Can women in less-developed countries use a simplified medical abortion regimen?

Background Mifepristpne-misoprostol abortion, consisting of oral pills. is potentially simple and safe enough for use in less-developed countries. But the labour-intensive, costly, clinic-based European protocols are not affo rdable or feasible in most less-developed countries. Methods We prospectively tested two simplifications to the French mifeprist one-misoprostol regimen in Vietnam and Tunisia. Women (n = 315) with amenor rhoea 8 weeks or less since their last menstrual period received 200 mg mif epristone in the clinic and then chose whether to take 400 mug oral misopro stol 2 days later either at home or in the clinic. Findings Despite the two-thirds reduction in mifepristone dose, success rat es were high: Vietnam 93%, Tunisia 91%. About 88% of participants chose hom e administration of misoprostol. Most Vietnamese and Tunisian women were sa tisfied with their abortions, but efficacy and satisfaction rates were high er among those who used misoprostol at home. Interpretations A simplified medical abortion regimen of 200 mg mifepriston e followed by the option of home administration of misoprostol seems feasib le.