Trained midwives 'could provide abortions'

Midwives and doctor assistants 'could aid' abortions in developing countries
Midwives and doctor assistants 'could aid' abortions in developing countries
 

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Trained midwives and doctor assistants could carry out abortions in the first three months of pregnancy as safely as doctors in developing countries, according to the World Health Organisation (WHO).

Such mid-level workers could help in developing countries where abortions are legal but doctors are scarce, leading to limited access to safe abortions, researchers for the international organisation argue in The Lancet medical journal.

Rates of complications in abortions carried out by doctors and mid-level providers (MLPs) in South Africa and Vietnam were compared in the study - the first time that such a comparison has taken place.

The study shows that 1,734 consenting women in Vietnam and 1,160 in South Africa were randomly assigned to a doctor or an MLP for their abortion.

WHO researchers found that overall complications rates were low. In South Africa the rate of complications was 1.4 per 100 women for the MLPs and zero for doctors. In Vietnam, the rate was 1.2 per 100 women for MLPs and the same for doctors.

Women reported equal satisfaction in the issues of pain management, clarity of explanations and the opportunity to ask questions before, during and after the procedure.

Writing in The Lancet, the researchers concluded: "The provision of first-trimester manual vacuum aspiration abortion by trained and accredited MLPs at the primary-care level provides women with more accessible and less costly means of safely terminating unintended pregnancies, freeing doctors for more complicated procedures."


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