title: Comparison of unscheduled re-attendance and contraception at discharge, among women having the final stage of early medical abortion at home and those remaining in hospital.
abstract: BACKGROUND
  Throughout Great Britain, increasing numbers of women having an early medical abortion are choosing to go home soon after administration of misoprostol, to expel the pregnancy at home (early medical discharge, EMD), rather than remain upon the hospital premises (day case). However, data are lacking on how this impacts upon an abortion service in terms of unscheduled re-attendance rates and contraception provision at discharge.
  
  
  METHODS
  A retrospective audit was carried out of women undergoing medical abortion (up to 64 days' gestation) over 9 months at a National Health Service hospital in Scotland, to determine (1) unscheduled re-attendance rates within 6 weeks of the procedure for an abortion-related complication and (2) method of contraception provided at discharge.
  
  
  RESULTS
  Over the audit period 1128 women had an early medical abortion of whom 590 (52%) chose EMD. There was no significant difference in unscheduled re-attendance rates between EMD (n=23, 4%) and day case groups (n=20, 4%). There was no significant difference in the proportion of women in each group who left hospital with an effective method of contraception (n=362, 61% and n=355, 60% for EMD and day case groups, respectively).
  
  
  CONCLUSIONS
  Women undergoing early medical abortion who choose to expel the pregnancy at home are no more likely to re-attend hospital with a post-abortal complication and are just as likely to receive effective contraception than those who remain on hospital premises.
authors.affiliation: College of Medicine and Veterinary Medicine, University of Edinburgh, Edinburgh, UK.
authors.forename: Hannah
authors.initials: H
authors.lastname: Astle
authors.forename: Sharon T
authors.initials: ST
authors.lastname: Cameron
authors.forename: Anne
authors.initials: A
authors.lastname: Johnstone
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000627:therapeutic use*; D000028:Abortion, Induced / Q000379:methods*; D000328:Adult; D001071:Appointments and Schedules; D003271:Contraceptive Agents, Female / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007182:Income; D016595:Misoprostol / Q000627:therapeutic use*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D010359:Patient Readmission / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D012189:Retrospective Studies; D012606:Scotland
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D003271:Contraceptive Agents, Female; D016595:Misoprostol