Post Abortion Care (PAC)

Post Abortion Care (PAC)

This is an approach for reducing morbidity and mortality from incompetent and unsafe abortion and resulting complications and for improving women’s sexual and reproductive health lives.

Elements of PAC:

There are 5 elements of PAC which are:

·              Treatment of incomplete and unsafe abortion and abortion related complications that are potentially life threatening

·              Counseling to identify and respond to women’s emotional and

·              Physical health needs and other concerns

·              Contraceptives and family planning services to

o     Help women prevent unwanted pregnancy

o     Encourage the practice of birth spacing

o     Reproductive and other health services that are: Provided on-site

o     Provide via referrals to other facilities in providers’ networks

·              Community and service provider partnerships to:

o     Prevent unwanted pregnancies and unsafe abortion

o     Mobilize resources for timely care for complications from abortion

o     Ensures health services reflect and meet community expectations and needs

Principles that Support Patients’ Rights in PAC Setting

o     Having empathy and respect for patients

o     Maintaining positive interaction and communication with patients

o     Respecting privacy and confidentiality

Roles of the Midwife in PAC

The midwife is the general overseer or manager of the totality of Manual vacuum Aspiration (MVA) services within the facility

o     The midwife has the responsibility of ensuring that the facilities and the necessary equipments are always available at the MVA room. Portable water should be made available.

o     She should ensure proper cleaning and setting of trolley. She must also ensure completeness of the items on both shelves of the trolley

o     Pre and post procedure care of the patients is an important responsibility of the midwife.

o     Her role in the actual MVA procedure depends on whether she is permitted to carry out the procedure or to assist the doctor during a procedure. In which ever situation, she must have a good grip of the procedure.

o     She must posses a proper understanding of cleaning and sterilization/or disinfecting of equipment used during the procedure and disposal of wastes, aspirates and sharp instruments in order to prevent infection especially HIV/AIDS

o     She is responsible for keeping record of details of the procedure.

Manual Vacuum Aspiration (MVA)

This is a procedure carried out to evacuate uterine contents in incomplete abortion. The indications are:

o     Threatened or imminent abortion, Inevitable abortion, Incomplete abortion

o     Infected abortion, Missed abortion, An embryonic pregnancy, Hydatidiform mole

o     Retained placental products

Advantages

·              Requires only slight dilatation and scrapes gently

·              Lower risk of complications, Lower cost of services, Can be used in low resource setting, Decreased need for hospitalization, is a day case.

The procedure is usually carried out by trained heath personnel. (Refer hand book for nurses and midwives for details)