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Best Pract Res Clin Obstet Gynaecol. 2016 Oct;36:145-155. doi: 10.1016/j.bpobgyn.2016.07.008. Epub 2016 Aug 3.

Role of birth spacing, family planning services, safe abortion services and post-abortion care in reducing maternal mortality.

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Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland. Electronic address:
FIGO Initiative of Prevention of Unsafe Abortion, International Federation of Gynecology and Obstetrics, UK; Center for Research of Reproductive Health of Campinas (Cemicamp), Campinas, Brazil; State University of Campinas (Unicamp), PO Box 6181, 13081-970, Campinas, SP, Brazil. Electronic address:


Access to contraception reduces maternal deaths by preventing or delaying pregnancy in women who do not intend to be pregnant or those at higher risk of complications. However, not all unintended pregnancies can be prevented through increase in contraceptive use, and access to safe abortion is needed to prevent unsafe abortions. Despite not preventing the problem, provision of emergency care for complications can help prevent deaths from such unsafe abortions. Safe abortion in early pregnancy can be provided at primary care level and by non-physician providers, and the risks of mortality associated with such safe, legal abortions are minimal. Although entirely preventable, unsafe abortions continue to occur because of numerous barriers such as legal and policy restrictions, service delivery issues and provider attitudes to abortion stigma. Overall, the provision of contraception and safe abortion is important not just to prevent maternal deaths but as a measure of our ability to respect women's decisions and ensure that they have access to timely, evidence-based care that protects their health and human rights.


contraception; family planning; maternal mortality; safe abortion; unsafe abortion

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