title: Factors associated with choice of medical or surgical abortion among women in Nepal.
abstract: OBJECTIVE
  To investigate factors associated with women's choice of medical abortion (MA) or manual vacuum aspiration (MVA) in Nepal, where the government recently began offering MA services.
  
  
  METHODS
  Structured exit interviews were conducted between January 19 and May 21, 2010, with women with a pregnancy of 63 days or less who underwent abortions at 7 clinics in 3 districts of Nepal. All those who accepted MA, and 1 in each 4 or 5 of those who underwent MVA, were invited for an interview. Of those interviewed, 499 chose MA and 542 underwent MVA.
  
  
  RESULTS
  Many women were not aware of both abortion methods before they came to the clinic. The odds of choosing MA were more than 3 times as high among those who knew about both methods as among those who did not. Of those who had decided on MVA prior to receiving information at the clinic, 29% chose MA. In contrast, only 10% of those who intended to accept MA opted for MVA after receiving information and counseling. Women who had more education, were of the upper Hindu caste, or resided in urban areas were more likely to choose MA.
  
  
  CONCLUSIONS
  Information and counseling have a large impact on the women's choice of an abortion method. To expand access to MA and to ensure that women can make an informed choice, it is essential that the government of Nepal create positions for trained counselors at all public abortion clinics.
authors: Center for Research on Environment Health and Population Activities, Kusunti, Kathmandu, Nepal. anand@crehpa.org.np
authors: Anand
authors: A
authors: Tamang
authors: Shareen
authors: S
authors: Tuladhar
authors: Jyotsna
authors: J
authors: Tamang
authors: Bela
authors: B
authors: Ganatra
authors: Bishnu
authors: B
authors: Dulal
mesh_terms: D000019:Abortifacient Agents; D000028:Abortion, Induced / Q000379:methods* / Q000523:psychology; D000293:Adolescent; D000328:Adult; D002755:Choice Behavior; D030881:Disclosure; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D009390:Nepal; D012959:Socioeconomic Factors; D055815:Young Adult
chemical_list: D000019:Abortifacient Agents