Self-care, as defined the in Glossary, is a broad-based concept and can encompass numerous actions that are intended to empower the individual to enhance their own health. Self-management approaches are one component of self-care. Given the nature of the medical abortion process, it is possible for women to manage the process by themselves in whole or part. While individuals may conduct some or all elements related to the abortion process (self-assessment of eligibility, self-administration of medicines and self-assessment of the success of the abortion) entirely on their own, more typically, self-management co-exists with interactions with trained health workers or with a health-care facility and in conjunction with service-delivery approaches described in section 3.6.1. It is the individual (i.e. the “self”) who drives the process of deciding which aspects of the abortion care will be self-managed and which aspects will be supported or provided by trained health workers or in a health-care facility.
Women may self-manage parts or all of the abortion process for a variety of reasons related to individual circumstances and preferences. For some women, this may be the only feasible option within their context and for others it may represent an active choice. However, from the perspective of the health system, self-management should not be considered a “last resort” option or a substitute for a non-functioning health system. Self-management must be recognized as a potentially empowering and active extension of the health system and task-sharing approaches. A supportive enabling environment as described in Chapter 1, section 1.3, is equally applicable to self-management approaches as it is to other elements of care provision. (author introduction)