductive health care

The expanded and updated post abortion care model
Adds partnership with the community as an essential element Counseling to identify and respond to women's emotional and physical health needs and other concerns Treatment of incomplete and unsafe abortion and complications that are potentially life-threatening Contraceptive and family planning services to help women prevent an unwanted pregnancy or practice birth spacing Linkage to reproductive and other health services that are Available in the hospital

The role of community participation
Education about the risks and consequences of unsafe abortion Participation by community members in decisions about which sexual and reproductive health services are offered Education about and promotion of human rights-based sexual and reproductive health services, including PAC Education to increase family planning and contraceptive use (preventing unwanted pregnancies and unsafe abortion) Education about the signs and symptoms of post abortion complications to promote appropriate care-seeking behaviors Mobilization of community resources to ensure that women suffering from incomplete abortion receive the care they need

Emergency post abortion care services
For treatment of incomplete and unsafe abortion Resuscitation Manual vacuum aspiration Antibiotics Blood transfusion Analgesia Laparotomy/laparoscopy

The aims of counseling:
Solicit and affirm women's feelings and provide emotional support Ensure that women receive appropriate answers to their questions Help women clarify their thoughts about their pregnancy, incomplete abortion, treatment, resumption of ovulation and reproductive health future Address other concerns women may have

post abortion family planning counseling and services
Ensure that patients receive information and counseling on post abortion contraception (including emergency contraception) before leaving the hospital. All methods of contraception can be considered for use after abortion Contraception should be started early after an abortion Diaphragm and cervical cap should be delayed till 6 weeks after a 2nd trimester abortion There is high risk of expulsion of intra uterine device and risk of infection if inserted at the time of 2nd trimester abortion. (delay for 3 months if infection is present).

Linkage to reproductive and other health services
: This encourages providing post abortion women with reproductive and other health services present in the hospital. STI/HIV prevention education, screening, diagnosis and treatment screening for sexual and/or domestic violence, and referral for medical/social/economic services and support infertility diagnosis, counseling and treatment nutrition education and hygiene cancer screening and referral, other health services

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