Guideline

Health worker roles in providing safe abortion care and post-abortion contraception

Year of Publication

2015

Issuing Institution

World Health Organization

Links

WHO IRIS,WHO IRIS

Recommendations

109 included recommendations

Management of abortion and post-abortion care for pregnancies in the first trimester. Vacuum aspiration for induced abortion. Health worker: Specialist doctors, non-specialist doctors. Recommended

Status

Maintained

Recommended

Management of abortion and post-abortion care for pregnancies in the first trimester. Vacuum aspiration for induced abortion. Health worker: Associate and advanced associate clinicians. Recommended

Status

Maintained

Recommended

Management of abortion and post-abortion care for pregnancies in the first trimester. Vacuum aspiration for induced abortion. Health worker: Midwives. Recommended

Status

Maintained

Recommended

Management of abortion and post-abortion care for pregnancies in the first trimester. Vacuum aspiration for induced abortion. Health worker: Nurses. Recommended

Status

Maintained

Recommended

Management of abortion and post-abortion care for pregnancies in the first trimester. Vacuum aspiration for induced abortion. Health worker: Auxiliary nurses (AN) and auxiliary nurse midwives (ANM). Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Management of abortion and post-abortion care for pregnancies in the first trimester. Vacuum aspiration for induced abortion. Health worker: Doctors of complementary systems of medicine Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Management of abortion and post-abortion care for pregnancies in the first trimester. Vacuum aspiration for induced abortion. Health worker: Pharmacists, pharmacy workers, lay health workers Recommended against

Status

Updated

Not recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with vacuum aspiration. Health worker: Specialist doctors, non-specialist doctors Recommended

Status

Maintained

Recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with vacuum aspiration. Health worker: Associate and advanced associate clinicians Recommended

Status

Maintained

Recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with vacuum aspiration. Health worker: Midwives Recommended

Status

Maintained

Recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with vacuum aspiration. Health worker. Nurses: Recommended

Status

Maintained

Recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with vacuum aspiration. Health worker. Auxiliary nurses (AN) and auxiliary nurse midwives (ANM) Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with vacuum aspiration. Health worker. Doctors of complementary systems of medicine Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with vacuum aspiration. Health worker. Pharmacists, pharmacy workers, lay health workers Recommended against

Status

Updated

Not recommended

medical abortion (MA) in the first trimester. Health worker. Specialist doctors, non-specialist doctors Recommended

Status

Maintained

Recommended

medical abortion (MA) in the first trimester. Health worker. Associate and advanced associate clinicians: Recommended

Status

Maintained

Recommended

medical abortion (MA) in the first trimester. Health worker. Midwives: Recommended

Status

Maintained

Recommended

medical abortion (MA) in the first trimester. Health worker. Nurses: Recommended

Status

Maintained

Recommended

medical abortion (MA) in the first trimester. Health worker. Auxiliary nurses and auxiliary nurse midwives: Recommended

Status

Maintained

Recommended

medical abortion (MA) in the first trimester. Health worker. Doctors of complementary systems of medicine: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

medical abortion (MA) in the first trimester. Health worker. Pharmacy workers: Recommended against

Status

Retired

Not recommended

provision of medical abortion subtasks in the first trimester by pharmacists. Assessing eligibility for medical abortion: Recommended within the context of rigorous research

Status

Retired

Recommendation in research context

Only in research contexts

provision of medical abortion subtasks in the first trimester by pharmacists. Administering the medications and managing the process and common side-effects independently: Recommended within the context of rigorous research

Status

Updated

Recommendation in research context

Only in research contexts

provision of medical abortion subtasks in the first trimester by pharmacists. Assessing completeness of the procedure and the need for further clinic-based follow-up Recommended within the context of rigorous research

Status

Retired

Recommendation in research context

Only in research contexts

Provision of medical abortion subtasks in the first trimester by lay health workers. Assessing eligibility for medical abortion: Recommended within the context of rigorous research

Status

Retired

Recommendation in research context

Only in research contexts

Provision of medical abortion subtasks in the first trimester by lay health workers. Administering the medications and managing the process and common side-effects: Recommended within the context of rigorous research

Status

Retired

Recommendation in research context

Only in research contexts

Provision of medical abortion subtasks in the first trimester by lay health workers. Assessing completeness of the procedure and the need for further clinic-based follow-up: Recommended within the context of rigorous research

Status

Retired

Recommendation in research context

Only in research contexts

Women’s role in managing the process of medical abortion. Self-assessing eligibility for medical abortion: Recommended within the context of rigorous research

Status

Retired

Recommendation in research context

Only in research contexts

Women’s role in managing the process of medical abortion. Managing the mifepristone and misoprostol medication without direct supervision of a health-care provider: Recommended in specific circumstances

Status

Maintained

Context specific recommendation

Only in specific contexts

Women’s role in managing the process of medical abortion. Self-assessing completeness of the abortion process using pregnancy tests and checklists: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with misoprostol. Health worker. Specialist doctors, non-specialist doctors: Recommended

Status

Maintained

Recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with misoprostol. Health worker. Associate and advanced associate clinicians: Recommended

Status

Maintained

Recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with misoprostol. Health worker. Midwives: Recommended

Status

Maintained

Recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with misoprostol. Health worker. Nurses :Recommended

Status

Maintained

Recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with misoprostol. Health worker. Auxiliary nurses and auxiliary nurse midwives Recommended

Status

Maintained

Recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with misoprostol. Health worker. Doctors of complementary systems of medicine: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with misoprostol. Health worker. Pharmacists and pharmacy workers Recommended against

Status

Retired

Not recommended

Management of uncomplicated incomplete abortion/miscarriage in the first trimester with misoprostol. Health worker. Lay health workers: Recommended within the context of rigorous research

Status

Retired

Recommendation in research context

Only in research contexts

abortion and post-abortion care for pregnancies beyond 12 weeks . Provision of D&E (Dilatation and evacuation) for pregnancies beyond 12 weeks. Health worker. Specialist doctors: Recommended

Status

Maintained

Recommended

abortion and post-abortion care for pregnancies beyond 12 weeks .Provision of D&E (Dilatation and evacuation) for pregnancies beyond 12 weeks. Health worker. Non-specialist doctors: Recommended

Status

Maintained

Recommended

abortion and post-abortion care for pregnancies beyond 12 weeks. Provision of D&E (Dilatation and evacuation) for pregnancies beyond 12 weeks. Health worker. Associate and advanced associate clinicians: Recommended within the context of rigorous research

Status

Retired

Recommendation in research context

Only in research contexts

abortion and post-abortion care for pregnancies beyond 12 weeks . Provision of D&E (Dilatation and evacuation) for pregnancies beyond 12 weeks. Health worker. Doctors of complementary systems of medicine: Recommended against

Status

Retired

Not recommended

abortion and post-abortion care for pregnancies beyond 12 weeks . Provision of D&E (Dilatation and evacuation) for pregnancies beyond 12 weeks. Health worker. Midwives, nurses, nurse-midwives, auxiliary nurse midwives, pharmacists, pharmacy workers, lay health workers: Recommended against

Status

Retired

Not recommended

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with osmotic dilators prior to D&E (Dilatation and evacuation). Health worker. Specialist doctors, non-specialist doctors> Recommended

Status

Maintained

Recommended

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with osmotic dilators prior to D&E (Dilatation and evacuation). Health worker. Associate and advanced associate clinicians Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with osmotic dilators prior to D&E (Dilatation and evacuation). Health worker. Midwives: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with osmotic dilators prior to D&E (Dilatation and evacuation). Health worker. Nurses: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with osmotic dilators prior to D&E (Dilatation and evacuation). Health worker. Auxiliary nurses and auxiliary nurse midwives: Recommended against

Status

Retired

Not recommended

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with osmotic dilators prior to D&E (Dilatation and evacuation). Health worker. Doctors of complementary systems of medicine: Recommended against

Status

Retired

Not recommended

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with osmotic dilators prior to D&E (Dilatation and evacuation). Health worker. Pharmacists, pharmacy workers, lay health workers: Recommended against

Status

Retired

Not recommended

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with medications prior to D&E (Dilatation and evacuation). Health worker. Specialist doctors, non-specialist doctors" Recommended

Status

Maintained

Recommended

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with medications prior to D&E (Dilatation and evacuation). Health worker. Associate and advanced associate clinicians: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with medications prior to D&E (Dilatation and evacuation). Health worker. Midwives: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with medications prior to D&E (Dilatation and evacuation). Health worker. Nurses: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with medications prior to D&E (Dilatation and evacuation). Health worker. Auxiliary nurses and auxiliary nurse midwives: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with medications prior to D&E (Dilatation and evacuation). Health worker. Doctors of complementary systems of medicine: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with medications prior to D&E (Dilatation and evacuation). Health worker. Pharmacists, pharmacy workers Recommended against

Status

Retired

Not recommended

abortion and post-abortion care for pregnancies beyond 12 weeks .Cervical priming with medications prior to D&E (Dilatation and evacuation). Health worker. Lay health workers: Recommended against

Status

Retired

Not recommended

Provision of medical abortion beyond 12 weeks. Health worker. Specialist doctors Recommended

Status

Maintained

Recommended

Provision of medical abortion beyond 12 weeks. Health worker. Non-specialist doctors: Recommended

Status

Maintained

Recommended

Provision of medical abortion beyond 12 weeks. Health worker. Associate and advanced associate clinicians Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Provision of medical abortion beyond 12 weeks. Health worker. Midwives: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Provision of medical abortion beyond 12 weeks. Health worker. Nurses: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Provision of medical abortion beyond 12 weeks. Health worker. Auxiliary nurses and auxiliary nurse midwives: Recommended against

Status

Retired

Not recommended

Provision of medical abortion beyond 12 weeks. Health worker. Doctors of complementary systems of medicine: Recommended against

Status

Retired

Not recommended

Provision of medical abortion beyond 12 weeks. Health worker. Pharmacists, pharmacy workers, lay health workers: Recommended against

Status

Retired

Not recommended

Initial management of non-life-threatening post-abortion infection. Specialist doctors, non-specialist doctors: Recommended

Status

Maintained

Recommended

Initial management of non-life-threatening post-abortion infection. Associate and advanced associate clinicians, midwives, nurses, auxiliary nurses and auxiliary nurse midwives: Recommended

Status

Maintained

Recommended

Initial management of non-life-threatening post-abortion infection. Doctors of complementary systems of medicine: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Initial management of non-life-threatening post-abortion infection. Pharmacists, pharmacy workers, lay health workers: Recommended against

Status

Retired

Not recommended

Initial management of non-life-threatening post-abortion haemorrhage. Health worker. Specialist doctors, non-specialist doctors: Recommended

Status

Maintained

Recommended

Initial management of non-life-threatening post-abortion haemorrhage. Health worker. Associate and advanced associate clinicians, midwives, nurses: Recommended

Status

Maintained

Recommended

Initial management of non-life-threatening post-abortion haemorrhage. Health worker. Auxiliary nurses and auxiliary nurse midwives: Recommended

Status

Maintained

Recommended

Initial management of non-life-threatening post-abortion haemorrhage. Health worker. Doctors of complementary systems of medicine: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Initial management of non-life-threatening post-abortion haemorrhage. Health worker. Pharmacists, pharmacy workers, lay health workers: Recommended against

Status

Retired

Not recommended

Provision of information on safe abortion. Health worker. Specialist doctors, non-specialist doctors, associate and advanced associate clinicians, doctors of complementary systems of medicine, midwives, nurses, auxiliary nurses and auxiliary nurse midwives: Recommended

Status

Maintained

Recommended

Provision of information on safe abortion. Health worker. Pharmacists: Recommended

Status

Maintained

Recommended

Provision of information on safe abortion. Health worker. Pharmacy workers: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Provision of information on safe abortion. Health worker. Lay health workers: Recommended

Status

Maintained

Recommended

Pre- and post-abortion counselling. Health worker. Specialist doctors, non-specialist doctors: Recommended

Status

Maintained

Recommended

Pre- and post-abortion counselling. Health worker. Associate and advanced associate clinicians: Recommended

Status

Maintained

Recommended

Pre- and post-abortion counselling. Health worker. Midwives: Recommended

Status

Maintained

Recommended

Pre- and post-abortion counselling. Health worker. Nurses, auxiliary nurses and auxiliary nurse midwives: Recommended

Status

Maintained

Recommended

Pre- and post-abortion counselling. Health worker. Doctors of complementary systems of medicine: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Pre- and post-abortion counselling. Health worker. Pharmacists Recommended against

Status

Retired

Not recommended

Pre- and post-abortion counselling. Health worker. Pharmacy workers: Recommended against

Status

Retired

Not recommended

Pre- and post-abortion counselling. Health worker. Lay health workers: Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Insertion and removal of an intrauterine device. Midwives and nurses. Recommended

Status

Maintained

Recommended

Insertion and removal of an intrauterine device. Auxiliary nurse midwives. Recommended

Status

Maintained

Recommended

Certainty of evidence

Moderate

Insertion and removal of an intrauterine device. Auxiliary nurses. Recommended within the context of rigorous research

Status

Maintained

Recommendation in research context

Only in research contexts

For intrauterine devices (IUDs): Suggest insertion/removal by traditional and complementary medicine professionals (TCMPs)

Status

Maintained

Context specific recommendation

Only in specific contexts

Insertion and removal of an intrauterine device. Pharmacists and pharmacy workers. Recommended against

Status

Updated

Not recommended

Insertion and removal of an intrauterine device. Lay health workers. Recommended against

Status

Maintained

Not recommended

Insertion and removal of (contraceptive) implants. Midwives and nurses. Recommended

Status

Maintained

Recommended

Insertion and removal of (contraceptive) implants. Auxiliary nurses and auxiliary nurse midwives. Recommended in specific circumstances

Status

Maintained

Context specific recommendation

Only in specific contexts

Insertion and removal of (contraceptive) implants. Doctors of complementary systems of medicine. Recommended in specific circumstances

Status

Maintained

Context specific recommendation

Only in specific contexts

Insertion and removal of (contraceptive) implants. Pharmacists and pharmacy workers. Recommended against

Status

Updated

Not recommended

Insertion and removal of (contraceptive) implants. Lay health workers. Recommended within the context of rigorous research

Status

Maintained

Recommendation in research context

Only in research contexts

Initiation and continuation of injectable contraceptives. Auxiliary nurses and auxiliary nurse midwives. Recommended.

Status

Maintained

Recommended

Initiation and continuation of injectable contraceptives. Doctors of complementary systems of medicine. Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

For injectable contraceptives (initiation and continuation): Recommend administration by pharmacists

Status

Maintained

Recommended

Certainty of evidence

Very low

Initiation and continuation of injectable contraceptives. Pharmacy workers. Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Certainty of evidence

Very low

Initiation and continuation of injectable contraceptives. Lay health workers. Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Certainty of evidence

Very low

Tubal ligation. Midwives and nurses. Recommended within the context of rigorous research

Status

Maintained

Recommendation in research context

Only in research contexts

Tubal ligation. Auxiliary nurses and auxiliary nurse midwives. Recommended against

Status

Maintained

Not recommended

Women’s role in managing the process of medical abortion. Self-assessing eligibility for medical abortion. Recommended within the context of rigorous research

Status

Retired

Recommendation in research context

Only in research contexts

Women’s role in managing the process of medical abortion. Managing the mifepristone and misoprostol medication without direct supervision of a health-care provider. Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Women’s role in managing the process of medical abortion. Self-assessing completeness of the abortion process using pregnancy tests and checklists. Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Self-administration of injectable contraception. Women (self administration). Recommended in specific circumstances

Status

Retired

Context specific recommendation

Only in specific contexts

Certainty of evidence

Very low