{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T22:24:51Z","timestamp":1788560691960,"version":"build-2803163510"},"reference-count":51,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2018,3,1]],"date-time":"2018-03-01T00:00:00Z","timestamp":1519862400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Women's Health"],"published-print":{"date-parts":[[2018,3]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>The consequences of unsafe abortion are devastating to women, their families, and their communities. Medication abortion presents an important alternative to harmful self-induction practices and surgical intervention under questionable circumstances. In settings where mifepristone is unavailable, the use of misoprostol alone is a safe and effective option for terminating an unwanted pregnancy. Studies have demonstrated the safety and efficacy of administration of misoprostol by community health workers (CHW) for indications such as postpartum hemorrhage and treatment of incomplete abortion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>The current study assesses the safety and efficacy of CHW managing misoprostol-only abortion in the first trimester.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>A retrospective review of clinical files of women who received abortion services in three countries in Latin America between April 2009 and December 2015 included analysis of 173 cases.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>In 94% of cases, the pregnancy was terminated without any further intervention. In the remaining cases, clients were referred for manual vacuum aspiration. In four cases, a complication was reported by the provider. In one, the complication was promptly resolved through referral to a higher level of care; in the remaining three, the complication was resolved directly by the provider. In 98% of cases, women reported being satisfied with the treatment they received.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>This study demonstrates that CHW are able to provide misoprostol-only abortion services to women effectively and safely. The benefits of this model of care also extend beyond the abortion service: CHW are able to offer women a comprehensive range of quality health services, including contraceptive services, increasing access to vital healthcare in areas with few other options.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/jwh.2016.6144","type":"journal-article","created":{"date-parts":[[2017,10,17]],"date-time":"2017-10-17T15:07:41Z","timestamp":1508252861000},"page":"311-316","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":9,"title":["Building Bridges: A Case for Community Health Worker Provision of Misoprostol-Only Abortion in the First Trimester"],"prefix":"10.1177","volume":"27","author":[{"given":"Claire","family":"Tebbets","sequence":"first","affiliation":[{"name":"Planned Parenthood Federation of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diana","family":"Santana","sequence":"additional","affiliation":[{"name":"Planned Parenthood Federation of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9","family":"Ros Silvestre","sequence":"additional","affiliation":[{"name":"Planned Parenthood Federation of America"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dee","family":"Redwine","sequence":"additional","affiliation":[{"name":"Planned Parenthood Federation of America"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2018,3,1]]},"reference":[{"key":"e_1_3_4_2_2","unstructured":"WHO UNICEF UNFPA World Bank Group United Nations Population Division. Trends in maternal mortality: 1990 to 2015. Geneva: WHO Press 2015."},{"key":"e_1_3_4_3_2","volume-title":"Safe abortion: Technical and policy guidance for health systems","author":"World Health Organization","year":"2012","unstructured":"World Health Organization. Safe abortion: Technical and policy guidance for health systems, 2nd ed. Geneva: WHO Press, 2012.","edition":"2"},{"key":"e_1_3_4_4_2","unstructured":"Guttmacher Institute. Induced abortion worldwide: Global incidence and trends. New York NY: Guttmacher Institute 2016."},{"key":"e_1_3_4_5_2","unstructured":"Center for Reproductive Rights. World's abortion laws map 2014 update. New York NY: Center for Reproductive Rights 2014."},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00404-011-2110-8"},{"key":"e_1_3_4_7_2","unstructured":"Gynuity Health Projects. Choices for medical abortion introduction in Brazil Columbia Mexico and Peru. New York NY: Gynuity Health Projects 2007."},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.05.131"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1517\/13543784.2012.647405"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2010.02636.x"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/1742-4755-9-34"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2012.03.039"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.6.1477"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2004.03.007"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(99)00032-3"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(03)00134-3"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2010.09.002"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)60914-3"},{"issue":"1","key":"e_1_3_4_19_2","first-page":"S21","article-title":"Improving care of women at risk of unsafe abortion: Implementing a risk-reduction model at the Uruguayan-Brazilian border","volume":"118","author":"Fiol V","year":"2012","unstructured":"Fiol V, , Briozzo L, , Labandera A, , Recchi V, , Pi\u00f1eyro M. Improving care of women at risk of unsafe abortion: Implementing a risk-reduction model at the Uruguayan-Brazilian border. Int J Gynaecol Obstet, 2012; 118 Suppl 1:S21\u2013S27.","journal-title":"Int J Gynaecol Obstet"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1007\/BF01849540"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2011.561940"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2012.10.020"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1363\/3707511"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2005.00704.x"},{"key":"e_1_3_4_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2011-100232"},{"key":"e_1_3_4_26_2","doi-asserted-by":"publisher","DOI":"10.3402\/gha.v6i0.19649"},{"key":"e_1_3_4_27_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2007.01274.x"},{"key":"e_1_3_4_28_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(99)00116-X"},{"key":"e_1_3_4_29_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijgo.2010.08.015"},{"key":"e_1_3_4_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2017.02.008"},{"key":"e_1_3_4_31_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.12.3079"},{"key":"e_1_3_4_32_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0010-7824(98)00037-7"},{"key":"e_1_3_4_33_2","doi-asserted-by":"publisher","DOI":"10.3109\/13625189909043478"},{"key":"e_1_3_4_34_2","doi-asserted-by":"publisher","DOI":"10.1080\/ejc.6.1.39.45"},{"key":"e_1_3_4_35_2","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/17.3.654"},{"key":"e_1_3_4_36_2","unstructured":"Ipas. Clinical updates in reproductive health. Chapel Hill NC: Ipas 2016."},{"key":"e_1_3_4_37_2","unstructured":"World Health Organization. Optimizing health care worker roles to improve access to key maternal and newborn health interventions through task shifting. Geneva: WHO Press 2012."},{"key":"e_1_3_4_38_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-13-44"},{"key":"e_1_3_4_39_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2393-12-120"},{"key":"e_1_3_4_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2012.06.028"},{"key":"e_1_3_4_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61935-8"},{"key":"e_1_3_4_42_2","doi-asserted-by":"publisher","DOI":"10.1363\/3813312"},{"key":"e_1_3_4_43_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.14.143990"},{"key":"e_1_3_4_44_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(10)62229-5"},{"key":"e_1_3_4_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0968-8080(09)33445-X"},{"key":"e_1_3_4_46_2","unstructured":"World Health Organization. Health worker roles in providing safe abortion care and post-abortion contraception. Geneva: World Health Organization 2015."},{"key":"e_1_3_4_47_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2004.06.005"},{"key":"e_1_3_4_48_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2011.08.009"},{"key":"e_1_3_4_49_2","doi-asserted-by":"publisher","DOI":"10.2471\/BLT.10.084046"},{"key":"e_1_3_4_50_2","doi-asserted-by":"publisher","DOI":"10.3109\/13625187.2013.763225"},{"key":"e_1_3_4_51_2","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0b013e31818d8eb4"},{"key":"e_1_3_4_52_2","unstructured":"Singh S Wulf D Hussain R Bankole A Sedgh G. Abortion worldwide: A decade of uneven progress. New York NY: Guttmacher Institute 2009."}],"container-title":["Journal of Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/jwh.2016.6144","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2016.6144","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/jwh.2016.6144","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T17:45:55Z","timestamp":1777657555000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/jwh.2016.6144"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,3]]},"references-count":51,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2018,3]]}},"alternative-id":["10.1089\/jwh.2016.6144"],"URL":"https:\/\/doi.org\/10.1089\/jwh.2016.6144","relation":{},"ISSN":["1540-9996","1931-843X"],"issn-type":[{"value":"1540-9996","type":"print"},{"value":"1931-843X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,3]]}}}