Only a few kinds of interventions account for most of the reductions in maternal mortality rates over the past 20 years.These are directed at the most important causes of maternal deaths worldwide.Unsafe abortion remains among the three leading causes in countries where access to safe abortion is restricted by law or tradition, notably in Africa and Latin America.Reduction of maternal deaths from unsafe abortion depends on adequate training of doctors and nurses to provide it.Several chapters in this book describe national programs to reduce maternal mortality that incorporated abortion training into both basic and post graduate education of health care providers.This chapter provides the rationale for training in safe abortion to reduce maternal mortality and the key components of successful efforts.

Physician approval or condemnation, advocacy or opposition, to abortion have often determined whether women can avoid the complications of unsafe abortion and, sometimes, early death.In the USA organized medicine’s early opposition to abortion outlawed it.A century later, obstetricians recognized the importance of abortion to public health.They fought to end restrictions, eventually making abortion legal in several states. At first, individual physicians violated restrictive laws, risking jail and their medical licenses.Colleagues soon supported this “civil disobedience” and influenced their professional organizations, first the American College of Obstetricians and Gynecologists then the American Medical Association, to take political action in support of abortion law reform.In many other nations, physicians advocated locally and through global organizations like WHO and FIGO for safe abortion to reduce maternal mortality.At medical schools, students insisted that their curriculums include contraception and abortion founding Medical Students for Choice to support advocacy for safe abortion despite official opposition at some schools.Those who planned careers in women’s health sought post graduate residency training that included abortion and became political adversaries of abortion bans in conservative states.