COMPARISON OF MEDICAL ABORTION WITH SURGICAL VACUUM ASPIRATION - WOMENS PREFERENCES AND ACCEPTABILITY OF TREATMENT

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 geme prost 1 mg vaginal pessary. Vacuum aspiration was performed under gene ral anaesthesia. Setting-Teaching hospital in Scotland. Patients-363 w omen undergoing legal induced abortion at less than nine weeks' gestat ion. Main outcome measures-Women's preferences for method of abortion before abortion; acceptability judged two weeks after abortion by reco rding the method women would opt to undergo in future and by semantic differential rating technique. Results-73 (20%) women preferred to und ergo medical abortion, and 95 (26%) vacuum aspiration; 195 (54%) were willing to undergo either method, and were allocated at random. Both p rocedures were highly acceptable to women with preferences. Gestation had a definite effect on acceptability in randomised women; at less th an 50 days there were no differences, but between 50 and 63 days vacuu m aspiration was significantly more acceptable. Conclusions-Women who wish to use a particular method should be allowed their choice, regard less of gestation. Women of 50-63 days' gestation without preferences for a particular method are likely to find vacuum aspiration more acce ptable. A patient centred, partially randomised trial design may be a useful tool in pragmatic research.