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ARMENIA: A WAY TO MAKE ABORTION SAFER
January 9, 2013 - 2:10pm, by Ingrida Platais
Armenia
EurasiaNet's Weekly Digest
Armenian Politics
Health
Reproductive Rights
EurasiaNet Commentary
In Armenia, abortion is widely available, but women continue to undergo
riskier means of terminating unwanted pregnancies. A major problem
is that a well-established alternative method, which is recommended
by the international medical community, is underutilized.
There are two methods of abortion available in Armenia. The most
commonly known method is a surgical procedure performed in a clinic or
a hospital. But this option carries some risk for women. In Armenia,
most surgical procedures are performed using outdated protocols and
older model aspirators. Women are also administered general anesthesia,
and providers are not trained in current cervical priming techniques
appropriate for later first- and second- trimester abortions
Another option is medical abortion, using two drugs, mifepristone
and misoprostol, to terminate unwanted pregnancy. This method has
been proven to be safe and acceptable. The combination of these two
drugs produces an effectiveness rate of up to 98 percent for abortions
occurring up to nine weeks after the most recent menstrual period,
according to a World Health Organization (WHO) technical and policy
guidance published in 2012.
In countries where mifepristone is not available, women have been using
misoprostol alone to induce abortions since it first became available
for the treatment of peptic ulcers in the 1980s. The first documented
case study was conducted in Brazil, where in the late 1980s and 90s
women seeking abortions were able to purchase misoprostol at pharmacies
without restrictions. Today, in many Latin America countries, where
stringent anti-abortion laws restrict women's access to abortion
in a clinic, misoprostol is a widely available option for women who
otherwise would be forced to seek more risky abortions.
Although misoprostol alone is not as effective when used without
mifepristone, it is still from 75 percent to 90 percent effective in
terminating pregnancy.
In late October, EurasiaNet.org reported that a significant number
of Armenian women appear to be turning to pharmacies for misoprostol
in order to conduct 'do-it-yourself' procedures. There is no evidence
that shows women are unable to abort at home safely. Research conducted
by Gynuity Health Projects has shown that women are able to follow
instructions, and prefer medical abortion in the home for reasons of
privacy and comfort.
The WHO and the government of Armenia have endorsed the home use
of misoprostol in their official guidelines. In 2010, the Republic
of Armenia's Ministry of Health issued abortion guidelines, titled
"Clinical Guideline on Organizing and Providing Health Care on Medical
Abortion," which recommend a mifepristone and misoprostol regimen for
first trimester abortion, and includes home use of misoprostol. If
substantial numbers of Armenian women are truly attempting to end
their pregnancies without consulting a doctor (as the EurasiaNet
article notes - no official data exists), then efforts need to be
made to educate women and pharmacists about the correct regimen,
and the importance of consulting a doctor before taking action.
A recent survey on abortion practices in Armenia indicates that some
health-care providers were aware of medical methods of abortion and
were making mifepristone and misoprostol available to women before
abortion pills were officially available. Medical abortion using the
two-drug regimen became available in Armenia in 2007. Unfortunately,
access to this method today is not as wide as it could be, and there
are no comprehensive national education campaigns in Armenia to inform
women about medical abortion using mifepristone and misoprostol.
Medical abortion is a safe, alternative method to surgical abortion
regardless of whether a woman administers pills at home, or in a
hospital. It is important that providers are trained in evidence-based
clinical guidelines and that they are able to provide abortion services
that respect women's dignity, privacy, and choice.
Editor's note: Ingrida Platais is Research Program Coordinator at
Gynuity Health Projects.
http://www.eurasianet.org/node/66376
January 9, 2013 - 2:10pm, by Ingrida Platais
Armenia
EurasiaNet's Weekly Digest
Armenian Politics
Health
Reproductive Rights
EurasiaNet Commentary
In Armenia, abortion is widely available, but women continue to undergo
riskier means of terminating unwanted pregnancies. A major problem
is that a well-established alternative method, which is recommended
by the international medical community, is underutilized.
There are two methods of abortion available in Armenia. The most
commonly known method is a surgical procedure performed in a clinic or
a hospital. But this option carries some risk for women. In Armenia,
most surgical procedures are performed using outdated protocols and
older model aspirators. Women are also administered general anesthesia,
and providers are not trained in current cervical priming techniques
appropriate for later first- and second- trimester abortions
Another option is medical abortion, using two drugs, mifepristone
and misoprostol, to terminate unwanted pregnancy. This method has
been proven to be safe and acceptable. The combination of these two
drugs produces an effectiveness rate of up to 98 percent for abortions
occurring up to nine weeks after the most recent menstrual period,
according to a World Health Organization (WHO) technical and policy
guidance published in 2012.
In countries where mifepristone is not available, women have been using
misoprostol alone to induce abortions since it first became available
for the treatment of peptic ulcers in the 1980s. The first documented
case study was conducted in Brazil, where in the late 1980s and 90s
women seeking abortions were able to purchase misoprostol at pharmacies
without restrictions. Today, in many Latin America countries, where
stringent anti-abortion laws restrict women's access to abortion
in a clinic, misoprostol is a widely available option for women who
otherwise would be forced to seek more risky abortions.
Although misoprostol alone is not as effective when used without
mifepristone, it is still from 75 percent to 90 percent effective in
terminating pregnancy.
In late October, EurasiaNet.org reported that a significant number
of Armenian women appear to be turning to pharmacies for misoprostol
in order to conduct 'do-it-yourself' procedures. There is no evidence
that shows women are unable to abort at home safely. Research conducted
by Gynuity Health Projects has shown that women are able to follow
instructions, and prefer medical abortion in the home for reasons of
privacy and comfort.
The WHO and the government of Armenia have endorsed the home use
of misoprostol in their official guidelines. In 2010, the Republic
of Armenia's Ministry of Health issued abortion guidelines, titled
"Clinical Guideline on Organizing and Providing Health Care on Medical
Abortion," which recommend a mifepristone and misoprostol regimen for
first trimester abortion, and includes home use of misoprostol. If
substantial numbers of Armenian women are truly attempting to end
their pregnancies without consulting a doctor (as the EurasiaNet
article notes - no official data exists), then efforts need to be
made to educate women and pharmacists about the correct regimen,
and the importance of consulting a doctor before taking action.
A recent survey on abortion practices in Armenia indicates that some
health-care providers were aware of medical methods of abortion and
were making mifepristone and misoprostol available to women before
abortion pills were officially available. Medical abortion using the
two-drug regimen became available in Armenia in 2007. Unfortunately,
access to this method today is not as wide as it could be, and there
are no comprehensive national education campaigns in Armenia to inform
women about medical abortion using mifepristone and misoprostol.
Medical abortion is a safe, alternative method to surgical abortion
regardless of whether a woman administers pills at home, or in a
hospital. It is important that providers are trained in evidence-based
clinical guidelines and that they are able to provide abortion services
that respect women's dignity, privacy, and choice.
Editor's note: Ingrida Platais is Research Program Coordinator at
Gynuity Health Projects.
http://www.eurasianet.org/node/66376