Comparative effectiveness, safety and acceptability of medical abortion at home and in a clinic: a systematic review
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Authors
Ngo, Thoai D
Park, Min Hae
Shakur, Haleema
Free, Caroline
Issue Date
2011
Type
Article
Language
en
Keywords
Medical abortion
Alternative Title
Abstract
Objective To compare medical abortion practised at home and in clinics in terms of effectiveness, safety and acceptability.
Methods A systematic search for randomized controlled trials and prospective cohort studies comparing home-based and clinic-based medical abortion was conducted. The Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE and Popline were searched.
Failure to abort completely, side-effects and acceptability were the main outcomes of interest. Odds ratios and their 95% confidence intervals (CIs) were calculated. Estimates were pooled using a random-effects model.
Findings Nine studies met the inclusion criteria (n = 4522 participants). All were prospective cohort studies that used mifepristone
and misoprostol to induce abortion. Complete abortion was achieved by 86–97% of the women who underwent home-based abortion (n = 3478) and by 80–99% of those who underwent clinic-based abortion (n = 1044). Pooled analyses from all studies revealed no difference in complete abortion rates between groups (odds ratio = 0.8; 95% CI: 0.5–1.5). Serious complications from abortion were rare. Pain and vomiting lasted 0.3 days longer among women who took misoprostol at home rather than in clinic. Women who chose home-based medical abortion were more likely to be satisfied, to choose the method again and to recommend it to a friend than women who opted for medical abortion in a clinic.
Conclusion Home-based abortion is safe under the conditions in place in the included studies. Prospective cohort studies have shown no differences in effectiveness or acceptability between home-based and clinic-based medical abortion across countries.
Description
Citation
Ngo, Thoai D, Park, Min Hae, Shakur, Haleema & Free, Caroline. (2011). Comparative effectiveness, safety and acceptability of medical abortion at home and in a clinic: a systematic review. Bulletin of the World Health Organization, 89 (5), 360 - 370. World Health Organization. http://dx.doi.org/10.2471/BLT.10.084046
Publisher
World Health Organization
Journal
Volume
Issue
PubMed ID
DOI
ISSN
0042-9686