title: The introduction of first trimester medical abortion in Armenia.
abstract: In Armenia, abortion is the main means of fertility regulation; however, before research activities were initiated only surgical methods were available and the quality of services was low in some areas. Our clinical study from 2008-2011 aimed to show that early medical abortion is an acceptable and feasible option. A total of 700 eligible women with pregnancies up to 63 days LMP presenting for abortion were recruited for the study in five locations. Participants took 200 mg mifepristone and 800 μg buccal misoprostol 24-48 hours later. They returned for a follow-up visit two weeks after mifepristone administration. 95% of the women had successful abortions and 95% were satisfied with the method. In 2012-2013, we conducted a follow-up assessment to examine the ongoing provision and quality of medical abortion services at the former research sites. Medical record reviews, interviews and observations were carried out three times approximately six months apart. The assessment found that all five sites had continued providing medical abortion, with about half of eligible women choosing the medical method. Four of the five sites were achieving high success rates. Staff turnover and the lack of trained providers likely contributed to the higher failure rate at the fifth site. These findings provide evidence that first trimester medical abortion is an acceptable and feasible option for Armenian women and providers, and that high quality services are being delivered.
authors.affiliation: Program Research Coordinator, Gynuity Health Projects, New York, NY, USA. Electronic address: klouie@gynuity.org.
authors.forename: Karmen S
authors.initials: KS
authors.lastname: Louie
authors.affiliation: Senior Program Associate, Gynuity Health Projects, New York, NY, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Chong
authors.affiliation: Senior Consulting Associate, Gynuity Health Projects, Tbilisi, Georgia.
authors.forename: Tamar
authors.initials: T
authors.lastname: Tsereteli
authors.affiliation: Head of Maternity and Reproductive Health Protection Unit, Ministry of Health, Republic of Armenia.
authors.forename: Gayane
authors.initials: G
authors.lastname: Avagyan
authors.affiliation: President, Women's Rights Centre, Yerevan, Republic of Armenia.
authors.forename: Susanna
authors.initials: S
authors.lastname: Vardanyan
authors.affiliation: President, Gynuity Health Projects, New York, NY, USA.
authors.forename: Beverly
authors.initials: B
authors.lastname: Winikoff
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage / Q000009:adverse effects; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage / Q000009:adverse effects; D000028:Abortion, Induced / Q000379:methods* / Q000523:psychology*; D000293:Adolescent; D000328:Adult; D001136:Armenia; D004338:Drug Combinations; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage / Q000009:adverse effects; D016595:Misoprostol / Q000008:administration & dosage / Q000009:adverse effects; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D011247:Pregnancy; D011261:Pregnancy Trimester, First; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D004338:Drug Combinations; D016595:Misoprostol; D015735:Mifepristone
keywords: Armenia; first trimester pregnancy; medical abortion; mifepristone; misoprostol