Positive experiences of completing early medical abortion at home, Scotland and Sweden.
Subject: Home care services (User statistics)
Home care services industry (User statistics)
Abortion services (User statistics)
Misoprostol (Dosage and administration)
Pub Date: 05/01/2012
Publication: Name: Reproductive Health Matters Publisher: Elsevier Science Publishers Audience: General Format: Magazine/Journal Subject: Family and marriage; Health; Women's issues/gender studies Copyright: COPYRIGHT 2012 Reproductive Health Matters ISSN: 0968-8080
Issue: Date: May, 2012 Source Volume: 20 Source Issue: 39
Topic: Event Code: 650 Sales & consumption
Product: Product Code: 8096000 Home Health Care; 8082000 Abortion Clinics NAICS Code: 62161 Home Health Care Services; 621498 All Other Outpatient Care Centers SIC Code: 8082 Home health care services; 8093 Specialty outpatient clinics, not elsewhere classified
Geographic: Geographic Scope: Scotland; Sweden Geographic Name: Scotland; Sweden Geographic Code: 4EUUS Scotland; 4EUSW Sweden
Accession Number: 296571592
Full Text: A retrospective audit of women in Scotland having an early medical abortion from January to September 2010 looked at unscheduled re-attendance within six weeks of the procedure for an abortion-related complication and method of contraception provided at discharge. It compared women who chose to go home soon after administration of misoprostol and those who stayed until the abortion was complete in a hospital medical abortion unit. Of the 1,128 women in the audit, 590 chose to abort at home. The study found no difference in the rate of unscheduled re-attendance (4%) between women who aborted at home and those who stayed in hospital. The only reasons for unscheduled re-attendance within six weeks for an abortion-related problem were heavy bleeding or pain, with no difference between those who aborted at home or in hospital. Re-attendance was significantly higher for women with pregnancies greater than eight weeks gestation (6.7% compared to 3%). The proportion of women who left with an effective hormonal method of contraception was almost the same (61% vs. 60%). There were significantly more women in the home group who received a "fast track" appointment at the local family planning clinic for an IUD to be fitted. The audit found there was no additional pressure on the hospital abortion service due to unscheduled re-attendance and that choosing to complete the abortion at home did not reduce the uptake of effective contraception. (1)

Factors affecting acceptability of home use of misoprostol following mifepristone for early medical abortion in a Swedish study among 387 women were having a partner or friend present and having a pregnancy test at follow-up. Most of the women had successful abortions. Acceptability was not affected by age, length of pregnancy or the need for extra pain medication. Most of the women accepting home abortion were parous. Home administration of misoprostol was highly acceptable. Increasing the number of complete abortions should be a focus of future research. Women should be encouraged to have a partner or friend present if they complete the abortion at home with misoprostol. (2)

(1.) Astle H, Cameron ST & Johnstone A. Comparison of unscheduled re-attendance and contraception at discharge, among women having the final stage of early medical abortion at home and those remaining in hospital. Journal of Family Planning and Reproductive Health Care 2012;38:35-40.

(2.) Kopp Kallner H, Fiala C & Gemzell-Danielsson K. Assessment of significant factors affecting acceptability of home administration of misoprostol for medical abortion. Contraception 2012;85:394-97.

Doi: 10.1016/S0968-8080(12)39628-6
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