Patients' Motivation for Surgical Versus Medical Abortion.

OBJECTIVE: Induced abortion is the second most common reproductive health procedure in Canada. Among all Canadian women, 31% will have at least one induced abortion in their life. Unfortunately, abortion services are disparate throughout the country. With the recent introduction of mifepristone in Canada, it is hoped that access to abortion will be improved. However, it is recognized that some women who are eligible for medical abortion with mifepristone will still choose surgical abortion. The purpose of this study was to understand the patient's motivation to choose surgical abortion instead of medical abortion. METHODS: A survey was given to a sample of women coming to the Women's Clinic at Kingston General Hospital in Kingston, Ontario, for surgical abortion who qualified for medical abortion at the time their appointment was made. The study was approved by the Queen's University Health Sciences and Affiliated Teaching Hospitals Research Ethics Board before data collection (#6022783) (Canadian Task Force Classification II-2). RESULTS: This study was conducted between February 13, 2018 and June 1, 2018. In agreement with previous studies, the most common perceived advantages of surgical abortion were that it is faster and requires fewer visits. Therefore, one of the greatest perceived obstacles to medical abortion is the need for follow-up. CONCLUSION: Being able to offer two highly effective options for induced abortion will hopefully improve equitable access to abortion. To increase women's acceptance of medical abortion as a feasible option, we need to consider making some changes to the follow-up plan in our clinic.

Medical Abortion.

OBJECTIVE: This guideline reviews the evidence relating to the provision of first-trimester medical induced abortion, including patient eligibility, counselling, and consent; evidence-based regimens; and special considerations for clinicians providing medical abortion care. INTENDED USERS: Gynaecologists, family physicians, registered nurses, midwives, residents, and other healthcare providers who currently or intend to provide pregnancy options counselling, medical abortion care, or family planning services. TARGET POPULATION: Women with an unintended first trimester pregnancy. EVIDENCE: Published literature was retrieved through searches of PubMed, MEDLINE, and Cochrane Library between July 2015 and November 2015 using appropriately controlled vocabulary (MeSH search terms: Induced Abortion, Medical Abortion, Mifepristone, Misoprostol, Methotrexate). Results were restricted to systematic reviews, randomized controlled trials, clinical trials, and observational studies published from June 1986 to November 2015 in English. Additionally, existing guidelines from other countries were consulted for review. A grey literature search was not required. VALUES: The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force for Preventive Medicine rating scale (Table 1). BENEFITS, HARMS AND/OR COSTS: Medical abortion is safe and effective. Complications from medical abortion are rare. Access and costs will be dependent on provincial and territorial funding for combination mifepristone/misoprostol and provider availability. SUMMARY STATEMENTS: Introduction Pre-procedure care Medical abortion regimens Providing medical abortion Post-abortion care RECOMMENDATIONS: Introduction Pre-procedure care Medical abortion regimens Providing medical abortion Post-abortion care.