Abortion: Quality Care and Public Health Implications

Class Central Tips

• Learn How to Sign up to Coursera courses for free
• 1600+ Coursera Courses That Are Still Completely Free

Abortion isa common experience for reproductive-aged women around the world.  In the US, half of all pregnancies areunintended and half of these end in abortion. (Finer 2013) Around the world,43.8 million abortions were done in 2008 representing one fifth of allpregnancies. (Sedgh 2012)  Abortion issafe and has lower morbidity and mortality than childbirth when carried out bytrained practitioners in sanitary conditions (Raymond 2012), but nearly half ofthe abortions done in the world are unsafe, according to the WHO definition.

Despiteits universality, abortion remains controversial and inaccessible for manywomen. Both the clinical and public health contexts of abortion are oftenexcluded from curricula in medicine, nursing, and other health professions. Restrictionsat the hospital or clinic level, and conscientious objection at the providerlevel compounded with legal restrictions further reduce women’s access toservices. 

In this six-weekcourse, over twenty faculty from various institutions and multiple disciplines will place abortion within the context ofpublic health and fill in the gaps left by its exclusion from mainstreamcurricula in health professions. Each week’s lectures will incorporate thestories of women who seek abortion in order to better portray abortion significance and rationale.  Other topics will include a briefhistory of abortion, the clinical aspects of medication and proceduralabortions in and after the first trimester, an overview of patient-centeredabortion-care, the basics of abortion counseling, the professional obligationsof health care practitioners to ensure that women have access to safe abortioncare, and the maze of restrictions that make safe abortion care inaccessible tomany women. 

In addition to video lectures, there will beweekly quizzes, peer assessments, and optional additional content and readingfor learners who want to explore the topic further.  

WEEK 1: Abortion in the U.S. And Around the World

• Introduction to the public-health frameworkof this course
  
• Who has abortions, why, and how do theyaccess care
  
• History of abortion and abortion stigma
  

WEEK 2: Abortion, Professionalism, and Patient-Centered Counseling

• Principles of pregnancy options counseling, abortion counseling,and informed consent
  
• Abortion in the United States after legalization
  
• Professional responsibilities around abortion care
  
• Values clarification about abortion care
  
• Conscientious provision and refusal in abortion care
  

WEEK 3: Abortion in the First Trimester

• Clinical aspects of medication abortion, aspiration abortion,post-abortion contraception, and pain management for abortion
• Legislative and policy obstacles to abortion access
  

WEEK 4: Abortion after the First Trimester: Obstacles to Accessing Safe Abortion in the U.S. And Worldwide

• Who has abortions after the first trimester and how do theyaccess care
  
• Clinical aspects of abortion after the first trimester
  
• Role of patient preference in appropriate care
  
• Guidelines for safe abortion care and the principles of high-quality abortion care across settings
• Complications and myths about abortion
  

WEEK 5: Overcoming Obstacles to AbortionAccess

• Sociology of abortion especially related to health andhealth-care disparities
  
• Impact of obstacles on clinical care
  
• Importance of abortion training for health professionals
  

WEEK 6: Early Pregnancy Loss and CourseConclusions

• Patient-centered care for early pregnancyloss
  
• Counseling and decision making for earlypregnancy loss
  
• Relationship between early pregnancy losscare and abortion care
  
• Course conclusions