PAC course outline

Course description

This clinical training course is designed to prepare participants to manage incomplete and unsafe abortion and work effectively as members of a team. The course begins with a two-week block at a designated training site and focuses on the development, application, and evaluation of knowledge and skills; the first week takes place in the classroom and the second week in designated clinical sites. The first two weeks are followed immediately by a six-week to three-month self-directed practicum at the participant’s worksite, during which the clinical trainers for the course provide at least one follow-up visit for mentoring and further evaluation.

Course Content

Topic  Contents/ fundamental concepts

Management of Post-abortion Complications

  • Shock
    • History Taking
    • Physical Examination
    • Pelvic Examination
    • Speculum Examination
    • Vaginal Bleeding
    • Management of Threatened Abortion
    • Management of Incomplete Abortion
    • Management of Complete Abortion
    • Follow-up Management of Ectopic Pregnancy
    • Management of Molar Pregnancy

Performing Manual Vacuum Aspiration (MVA) • Instrument
• The MVA procedure
• Preparing for the MVA procedure
• No-Touch Technique
• Performing the Procedure
• Post Procedure Care
• Pain Management
Medical Management of Incomplete Abortion • Regimen
• Treatment and Follow up
• Bleeding
• Side effects
Communication • Staff attitude
• Counselling
• Privacy and Confidentiality
• Post abortion family planning
Infection Prevention • Gloves and Gloving
• Aseptic technique
• Processing instruments
• Waste disposal

Course goals

• Influence in a positive way the attitudes of the participant towards teamwork and his/her abilities to manage and provide PAC services
• Provide the participant with the knowledge and clinical skills needed to respond appropriately to obstetric emergencies
• Provide the participant with the decision-making skills needed.
• Provide the participant with the interpersonal communication skills needed to respect the right of women to life, health, privacy and dignity.

Learning objectives
By the end of this course, participants will be able to:
• Use the recommended IP practices for all aspects of PAC
• Describe the process of rapid initial assessment and management of a woman who presents with a problem
• Describe and identify the presenting signs and symptoms of shock and describe immediate and specific management
• Describe and identify the presenting signs and symptoms of complications of unsafe or incomplete abortion
• Provide post-abortion family planning Counselling and methods.

Training/learning methods
• Illustrated lectures and group discussions
• Case studies
• Role-plays
• Simulated practice with anatomic models
• Simulations for clinical decision-making
• Guided clinical activities (providing care and performing procedures for women who require post-abortion care)

Participant selection criteria

Participants for this course must be:
Practicing clinicians (doctors, midwives and/or nurses with midwifery skills) who work at a facility where PAC is being provided or planned actively involved in the management of incomplete or unsafe abortion at the beginning of the course and committed to continuing their involvement upon completion of the course, including the provision of PAC services

Selected from health facilities capable of demonstrating consistent institutional support for
PAC services (i.e., supplies, equipment, supervision, linkages with referral facilities) supported by their supervisors or managers to achieve improved job performance after completing the course. In particular, participants should be prepared to communicate with supervisors or managers about the course and seek endorsement for training, encouragement for attendance and participation, and involvement in the transfer of new knowledge and skills to their job.


Course duration

The course is composed of 10 classroom sessions (four days), followed by one week of supervised clinical skills practice and a six-week to three-month self-directed practicum. It is important to note that course duration may need to be revised depending on participants’ experience and progress in learning new knowledge and skills. For example, if participants do not develop skills competency by the end of the course, it may be necessary to extend supervised clinical skills practice and/or the self-directed practicum. Alternatively, it may also be necessary to extend the classroom component of the course.