Medical abortion or vacuum aspiration? Two year follow up of a patient preference trial

Abstract

Objective To describe and compare health outcomes two years after medical abortion or vacuum Design Women recruited to the original, partially randomised study were contacted for assessment using Setting Grampian region of Scotland, UK.Participants One hundred and forty women who had participated in a partially randomised study of first Intervention Vacuum aspiration or medical abortion using mifepristone and gemeprost.Main outcome measures Long-term general, reproductive and psychological health; acceptability of procedure; perceived value of choice of method of termination.Results There were no significant differences between women who had undergone medical abortion or vacuum aspiration two years previously in general, reproductive or psychological health. Almost all women placed a high value on the provision of choice of method of termination. There was a significant difference in perception of long term procedure acceptability among women who had been randomised to a method of termination.Conclusions Women should have the opportunity to choose the method of termination. This opportunity will result in high levels of acceptability, particularly at gestations under 50 days of amenorrhoea.aspiration in women recruited into a patient preference trial during 1990 to 199 1. a structured interview.trimester abortion two years previously.

Abortion and Mental Health: Evaluating the Evidence

“…Findings of these studies are consistent with several others based on non-U.S. samples in suggesting that method of termination does not affect emotional adjustment or psychological experiences after the procedure among women given a choice of procedure (Ashok et al, 2005;Howie, Henshaw, Naji, Russell, & Templeton, 1997;Lowenstein et al, 2006).…”

Randomised preference trial of medical versus surgical termination of pregnancy less than 14 weeks' gestation (TOPS)

“…40 Depression is the main problem service providers have been concerned about. 21 Both the IES and HADS have been used in women after termination of pregnancy [21][22][23] and in our pilot study.…”

“…This technique is being increasingly used in health technology assessment 32 and has been used previously for assessing strength of preference for abortion method. 23,33 Interviews will be conducted, using the payment card method, 34 in all women in the preference arm prior to the procedure where they will be asked to state their maximum 'willingness to pay' amount for the termination method they have chosen. Interviews will also be conducted on all women in both the randomised and preference arms at 2 weeks after the procedure when they will be asked to state their maximum 'willingness to pay' amount to receive their preferred option at a future date.…”

“…Patient satisfaction with their care is the most commonly used indicator in research on patient evaluations, 23 but definitions of satisfaction vary, and different measures incorporate different dimensions of the construct, such as adequacy, suitability and acceptability. A common problem with satisfaction measures is that they exhibit ceiling effects, i.e.…”

A randomised preference trial of medical versus surgical termination of pregnancy less than 14 weeks' gestation

“…21 Henshaw et al 14 performed a partially randomised preference trial of termination of pregnancy < 9 weeks and found no differences in depression, anxiety or low selfesteem 2 weeks after the procedure 22 nor, in a much smaller number, 2 years later. 23 Whether medical termination of pregnancy is associated with more adverse psychological consequences after 9 weeks' gestation is not known.…”