Simplifying medical abortion: Home administration of misoprostol
Objective: To increase access to safe abortion, the feasibility, efficacy and acceptability of a medical abortion regimen entailing a reduced dose of mifepristone and the option of home administration of sublingual misoprostol was assessed at a government hospital providing legal abortion services on a regular basis. Methods: Consenting women (n=99) with amenorrhea of =56 days received mifepristone 200mg orally at the hospital. Two days later, women either returned to the hospital for 400µg sublingual misoprostol or took it at home. All women returned after two weeks for abortion confirmation. Results: The vast majority of women (88%) chose home use of misoprostol and did so mainly to decrease the number of clinic visits (65%) and to take care of their household responsibilities (16%). Adherence to the drug protocol was comparable among home and clinic users, with only a single woman in each group not taking misoprostol at the scheduled time. Efficacy was similarly high in both groups (home users 95% vs. clinic users 96%). No serious side effects were noted in either home or clinic users. Conclusion: The safety, efficacy and acceptability of home use of misoprostol observed in our study suggest this option should be available to women in India.
Mundle, Shuchita, Shveta Kalyanwala, Batya Elul, and S. Ugahade. 2008. "Simplifying medical abortion: Home administration of Misoprostol," Journal of Obstetrics and Gynecology of India 58(5): 410–416.