RT Journal Article
SR Electronic
T1 Impact of self-administration of misoprostol for early medical abortion: a prospective observational cohort study
JF BMJ Sexual & Reproductive Health
JO BMJ Sex Reprod Health
FD British Medical Journal Publishing Group
SP 296
OP 301
DO 10.1136/bmjsrh-2018-200278
VO 45
IS 4
A1 Rebecca Elizabeth Finch
A1 Kevin McGeechan
A1 Anne Johnstone
A1 Sharon Cameron
YR 2019
UL http://jfprhc.bmj.com/content/45/4/296.abstract
AB Introduction In October 2017, Scotland legalised the home use of misoprostol for the purpose of early medical abortion (EMA). Women up to 9+6 weeks’ gestation can now self-administer the drug at home, 24–48 hours after receiving mifepristone in the clinic.Objective To evaluate the impact of this change on the uptake and success rate of EMA, and on the provision of effective contraception on discharge.Methods A prospective observational study was conducted to compare the outcomes of two cohorts of women in the 6 months before and 6 months after the introduction of home administration of misoprostol. The main outcome measures were uptake of EMA, success of EMA and provision of long-acting reversible contraception (LARC) to women undergoing EMA.Results There was a statistically significant increase in the uptake of EMA from 698/1075 (64.9%) women in the first study period to 823/1146 (71.8%) in the second study period. There was no statistically significant difference in the success rate of EMA: 99.3% and 98.9% in clinic and home misoprostol cohorts, respectively. There was also no statistically significant difference in the proportion of women provided with LARC: 37.7% and 33.7% in clinic and home misoprostol cohorts, respectively.Conclusions Self-administration of misoprostol at home increased uptake of EMA, with no effect on the high success rate that was previously seen with clinic administration of misoprostol. In addition, the reduced number of visits associated with home use of misoprostol has not affected the provision of effective contraception to women.