1. Misoprostol for PAC Nuriye Nalan Sahin Hodoglugil, MD, MA, DrPH Associate Medical Director nuriye@venturestrategies.org

2. Integration of misoprostol into PAC services Very effective, safe, first line of treatment Integration into training manuals and documents for PAC MVA and misoprostol offered together Registration of misoprostol for incomplete abortion and miscarriage

3. Misoprostol for PAC in Sudan Challenges with the registration (for treatment and prevention of PPH) Current use: well accepted by OB/GYNs Future use: –Pilot study to compare MVA with PAC –DKT trainings for MVA including misoprostol; integrated into the documents approved by a technical committee of MOH

4. Registration of Misoprostol in Africa & Asia

5. Integrated CAC (Comprehensive Abortion Care) Model Services by Level of Care Health Post Health Center Hospital Distribute contraceptives Refer for safe abortion & post-abortion services Provide pain medication Medication Abortion: = < 9 weeks gestation, * = < 12 weeks gestation * * MVA < 12 weeks gestation Treatment of incomplete abortion < 12 weeks with misoprostol Treatment of incomplete abortion < 12 weeks with MVA Administer antibiotics and IV fluids Second trimester uterine evacuation (abortion, IUFD, incomplete abortion) Treatment of complications

6. PAC as a Women’s Right Issue: Excerpt from the United Nations Fourth World Conference on Women (Beijing, China - September 1995) “In circumstances where abortion is not against the law, such abortion should be safe. In all cases, women should have access to quality services for the management of complications arising from abortion. Post-abortion counseling, education and family-planning services should be offered promptly, which will also help to avoid repeat abortions", consider reviewing laws containing punitive measures against women who have undergone illegal abortions…”

7. Thank you!