Learnings from ICFP 2025: A practical, transformative solution to safe abortion care

For many people around the world, safe abortion care is not accessible. In my work as a Sexual and Reproductive Health and Rights (SRHR) specialist with Oxfam Canada, we see this reality in the communities and programmes that we work with. This is why I wanted to listen and learn first-hand from the activists, health care providers, researchers, policy makers, civil society organizations and governments who work to promote SRHR, including the right to safe abortion care. To do this, I recently travelled to Bogotá, Colombia, to attend the International Conference on Family Planning (ICFP). Grounded by the theme Equity Through Action  the global gathering brought together thousands of people from over 100 countries to reflect, learn, and re-commit to advancing SRHR around the world. 

There are many barriers to safe abortion care: a lack of accurate information on where services are available or whether abortion is legally permitted, stigma and judgement, long distances to health facilities, high costs, shortages of trained health care providers, and lack of privacy and confidentiality.

Abortion is legally permitted in most countries around the world. However, in many contexts, restrictive laws narrow eligibility criteria, impose mandatory waiting times, or require burdensome approvals. Restrictive laws can also suppress access beyond the legal criteria.

When safe abortion is inaccessible, people resort to unsafe abortion. Unsafe abortion is defined as an abortion carried out by someone lacking necessary skills, in an environment that does not meet minimal medical standards, or both. This can include dangerous methods such as inserting foreign objects into the vagina or ingesting toxic substances. The consequences are devastating. Unsafe abortion leads to serious complications like bleeding and infection – and remains one of the leading causes of maternal mortality. Worldwide, almost 7 million hospitalizations and 40,000 preventable deaths are estimated to result from unsafe abortion every year.

These complications and deaths are completely preventable. Safe abortion saves lives. 

Ensuring access to safe abortion requires multiple, coordinated actions: addressing stigma, promoting accurate information, training health care providers, expanding who can provide abortion care, ensuring availability of medicines and supplies, and decriminalizing abortion.

One practical, transformative solution that I heard repeatedly at ICFP was self-managed abortion.

Self-managed abortion is when someone ends a pregnancy using medication outside a clinical setting, with access to accurate information, counselling, and support. For it to be safe and effective, people need clear guidance on how to use the medicine, what to expect in the process, and when to seek medical care if needed. They also need access to quality medicines and access to health care if complications arise. 

Self-managed abortion is safe and effective and the risk of severe, life-threatening complications are rare. In legally restricted settings, abortion pills are widely available in pharmacies, informal vendors, or online. Many people prefer self-managed abortion because it offers autonomy, comfort, accessibility and flexibility. It allows people to choose when or where to manage the process, arrange childcare or time off work, avoid long, costly travel, and reduce exposure to stigma and judgement in health care settings. 

Self-managed abortion should expand choice – not replace health facility-based care. People should still be given the option to have a safe abortion in a health facility if they want or need to.

In Oxfam’s Stand Up for Sexual and Reproductive Health and Rights project, this continuum of self-managed and health facility-based care is put in practice in Mozambique. Partners support safe abortion care in health facilities and also ensure people have access to clear information and supportive counselling about self-managed abortion to help them make informed choices.

At ICFP, researchers, program specialists, and activists showcased how they are promoting access to self-managed abortion.

• Feminist accompaniment and activist networks in Latin America – known as acompañantes – facilitate access to medication and support pregnant people through self-managed abortion outside of clinics with holistic, quality, person-centred, non-stigmatizing, demedicalized support. Acompañantes are part of a broader feminist political movement grounded in the belief in bodily autonomy, self-determination and collective care. 

• Women Help Women and Mobilizing Activists around Medical Abortion (MAMA) Network support local feminist groups to support self-managed abortions in legally restrictive settings as a tool of empowerment. They provide training and a practical self-managed abortion guide for advocates and community health workers. They also facilitate access to abortion pills and connections to global movements. 

• Hotlines, digital platforms, and apps are being developed and offered to ensure people have access to accurate information and counselling. In Kenya, the Aunty Jane toll-free hotline offers non-judgmental, quality and confidential information and referrals for safe abortion and post-abortion care by trained counsellors. In Venezuela, the Aya Contigo app connects users with a peer counsellor who guides them through the abortion journey with personalized, confidential, compassionate, trauma-informed support. Clear information is also provided on what to expect, when and where to seek care, and how to navigate the experience. In the Middle East, Médecins sans Frontières (MSF) implemented a telehealth model that combines quick, discreet provision of abortion medication in the clinic and remote counselling and support over the phone. This was simple, low-cost and effective.

• In humanitarian emergencies, unsafe abortion is often the leading cause of maternal mortality. Despite the scale of need for safe abortion care, it remains largely absent from humanitarian health responses. A response from one organization described training friendship networks to provide calm reassurance, help in accessing abortion medication and navigating care, and discreet “comfort kits” with pain medicines, herbal tea, and emergency contraception to prevent future unintended pregnancies.

At ICFP, I reflected on how strategies and solutions to promote safe abortion care are not only within health systems, laws and policies – but with people and communities. I witnessed how feminists and activists are supporting women taking control of their health and bodies. I was inspired by the stories of women, in all their diversity, claiming their autonomy. 

Advancing access to self-managed abortion requires sustained investment in accurate information, community-based support, accessible health systems, and supportive policies and laws. 

Leaving ICFP, I felt urgency and hope. Urgency because of the immense and immediate needs. Hope because of the solutions that exist and the work so many are already doing together.

Colleen Dockerty is a Sexual and Reproductive Health and Rights and Gender-Based Violence specialist with over a decade of experience in humanitarian and development settings. She is a Registered Nurse, holds a Master’s in Public Health, and brings a feminist, rights-based, and evidence-informed approach to advancing sexual and reproductive health and rights (SRHR). Colleen has worked with Oxfam Canada, Médecins Sans Frontières and Norwegian Church Aid, providing technical leadership and supporting multi-country projects across Africa, the Middle East and Asia.