Efficacy, acceptability and safety of medication abortion in low-income, urban Latina women

Abstract

Background Health care providers may be reluctant to offer medication abortion to low-income, non-English-speaking populations. Concerns include lack of patient interest, incorrect use of misoprostol at home, missing mandatory follow-up visits and inappropriate use of emergency services. We describe the appeal, acceptability, safety and follow-up rates of medication abortion in a low-income Latina population in New York City. Study Design Nested analysis of 270 subjects up to 63 days' gestation enrolled in a multicenter trial of medication abortion comparing different mifepristone–misoprostol intervals. After receiving mifepristone, subjects were instructed on home use of misoprostol, what to do in an emergency and when to return. Results This population was predominantly Spanish-speaking, unmarried, poor and publicly insured. Ninety-six percent took the misoprostol at home correctly, 90% returned as scheduled without reminders and 2% were lost to follow-up. Ninety-six percent described the experience as positive or neutral and 94% would recommend medication abortion to a friend. Three serious adverse events occurred and women accessed emergency services appropriately. Conclusion Medication abortion can be a very appealing, safe and effective option in low-income, non-English-speaking populations.