Simplifying medical abortion: home administration of misoprostol

Objective: To increase access to safe abortion, the feasibility, efficacy and acceptability of a medical abortion regimen entailing a reduced dose of mifepristone and the option of home administration of sublingual misoprostol was assessed at a government hospital providing legal abortion services on a regular basis. Methods: Consenting women (n=99) with amenorrhea of = 56 days received mifepristone 200mg orally at the hospital. Two days later, women either returned to the hospital for 400 ae g sublingual misoprostol or took it at home. All women returned after two weeks for abortion confirmation. Results: The vast majority of women (88%) chose home use of misoprostol and did so mainly to decrease the number of clinic visits (65%) and to take care of their household responsibilities (16%). Adherence to the drug protocol was comparable among home and clinic users, with only a single woman in each group not taking misoprostol at the scheduled time. Efficacy was similarly high in both groups (home users 95% vs. clinic users 96%). No serious side effects were noted in either home or clinic users. Conclusion: The safety, efficacy and acceptability of home use of misoprostol observed in our study suggest this option should be available to women in India.