Schulte-Hillen Catrin, Staderini Nelly, Saint-Sauveur Jean-François
Médecins Sans Frontières International, 78 rue de Lausanne, 1201 Geneva, Switzerland.
Médecins Sans Frontières Switzerland, 78 rue de Lausanne, 1201 Geneva, Switzerland.
Confl Health. 2016 Sep 21;10:19. doi: 10.1186/s13031-016-0086-5. eCollection 2016.
MSF responds to needs for the termination of pregnancy, including on request (TPR); it is part of the organization's work aimed at reducing maternal mortality and suffering; and preventing unsafe abortions in the countries where we work. Following the publication of "Why don't humanitarian organizations provide safe abortion care?" we offer an insight into MSF's experience over the past few years. The article looks at the legal concerns and proposes that the importance of addressing maternal mortality should replace them and the operational set-up and action organized in a way that mitigates risks. MSF took a policy decision on safe abortion care in 2004; the fact that care did not expand rapidly to relevant MSF projects came as a surprise, reflecting the important weight social norms around abortion have everywhere. The need to engage in an open dialogue with staff, relevant medical actors and at community level became more obvious. Finally the article looks some key lessons that have emerged for the organization as part of the effort to prevent ill health, maternal death and suffering caused by unwanted pregnancy and unsafe abortion.
无国界医生组织回应终止妊娠的需求，包括应要求提供终止妊娠服务（TPR）；这是该组织旨在降低孕产妇死亡率和痛苦、并在我们开展工作的国家预防不安全堕胎的工作的一部分。在《为何人道主义组织不提供安全堕胎护理？》一文发表后，我们深入探讨了无国界医生组织过去几年的经验。文章审视了法律方面的担忧，并提出应对孕产妇死亡率的重要性应取代这些担忧，以及应以降低风险的方式进行业务设置和组织行动。无国界医生组织在2004年就安全堕胎护理做出了政策决定；护理服务未能迅速扩展到相关的无国界医生项目这一事实令人惊讶，这反映出堕胎相关的社会规范在各地都具有重要影响。与工作人员、相关医疗行为体以及社区层面开展公开对话的必要性变得更加明显。最后，文章探讨了该组织在预防意外怀孕和不安全堕胎导致的健康问题、孕产妇死亡和痛苦的努力中所汲取的一些关键经验教训。
