Knowledge and perceptions of medical abortion among potential users

Abstract

Nearly two-thirds of 73 women aged 18-34 who participated in focus groups on medical abortion conducted in three cities had heard about this new abortion method, but only a few could describe it accurately. Once the method was described to them, they cited its potential advantages over vacuum aspiration as being fewer major complications, the absence of surgery, a greater "naturalness," and its use earlier in pregnancy. Women listed as disadvantages the multiple visits needed for medical abortion, the unknown aspects of the new technology, especially regarding the expulsion of the conceptus, and concern that mifepristone would make an abortion too easy and lead some women to take the decision lightly. More than one-third of discussants said they would choose mifepristone if the method were available.

PIP: The aim of the study was to assess the level of knowledge about mifepristone (RU-486) among US women and to examine the perceived advantages and disadvantages of the drug compared with surgical abortion. In May 1994, 8 focus groups were conducted on medical abortion with 73 sexually active women ages 18-34 recruited from family planning clinics: 3 groups were held with 30 non-Hispanic Whites, 3 with 27 Blacks, and 2 with 16 Hispanics in New York City, Los Angeles, and Portland, Oregon. The mean number of years of education was 13.4 years. 78% were single, 63% had ever been pregnant, and 45% had had an abortion. 63% of 73 women had heard about this new abortion method, but only a few could describe it accurately. Some asserted that RU-486 was the morning-after pill, others referred to it as the abortion pill which was not available in the US. Once the method was described to them in a written profile, they cited its potential advantages over vacuum aspiration as fewer major complications, no risk of uterine perforation, the absence of surgery and anesthesia, its natural and noninvasive nature, and its use earlier in pregnancy. Women listed as disadvantages the multiple visits needed for medical abortion, the unknown aspects of the new technology, especially regarding the expulsion of the conceptus, and concern that mifepristone would make an abortion too easy and lead some women to take the decision lightly. Most women perceived the 2-day wait between pills as disadvantage, and they were curious about the effect on the fetus, if any, if subsequently the pregnancy were carried to term. More than 3/4 of the 27 women who selected RU-486 said they preferred it because it avoids surgery and anesthesia. 1/3 of these cited the absence of the risk of uterine perforation and infection.