Medical abortion: A path to safe, high-quality abortion care in Latin America and the Caribbean

Abstract

Background Abortion rates in Latin America and the Caribbean (LAC) are nearly triple those in Western Europe, due to less use of contraception and highly restrictive abortion laws. Women resort to clandestine and often unsafe methods to end unwanted pregnancies, exposing themselves to the risk of complications and mortality. Medical abortion (MA) presents a safer alternative.

Objectives To present evidence of MA's contributions to reduced complications, describe strategies to enhance safe MA, and highlight existing barriers to access in LAC, while examining MA's role in newly legal abortion services.

Results Substantial declines in abortion-related morbidity and mortality and lower costs of treating complications are observed in LAC with MA than with other self-induction methods. Telephone hotlines, telemedicine and harm reduction models enhance access to safer abortion and help reduce complication rates by facilitating information on MA's proper use. Misoprostol is registered in most LAC countries, but access is increasingly limited by regulations and cost.

Conclusion Despite highly restrictive abortion laws in LAC, MA increases access to safer abortion. Yet, significant barriers remain and much more must be done to enhance use of modern contraceptive and safer abortion methods among women in the region.

Keywords:

• Abortion
• Medical abortion
• Latin America
• Caribbean
• Misoprostol
• Mifepristone

ACKNOWLEDGEMENTS

The authors thank Rayna Sobieski, Jennifer Britton and Kathryn Conkling for their assistance with preparation of the manuscript and figures.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and the writing of the paper.