Harm reduction isn't just for drug users anymore! How abortion pills can reduce the harms of self-induced abortion for women globally

The term harm reduction defines policies, programs and practices seeking to reduce harms associated with an activity rather than eliminating the activity altogether. This term originated in drug-use prevention work to advocate for needle exchange programs to reduce HIV transmission and has since been applied to other public health issues. Harms associated with unsafe abortion have been widely documented. With the advent of abortion pills, also known as medical abortion, the landscape of unsafe abortion is quickly changing. Women increasingly find and obtain information and pills from pharmacists, medicine sellers, community midwives, market women, friends, family, and the Internet. Although WHO defines unsafe abortion as a procedure carried out by someone lacking necessary skills and/or in an environment that does not meet minimum medical standards, this definition comes from the late 1980s when most abortions were surgical. Abortion pills have since redefined the specific “skills” and “environment” characterizing unsafe abortion. Evidence shows that widespread use of abortion pills, both within and outside formal health-care facilities, has made self-induced abortion safer. The core principles of harm reduction—neutrality, humanism, and pragmatism—offer a conceptual framework for making medical abortion information and care available directly to women through a variety of creative means. This presentation will describe examples and lessons learned from the application of this successful public health paradigm to reduce unsafe abortion globally.