Acceptability and feasibility of medical abortion in Nepal

Abstract

Objective To test the feasibility and acceptability of a simplified mifepristone–misoprostol regimen for early abortion in 2 tertiary teaching hospitals and 2 family planning clinics in Nepal. Methods Consenting pregnant women (n = 400) with amenorrhea of 56 days or less seeking termination of pregnancy received 200 mg of oral mifepristone followed 48 hours later with 400 µg of oral misoprostol, administered either at home or at the clinic. Prospective data were collected to determine the women's experience, abortion outcome, and the operational requirements for providing the method. Results Most (91.3%) of the 367 women with known outcomes had successful medical abortions. Given the option, most (89.7%) women elected to administer the misoprostol at home. Conclusion A simplified medical abortion protocol, including home administration of misoprostol, can be successfully integrated into clinical services in Nepal, where abortion services were recently legalized.