Comparison of medical abortion with surgical vacuum aspiration: women's preferences and acceptability of treatment

OBJECTIVES--To assess women's preferences for, and the acceptability of, medical abortion and vacuum aspiration in the early first trimester. DESIGN--Patient centred, partially randomised trial. Medical abortion was performed with mifepristone 600 mg followed 48 hours later by gemeprost 1 mg va...

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Bibliographic Details
Published in:BMJ 1993-09, Vol.307 (6906), p.714-717
Main Authors: Henshaw, R C, Naji, S A, Russell, I T, Templeton, A A
Format: Article
Language:English
Subjects:
Abortifacient Agents, Nonsteroidal - therapeutic use
Abortion
Abortion, Induced - methods
Abortion, Induced - psychology
Adjectives
Adult
Alprostadil - analogs & derivatives
Alprostadil - therapeutic use
Bioethics
Choice Behavior
Clinical trials
Female
Gender equality
Gynecology
Humans
Induced abortion
Medical procedures
Mifepristone - therapeutic use
Patient Satisfaction
Population
Pregnancy
Pregnancy Trimester, First
Pregnant Women
Surgical specialties
Vacuum aspiration
Vacuum Curettage
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Summary:OBJECTIVES--To assess women's preferences for, and the acceptability of, medical abortion and vacuum aspiration in the early first trimester. DESIGN--Patient centred, partially randomised trial. Medical abortion was performed with mifepristone 600 mg followed 48 hours later by gemeprost 1 mg vaginal pessary. Vacuum aspiration was performed under general anaesthesia. SETTING--Teaching hospital in Scotland. PATIENTS--363 women undergoing legal induced abortion at less than nine weeks' gestation. MAIN OUTCOME MEASURES--Women's preferences for method of abortion before abortion; acceptability judged two weeks after abortion by recording the method women would opt to undergo in future and by semantic differential rating technique. RESULTS--73 (20%) women preferred to undergo medical abortion, and 95 (26%) vacuum aspiration; 195 (54%) were willing to undergo either method, and were allocated at random. Both procedures were highly acceptable to women with preferences. Gestation had a definite effect on acceptability in randomised women; at less than 50 days there were no differences, but between 50 and 63 days vacuum aspiration was significantly more acceptable. CONCLUSIONS--Women who wish to use a particular method should be allowed their choice, regardless of gestation. Women of 50-63 days' gestation without preferences for a particular method are likely to find vacuum aspiration more acceptable. A patient centred, partially randomised trial design may be a useful tool in pragmatic research.
ISSN:0959-8138
1468-5833
1756-1833
DOI:10.1136/bmj.307.6906.714