Women's opinions on the home management of early medical abortion in the UK

Abstract

Background and methodology: This survey was undertaken to obtain the opinions of women in the UK about their home management of early medical abortion (EMA) with mifepristone and misoprostol. All eligible women undergoing EMA at any BPAS clinic during a 2-week period were invited to participate. Women were contacted by telephone 1 week after the EMA and a five-item structured questionnaire was administered. One open-ended question gave women the opportunity to freely comment. Demographics and responses were tabulated using descriptive statistics. Mulitivariable logistic regression was used to assess the influence of demographic characteristics on responses.

Results: Of 249 enrolled participants, 162 were successfully surveyed (a 65% response rate). Most respondents (86%) would rather go home to complete an EMA than remain in a clinical setting. The majority (96%) found home management very or somewhat acceptable and 96% felt they could have obtained medical help easily if necessary. Most respondents (62%) would prefer home use of misoprostol as opposed to returning to the clinic to obtain and use the medication. Women were less likely to prefer home management if they were Asian (OR 0.21, 95% CI 0.05-0.87) or had a gestational age >49 days (OR 0.26, 95% CI 0.10-0.71).

Discussion and conclusions: Home management of EMA is acceptable to most women in the UK who have experienced it and is, for many, preferable to a clinical setting. Consideration should be given to updating the interpretation of the UK's 1967 Abortion Act to allow home administration of misoprostol.