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PRIORITYMEASURE42
“Ensure, in those caseswhere abortion is legal or decriminalizedunder the relevant national legislation, the availability of safe, good-quality abortion services
forwomenwithunwanted andunacceptedpregnancies, and urge all other States to consider amending their laws, regulations, strategies
and public policies relating to the voluntary termination of pregnancy in order to protect the lives and health of women
and adolescent girls, improve their quality of life, and reduce the number of abortions.”
Possible lines of action
1. Establish the necessarymechanisms to provide timely, safe, accessible and readily available abortion services for all womenwho need
them (in caseswhere abortion is legal or decriminalized); 2. Ensure the necessary conditions for applying the different legal provisions in
each context, including the tools needed for interpreting them in accordance with international human rights frameworks; 3. Ensure that
services for the voluntary termination of pregnancy are available at the primary care level and have referral systems when necessary;
4. Encourage abortion to be performedwithmedications andwithmanual vacuum aspiration (MVA); 5. Ensure that information on legal
abortion and the prevention of unsafe abortion is available to allwomen; 6. Establish protocols for health service providers to develop the
skills needed to detect and respond to situations involving the coercion or oppression of women so as to avoid abortion against their will
(for example, based on their health status, such as living with HIV); 7. Eliminate all regulatory, policy, programme, administrative and
cultural barriers that impede access to timely and risk-free abortion care; 8. Ensure that the legal framework eliminates the adverse
impact of conscientious objection on the provision of SRH services, and abortion in particular; 9. Promote counselling on contraception
and provide contraception methods in the context of abortion care; 10. Encourage the prevention of unwanted pregnancy, including
emergency contraception, and the prevention of unsafe abortion; 11. Guarantee, regardless of the legal context, that women subjected to
unsafe abortions receive timely and good-quality care to reduce the morbidity and mortality associated with complications;
12. Strengthenhealth institutions and ensure that there are sufficient providers of these services so as to eliminate unsafe abortion.
Targets
1. Reduce to zero the rates of maternal morbidity and mortality due to abortion; 2. Existence of standards and protocols on the use of
medical abortion medications for all instances of abortion allowed under the law; 3. All primary health care centres have implemented
updated service protocols for the voluntary termination of pregnancy (in cases where abortion is legal or decriminalized in national or
local legislation); 4. All health centres (including primary care establishments) have implemented care protocols for unsafe abortion and
havematerials, inputs and providers duly trained to deliver this service.
Tentative indicators
1. Number of maternal deaths due to abortion; 2. Number of hospitalizations resulting from complications arising after abortion, by age
group; 3. Number of women making use of legal and safe abortion services; 4. Percentage of unplanned births disaggregated by age
group; 5. Percentage of health centres (including primary care establishments) that have implemented updated protocols to treat the
complications arising from unsafe abortion; 6. Percentage of health centres (including primary care establishments) that havemedications
for abortion and trained personnel andmaterials for carrying out safe abortions and providingpost-abortion care.
Related instruments,
forums andmechanisms
1. SDG3, “Ensure healthy lives andpromotewell-being for all at all ages”; target 3.1: “By 2030 reduce the globalmaternalmortality rate to
less than 70 per 100,000 live births;” 3.7: “By 2030 ensure universal access to sexual and reproductive health care services, including for
family planning, information and education, and the integration of reproductive health into national strategies and programmes;” 2. Santo
Domingo Consensus, C78: “Ensure, in cases where abortion is legal or decriminalized in national legislation, the existence of safe, good-
quality abortion services for women with unwanted and unaccepted pregnancies;” 3. Brasilia Consensus, 6f: “Review laws that punish
womenwho have undergone abortions, as recommended by the Platform for Action of the FourthWorldConference onWomen, including
the further initiatives and actions identified for the implementation of the Beijing Declaration and Platform for Action, as well as the
ProgrammeofActionof the InternationalConferenceonPopulation andDevelopment and thegeneral observations of theCommitteeagainst
Tortureof theUnitedNations, and ensure that abortions areperformed safelywhere authorizedby the law.”
Comments
1. This measure is complementary to PM 37 on access to comprehensive SRH services, PM 40 onmaternal mortality, on PM 14 which
addressed, among other things, unsafe abortion in chapterB’s reference group (children, adolescents andyoungpeople).
