Increasing access to safe abortion services in rural India: experiences with medical abortion in a primary health center.
BACKGROUND
To increase access to safe abortion in rural India, the feasibility and acceptability of mifepristone-misoprostol abortion was assessed in a typical government run primary health center (PHC) in Nagpur district, Maharashtra State, that does not offer surgical abortion services and must refer off-site for emergency and backup services.


METHODS
Consenting pregnant women (n=149) with <or=56 days amenorrhea seeking terminations received 200 mg mifepristone, and returned 48 h later for 400-microg sublingual misoprostol and 12 days later for abortion confirmation. Surgical backup was conducted at a nearby community health center (CHC).


RESULTS
Nearly all women (98.6%) with known outcomes had successful medical abortions, and those who did not (1.4%) were successfully referred to the CHC for surgical backup. Women reported the method's ease and simplicity as the best features.


CONCLUSIONS
Medical abortion provision is feasible and acceptable in an Indian rural PHC that does not offer surgical abortion services. This study suggests that introduction of medical abortion at lower levels of the health-care system could increase access to safe abortion in rural India.
Mundle
Shuchita
S
Department of Obstetrics and Gynaecology, Government Medical College, Nagpur 440003, India.
Elul
Batya
B
Anand
Abhijeet
A
Kalyanwala
Shveta
S
Ughade
Suresh
S
D000019:Abortifacient Agents / Q000008:administration & dosage; D000028:Abortion, Induced / Q000379:methods / Q000592:standards / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D005240:Feasibility Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D007194:India; D015735:Mifepristone / Q000008:administration & dosage; D016595:Misoprostol / Q000008:administration & dosage; D011247:Pregnancy; D011320:Primary Health Care / Q000592:standards; D019035:Rural Health Services / Q000592:standards / Q000706:statistics & numerical data*; D017751:Safety Management; D014932:Women's Health Services / Q000592:standards / Q000706:statistics & numerical data*
D000019:Abortifacient Agents; D016595:Misoprostol; D015735:Mifepristone