Expanding medical abortion in Tunisia: women's experiences from a multi-site expansion study

• Published in: Contraception (Stoneham) Vol. 70; no. 6; pp. 487 - 491
• Main Authors: Hajri, Selma, Blum, Jennifer, Gueddana, Nabiha, Saadi, Habib, Maazoun, Leila, Chélli, Hela, Dabash, Rasha, Winikoff, Beverly
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-12-2004; Elsevier Science
• Subjects: Abortifacient Agents, Nonsteroidal - administration & dosage; Abortion, Induced - methods; Abortion, Induced - psychology; Administration, Oral; Adult; Biological and medical sciences; Birth control; Developing countries; Female; Gynecology. Andrology. Obstetrics; Health Services Accessibility - statistics & numerical data; Humans; Induced abortion. Therapeutic abortion; Medical abortion; Medical sciences; Mifepristone; Mifepristone - administration & dosage; Misoprostol; Office Visits - statistics & numerical data; Patient Satisfaction; Pregnancy; Safety; Tunisia - epidemiology; Tunisia; Africa; Developing countries; Mifepristone; Misoprostol; Medical abortion; Human; Abortifacient; Antiprogesterone; Induced abortion; Female; Prostaglandin derivatives
• ISSN: 0010-7824; 1879-0518
• DOI: 10.1016/j.contraception.2004.06.012

From November 2000 to July 2001, 321 consenting women were enrolled at four sites across the country in an effort to demonstrate that mifepristone medical abortion could safely be used by providers throughout Tunisia. Women who met the study's inclusion criteria were given 200 mg oral mifepristone and offered the choice of taking 400 μg oral misoprostol 2 days later either at home or at the clinic. At follow-up, women were examined to determine completed abortion status and surveyed to gauge their satisfaction with the method. Ninety-six percent of women had a successful abortion using this method. Women expressed a strong preference for home use of misoprostol, indicating that it is more confidential (34%), easier (28%) and requires fewer clinic visits (28%). The high rate of success, demonstrated safety and acceptability of the method in new facilities and with new providers suggests that medical abortion can be safely expanded to new settings with reasonable levels of training and supervision.