The acceptability of home medical abortion to women in UK settings

Abstract

Objective: To assess the acceptability of home medical abortion to women in UK settings.

Design: Questionnaire survey.

Setting: Four NHS gynaecology units in England and Scotland.

Subjects: Women undergoing conventional, hospital-based, medical abortion up to nine weeks of gestation.

Methods: A self-complete questionnaire explored the acceptability of abortion in hospital (including pain and bleeding experienced) and at home. Comparisons were made between centres (English and Scottish).

Main outcome measure: Women's views on home administration of misoprostol for medical abortion; perceived acceptability and perceived ability to cope with the process at home.

Results: Sixty-six percent (366/553) of the questionnaires were returned: Edinburgh, 204 (56%); London, 92 (25%); Hull, 43 (12%); and Glasgow, 27 (7%). Individual questionnaire items were answered by varying numbers of women: 228/320 (71%; 95% CI: 66-76%) said there was nothing that happened during abortion in the hospital that they would have been unable to cope with at home; 123/342 (36%; 95% CI: 31-41%) said they would have opted to have home abortion, had that choice been available. However, 219/342 (64%; 95% CI: 59-69%) indicated that they would prefer to have abortion in the hospital. The majority of women said they would have coped at home with bleeding (280/355, 79%; 95% CI: 74-83%) and with pain if given analgesia (203/268, 76%; 95% CI: 70-81%).

Conclusion: This study suggests that most women would welcome being offered the choice of having medical abortion at home or in hospital. The development of home abortion must be seen as complementary, not an alternative, to hospital services.