Medical Abortion: Outcomes in a Family Medicine Setting

Purpose: To compare outcomes of early medical abortion with mifepristone and misoprostol in a family medicine setting and specialized reproductive health clinics. Methods: This study used data collected from a prospective, open-label, randomized trial of oral versus buccal misoprostol efficacy. A secondary analysis was performed, evaluating efficacy, acceptability, and interventions after medication at the family medicine site compared with the 6 specialized reproductive health sites. Results: Comparing data from patients in the family medicine setting (n = 116) to specialized reproductive health sites (n = 731) revealed no difference in overall efficacy (95.7% vs 93.4%; P = .351). The family medicine site used a second dose of misoprostol more frequently than the other sites (6.9% vs 2.5%; P = .018). In addition, uterine aspiration after medical abortion at the family medicine site was not used for medically necessary reasons whereas reproductive health clinics used it 2.6% of the time (marginally significant; P = .094). Patient satisfaction at family medicine sites was comparable to the other sites (91.2% vs 92.0%; P = .792). Conclusion: Medical abortion has similar efficacy and patient satisfaction when offered in a family medicine practice or at a reproductive health specialty clinic. These findings should reassure family physicians that medical abortion can be offered safely in their practices. (J Am Board Fam Med 2010;23:509-513.)