Determination of medical abortion success by women and community health volunteers in Nepal using a symptom checklist

BMC Pregnancy and Childbirth
K L AndersenEmily Jackson

Abstract

We sought to determine if female community health volunteers (FCHVs) and literate women in Nepal can accurately determine success of medical abortion (MA) using a symptom checklist, compared to experienced abortion providers. Women undergoing MA, and FCHVs, independently assessed the success of each woman's abortion using an 8-question symptom checklist. Any answers in a red-shaded box indicated that the abortion may not have been successful. Women's/FCHVs' assessments were compared to experienced abortion providers using standard of care. Women's (n = 1153) self-assessment of MA success agreed with abortion providers' determinations 85% of the time (positive predictive value = 90, 95% CI 88, 92); agreement between FCHVs and providers was 82% (positive predictive value = 90, 95% CI 88, 92). Of the 92 women (8%) requiring uterine evacuation with manual vacuum aspiration (n = 84, 7%) or medications (n = 8, 0.7%), 64% self-identified as needing additional care; FCHVs identified 61%. However, both women and FCHVs had difficulty recognizing that an answer in a red-shaded box indicated that the abortion may not have been successful. Of the 453 women with a red-shaded box marked, only 35% of women and 41% of FCHVs identified the need ...Continue Reading

References

Jan 23, 2010·Obstetrics and Gynecology·Wesley ClarkBeverly Winikoff
Jan 28, 2010·Contraception·Lisa K PerrieraMitchell D Creinin
Nov 26, 2010·BJOG : an International Journal of Obstetrics and Gynaecology·H BrackenB Winikoff
May 17, 2011·Contraception·Daniel Grossman, Kate Grindlay
Oct 5, 2011·BJOG : an International Journal of Obstetrics and Gynaecology·A BhandariG Shakya
Nov 10, 2011·Contraception·Andrea V JacksonAlisa B Goldberg
Oct 24, 2012·Obstetrics and Gynecology·Beverly WinikoffYael Swica
Aug 5, 2015·Obstetrics and Gynecology·Melissa J Chen, Mitchell D Creinin

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BETA
pregnancy tests
pregnancy test

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