Today several very early abortion methods are available; effective and safe, medical as well as surgical. The aim of the present study is to estimate women's attitudes towards three early abortion methods, to see if one or several of these methods are preferable--or best avoided--for psychological reasons, and to assess if women of a certain social or psychological background would benefit from a specific abortion method. Three groups of women were interviewed two weeks after a first trimester abortion; 1/43 women having an 'ordinary abortion' with preoperative ripening of the cervix followed by a vacuum aspiration under heavy sedation, 2/40 women having a modified Karman exeresis with a paracervical block, 3/45 women having a medical abortion with RU 486 and prostaglandin. There was a noticeable difference in the effect the three abortion methods had on the women taking part in the study. Women with a medical abortion reported more bleeding and somewhat more pain and moral considerations than the other women, but also a relief to be spared a surgical procedure. Most of the women said they preferred the abortion method they had just experienced. A short waiting time appeared to be more important than whether a surgical or a medical method was used. Which abortion method is the best in each case is dependent on a variety of personal reasons, and can only be decided by each woman, in consultation with her doctor.
PIP: In 1987-90 at South or Karolinska Hospitals in Stockholm, Sweden, a physician interviewed 128 women 2 weeks postabortion to determine their assessments of 1st trimester abortion methods: modified Karman vacuum exeresis (K-group), dilatation and vacuum aspiration (D&V), and medical abortion (RU-486/prostaglandin). Most women were satisfied with the abortion method they chose (D&V, 72%; K-group, 88%; ru-486, 87%). Women in the RU-486 group were much more likely to experience more pain than those in the other groups (44% vs. 23% in D&V group and 15% in the K-group; p .01). They were also more likely to find the amount of blood loss to be heavier than normal menstrual bleeding (64% vs. 21% in D&V group and 5% in the K-group; p .001). Women in the RU-486 group were more likely to report feelings of guilt or shame than those in the other groups (p .05 for shame), perhaps because they tended to be repeat aborters and they were more likely to be ashamed than 1st time aborters (p .05). Quite a few RU-486 women (40%) spontaneously mentioned relief that they did not have to undergo a surgical abortion. 1st time aborters had a tendency to change their opinion about abortion more often than repeat aborters (p = .052), but the change was in the direction of a more permissive and more understanding attitude. A short interval between the day of decision to undergo an abortion and the actual day of abortion appeared to be more important than the type of abortion used. For example, 80% of women in the RU-486 group found the interval to be acceptable (6.3 days vs. 10.8 for K-group and 15 for D&V group) compared with 51% for D&V group (p .01) and 65% for K-group. In conclusion, individual circumstances determine the abortion method chosen and only women should decide what method to use in consultation with their physician. Medical staff need to support women undergoing abortion regardless of the method chosen.