Reducing the Need for In-Clinic Follow-Up for Medical Abortion in Moldova and Uzbekistan

The Acceptability and Feasibility of Reducing the Need for In-Clinic Follow-Up for First Trimester Medical Abortion in Moldova and Uzbekistan

The purpose of this study is to determine whether an alternative method of follow-up after medical abortion is acceptable and feasible for use in Moldova and Uzbekistan.

Medical abortion using mifepristone and misoprostol is a highly effective procedure, but access to it may be impeded by the fact that not all women can afford or want to return for a follow-up visit. This often results in a high loss to follow-up rate. Additionally, with medical abortions of those women who do return for follow-up, higher costs are borne by both the woman and the healthcare system.

This study compares two methods of follow-up after medical abortion: standard of care versus alternative follow-up. The former involves a routine clinic visit two weeks after misoprostol administration. The latter consists of a low-sensitivity pregnancy test and a self-administered questionnaire. Based on the results of the test and questionnaire, women may be flagged as needing in-clinic follow-up or discharged from the study if their abortion is complete.

Inclusion Criteria:

• Reproductive-age woman seeking a medical abortion
• Woman in good general health
• Woman with an intrauterine pregnancy less than or equal to 63 days gestation on the day of mifepristone administration
• Woman able and willing to sign consent forms
• Woman eligible for medical abortion according to clinician's assessment
• Woman agreeing to be followed up with, by phone or at a clinic visit

Exclusion Criteria:

• Woman with a pregnancy greater than 63 days gestation on the day of mifepristone administration