Medical versus surgical abortion: comparing satisfaction and potential confounders in a partly randomized study

Abstract

Background: The aim of the study was to compare satisfaction with medical and surgical abortion and to identify potential confounders affecting satisfaction.

Methods: 1033 women with gestational age (GA) < or = 63 days had either a medical (600 mg mifepristone followed by 1 mg gemeprost) or a surgical abortion (vacuum aspiration in general anaesthesia). The procedure was determined either by randomization (n = 111) or by choice (n = 922). Data on satisfaction, side effects and expectations were collected from questionnaires 2 and 8 weeks after termination.

Results: More women were very satisfied or satisfied after a surgical than a medical abortion both after choosing method (92% vs 82%, P < 0.0001), and after randomization (94% vs 68%, P < 0.001). Satisfaction was higher after choosing a medical procedure than after randomization to the same procedure; 82% and 68%, respectively, P < 0.05. Satisfaction with the medical procedure was inversely correlated with GA and the intensity of pain, nausea, vomiting and dizziness, while satisfaction with the surgical procedure was unaffected by these side effects. Fewer women with a failed medical than a failed surgical abortion were satisfied (17% vs 62%), P < 0.05.

Conclusions: Satisfaction with both medical and surgical abortions is high, although higher with the surgical than the medical procedure, and higher after choosing method than after randomization.