Technical Areas

Frequently Asked Questions about Postabortion Care (PAC)

How are Complications of Abortion, Including Hemorrhage, Treated?
What is MVA?
What are the Advantages and Disadvantages of MVA?
Does USAID Provide MVA Kits?
Is U.S. Foreign Assistance Used to Perform or Promote Abortion as a Method of Family Planning?
How Do We Know that Groups Comply with USAID's Abortion Policy?
Have Any Violations of USAID Policy Regarding Abortion Ever Been Identified?

How are Complications of Abortion, Including Hemorrhage, Treated?

Treatment includes pain management, infection prevention and, in the case of hemorrhage, the removal of any tissue left after a miscarriage or an unsafe abortion. Providers have relied on dilation and curettage [D&C] to remove uterine tissue. However, in many countries, women who face life-threatening bleeding are unable to get to clinics with equipment and trained staff needed to provide such treatment. An effective, alternative technology to treat hemorrhage is manual vacuum aspiration (MVA).

What is MVA?

Manual vacuum aspiration [MVA] is a method of suction that is effective in treating post-abortion complications. MVA can be performed by trained nurses and can be used in settings where physicians and operating rooms are not available, thus bringing treatment closer to the women who may need it in emergency situations.

What are the Advantages and Disadvantages of MVA?

MVA offers significant advantages over D&C, including reduced risk of complications and significantly less blood loss. MVA will be unsuccessful in stopping bleeding in a small percentage of cases. Furthermore, because women do not need general anesthesia, recovery time is short, allowing the patient to be treated on an outpatient basis. There is some risk that MVA may be misused to perform illegal abortions. This risk is comparable to the risk of misuse of other medical interventions.

Does USAID Provide MVA Kits?

No. As a matter of policy USAID does not purchase or distribute MVA equipment for any purpose.

Is U.S. Foreign Assistance Used to Perform or Promote Abortion as a Method of Family Planning?

No. Under the Helms Amendment, U.S. foreign assistance is prohibited from being used to perform or promote abortion as a method of family planning. "Menstrual regulation" and medical abortion [i.e. RU-486] are considered abortion and are thus activities that are prohibited from receiving USAID funding.

How Do We Know that Groups Comply with USAID's Abortion Policy?

Strict procedures exist to ensure Agency policies and requirements are implemented, including:

• Legally binding agreements. The standard provisions that are included in all agreements and contracts that receive population funds specifically prohibit the use of USAID funds to finance, support, or be attributed to the following activities: procurement of equipment or distribution of equipment intended to be used for the purpose of inducing abortions as a method of family planning; special fees or incentives to women to coerce or motivate them to have abortions; payment to people to perform abortions or to solicit women to undergo abortions; information, education, training or communication programs that seek to promote abortion as a method of family planning; and lobbying for abortion. Agreements and contracts are legally binding agreements that can be terminated for noncompliance.
  
  
• Close technical monitoring. Through field visits USAID closely monitors implementation of its technical activities. With the restoration of the Mexico City Policy on January 21, 2001, all foreign NGOs receiving assistance for family planning were prohibited from using any funds to perform or actively promote abortion as a method of family planning. US NGOs and foreign governments, while able to use their non-USAID resources to engage in abortion-related activities where legal, are required to keep their USAID funds in segregated accounts and are prohibited from using them to perform or promote abortion as a method of family planning. Furthermore, recipients are acutely aware that non-compliance with USAID's abortion policy would jeopardize their family planning funding and therefore have a powerful incentive to comply.
  
  
• Special monitoring activities. In 1990 USAID conducted a study of the implementation of the Mexico City Policy. The review, which included visits to USAID-supported US NGO and foreign NGO sites, concluded that "Both the recipients of assistance [US NGOs] and their subgrantees [foreign NGOs] were found to be in complete compliance with the requirements of the Mexico City Policy." More recently, a GAO review found USAID to be in fully compliance with all restrictions affecting population funding.
  
  
• Regular Audits. Beyond technical and financial monitoring by USAID staff, USAID grantees and contractors are required to maintain extensive documentation of activities and expenditures of foreign partners. They are subject to regular independent audits to ensure that their funds are used as intended.
  
  
• Office of Inspector General Audits. When the USAID/OIG audits family planning activities, the terms of reference include assessing compliance with all relevant requirements.

Have Any Violations of USAID Policy Regarding Abortion Ever Been Identified?

No. Since 1973 internal or independent oversight investigators have found no violations.