Abortion and Postabortion Care: Ethical, Legal, and Policy Issues in Developing Countries


  • Suellen Miller CNM, PhD,

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    • Suellen Miller, CNM, PhD, is the Director of Safe Motherhood Programs, Women's Global Health Imperative, Department of Obstetrics and Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, and Adjunct Assistant Professor, Maternal and Child Health Program, School of Public Health, University of California, Berkeley, Berkeley, CA.

  • Deborah L. Billings PhD

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    • Debbie Billings, PhD, is a sociologist and Senior Research Associate at Ipas, based in Mexico City. She is an Adjunct Associate Professor in the Department of Maternal and Child Health, the University of North Carolina School of Public Health.

Suellen Miller, CNM, PhD, UCSF-WGHI, 74 New Montgomery Street, Suite 600, San Francisco, CA 94105. E-mail: smiller@psg.ucsf.edu


This case study of a woman who wants to terminate her pregnancy but does not have access to safe services explores the technical, ethical, and legal effects of the Mexico City Policy (Global Gag Rule) on health care providers working in developing countries. This woman's self-induced termination resulted in an incomplete abortion, and she sought care from a midwife. The current Mexico City Policy effectively limits a health care provider's ability to offer abortion services and counseling, even when these services are legal. The policy has an adverse impact on women's access to safe care. The provision of comprehensive postabortion care, not restricted by the Mexico City Policy, is the key to preventing abortion-related morbidity and mortality.