Abstract
BackgroundIncreasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion, which is achieved by increasing safe choices for pregnancy termination. Medical abortion for termination of early abortion is said to safe, effective, and acceptable to women in several countries. In Ethiopia, however, medical methods have, until recently, never been used. For this reason it is important to assess women's preferences and the acceptability of medical abortion and manual vacuum aspiration (MVA) in the early first trimester pregnancy termination and factors affecting acceptability of medical and MVA abortion services.MethodsA prospective study was conducted in two hospitals and two clinics from March 2009 to November 2009. The study population consisted of 414 subjects over the age of 18 with intrauterine pregnancies of up to 63 days' estimated gestation. Of these 251 subjects received mifepristone and misoprostol and 159 subjects received MVA. Questionnaires regarding expectations and experiences were administered before the abortion and at the 2-week follow-up visit.ResultsThe study groups were similar with respect to age, marital status, educational status, religion and ethnicity. Their mean age was about 23, majority in both group completed secondary education and about half were married. Place of residence and duration of pregnancy were associated with method choice. Subjects undergoing medical abortions reported significantly greater satisfaction than those undergoing surgical abortions (91.2% vs 82.4%; P < .001). Of those women who had medical abortion, (83.3%) would choose the method again if needed, and (77.4%) of those who had MVA would also choose the method again. Ninety four percent of women who had medical abortion and 86.8% of those who had MVA would recommend the method to their friends.ConclusionsWomen receiving medical abortion were more satisfied with their method and more likely to choose the same method again than were subjects undergoing surgical abortion. We conclude that medical abortion can be used widely as an alternative method for early pregnancy termination.
Highlights
Increasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion, which is achieved by increasing safe choices for pregnancy termination
The mean age of women who opted for the medical method was 23.1 years and that of manual vacuum aspiration (MVA) was 23.7 years respectively
The duration of pregnancy was less than 7 weeks in 174 (69.3%) women who chose medical abortion and 89 (56.0%) of those who chose MVA (Table 2)
Summary
Increasing access to safe abortion services is the most effective way of preventing the burden of unsafe abortion, which is achieved by increasing safe choices for pregnancy termination. In Ethiopia, medical methods have, until recently, never been used For this reason it is important to assess women’s preferences and the acceptability of medical abortion and manual vacuum aspiration (MVA) in the early first trimester pregnancy termination and factors affecting acceptability of medical and MVA abortion services. Based on the revised law, the Federal Ministry of Health of Ethiopia developed technical and procedural guidelines for safe abortion services [2]. According to the national guidelines on safe abortion services, the Family Health Department of the Ministry of Health of Ethiopia, and partners like Ipas are collaborating to expand access to comprehensive abortion services. The preparation consists of 200 mg mifepristone (one tablet), to be taken on day 1, and 0.8 mg misoprostol (four tablets) to be taken on day 2 or day 3
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