Eliminating Deaths from Unsafe Abortion

Although abortion is medically safe when done in accordance with recommended guidelines, restrictive laws force many women to undergo unsafe procedures that jeopardize their lives.

It was in this context that, in 2001, a group of health professionals in Uruguay that would later found our local partner, Iniciativas Sanitarias, piloted a program to eliminate the deaths and injuries caused by unsafe abortion.

Inspired by “harm reduction”models designed to reduce the transmission of HIV/AIDS among intravenous drug users, Iniciativas adopted a similar approach to the problem of unsafe abortion in Uruguay. The model provides women contemplating abortion with judgment-free, accurate information on, among other things, the use of misoprostol to terminate a pregnancy. The program, which consists of two visits, also includes post-abortion care and access to contraception that give women the power to prevent future unintended pregnancies.

Evaluations of the Uruguayan model found that it eliminated maternal deaths among women who participated in the program. The model also helped pave the way for the legalization of abortion in Uruguay in 2012 by reframing abortion as a public health issue.

IPPF/WHR has supported the replication of this model throughout the region, and in the past two years, in East Africa. After a visit to Iniciativas, the former president of Uganda’s association of gynecologists and obstetricians implemented the model at a hospital in the capital city, and neighboring Tanzania soon followed in Uganda’s footsteps. The Iniciativas model has been very well received in both countries, and implementation is progressing steadily.

The Uruguay model was featured in The New York Times in June 2016. To read more, visit: