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Home use of misoprostol for early medical abortion in a low resource setting: secondary analysis of a randomized controlled trial
Department of Women's and Children's Health, Karolinska Institute, WHO collaborating Centre, Karolinska University Hospital, Stockholm, Sweden.
Department of Women's and Children's Health, Karolinska Institute, WHO collaborating Centre, Karolinska University Hospital, Stockholm, Sweden.
Action Research & Training for Health (ARTH), Satyam, Ramgiri, Badgaon, Udaipur, Rajasthan, India.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Women's and Children's Health. (Internationell kvinno- & mödrahälsovård och migration/Essén)
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2016 (English)In: Acta Obstetricia et Gynecologica Scandinavica, ISSN 0001-6349, E-ISSN 1600-0412, Vol. 95, no 2, 173-181 p.Article in journal (Refereed) Published
Abstract [en]

INTRODUCTION: Although home use of misoprostol for early medical abortion is considered to be safe, effective and feasible, it has not become standard service delivery practice. The aim of this study was to compare the efficacy, safety, and acceptability of home use of misoprostol as compared to clinic misoprostol in a low-resource setting.

MATERIAL AND METHODS: This was a secondary analysis of a randomised controlled trial conducted in 6 primary care clinics in India. Women seeking medical abortion up to 9 gestational weeks (n= 731) received mifepristone in the clinic, and were allocated either to home or clinic administration of misoprostol. Follow-up contact was after 10-15 days.

RESULTS: Of 731 participants, 73% were rural and 55% had no formal education. Complete abortion rates in the home and clinic misoprostol groups were 94.2% and 94.4% respectively. The rate of adverse events was similar in both groups (0.3%). A greater proportion of home users (90.2%) said that they would opt for misoprostol at home in the event of a future abortion, than the proportion of clinic users (79.7%) that would opt for misoprostol at the clinic, in a similar situation (p=0.0002). Ninety six percent women using misoprostol at home or in the clinic were satisfied with their abortion experience.

CONCLUSIONS: Home-use of misoprostol for early medical abortion is as effective and acceptable as clinic use, in low resource settings. Women should be offered a choice of this option regardless of distance of their residence from the clinic and communication facilities.

Place, publisher, year, edition, pages
2016. Vol. 95, no 2, 173-181 p.
Keyword [en]
Termination of pregnancy; home administration; mifepristone; misoprostol; medical abortion; low-resource setting; India
National Category
Obstetrics, Gynecology and Reproductive Medicine
Identifiers
URN: urn:nbn:se:uu:diva-268452DOI: 10.1111/aogs.12815ISI: 000368004300006PubMedID: 26565074OAI: oai:DiVA.org:uu-268452DiVA: diva2:876763
Funder
Sida - Swedish International Development Cooperation AgencySwedish Research Council, 2011-3525
Available from: 2015-12-04 Created: 2015-12-04 Last updated: 2017-12-01Bibliographically approved

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Paul, MandiraEssén, Birgitta

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