Acceptability of medical abortion in early pregnancy

Abstract

A review of 12 published studies on patient attitudes and reactions to early first-trimester pregnancy termination by medical methods shows consistent patterns, despite important differences in study design, measurement and outcome. In most trials that offered participants a choice between surgical and medical abortion, 60-70% of patients chose the medical method. The most common reasons cited for choosing the medical method were greater privacy and autonomy, less invasiveness and greater naturalness than surgery. Frequently mentioned drawbacks included pain, the duration of bleeding, the number of visits, and the waiting time to know if the treatment has been successful. Most women who had a medical abortion said they were satisfied with the method, would recommend it to friends and would use it again if they needed another abortion.

PIP: A review of the 12 published articles on the acceptability of RU-486-induced first-trimester abortion indicated that 60-70% of women preferred medical abortion to the surgical method. The 12 studies, conducted in Sweden, England, Hong Kong, Scotland, Denmark, France, and the US, differed in terms of clinical regimen (RU-486 alone or in combination with a prostaglandin suppository), sample size (range, 18-251), duration of amenorrhea (maximum, 63 days), and patient allocation (random or patient choice). In surveys where pregnant women were offered a choice of abortion method, those who selected RU-486 induction did so because of a fear of surgery or anesthesia, its "naturalness," and privacy and autonomy. After medical abortion, women reiterated these advantages; on the other hand, those who received concomitant prostaglandin administration reported more pain and heavier bleeding than they anticipated. Other drawbacks identified included the need for multiple clinic visits and the long wait to know if the method had been successful. In the eight studies where women were asked if they would undergo another medical abortion, 64-85% responded affirmatively. In general, RU-486 acceptors who had the option of choosing between medical or surgical abortion were more likely to be positive about the method.