An uncontrolled pre and post-test study examined changes in the costs of providing postabortion care that are associated with the introduction of manual vacuum aspiration and improved case management procedures, including linkages with family planning services. Both treatment and overhead costs were collected by The International Population Council in Cairo to examine the effect of intervention of using MVA and counseling instated of D&C. The data collected on site in a provincial general and district hospital in Upper Egypt (Abu Quarks and general El Minia Hospitals). The results showed that over all there was a substantial decrease in the average time that patients spent in each hospital, with the greatest reduction occurring in the post-operative period. There were no important changes in the costs of the staff time, however, due to the low salary level of the principal service providers. The cost of supplies, materials and medicines increased substantially as a result of improvements in the quality of postabortion medical services, which were largely deficient prior to the introduction of the new case management procedures. Over all there was a 8 percentage point increase in the total patient costs in the larger general hospital and a 36 percentage point increase in the total patient cost in the smaller district hospital associated with the improvements in the quality of postabortion services. Selected outcome measures were utilized for estimating the cost effectiveness of the service delivery improvements. For example, there was an overall cost savings of 87%, or $143.4 per patient annual costs for the two hospitals combined in communicating the need for follow-up appointments to postabortion patients. The results of this study suggest that while overdue improvements to a neglected women's health care service are costly, there is an important spillover effect that leads to cost savings in the provision of related health care services. Future cost studies of postabortion care should continue to experiment with cost effectiveness measures to increase our knowledge of these additional benefits.