Efficacy, acceptability and safety of medication abortion in low-income, urban Latina women.
BACKGROUND
Health care providers may be reluctant to offer medication abortion to low-income, non-English-speaking populations. Concerns include lack of patient interest, incorrect use of misoprostol at home, missing mandatory follow-up visits and inappropriate use of emergency services. We describe the appeal, acceptability, safety and follow-up rates of medication abortion in a low-income Latina population in New York City.


METHODS
Nested analysis of 270 subjects up to 63 days' gestation enrolled in a multicenter trial of medication abortion comparing different mifepristone-misoprostol intervals. After receiving mifepristone, subjects were instructed on home use of misoprostol, what to do in an emergency and when to return.


RESULTS
This population was predominantly Spanish-speaking, unmarried, poor and publicly insured. Ninety-six percent took the misoprostol at home correctly, 90% returned as scheduled without reminders and 2% were lost to follow-up. Ninety-six percent described the experience as positive or neutral and 94% would recommend medication abortion to a friend. Three serious adverse events occurred and women accessed emergency services appropriately.


CONCLUSIONS
Medication abortion can be a very appealing, safe and effective option in low-income, non-English-speaking populations.
Teal
Stephanie B
SB
University of Colorado, Denver School of Medicine, Denver, CO, USA. Stephanie.Teal@ucdenver.edu
Harken
Tabetha
T
Sheeder
Jeanelle
J
Westhoff
Carolyn
C
D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage* / Q000009:adverse effects*; D000028:Abortion, Induced / Q000523:psychology / Q000706:statistics & numerical data*; D000293:Adolescent; D000328:Adult; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D016595:Misoprostol / Q000008:administration & dosage* / Q000009:adverse effects*; D009519:New York City; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D011203:Poverty / Q000706:statistics & numerical data; D016896:Treatment Outcome; D019037:Urban Health Services / Q000706:statistics & numerical data; D055815:Young Adult
D000020:Abortifacient Agents, Nonsteroidal; D016595:Misoprostol