Lasserre Laureline, Staderini Nelly, Hasan Maysa'a, Rossi Vanessa
Médecins Sans Frontières, Geneva, Switzerland.
Confl Health. 2025 Feb 11;19(1):8. doi: 10.1186/s13031-024-00641-1.
Access to safe abortion care (SAC) should be improved in fragile and humanitarian settings, and the implementation of interventions in that regard are currently limited. This is especially true for self-managed abortion (SMA), although it holds the potential of revolutionizing the prevention of maternal death and suffering.
The medical humanitarian organization Doctors Without Borders/Médecins Sans Frontières (MSF) piloted a self-managed abortion model of care in the Middle East. 22 women were remotely supported in managing their safe abortions with a counsellor over the phone, using misoprostol doses that they took at home after having taken mifepristone in our health facility. We share our experience by describing the model of care and discussing the lessons learned through its implementation.
The program delivered abortion services successfully and required few resources. This paper also reflects on the importance of facilitating SMA in humanitarian contexts. It increases access to care by providing increased confidentiality, close support, ample information, autonomy, and flexibility. It is simple to implement, effective, often preferred by women, and can be linked to information about contraception. The implementation of self-managed models should be expanded, notably in projects that do not have a sexual and reproductive health focus and in restrictive and challenging contexts. It represents a true revolution for access to safe abortion care.
在脆弱和人道主义环境中，应改善安全堕胎护理（SAC）的可及性，而目前这方面干预措施的实施有限。对于自我管理堕胎（SMA）而言尤其如此，尽管它有潜力彻底改变孕产妇死亡和痛苦的预防状况。
医疗人道主义组织无国界医生组织（MSF）在中东试点了一种自我管理堕胎护理模式。22名妇女在我们的医疗机构服用米非司酮后在家中服用米索前列醇，并通过电话由一名顾问远程支持她们进行安全堕胎管理。我们通过描述护理模式并讨论实施过程中的经验教训来分享我们的经验。
该项目成功提供了堕胎服务且所需资源很少。本文还反思了在人道主义背景下促进自我管理堕胎的重要性。它通过提供更高的保密性、密切支持、充分信息、自主性和灵活性来增加护理的可及性。它易于实施、有效，通常受女性青睐，并且可以与避孕信息相联系。自我管理模式的实施应予以扩大，特别是在那些没有性与生殖健康重点的项目以及限制多且具有挑战性的环境中。它代表了安全堕胎护理可及性方面的一场真正革命。
