Skip to main content
PMC home page
The BMJ logoLink to The BMJ
. 1993 Sep 18;307(6906):714–717. doi: 10.1136/bmj.307.6906.714

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

R C Henshaw 1, S A Naji 1, I T Russell 1, A A Templeton 1
PMCID: PMC1678709  PMID: 8401094

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.

Full text

PDF
714

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bachelot A., Cludy L., Spira A. Conditions for choosing between drug-induced and surgical abortions. Contraception. 1992 Jun;45(6):547–559. doi: 10.1016/0010-7824(92)90106-4. [DOI] [PubMed] [Google Scholar]
  2. Botting Beverley. Trends in abortion. Popul Trends. 1991 Summer;64:19–29. [PubMed] [Google Scholar]
  3. Brewin C. R., Bradley C. Patient preferences and randomised clinical trials. BMJ. 1989 Jul 29;299(6694):313–315. doi: 10.1136/bmj.299.6694.313. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Castadot R. G. Pregnancy termination: techniques, risks, and complications and their management. Fertil Steril. 1986 Jan;45(1):5–17. doi: 10.1016/s0015-0282(16)49089-8. [DOI] [PubMed] [Google Scholar]
  5. Charlson M. E., Horwitz R. I. Applying results of randomised trials to clinical practice: impact of losses before randomisation. Br Med J (Clin Res Ed) 1984 Nov 10;289(6454):1281–1284. doi: 10.1136/bmj.289.6454.1281. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Dudley H. A. The controlled clinical trial and the advance of reliable knowledge: an outsider looks in. Br Med J (Clin Res Ed) 1983 Oct 1;287(6397):957–960. doi: 10.1136/bmj.287.6397.957. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Heard M., Guillebaud J. Medical abortion. BMJ. 1992 Jan 25;304(6821):195–196. doi: 10.1136/bmj.304.6821.195. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Hill N. C., Ferguson J., MacKenzie I. Z. The efficacy of oral Mifepristone (RU 38,486) with a prostaglandin E1 analog vaginal pessary for the termination of early pregnancy: complications and patient acceptability. Am J Obstet Gynecol. 1990 Feb;162(2):414–417. doi: 10.1016/0002-9378(90)90398-q. [DOI] [PubMed] [Google Scholar]
  9. Marshall J. F. Acceptability of fertility regulating methods: designing technology to fit people. Prev Med. 1977 Mar;6(1):65–73. doi: 10.1016/0091-7435(77)90005-6. [DOI] [PubMed] [Google Scholar]
  10. McNeil B. J., Pauker S. G., Sox H. C., Jr, Tversky A. On the elicitation of preferences for alternative therapies. N Engl J Med. 1982 May 27;306(21):1259–1262. doi: 10.1056/NEJM198205273062103. [DOI] [PubMed] [Google Scholar]
  11. Melzack R. The McGill Pain Questionnaire: major properties and scoring methods. Pain. 1975 Sep;1(3):277–299. doi: 10.1016/0304-3959(75)90044-5. [DOI] [PubMed] [Google Scholar]
  12. Patient preferences and randomised clinical trials. BMJ. 1989 Sep 9;299(6700):684–685. doi: 10.1136/bmj.299.6700.684-c. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Rosén A. S., Nystedt L., Bygdeman M., Lundström V. Acceptability of a nonsurgical method to terminate very early pregnancy in comparison to vacuum aspiration. Contraception. 1979 Feb;19(2):107–117. doi: 10.1016/s0010-7824(79)80023-2. [DOI] [PubMed] [Google Scholar]
  14. Rosén A. S., von Knorring K., Bygdeman M., Christensen N. J. Randomized comparison of prostaglandin treatment in hospital or at home with vacuum aspiration for termination of early pregnancy. Contraception. 1984 May;29(5):423–435. doi: 10.1016/0010-7824(84)90016-7. [DOI] [PubMed] [Google Scholar]
  15. Russell I. T., Wilson B. J. Audit: the third clinical science? Qual Health Care. 1992 Mar;1(1):51–55. doi: 10.1136/qshc.1.1.51. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Schwartz D., Lellouch J. Explanatory and pragmatic attitudes in therapeutical trials. J Chronic Dis. 1967 Aug;20(8):637–648. doi: 10.1016/0021-9681(67)90041-0. [DOI] [PubMed] [Google Scholar]
  17. Tang G. W. A pilot study of acceptability of RU486 and ONO 802 in a Chinese population. Contraception. 1991 Nov;44(5):523–532. doi: 10.1016/0010-7824(91)90154-8. [DOI] [PubMed] [Google Scholar]
  18. Ulmann A., Silvestre L., Chemama L., Rezvani Y., Renault M., Aguillaume C. J., Baulieu E. E. Medical termination of early pregnancy with mifepristone (RU 486) followed by a prostaglandin analogue. Study in 16,369 women. Acta Obstet Gynecol Scand. 1992 May;71(4):278–283. doi: 10.3109/00016349209021052. [DOI] [PubMed] [Google Scholar]
  19. Urquhart D. R., Templeton A. A. Psychiatric morbidity and acceptability following medical and surgical methods of induced abortion. Br J Obstet Gynaecol. 1991 Apr;98(4):396–399. doi: 10.1111/j.1471-0528.1991.tb13431.x. [DOI] [PubMed] [Google Scholar]

Articles from BMJ : British Medical Journal are provided here courtesy of BMJ Publishing Group

RESOURCES