Intended for healthcare professionals


Medical abortion for adolescents

BMJ 2011; 342 doi: (Published 20 April 2011) Cite this as: BMJ 2011;342:d2185
  1. David A Grimes, clinical professor1,
  2. Elizabeth G Raymond, senior medical associate2
  1. 1Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, NC 27599-7570, USA
  2. 2Gynuity Health Projects, New York, USA
  1. dgrimes{at}

Seems to be as effective and safe as in older women

Decades of experience have established that surgical abortion is safe for adolescent women.1 Because young women are generally healthier and have less comorbidity than adults, they fare better. However, few studies have specifically assessed the risks of medical abortion in adolescents. In the linked retrospective cohort study (doi:10.1136/bmj.d2111), Niinimäki and colleagues assessed outcomes in 3024 adolescent women and 24 006 adults who underwent medical abortion between 2000 and 2006.2

The development of modern methods for medical abortion began in the 1970s.3 Initial approaches used prostaglandins alone. When given at any point in pregnancy, prostaglandins induce uterine contractions that can lead to expulsion of the embryo or fetus. However, the effectiveness of medical abortion with early prostaglandin compounds alone was suboptimal. Moreover, gastrointestinal side effects limited their acceptability.

Medical abortion improved in the 1980s with the development of …

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