Safe Motherhood/ Abortion

SAFE MOTHERHOOD
 
OVERALL OBJECTIVE - Reduce maternal mortality and morbidity by providing quality MNCH service.
 
BRIEF SUMMARY -
According to the WHO, reproductive health problems account for more than one third of the total burden of disease in women. An estimated 40% or more of pregnant women (about 5 million each year) experience pregnancy- related problems (morbidities) during or after child birth. 50% of these women suffer serious from debilitating complications such as uterine prolapsed, fistulae, pelvic inflammatory disease, and infertility. The rationale for integrating safe motherhood is to enhance the health of the mothers and infants for the well being of the community. The major activities are ANC, Postnatal care, immunization and skilled delivery services.
 
SAFE ABORTION
 
OVERALL OBJECTIVE - Contribute to the national reduction of abortion-related maternal morbidity & mortality, particularly among the young.
 
BRIEF SUMMARY -
Unsafe abortion is one of the key contributors of maternal mortality in Ethiopia and accounted for up to 32% of maternal deaths in the country (EDHS 2005). The Ethiopian Criminal Code of 2005 authorized and ensured increased access to safe abortion services for women. Termination of pregnancy is now legal when the pregnancy results from rape or incest, when continuation of the pregnancy endangers the health or life of the woman or the fetus, in cases of fetal impairment, for women with physical or mental disabilities, for minors who are physically or psychologically unprepared to raise a child and in cases of grave and imminent danger that can be averted only through immediate pregnancy termination. These are major changes from the previous law, which permitted safe abortion.
 
Additionally, the Ministry of Health issued technical and procedural guidelines in 2006 G.C for the provision of safe abortion services using Manual Vacuum Aspiration (MVA) and the combined regimen of misoprostol and mifepristone. However access to safe abortion services remains very low. One major strategy to reduce unsafe abortion related maternal mortality is to make safe abortion services as widely available as possible. The new technologies, mainly medication abortion offer the advantage to take safe abortion services to the most remote areas, at the lowest levels of the health care system.
 
As a result, the Family Guidance Association of Ethiopia (FGAE) has committed itself to improving access and utilization of comprehensive abortion care services through its network of clinics and youth centres.
 
CASE STORIES -
 
1. A 14 years old girl who came from Tigray, came to our clinic seeking help. She was raped by her sister’s husband one month ago, but she kept the case secretly and did not report on time. The girl had started showing some symptoms, her sister suspected and brought her to our clinic and her result showed pregnancy. As a result, CAC service was done and additional counseling and treatment was also given, which was a success.
 
2. A 16 years old girl came to Dire Dawa Youth Center complaining absence of menstruation, nausea and vomiting. According to her history she explained that her boyfriend was much older than her. He told her that he had a permanent contraceptive method. He also showed medical certificate that shows negative result for STI and HIV. As she said, she believed the man and started unsafe sex with him. For the first four months she was ok, however, when she felt the above mentioned symptoms she suspected pregnancy. She also tried to discuss the issue with her boyfriend but he considered as a simple thing and ignored her.
 
Physical examination was carried out and urine test for pregnancy was ordered. The Lab result showed that the girl was positive for pregnancy. Then, the young girl requested for the termination of her unwanted pregnancy. Medical abortion was given to her and the procedure was also successful.
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