When Beninese community leader Simon Gnansounou was first approached by volunteers from the Association Beninoise pour la Promotion de la Famille (ABPF) seeking support to provide abortion-related information and care in the town of Cocotomey-La Paix, he was sceptical. “I thought that it was to organize depravity,” the gregarious economist said at his small home office, surrounded by textbooks. “I was a bit suspicious at first!” Gnansounou, a highly respected figure in this close-knit neighbourhood, changed his mind after persistent attempts by young volunteers to reassure him they wanted to stop young girls from risking injury and death due to unsafe abortion. “The first goal is actually to help the young girls not to get pregnant,” he added. “It’s a project for social development, and I am all for that.” Men like Gnansounou are vital in ABPF’s work to fight abortion stigma in Benin, where 19 percent of births are unplanned and the rate of contraceptive use is around 9 percent of the population, according to the Guttmacher Institute. Stigma stops young women from seeking safe abortions and pushes them into the hands of unregulated witchdoctors or advice from friends without medical training. But support from partners, fathers and brothers is making a huge difference, even if they are nervous about discussing sexuality, which remains a taboo subject in Beninese families. “I have four daughters. I have never had the courage to talk about this with them,” Gnansounou said, shaking his head. “This is another chance, a chance that we cannot miss.” Student for change Amour, 21, is a student at the University of Abomey-Calavi and a self-declared former “player”. “I started having sex really young. When I was around 12,” he said. “My parents left me to work things out for myself. I had a lot of partners and we didn’t use condoms. I had no idea about that,” Amour adds. After joining the Young People’s Action Movement, which advocates for reproductive rights among people aged 10-25, Amour decided to abstain for sex for two years as he absorbed material about abortion, stigma and contraception on campus. When a friend confided that she was pregnant after he noticed her vomiting - the first signs of morning sickness - Amour offered his support. “Her friends told her to take laxatives and other products, to put things in her vagina, to wash with hot water, to move about a lot,” Amour said, shaking his head. “Thanks to the Youth and Abortion Stigma Project, I had benefited from training on how to talk to girls if they came to ask about abortion.” The student tried to act as a mediator with her family when she struck up the courage to tell her parents. “Her mum hit her when she told her she was pregnant,” he recalled. “She accused me of giving her bad advice.” Amour says he uses condoms with his own partner and feels freer to discuss sexuality than when he was younger. “When we talk about abortion in Africa, and especially in Benin, it’s something people don’t want to hear about. It’s not well seen,” he admits. That hasn’t stopped him from joining community outreach sessions in and around the capital, Cotonou, where he educates school children and young apprentices on their right to choose. Promoting choice For Kader, a 26-year-old ABPF youth champion, the effects of unsafe abortion and struggles with unintended pregnancy were “part of everyday life” in his neighbourhood. “A lot of young women I know got pregnant very early,” says Kader, who acts as a link between young people in schools and workplaces and the Association Beninoise pour la Promotion de la Famille (ABPF), in Cotonou. “I know people who have died because of unsafe abortion,” he adds, speaking at ABPF’s centre dedicated to young people, while organising a Twitter discussion focused on stigmatization. Before joining ABPF’s youth movement in 2011, he admits, he was quick to judge classmates and girls he knew who got pregnant early. Spending the greater part of his twenties learning of the effects of marginalizing young women in this way left him feeling a little ashamed. “The people I judged in the past made me think about my own behaviour, especially towards one female friend,” Kader explains, as volunteers began drifting in to the courtyard. When his aunt had an abortion, it quickly became public knowledge in the neighbourhood, and he remembers how she was treated. “She had a lot of problems. Everyone taunted her”. The day after a Twitter session at a school event, Kader gently argues with a teacher who says girls at his school are getting pregnant deliberately, so they can bunk off. Kader asks the group to think about decision making and family support, and how they might act differently if they had full ownership of their choices. “We can avoid so much of it if people have the right information.” Kader adds.  

Many women and girls in Benin who are considering an abortion tell no one. Since 2014, the Association Beninoise pour la Promotion de la Famille (ABPF) has been running a project, supported by the Packard Foundation, specifically aimed at tackling abortion stigma so that women and girls seeking a safe abortion can access the right information and services.   Some young women are making their own decision to end an unintended pregnancy safely at ABPF clinics and telling friends that help without judgement is available.   Choosing education   When 22-year-old economics student, Floriane*, missed a period and discovered she was pregnant, she says, “I couldn’t believe it; I was two months pregnant.” Floriane says she wasn’t ready to get pregnant and decided to have an abortion. She wanted to continue with her education and graduate.   At her follow-up appointment two months after the abortion, Floriane received a full health check and contraceptive advice. Floriane had heard about the ABPF clinic at an event on her campus in 2016 and joined the Young People’s Action Movement. “The other friends I have in the movement knew [about my abortion],” along with her boyfriend, she said. But her parents could not know what had happened. “I can’t talk about that with them,” she says. “They wouldn’t have taken that well. My dad had paid for my studies.”  Facing choices alone   Marielle, 27, only told her immediate family about her abortion, which she opted for after recent surgery left her feeling unable to carry a pregnancy to term.  “My extended family would not have agreed with it though,” she explains, “and neither would anyone at work. The judgement is very hurtful, and they won’t necessarily say it to your face, but Benin society is very tradition-bound,” the hospitality worker adds.   Since her abortion at the ABPF clinic, Marielle has acted as a confidante for a friend whose own family would be less than supportive of an abortion. “I’ve already told her about the services they offer here. Public hospitals don’t listen to you; they just judge you,” she said. Marielle says that she knows women from all sectors of society who have been attacked and criticized for having an abortion, a phenomenon she says is immune to social status. “No one is spared. It doesn’t matter how rich you are,” she notes.   Pregnancy outside of marriage in Benin is usually seen as incompatible with education, even though many young people remain at school well into their twenties.  Joceline* did not tell her father about her abortion. Her father supports her financially and she feared his response to her being pregnant and unmarried. “Then there is the neighbourhood, what would everyone else say if they knew I had an abortion?” she added, looking at the floor.   “I came here alone,” said Joceline, referring to the day she visited the ABPF youth clinic in Cotonou to end an unwanted pregnancy. “I preferred to come by myself so I wouldn’t expose myself to problems,” the 20-year-old apprentice tailor said. “The father couldn’t support the baby but he did ask a friend who knew about this place. That friend helped us.”   Fear of stigmatization pushes many young women to seek abortions with unsafe providers in Benin, including local witchdoctors, or to attempt to get end a pregnancy themselves. “Before, I was thinking about taking insecticide to get rid of the pregnancy,” Joceline says frankly.   Those who attend the ABPF youth group sessions say their experiences with the young volunteers have given them the confidence to open up about their abortion, and to not feel ashamed about their choice.   Tackling stigma and tradition   Stigmatization for social and religious reasons makes the work of medical professionals much more difficult, explains Souliya Mevo Tairou, a midwife at a youth-only ABPF clinic in Cotonou.   “Stigmatization complicates our work. Fourteen and 15-year-olds come here without their parents and it’s hard to work with them. The girls are so scared that they can’t really explain what’s happening to them,” she says. “They come here after going to the traditional healers when that hasn’t worked, and they are bleeding or have an infection.”   Unsafe abortions account for 15 percent of maternal deaths in Benin, according to hospital statistics.   The antidote, says Mevo Tairo, is the Young People’s Action Movement. “Here, with the Youth and Abortion Stigma Project, we have awareness sessions. The young people and those supervising give out their numbers and tell them to call if they have a problem. When one comes and is satisfied… they tell the others,” she adds. That creates whisper networks to carry the right information to women and girls in need.     *Names have been changed

After years of progressive change by activists, advocates and organizations, abortion in Nepal was finally legalized in 2002. Legalization, however, did not mean accessibility, especially to women and girls in hard-to-reach and rural areas. That is until medical abortion became an option.  Since being introduced in 2009, medical abortion (the abortion pill), is revolutionizing how women access abortion care with almost half of the abortions performed in Nepal are through the medical procedure. Through clinics, outreach programmes, workshops and peer educators, our Member Association, Family Planning Association of Nepal are ensuring women and girls in hard-to-reach and rural areas know their abortion care options.

International Planned Parenthood Federation (IPPF) today launched a new report on global medical abortion access as an urgent call to action. The Her in Charge report presses governments, health, academic and NGO sectors to take immediate steps to stop women from dying and suffering disabilities due to an unsafe abortion by radically scaling up medical abortion efforts. Nearly one in every two abortions that occur is unsafe – 25 million women each year are forced to find their own, often dangerous, solutions to an unintended pregnancy. The knowledge, the technology, and the experience to make all abortions safe abortions exist. Yet tens of millions of women each year still lack access to completely safe abortions. Medical abortion – the use of the medicines misoprostol alone or in combination with mifepristone to opt out of a pregnancy – is safe, cheap and simple to administer. Dr Alvaro Bermejo, IPPF Director General said: “Medical abortion is not new, but its full potential has not been reached due to the lack of action and prioritisation by governments, donors, medical professionals and private and civil society health providers. The fact we’ve had this technology for so long but is still not as accessible, is a global tragedy.   The report shows that medical abortion has the potential to revolutionise the delivery of safe abortion globally. Without medical abortion, women are denied proper care.They should not be forced to take risks with their health. For all abortions to be a safe abortion, action is needed now”. IPPF’s Her In Charge report demonstrates how medical abortion access can exponentially increase access to safe abortion, enabling women to be in charge about the decisions about their bodies. An essential part of women’s rights.  Medical abortion facilitates task-sharing, which is transformational in low-resource settings where primary-care level and lay workers are trained and equipped to administer abortion.   Key recommendations: Governments should create a supportive environment to ensure women can access safe and legal abortion, including the political, social, economic, health and legal frameworks.   Medical abortion should be embedded in health systems. Governments can ensure the quality, availability and affordability of medical abortion drugs by registering misoprostol and mifepristone in the list of essential medicines of their countries.   Women must be supported by health systems in accessing the information they need to have a medical abortion safely and to access post-abortion care. This includes medical abortion without medical supervision. Health systems should include self-administered medical abortion. Women must have full information about medical abortion risks factors, dosage and have access to post-abortion care and contraception.   Women must have all options available to them: either medical or surgical abortion, in a health facility or at home – whatever they prefer. It is their right.   The full report can be found here. More information on the 'I decide' campaign can be found here.

The International Planned Parenthood Federation today launched www.MedAb.org – the Medical Abortion Commodities Database, which houses information on the availability of quality misoprostol, mifepristone and co-packaged mifepristone and misoprostol (combipacks) at national level.  The www.MedAb.org database is a resource for public health professionals seeking information to inform policy and use in reproductive health care programmes. These include public health and service delivery managers, staff involved in safe abortion programmes, donors funding projects on safe abortion and maternal health, policy analysts, clinical service providers and supply chain logisticians. IPPF worked closely with Gynuity Health Projects and Concept Foundation to develop this database to help increase the availability of and access to safe abortion care.  www.MedAb.org includes information on brands of mifepristone, misoprostol or combipacks that are registered and available in a country and – for brands of misoprostol and combipacks – have sufficient and objective evidence to indicate they are of good quality.  Dr Alvaro Bermejo, IPPF Director-General, said: “A woman controlling her body is a woman controlling her life and building her future. Access to safe and legal abortion saves lives. This means working to enable those on the frontline to give women more options when they need it most. We are delighted to launch this database. It will enable those working on safe abortion to identify, select and procure quality commodities that can be used to provide women with safe medical abortion services.”  The database provides collated information on the products that are available in each country. It does not provide counselling, clinical assessments, dosing regimens or other information that is essential for a quality medical abortion service as defined and implemented by IPPF.   As a leading advocate and service provider for safe and legal abortion, IPPF has compiled a list of resources and guidance to complement the database related to global abortion laws and policies, WHO guidelines on safe abortion and access to other organizations working to make abortions safe. Links to these resources are available in the External Resources section of www.MedAb.org.   The database initially includes information on medical abortion commodities in 89 countries; it will be updated regularly with information on commodities in additional countries, and to reflect changes as necessary. IPPF welcomes feedback, information and updates on the availability of quality medical abortion commodities.  For more information, or to provide feedback and updates, please contact [email protected].

Globally, an estimated 25 million unsafe abortions occur every year, with 97 per cent of those in developing countries in Africa, Asia and Latin America, most with restrictive abortion laws. In the past decade, however, abortions have become safer, largely due to the increasing use of medical abortion with mifepristone and misoprostol. Wider availability of these medical abortion commodities – especially misoprostol – has improved women’s access and contributed to provision of services beyond health facilities. Although medical abortion is most effective with a combined regimen of mifepristone and misoprostol, mifepristone is not as widely available as misoprostol, and many abortions are carried out safely using misoprostol only.  Misoprostol is prone to rapid degeneration when exposed to humidity and moisture. There have been anecdotal and documented reports of poor quality misoprostol used in some settings, which can result in a range of complications including continued pregnancy, bleeding or retained products of conception. Quality assurance of safe abortion drugs is often neglected, and there are very few internationally quality assured misoprostol products. IPPF recognized that there was no single, searchable place with country-level information on medical abortion commodities. While the incidence of medical abortion is increasing, service providers and procurement personnel face challenges in knowing which misoprostol brands to procure for safe medical abortion at the country level.  As a global advocate for and provider of safe and legal abortion services, IPPF decided to fill this knowledge gap and contribute to the global efforts to increase women’s access to safe abortion. Recognizing that such a big undertaking could not be done in isolation, we partnered with Gynuity Health Projects and Concept Foundation, and sought collaboration from many other organizations working on safe abortion. Together, we determined the availability and quality of medical abortion commodities around the world and set out to find a ‘home’ for this valuable information.  The result is IPPF’s new Medical Abortion Commodities Database, which houses information on the availability of quality misoprostol, mifepristone and combined packs of both drugs at the country level. It is a resource for public health professionals looking for information to use in reproductive health care programmes, and to inform policy. It provides a single place to find this important information, in an easy-to-navigate website. People can search by country, commodity type and/or brand name, from their desktops, tablets or smartphones. Only the misoprostol brands with sufficient evidence of quality are included on the site.  IPPF hopes that the information provided on the database will inform everyone working on safe abortion to identify, select and procure quality commodities to provide safe medical abortion services. We also see the database as having a role to play in shaping policy and identifying where to invest resources and efforts to increase availability of quality medical abortion commodities. IPPF hopes that the external interest in and support for this database continues and that we can update it on an ongoing basis with new information that is shared with us. 

Watch our surgical abortion explainer video to find out more about the procedure. Please note this is a brief overview of surgical abortion. Contact your local healthcare provider to discuss further details and options available to you.

Ever wonder how medical abortion also known as the 'abortion pill', works? In this explainer video, we go through the steps of what to expect during a medical abortion. Please note that this video is an overview of the procedure. For further details on medical abortion, contact your local healthcare provider.

The Global Comprehensive Abortion Care Initiative (GCACI) improves access to quality abortion care and contraception in IPPF Member Association clinics. Launched in 2008, GCACI is now in its 10th year of supporting IPPF Member Associations through training to build staff skills and expertise, clinic strengthening to ensure quality of care, community awareness raising and education, and abortion stigma reduction. No refusal policy The Parivar Swasthya Kendra (PSK) clinic outside Mumbai sees a wide range of clients from the underserved communities in the district. The Family Planning Association of India (FPAI) opened the clinic at the request, and need, of a local fisherwomen’s group. The clinic is supported by IPPF’s Global Comprehensive Abortion Care Initiative  (GCACI), which celebrates its 10th anniversary this year. The clinic is in Bhiwandi, on a busy street surrounded by slums, shops and factories.  Konika* is 20 years old, and mother of three. Like many local young women, she decided to have an abortion when she became pregnant for the fourth time within five years, citing financial issues as the driving force behind her decision. Through a neighbour, Konika approached the PSK clinic in Bhiwandi for an abortion. Because of the clinic, she now feels many young women now have the power to choose to be pregnant or not. The clinic has a “no refusal” policy, ensuring that all women are provided with care in the clinic, irrespective of their ability to pay This has helped to build trust with local women who come long distances to seek an abortion and contraceptive services.  The clinic serves a large population of migrants and a community of sex workers.    “These women are my flesh and blood” FPAI works with a network of volunteer link workers, who disseminate information about services available in the PSK clinic, make referrals, and often accompany women to the clinic for support. One of these link workers is Rekha. Rekha says: "I have been involved with PSK for five years. And today I can proudly say that since the first awareness campaigns, there has been not a single death in the village due to an unsafe abortion." She adds: "These women are my flesh and blood. They know I only want the best for them… Within our communities we spread the message of safe sex and safe abortion through songs and skits which are easily understood. And I think the trick is to include mother-in-laws in our work. We have a high success rate in providing safe abortion care.” Shajahan Khan is a link worker in the nearby Muslim district, where women pack into a house in the narrow village lanes to wait to speak to her.  She says: "I am a Muslim. In my community, abortion is frowned upon, and contraception is considered a sin." "Initially, the women thought I was going against our customs, and the men thought I was a bad influence on their wives. Some of the men in our area even approached my husband and asked him to order me to stop these efforts." But Khan's husband was supportive, telling other men that it was also their responsibility to be part of the process. It took several years, but eventually, Khan won the trust of the women and men of her area. "Today, every woman in my area comes to me when it concerns matters of sexual health." “I want to reach every corner of the country” Gauri has worked for FPAI for years and remembers hearing about the experiences of women who’d had unsafe abortions. "I had heard first-hand accounts of [unsafe] abortions that left women reeling in pain, suffering permanent infertility. I had also seen the grief in the faces of men whose wives died. So today when I see women leaving us, after an abortion, in perfect health, I feel like I've done something right with my life."  Gauri continues: "My work may have started with one area, but I want to reach every corner of the country with FPAI - so that no woman in India becomes a statistic." In the district of Gwalior in Madhya Pradesh, the summer season has started and the heat in town is already extreme. Here, the FPAI clinic serves many people living in poverty. In the ten years since the GCACI project started there, the clinic has provided 16,301 women with comprehensive abortion care and 202,758 women with contraceptive services. The two-storey clinic is situated in a residential area and, inside, women queue up to see the counsellors and medical staff. Many are accompanied by link workers who have travelled with them from outlying districts.    Neelam Dixit is in charge of the branch. “There is a shift in attitude among women since FPAI started providing services. Presently, there is little stigma attached to abortion. Our aim is to provide quality health services at low cost. We create awareness about the consequences of unsafe abortion and train volunteers to be sure women in villages are aware of our clinic.” The clinic serves around 300,000 people from rural and semi-urban populations with comprehensive sexual and reproductive health services, and  provides both first- and second-trimester abortion services. Dixit adds: “Most women are from vulnerable sections of society and are denied the right to make their own decisions.”  “I want to live to see my other children grow” At 23, Nisha Boudh is already a mother to two children and, like many women in India, severely anaemic. She feels she is in no position to have a third child, but her in-laws are not supportive. Nisha chose to have an abortion at FPAI’s Gwalior clinic. “I have been weak since childhood and, honestly, motherhood has taken a toll on my health.  Doctors in other clinics were not willing help me and I would have died had FPAI not come to my rescue. With their doctors’ advice I have now decided to undergo an operation [tubal ligation] as I do not want to conceive.  “My mother-in-law was upset with my decision but I want to live to see my other children grow,” said Boudh. Manju Rana was forced to marry at fifteen. “I have had two children in eight years of marriage,” she says. “My mother-in-law wanted me to keep having children. She does not understand I would not be able to give them a good education if I had more children. My husband is a driver and we cannot afford to have any more. When I learnt I was pregnant, without taking anyone’s permission, I went with the link worker of my area to the clinic and had an abortion.”  Manju adds: “In these affordable clinics we can choose about pregnancy. They also made sure I was counselled, as coming to a decision about abortion is not easy.” “They now know they have a right over their body” “The big problem in this part of India is early marriage and pregnancy. Both of which need to be handled very delicately,” says medical officer Mala Tiwari.  “Slowly, things are changing as women are becoming aware of their rights. Previously when GCACI did not exist there was very little interaction with the link workers, and they [and the community] feared it was illegal to get an abortion. They did not know they did not need the consent of their husbands and in-laws. They now know, women have a right over their body.”   Link worker Rajini agrees, "Due to poverty, many women can’t afford an abortion or many a time they have no right to decide about pregnancy as we belong to a patriarchal society. We all have a right to a life of dignity and it’s my responsibility to see that every woman knows about the clinic. I believe in equality. FPAI has taught me to fight for my rights.”

The Argentinian Senate voted narrowly against a bill that would have legalized abortion up to 14 weeks. The vote tally was 31 in favour, 38 against, 2 abstentions, and 1 absence.     Giselle Carino, IPPF Western Hemisphere Region’s Director (IPPF/WHR) and CEO, issued the following statement:   "Today, the Argentinian Senate failed women by voting to maintain a status quo that leads to anguish, forced pregnancy, and preventable death. This compassionless vote denies women’s lived experiences, evidence-based public health policies and international agreements. While the senate has demonstrated that they are out of touch, women will not retreat. Tens of thousands of women organized, mobilized, and took to the streets to support this bill, and their courage have inspired activists across Latin America to share their stories and take on the stigma that too often keeps abortion care out of public discourse. We stand firmly and in solidarity with all women until forced pregnancies become a thing of the past—until all women are treated as equals.”       While current law in Argentina technically permits a woman access to abortion services when her life is in danger, or when the pregnancy is the result of rape, the true issue is one of accessibility: Women with fewer economic and social resources have less access to care than upper-class women in urban centers.   Dr Alvaro Bermejo, IPPF’s Director General:  “Poor women bear the brunt of these restrictive laws and will continue to pay with their health and lives until abortion is decriminalized and becomes an integral part of sexual and reproductive health care. IPPF congratulates our partners, civil society and all the activists who fought so valiantly for women’s rights. We will continue working closely with our partners and allies in Argentina in the fight for sexual and reproductive rights for all. ”