Implementing first-trimester public-sector legal abortion services in Mexico’s Federal District
Christopher Bross, Raffaela Schiavon, Rubén Ramirez, Patricio Sanhueza (IPAS, Mexico)
Christopher Bross, Ipas, 300 Market Street, Suite 200, Chapel Hill, NC 27516, USA
The passage of the law legalizing first trimester abortion in Mexico’s Federal District marked an important milestone in the campaign to reduce unsafe abortion, both in Mexico and within the Latin America region. Within three days of passage of the law, women began receiving legal abortion services in designated hospitals of the Federal District’s Ministry of Health (MOH). Ipas has been providing training and technical assistance to the MOH in support of its efforts to provide high-quality abortion services. This presentation will look at the experience in launching and sustaining public sector services during the first year, training and equipping needs identified and implemented by the MOH, technical assistance provided by Ipas and selected partners, and observable trends from the official data. In particular, the presentation will provide a brief context about the law, key aspects of the official guidelines that were emitted by the MOH within 2 weeks following the law’s passage, the evolution of service provision within the health system, trends in abortion technologies utilized in public services and number and characteristics of women receiving legal abortion services in the public sector. By the end of first year, more than 8,000 women had received a legal abortion in public hospitals. The mean age of women was 25 years and 55% of abortion clients were single. Seventy-nine percent resided in Mexico City, 85% identified themselves as Catholics, 84% received their first abortion, and 57% were experiencing their first pregnancy. The mean gestational age at request was 8 weeks and in 95% of the cases, the women requested the abortion for personal reasons. Only 5% reported they were seeking an abortion because of rape, risk to health or congenital malformations. Overall, 34% of procedures were performed using sharp curettage, 29% with MVA and 37% with misoprostol alone. However, the trends in type of procedure indicate a dramatic shift away from previously common practice of sharp curettage towards misoprostol alone or misoprostol in combination with MVA.