Professor Alison Fiander, Clinical Lead for the RCOG Leading Safe Choices Programme, writes…
On Tuesday 3 November, we officially launched Leading Safe Choices at the House of Lords. This incredibly exciting project, under the directorship of RCOG Vice-President for Strategic Development, Professor Lesley Regan, presents an opportunity to confront two major issues that have persistently hindered progress in women’s health: contraception and abortion.
Approximately 225 million women in the world have no access to family planning and therefore little control over whether and when they become pregnant. Providing these women with the choice to use effective contraception and to space their babies by 24 months or more, would prevent 54 million unintended pregnancies, 79,000 maternal deaths and 1.1 million infant deaths.
On top of this, around 22 million unsafe abortions take place each year, resulting in the death of nearly 50,000 women. Another 5 million women suffer injury as a result of complications due to unsafe abortion, often leading to chronic disability. Safe abortion should be and can be available and accessible for all women to the full extent that the law allows.
Leading Safe Choices is a three year programme which aims to improve the competence of healthcare professionals in South Africa and Tanzania to deliver high quality postpartum family planning (PPFP) in both countries, as well as comprehensive abortion care (CAC) in South Africa and comprehensive post-abortion care (CPAC) in Tanzania.
Maternal morbidity and mortality rates are high in these countries, but almost all of these illnesses and deaths are preventable and we believe that obstetricians and gynaecologists have a moral and professional obligation to change this tragic and unacceptable reality.
Leading Safe Choices is not rocket science, it is about simple and basic medicine, but it requires a step change in the way that we think about reproductive healthcare. We have developed Best Practice Papers, training courses and accompanying manuals which form the foundations of the programme. They are accessible, practical and simplified tools to support professionals on the ground and can be adapted and used globally.
We are focused on captivating and harnessing the hearts, minds and skills of healthcare professionals to deliver high quality reproductive health services. The next stage of the project is crucial as it involves training and mentoring healthcare professionals, including doctors, nurses and midwives in both South Africa and Tanzania. The first training courses will be held in South Africa in December and the Leading Safe Choices team is very excited to start training in-country.
The training will include the provision of long acting reversible contraceptives (LARCs) immediately postpartum so that women who struggle to access family planning services are able to space their children and avoid unintended pregnancies. We will also conduct training to improve women’s access to safe abortion and post abortion care to the full extent of the local law. This is vital to ensure that not only do women have access to safe services, where they are treated with dignity and respect, but that providers feel equipped, motivated and supported to deliver those services too.
A key part of our strategy will be to develop a system that measures and recognises the skills and competence of these dedicated providers of reproductive health services. By establishing a locally owned accreditation process, we aim to enhance the pride and self-esteem of these professionals and raise their standing and respect amongst peers.
By investing in improving reproductive healthcare, the RCOG will make a real and sustainable difference to the quality and availability of postpartum family planning and comprehensive abortion care offered to women. We hope that Leading Safe Choices will inspire healthcare professionals, wherever we work, to think about how we can stand up for women’s health and how to value all women in our society.