**5. Conclusions**

Surgical methods for abortion are effective and more cost-effective than medical management, particularly in LMICs where access to medical interventions might be limited. They are associated with fewer side effects such as pain and bleeding—a critical advantage in LMICs, where health facilities might be distant and transportation difficult.

Access to VA and D&C should be increased by training more health workers and investing in surgical equipment in secondary health-care settings. Although surgical management of incomplete abortion predominates where such services are available in LMICs, increased access should be a priority to improve postabortion care and reduce abortion-related morbidity and mortality. Medical abortion is an effective, safe, private pregnancy termination. It should be provided as a personal choice for use.

Supporting patients to identify high-quality decision aids and facilitating nonspecialist developers' adoption of best practices are needed. Increased investment in family planning will help satisfy the large unmet need for contraception by reducing the number of unintended pregnancies and dramatically lower maternal mortality and morbidity as well as the number of unsafe abortions.
