Management of Unintended and Abnormal Pregnancy

This book was written as an authoritative update to the previous textbook produced in 1999 by the National Abortion Federation (NAF). The previous text, A Clinician’s Guide to Medical and Surgical Abortion, addressed rapidly changing issues of the time in the provision of excellent abortion care. This new text further updates the ongoing evolution of the field, in an area of medical care with a fairly scanty literature. The important context of such work is the immense political and religious turmoil in the United States, and the world, on the subject of abortion, despite the fact that it is one of the most common procedures performed in medicine. Abortion has been a common, if often hidden, fact of life in all cultures, in all periods of history. Unsafe abortion leads, all too often, to death or permanent injury; safe abortion is much medically safer than continuing a pregnancy. The intent of this book is to improve the provision of safe abortion. The book addresses a broad range of abortion-related issues, from the sociopolitical and global health challenges, to technical aspects of specialized areas of abortion care such as late pregnancy terminations and selective reduction of multiple gestations, as well as practical aspects of counseling, contraception, and requirements for establishing safe services. There is a comprehensive appendix of resources for abortion providers. The book is consistently readable. The organization is sound, and the progression of chapters and topics flows quite smoothly. What I particularly appreciated was the flexibility of recommendations. Many clinicians will have strong preferences for the “right” way to do things. This text strives to offer appropriate options for individual practice, without insisting on a specific method. The panel of editors includes some of the most highly regarded experts in the field and draws on a distinguished group of authors, including some from England, Sweden, and the World Health Organization in Switzerland. I was disappointed by the absence of family physicians in the authorial collection. Family physicians are an increasingly active group within the abortion community, and increasing access to abortion training in family medicine residencies is an area of ongoing activism within our field. Physicians from several disciplines other than OB-GYN, particularly family medicine and pediatrics, have produced significant research in the abortion field and have contributed considerably to the provision of abortion services, particularly in communities where there would otherwise be little to no access to such care. This book will be most useful for clinicians providing abortion care, at every level of training and experience, from medical students to senior practitioners. It will, however, also prove useful for those interested in the social, psychological, and public health aspects of abortion. Many readers will learn from a single reading; abortion clinicians will want this book on their reference shelf.