REPRODUCTIVE HEALTH PROGRAM (EBERT)
Reducing Unsafe Abortion

Medical Abortion Research

In collaboration with colleagues internationally, Population Council staff conduct medical abortion research. As part of the overarching goal of saving women’s lives by reducing abortion-related morbidity and mortality, the goal of these studies is to improve the availability and quality of medical abortion services. Compared to surgical alternatives, medical methods are considered highly effective and very safe, particularly for use in countries where surgical procedures are either unavailable or the quality of services is poor.

The majority of the Council’s research focuses on mifepristone-misoprostol medical abortion. Mifepristone was first approved in France in 1988 for termination of early pregnancies—up to 49 days since last menses. In September 2000 it was approved by the U.S. Food and Drug Administration (FDA), for this same indication.

Population Council medical abortion research includes:

• Exploring Extending Gestational Age Limits for Medical Abortion
  Increasing the gestational age limits for medical abortion is critical in use of the method. In particular, use beyond 63 days since the last menstrual period (LMP) is likely to help make medical methods a more standard part of abortion services in places where women typically present for termination late in the first trimester. Population Council researchers conducted a study at two sites—Rochester, New York, and Pune, India—to assess the efficacy of a mifepristone-misoprostol regimen for gestations between nine and twelve weeks LMP. Interim results suggest that medical abortion with mifepristone and misoprostol may be a safe, effective, and acceptable alternative to surgery later in the first trimester. Given international colleagues’ interest in identifying a non-surgical alternative for women seeking pregnancy termination late in the first trimester, a research site was recently added in Vietnam.
    
• Developing a Highly Effective and Simple Home Use Medical Abortion Regimen
  The efficacy of early medical abortion using 600 mg mifepristone, followed 48 hours later by 400 mcg oral misoprostol, has been firmly established at a rate of between 92 and 97%. In an effort to boost efficacy and to assess acceptability of this method, Population Council researchers have investigated simplified medical abortion regimens. For instance, several Council studies have been undertaken in collaboration with researchers in developing countries to study medical abortion regimens with a reduced mifepristone dose (200 mg) followed by home administration of misoprostol. (See "Can Women in Less-developed Countries Use a Simplified Medical Abortion Regimen?" in Publications/Resources section below.) Using this simplified medical abortion regimen, more than 90% of women have been able to successfully terminate their unwanted pregnancy.
    
• Expanding Access to Mifepristone in Less Developed Countries
  Council researchers are also committed to exploring expanded access to medical abortion in less developed countries, where surgical options, though legal, are either inaccessible, unsafe, or the quality of services is poor. This includes research in Eastern Europe, where medical abortion has not previously been available; laying the groundwork to test medical abortion in Thailand, where access to abortion is legally restricted; exploring provision of medical abortion in peri-urban and rural areas of Tunisia through mobile clinics; and researching provision of medical abortion at various levels of the health-care system in Vietnam.

Research Studies

• Reducing Unsafe Abortion
• Postabortion Care Research
    

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This page updated on
19 October, 2007