A prospective trial was conducted including 300 pregnant women seeking
elective abortion to evaluate the efficacy and acceptability of metho
trexate and misoprostol for abortion at less than or equal to 56 days
gestation. Subjects received methotrexate 50 mg/m(2) intramuscularly f
ollowed 7 days later by misoprostol 800 mu g vaginally. The misoprosto
l dose was repeated the next day if the abortion did not occur. Effica
cy is reported elsewhere. Subjects were questioned before the study as
to their reasons for choosing a medical abortion and past experience
with surgical abortion. After the study was completed, the women were
questioned about their medical abortion experience. All questions were
asked in an open-ended manner. Main outcome measures included reasons
for abortion and study participation, attitudes about the nonsurgical
abortion experience, and feelings about preference of nonsurgical or
surgical abortion. The most common reason cited as to why women chose
to have a nonsurgical abortion was to avoid some aspect of the surgery
(48.4%). The percent of women who cited that avoiding surgery was an
important reason in their choice of nonsurgical abortion varied by stu
dy site and according to whether the woman had a prior surgical aborti
on. Upon completion of the study, 73.4% of women stated it was a good
experience, 19.5% a neutral experience, 7.1% a bad experience, and 1.0
% gave no response. When asked what method they would choose if they h
ad to have another abortion, 83.5% would choose this method of medical
abortion rather than a surgical abortion. Intramuscular methotrexate
and vaginal misoprostol are an acceptable and desirable method of abor
tion.