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International Conference on Second Trimester Abortion

CONFERENCE OBJECTIVES

- To highlight the importance of second trimester abortion as a women's health, ethical and public policy issue.
- To review the situation with respect to second trimester abortion in relation to safety and efficacy of methods; legality and policy dimensions; access and service delivery; and the contribution of second trimester abortions to maternal morbidity and mortality.
- To delineate the place of medical methods within second trimester abortion.
- To provide a forum to share this information and to start a process of developing guidance on these matters and disseminate the information globally.

AGENDA
29 March - Day 1 
MORNING  Chairs: Eunice Brookman-Amissah, Cristina Villarreal
8:00- 8:45   Registration
8:45-9:00    Welcome, introduction to ICMA and the conference - 
                   Rodica Comendant, Coordinator, ICMA
9:00-9:15    Opening remarks - Dorothy Shaw, President, FIGO
9:15-9:30    Agenda and practical Issues - Rodica Comendant
9:30-12:30  Background

  • Why focus on second trimester abortions? What does "late" abortion mean? What does "early" abortion mean? Reasons for second trimester abortion; feasibility of choice of second trimester method; who carries the burden of the abortion (the doctor, the woman or the nurse) [Marge Berer]
  • Epidemiology of second trimester abortion, and mortality and morbidity from second trimester abortions compared to first trimester abortions - global overview. [Beverly Winikoff]
  • Medical and surgical abortion - overview of methods and regimen changes at different stages of pregnancy for each, from 10 weeks of pregnancy. [Kristina Gemzell]  
    [Presentations 15 minutes each and 15 minutes discussion each]

11:00-11:30  Coffee

  • Laws, policies and regulations governing second trimester abortion - global overview [Christina Zampas]
  • Ethical matters - for most people, as pregnancy progresses, the idea of abortion becomes more and more difficult. [Mette Løkeland]

12:30-2:00  Lunch
AFTERNOON  Chairs: Christine Kaseba-Sata, Tengiz Asatiani
2:00-3:30  The case for different second trimester abortion methods

Each of these three speakers covered the following aspects, as appropriate:

  • Appropriate procedures at different stages of pregnancy
  • Safety and efficacy
  • Type of provider, skills and training required
  • Aspects of procedures - anaesthetic; analgesia; cervical priming; side effects, complications; indications/contraindications, e.g. women with previous caesarean sections; and feticide.
    [Presentations 15 minutes each and 15 minutes discussion each]

3:30-4:00  Tea
4:00-5:30  Panel: Why are some second trimester methods being favoured over others in different settings 
             [Marijke Alblas, Hajo Wildschut, Khishgee Seded, Nguyen Duc Hinh]
             [Presentations 10 minutes each, discussion 40 minutes at the end]

30 March - Day 2
MORNING  Chairs: Friday Okonofua, Gunta Lazdane
9:00-10:45  Service delivery 

  • Setting up second-trimester abortion services: service delivery and training issues [Traci Baird]
    [Presentation 15 minutes; 10 minutes discussion]
  • Challenges in introducing and providing second trimester abortion services: country perspectives [Irina Zhirova; Hoang Thi Diem Tuyet; Ann Furedi]  [Presentations 15 minutes each; discussion 30 minutes at end]

10:45-11:15  Coffee
11:15-1:00

  • Providing second trimester abortion in legally restricted settings [Oladapo Shittu; Aníbal Faúndes]
    [Presentations 15 minutes each; discussion 15  minutes]
  • Mortality and morbidity following second trimester abortion [Daniel Grossman] 
    [Presentations 15 minutes each; discussion 15  minutes]
  • Values clarification on second trimester abortion. [Mosotho Gabriel and Alyson Hyman]
    [Participative session 30 minutes]

1:00-2:15  Lunch
AFTERNOON  Chairs: Christian Fiala, Mariana Romero
2:15-3:45  Women's perspectives and providers' perspectives

3:45-4:15  Tea
4:15-5:25

  • Balancing providers' perspectives and women's perspectives on second trimester abortion; differential acceptability of second trimester abortions depending on the reason for the abortion; provider burnout [Ann Furedi ]
  • How providers treat women seeking a second trimester abortion? [Marijke Alblas]
    [Presentations 15  minutes each and discussion 15 minutes]
  • Fetal pain: the evidence [Stuart Derbyshire] 
    [Presentation 10 minutes and discussion 15 minutes]

EVENING
6:00-8:00pm  Reception / dinner for conference participants, British guests
Novartis Foundation, 41 Portland Place, London W1

31 March - Day 3
MORNING  Chairs: Susana Chávez, Wanda Nowicka
9:00-10:30  Law, policy and advocacy

  • Sex selection - influence on law and policy on abortion in Asian countries [Bela Ganatra]
  • Women traveling between countries in Europe for late abortions [Christian Fiala]
  • Viability and resuscitation, Netherlands policy [Hajo Wildschut]
  • Upper time limits on second trimester abortion - women's needs and legal,
    ethical and viability issues: what should be the basis for legislation and
    practice? [Marge Berer]

          [Presentations 15 minutes each; discussion 30 minutes]

10:30-11:00 Coffee
11:00-1:00 Second trimester abortion in law, policy and advocacy: country perspectives

  •  Advocacy for second trimester abortion [Vicki Saporta; Boniface Oye-Adeniran[Presentations 10 minutes each and discussion 15 minutes at end]
  • Participants speaking 5 minutes each from the floor, e.g. Nana Oye Lithur, Ana Cristina González, Irina Zhirova, Nozer Sheriar, Cristina Villarreal and 8-10 additional people from the floor [75 minutes]

1:00-2:00  Lunch
AFTERNOON  Chairs: Marge Berer, Sharad Iyengar
2:00-3:30