Population Council Research that makes a difference

Abstract

Acceptability and feasibility of early pregnancy termination by mifepristone-misoprostol (PDF) 
Winikoff,Beverly; Ellertson,Charlotte; Elul,Batya; Sivin,Irving
Archives of Family Medicine 7(4): 360-366
Publication date: 1998

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Objectives
To evaluate whether the regimen of oral mifepristoneand misoprostol for medical abortion is acceptable to womenand providers, in the United States, including physicians, nurses,and counselors, and whether proposed modifications of this regimenappear feasible for clinical practice.

Design
A prospective study.

Setting
Seventeen clinics in 15 states.

Participants
A total of 2121 women with pregnancies of63 days or less in duration.

Interventions
The administration of mifepristone, 600mg, orally, followed after 2 days by the administration of misoprostol,400 µg, orally. Clinical observation for 4 hours followedmisoprostol administration. Two weeks later, at a checkup, womenwere questioned about the abortion experience. Providers alsoanswered questions about acceptability and feasibility.

Main Outcome Measures
Patient reports of overall satisfactionwith the abortion, the number of women who would choose medicalabortion again if needed or recommend the method to others,the best and worst features of the method, and provider andpatient assessments of home use.

Results
The regimen was highly acceptable. Nearly allwomen (95.7%) would recommend it to others, 91.2% would chooseit again, and 87.6% found it very or moderately satisfactory.Even among women for whom the method failed, 69.6% would tryit again, 84.9% would recommend it to others, and 51.9% foundit very or moderately satisfactory. The chance to avoid a surgicalprocedure was reported as the method's best feature. The mostcommonly cited worst features were the uncertainty and fearof side effects. Providers and women considered home use feasibleand safe.

Conclusions
American women found abortion with the useof mifepristone and misoprostol acceptable. Even most with unsuccessfuloutcomes would select the regimen again and recommend it toothers. Most providers and women thought that home use of misoprostolshould be available for women who prefer it.

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