Medical vs. surgical abortion: the importance of women's choice

Abstract

Background Using a large national sample of women undergoing an abortion in France, we explore the factors associated with medical or surgical abortion. We draw particular attention to the influence of women’s preferences in the decision making process. Study design The data are drawn from a nationally representative survey of 8,245 women undergoing an elective abortion in France in 2007. Analyses of factors associated with the type of abortion technique were performed among the 4,650 women who were identified as being eligible for the two techniques. Results Sixty-seven percent of all abortions were medical procedures among women eligible for both techniques. The type of abortion technique was not dependent on women’s age, parity, cohabitation status, socioeconomic circumstances nor on the type of facility providing the abortion (private or public). Conversely, women’s participation in the decision making process was strongly associated with the type of abortion method. Among the 50% of women who reported they had been given a choice, 84% underwent a medical procedure versus 52% of those who were not offered a choice. Among the 2,286 women who were not involved in the decision, 35% indicated they trusted their doctor to make the best choice for them, while 44% were told it was too late for a medical procedure, although they had consulted before 8 weeks of amenorrhea. Conclusion In this sample of French women who participated in a national survey on abortion, those who were involved in the decision making process as to whether to have a medical or surgical procedure showed a strong preference for the medical procedure.

Medical abortion service in rural areas of Henan Province, China: A provider survey

“…Results of a study conducted in Ethiopia also found that the proportion of women who would choose the same method again if needed after having medical abortion was higher than that in women who had undergone surgical abortion (83.3% vs 77.4%), and the proportion of women who would recommend the same method to their friends after having medical abortion was also higher than that in women who had undergone surgical abortion (94.0% vs 86.8%) 20 . In contrast with women's preference for medical abortion in previous studies, 17,20 in the present study, among providers who had a preference in abortion methods, the proportion of providers with preference for surgical abortion was more than double that of those with preference for medical abortion (69.8% vs 30.2%). The preference discrepancy between providers and women seeking abortion might be due to finance.…”

“…Consequently, medical abortion was becoming more and more popular among women seeking abortion. In a national representative survey including 8245 women undergoing abortion in France, the proportion of women who underwent a medical procedure among those given elective abortion was much higher than those not given a choice (84% vs 52%) 17 . A study of 414 subjects with gestation up to 63 days in northwest Ethiopia indicated that women undergoing medical abortion were more satisfied than those undergoing surgical abortion (91.2% vs 82.4%) 20 .…”

“…When facing the two commonly used abortion methods, medical and surgical abortion, women had difficulties in deciding because of their superficial understanding of abortion, especially those living in poor rural areas. Under this situation, abortion counseling was necessary and Moreau's study showed that women (35%) trusted and accepted the abortion methods suggested by doctors 17 . Therefore, before providing elective abortion to women, it is important to understand the knowledge and attitudes on medical abortion of abortion service providers.…”

Results from a study using misoprostol for management of incomplete abortion in Vietnamese hospitals: implications for task shifting

“…While safe surgical services are becoming more widespread, there is still a risk of complications, such as uterine adhesion, from these procedures. In addition, as seen in the induced abortion literature, many women prefer medical over surgical treatment when given the option [12-14]. Introducing misoprostol treatment for incomplete abortion is an important step towards improving care for women experiencing abortion complications.…”

Access, equity and costs of induced abortion services in Australia: a cross‐sectional study

“…The treatment can be taken earlier in pregnancy, and women can safely undergo the abortion at home, and experience it more naturally as a miscarriage, 10 options that women value and find acceptable. 11 Recent data from England, Wales and France indicate that amongst women eligible for both options, a majority chose medical, 12,13 and in the United States, this proportion is steadily increasing. 14 In Australia, the number of certified prescribers and pharmacy dispensers is growing, including in non-metropolitan areas.…”