Resumen : To assess the acceptability of medical abortion in developing country settings, women presenting to six urban clinics in China, Cuba, and India were given a choice between surgical or medical abortion. The final sample included 799 medical and 574 surgical abortion clients. The former received 600 mg of mifepristone followed, 48 hours later, by 400 mcg of misoprostol, while the latter underwent dilatation and sharp curettage. Medical abortion patients tended to base their choice on the avoidance of surgery and anesthesia, while surgical abortion patients viewed that option as faster and simpler. 92% of Chinese, 80% of Cuban, and 89% of Indian medical abortion patients aborted by the end of the day the prostaglandin was administered. Failure rates for medical and surgical abortion were highest in Cuba (16% and 4%, respectively), intermediate in China (8.6% and 0.4%, respectively), and lowest in India (5% and 0%, respectively). Side effects such as nausea, vomiting, cramping, pain, diarrhea, and bleeding were significantly more frequent among medical than surgical abortion patients, yet general assessments of well-being given at exit interviews were similar. 84-95% of medical and 94-100% of surgical abortion patients were either satisfied or highly satisfied with their experience. Medical patients were more likely than surgical patients to state they would select the same method if they needed another abortion. Of 28 providers surveyed, 14 preferred to offer medical abortion, 5 preferred surgical abortion, and nine had no preference. These findings suggest that medical abortion can be delivered safely and effectively to women in at least some developing countries.
Web site : http://www.agi-usa.org/pubs/journals/2307397.pdf