Access to my choice

Vol. 3 No. 2, Apr - Jun 2017 info@dktethiopia.orgSocial Marketing for a Better Life www.dktethiopia.org

SAFE ABORTION

MVA KITMEDICATION ABORTION

What is it and what does it mean in the Ethiopian context?

Vol. 3 No. 2 Apr-Jun 2017 www.dktethiopia.org Tel: +251 116 632222 Fax: +251 116 632223 PO Box 8744

Access, Apr - Jun 20172

Women’s healthcare providers in Ethiopia can often encapsulate the effects of un-safe abortion in a few words.

The septic room. The ward at Black Lion.

They easily recall stories of women injured or lost from self-induced abortion. A trail of blood on the clinic floor. A beautiful woman dying shortly after arrival at care. Most can also speculate how the ab-sence of safe abortion ser-vices, legalized in 2005, would lead to harmful consequences for women in the country.

BackgroundUnsafe abortion is defined by the World Health Organiza-tion (WHO) as, “a procedure for terminating a pregnancy performed by persons lacking the necessary skills or in an environment not in conformity with minimal medical stand-ards, or both”[1]. Safe abortion, it stands to reason, must be performed by a capable person in a medically conducive envi-ronment.

In 2005, the Ethiopian Govern-ment amended the country’s Penal Code to expand instanc-es in which a woman could legally obtain an abortion (see right). Prior to this time, (con’t on back)

SAFE ABORTIONTHE ETHIOPIAN CONTEXT

Saving. Women’s. Lives.

This is a core objective of DKT’s work in Ethiopia as well as that of our parent organization, DKT Interna-tional.

One way we pursue this is through the provision of comprehensive abortion care (CAC) products, in-cluding medication abor-tion (MA) drugs as well as manual vacuum aspiration (MVA) kits.

The need is great. In coun-tries where abortion is ille-gal, women resort to harm-ful self-treatments or those provided by traditional pro-viders. Even in Ethiopia, women suffer severe injury - and worse - when they can-not access abortion prod-ucts and services.

More must be done to pro-mote the modern contra-ceptive technologies that prevent unwanted pregnan-cy. Research shows that modern contraception costs 3 - 12% the cost of provid-ing post-abortion care. This redoubles our urgency to promote the pills, injections, implants and IUDs that are so necessary. New products like our post-partum intra-uterine device (PPIUD), currently being tested in Ad-dis Ababa, also hold great promise.

- Rory

Greetings DKT Supporter,

A sign at a health center reading, “No woman should die while giving life”

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Access, Apr -Jun 2017 3

Article 551 of the Criminal Code of Ethiopia

Medication Abortion

(1) Termination of pregnancy by a recognized medical institution within the period permitted by the profession is not punishable where:

a) the pregnancy is the result of rape or incest; orb) the continuance of the pregnancy endangers the life of the mother or the child or the health of the mother or where the birth of the child is a risk to the life or health of the mother; orc) where the child has an incurable and serious deformity; ord) where the pregnant woman, owing to a physical or mental deficiency she suf-fers from or her minority, is physically as well as mentally unfit to bring up the child.

(2) In the case of grave and imminent danger, which can be averted only by an immediate intervention, an act of terminating pregnancy in accordance with the provision of Article 75 of this Code is not punishable.

The MVA or manual vacu-um aspiration kit is a device used to manually suction uterine contents. In Ethiopia, MVA can be administered for pregnancies up to 12 weeks completed. Unlike MA, which requires a return visit to healthcare following initial regimen, the MVA procedure can be completed in a single session.

MVA Kit

Access is DKT Ethiopia’s quarterly publication. All Ac-cess publications are available at www.dktethiopia.org. For media and other inquiries, please contact Fitih Tola, DKT Ethiopia’s Public Relations Officer, at +251 11 6 632222 or fitih.t@dktethiopia.org.

Safe-t-Kit, DKT Ethiopia’s medi-cation abortion (MA) product, is a combination treatment contain-ing mifepristone and misoprostol and is effective through 9 weeks of pregnancy. Alternative MA regimens are available for later-term pregnancies.

Definition Abortion is the termina-tion of pregnancy before fetal viability, which is conventionally taken to be less than 28 weeks from last normal menstrual period (LNMP); and if the LNMP is not known a birth weight of 1000 gm.

Vol. 3 No. 2 Apr-Jun 2017 www.dktethiopia.org Tel: +251 116 632222 Fax: +251 116 632223 PO Box 8744

Access, Apr - Jun 20174

DISPOSABLE PPIUD

DKT ETHIOPIA Bole Airport, WOMSADCO Building, Box 8744Addis Ababa, Ethiopia +251 11 6 63 22 22 (t), +251 11 6 63 22 23 (f)www.dktethiopia.org, info@dktethiopia.org

DKT BRIEFS

DKT is in the final stages of pre-paring the introduction of orange-flavored LemLem and LemLem Plus. DKT has also launched Mela-One emergency contracep-tive pill, a single tablet EC, which replaces fasile-One.

(con’t from 2)abortion was only allowed in cases, “done to save the pregnant woman from grave and permanent danger to life or health, which it is impossible to avert in any other way”.

This determination had to be made by two physicians, “qualified as specialist[s] in the alleged defect of health from which the pregnant woman [was] suffering”, compounding the risk to pregnant women in a coun-try that had just one physi-cian for every 50,000 Ethio-pians in 2000[2].

At the time Ethiopia amend-ed its Penal Code, the country’s maternal mortality ratio (MMR) was 743 per 100,000 live births, among the highest in the world, though decreasing thanks to the introduction and

uptake of modern contracep-tive methods and expanding healthcare infrastructure. It was estimated that abortion-related complications ac-counted for 32% of all ma-ternal deaths[3]. The cost of care associated with abor-tion was also suggested to be “enormous”[3].

Abortion todayEthiopia has shown consid-erable progress decreasing abortion-related mortality. In 2014, abortion accounted for 6-9% of maternal mortal-ity, a roughly three-quarters’ reduction from 2005[5].

According to the Federal Ministry of Health, an es-timated 420,000 induced abortions occurred in 2016 out of 4.2 million pregnan-cies (FMoH Internal Docu-ment). A 2014 study put this figure at 620,300[6],(con’t www.dktethiopia.org)

(see dktethiopia.org/products)

New Sensation variants will be released in 2018. Check a phar-macy near you !

DKT receives funding from an anonymous donor as well as non-abortion funding from the Gates Foundation.

Source: World Health Organization et al. “Maternal mortality in 1990-2015”