title: Implementing medical abortion with mifepristone and misoprostol in Norway 1998-2013.
abstract: Medical abortion with mifepristone and misoprostol was introduced in Norway in 1998, and since then there has been an almost complete change from predominantly surgical to medical abortions. We aimed to describe the medical abortion implementation process, and to compare characteristics of women obtaining medical and surgical abortion.
  
  
  
  Information from all departments of obstetrics and gynaecology in Norway on the time of implementation of medical abortion and abortion procedures in use up to 12 weeks of gestation was assessed by surveys in 2008 and 2012. We also analysed data from the National Abortion Registry comprising 223 692 women requesting abortion up to 12 weeks of gestation during 1998-2013.
  
  
  
  In 2012, all hospitals offered medical abortion, 84.4% offered medical abortion at 9-12 weeks of gestation and 92.1% offered home administration of misoprostol. The use of medical abortion increased from 5.9% of all abortions in 1998 to 82.1% in 2013. Compared with women having a surgical abortion, women obtaining medical abortion had higher odds for undergoing an abortion at 4-6 weeks (adjusted OR 2.33; 95% confidence interval 2.28-2.38). Waiting time between registered request for an abortion until termination was reduced from 11.3 days in 1998 to 7.3 days in 2013.
  
  
  
  Norwegian women have gained access to more treatment modalities and simplified protocols for medical abortion. At the same time they obtained abortions at an earlier gestational age and the waiting time has been reduced.
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.|Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway.|Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Mette
authors.initials: M
authors.lastname: Løkeland
authors.affiliation: Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.|Cancer Registry of Norway, Oslo, Norway.
authors.forename: Tone
authors.initials: T
authors.lastname: Bjørge
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.|Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Ole-Erik
authors.initials: OE
authors.lastname: Iversen
authors.affiliation: Department of Health Registries, Norwegian Institute of Public Health, Bergen, Norway.
authors.forename: Rupali
authors.initials: R
authors.lastname: Akerkar
authors.affiliation: Department of Clinical Medicine, University of Bergen, Bergen, Norway.|Department of Obstetrics and Gynaecology, Haukeland University Hospital, Bergen, Norway.
authors.forename: Line
authors.initials: L
authors.lastname: Bjørge
mesh_terms: D000020:Abortifacient Agents, Nonsteroidal / Q000008:administration & dosage*; D000021:Abortifacient Agents, Steroidal / Q000008:administration & dosage*; D000028:Abortion, Induced / Q000379:methods / Q000639:trends*; D000293:Adolescent; D000328:Adult; D004359:Drug Therapy, Combination; D005260:Female; D005865:Gestational Age; D006297:Health Services Accessibility / Q000639:trends; D006801:Humans; D016015:Logistic Models; D008875:Middle Aged; D015735:Mifepristone / Q000008:administration & dosage*; D016595:Misoprostol / Q000008:administration & dosage*; D015999:Multivariate Analysis; D009664:Norway; D017060:Patient Satisfaction; D011247:Pregnancy; D011446:Prospective Studies; D012042:Registries; D012646:Self Administration; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000020:Abortifacient Agents, Nonsteroidal; D000021:Abortifacient Agents, Steroidal; D016595:Misoprostol; D015735:Mifepristone
keywords: Medical abortion; Norway; mifepristone; misoprostol; registry