Could American women use mifepristone-misoprostol pills safely with less medical supervision?

Contraception
Cynthia C HarperB Winikoff

Abstract

Medical methods of early abortion differ from surgical methods in that women themselves can potentially administer the regimens. As currently researched and offered, however, the main regimen used for medical abortion, mifepristone-misoprostol, is highly medicalized, involving several clinic visits and extensive physician involvement. We re-examined the role of clinical supervision in each step of the abortion process, using data collected during a large clinical trial of mifepristone-misoprostol abortions in the US, fielded during 1994-1995. The trial was carried out in 17 geographically diverse centers, including private, public, and nongovernmental organization clinics, and enrolled 2121 women, aged 18-45 years, seeking early abortion (< or =63 days since last menstrual period). Women received 600 mg oral mifepristone, followed 48 h later by 400 microg oral misoprostol. Evidence suggests that most women can handle most steps of the medical abortion process themselves, effectively and safely. The utility of clinic visits to ingest mifepristone and misoprostol is questionable. For many women, even the follow-up visit could perhaps be replaced by telephone follow-up, combined with home pregnancy tests. Alternatives to the prese...Continue Reading

Associated Clinical Trials

Feb 9, 2017·Carolyn WesthoffCarolyn Westhoff

References

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Citations

Sep 16, 2003·Best Practice & Research. Clinical Obstetrics & Gynaecology·Karen R Meckstroth, Philip D Darney
Mar 12, 2005·Annual Review of Public Health·Cynthia C HarperPhilip D Darney
Aug 8, 2014·Obstetrical & Gynecological Survey·Amy G BryantGretchen Stuart
Mar 31, 2004·Obstetrics and Gynecology·Daniel GrossmanDilys Walker
Feb 2, 2006·American Journal of Public Health·Daniel GrossmanFrancisco T Rivas
May 17, 2011·Contraception·Daniel Grossman, Kate Grindlay
Jun 17, 2004·BJOG : an International Journal of Obstetrics and Gynaecology·Helena HonkanenUNKNOWN WHO Research Group on Post-Ovulatory Methods for Fertility Regulation
Mar 22, 2005·BJOG : an International Journal of Obstetrics and Gynaecology·Sunita SharmaHelen Axby
Nov 18, 2005·Reproductive Health Matters·María Mercedes LafaurieSusana Chávez
Dec 7, 2013·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Regina-Maria RennerDalia Brahmi
Jul 15, 2015·Women's Health Issues : Official Publication of the Jacobs Institute of Women's Health·Laura Britton, Amy Bryant
Apr 29, 2015·Contraception·Elizabeth G Raymond, Hillary Bracken
May 22, 2016·Journal of Obstetrics and Gynaecology Canada : JOGC = Journal D'obstétrique Et Gynécologie Du Canada : JOGC·Dustin CostescuMatthew Reeves
Dec 2, 2005·The European Journal of Contraception & Reproductive Health Care : the Official Journal of the European Society of Contraception·W H ClarkB Winikoff
Mar 21, 2017·BJOG : an International Journal of Obstetrics and Gynaecology·N KappD Brahmi
Feb 18, 2021·Contraception·Elizabeth G RaymondIngrida Platais
Dec 5, 2021·BMJ Sexual & Reproductive Health·Katherine EhrenreichDaniel Grossman

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