We are really grateful in WHO that we have been working together both in the area of medical abortion and emergency contraception. Unsafe abortion is really a tragedy that can be prevented. This conference is going to review how good medical abortion is over surgical abortion. It is a great pleasure to be involved and trying to assist in this work.

The World Health Organisation estimated that 46 million pregnancies end in induced abortions every year and that some 19 million of these abortions are unsafe, performed by persons lacking the necessary skills or in an environment lacking the minimal medical standards or both. More than half of all unsafe abortions take place in Asian countries and over 30% of them among women younger than 25 years of age. Complications resulting from unsafe abortion contribute to serious sequelae for women’s health, leading to temporary or permanent disability including infertility.

The consequences of unsafe abortion could not be ignored at the International Conference on Population and development in 1994. The Programme of Action called for governments and other relevant organization “....to reduce the recourse to abortion through expanded and improved family planning services” and stated that where it is legal ... “abortion should be
safe”.

The department of Reproductive Health and Research at WHO has contributed to preventing unsafe abortion by developing new improved methods of family planning for regular and emergency use, providing guidelines to improve the quality and care of family planning services and by providing guidelines on the management of complications of unsafe abortion, including post-abortion contraception. The work of the Department has been crucial for the development of non-surgical alternatives for pregnancy termination. The department has also formulated technical and policy guidance on safe abortion for health systems; the guide will be available within a few months. It is easy to agree that unwanted pregnancies and abortions should be prevented. In many countries, high levels of induced abortions reflect an unmet need for effective contraception. The use of effective contraception will surely decrease abortion rates, but the need for abortion will still remain: no family planning method is 100% effective and people do not always use the methods correctly.

Our aim in this conference is to come up with a national consensus on medical, i.e. non-surgical abortion. Although our focus is on new technologies of pregnancy termination, we should not forget the broader context : the final aim should be to reduce recourse to abortion and eliminate unsafe abortion. Medically-induced abortion could play a role in making abortion services more accessible to women; however, what role medical abortion can play in
improving the services will depend on the current situation in a given country. Therefore, before any new methods are introduced on a full scale, there is a need to assess the current service to see what changes need to be made. Non-surgical abortion gives a choice of the abortion method to women, but it will never eliminate the need for surgical abortion which is needed as a back-up. Also, all women are not suitable for medical abortion or they may
have reason why they prefer to have the surgical prcedure. It is important to establish national norms and standards that govern the provision of quality abortion care. This meeting is one step towards that aim. I wish you success for this important consortium on medical abortion in India.