title: Improving care of women at risk of unsafe abortion: implementing a risk-reduction model at the Uruguayan-Brazilian border.
abstract: OBJECTIVE
  To describe the initial stages of the implementation of a risk-reduction model designed by Iniciativas Sanitarias to shield women from unsafe abortion in a traditional community on the Uruguay-Brazil border.
  
  
  METHODS
  This mixed-design study was conducted first between 22 and 26 March 2010, and then between 2 and 7 May 2011, in Rivera, Uruguay, to gather information from women seen at health centers, healthcare providers, and local policy makers before the project started and midway through the project.
  
  
  RESULTS
  At baseline most women and providers considered abortion justifiable only on narrow grounds, yet favored the implementation of a risk-reduction model that would include preabortion as well as postabortion counseling, the former providing information on different abortion methods and their risks. By the midterm assessment, the counseling service had assisted 87 women with unwanted pregnancies. Of the 52 who came for a postabortion visit, 50 had self-administered misoprostol, with no complications. Women were highly satisfied with the counseling. At baseline, misoprostol seemed to be available from both pharmacists and informal sellers. At midterm, it was still available from informal vendors but pharmacists said they did not provide misoprostol. The risk-reduction initiative heightened public attention to the abortion issue but the controversy it generated did not seriously impede its implementation.
  
  
  CONCLUSIONS
  It is feasible to implement the proposed risk-reduction model in a traditional community such as Rivera, not only in Uruguay but in any country irrespective of its abortion laws.
authors: Iniciativas Sanitarias, Montevideo, Uruguay. verofiol@hotmail.com
authors: Verónica
authors: V
authors: Fiol
authors: Leonel
authors: L
authors: Briozzo
authors: Ana
authors: A
authors: Labandera
authors: Víctor
authors: V
authors: Recchi
authors: Marta
authors: M
authors: Piñeyro
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal; D000028:Abortion, Induced / Q000523:psychology*; D001291:Attitude of Health Personnel; D001938:Brazil; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D016595:Misoprostol; D011247:Pregnancy; D011275:Pregnancy, Unwanted; D011639:Public Opinion; D034121:Reproductive Health Services / Q000458:organization & administration*; D040242:Risk Reduction Behavior; D014583:Uruguay
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol