Research Article

Comparison of medical abortion with surgical vacuum aspiration: women's preferences and acceptability of treatment.

BMJ 1993; 307 doi: http://dx.doi.org/10.1136/bmj.307.6906.714 (Published 18 September 1993) Cite this as: BMJ 1993;307:714
  1. R C Henshaw,
  2. S A Naji,
  3. I T Russell,
  4. A A Templeton
  1. Department of Obstetrics and Gynaecology, Aberdeen Maternity Hospital.

    Abstract

    OBJECTIVES--To assess women's preferences for, and the acceptability of, medical abortion and vacuum aspiration in the early first trimester. DESIGN--Patient centred, partially randomised trial. Medical abortion was performed with mifepristone 600 mg followed 48 hours later by gemeprost 1 mg vaginal pessary. Vacuum aspiration was performed under general anaesthesia. SETTING--Teaching hospital in Scotland. PATIENTS--363 women undergoing legal induced abortion at less than nine weeks' gestation. MAIN OUTCOME MEASURES--Women's preferences for method of abortion before abortion; acceptability judged two weeks after abortion by recording the method women would opt to undergo in future and by semantic differential rating technique. RESULTS--73 (20%) women preferred to undergo medical abortion, and 95 (26%) vacuum aspiration; 195 (54%) were willing to undergo either method, and were allocated at random. Both procedures were highly acceptable to women with preferences. Gestation had a definite effect on acceptability in randomised women; at less than 50 days there were no differences, but between 50 and 63 days vacuum aspiration was significantly more acceptable. CONCLUSIONS--Women who wish to use a particular method should be allowed their choice, regardless of gestation. Women of 50-63 days' gestation without preferences for a particular method are likely to find vacuum aspiration more acceptable. A patient centred, partially randomised trial design may be a useful tool in pragmatic research.