Observational study of the mifepristone-misoprostol regimen for second-trimester abortion in Western Cape Province, South Africa
Despite medication abortion using mifepristone being the recommended regimen by the World Health Organization, use of mifepristone-misoprostol has been limited in the developing world due to the relatively high cost of mifepristone, restricted availability, and lack of experience with the regimen. Second-trimester abortion accounts for over 20-25% of all abortions in South Africa, and medical induction with misoprostol used alone has been the standard of care for second-trimester abortion. Mifepristone was recently added to South Africa’s Essential Drug List for second-trimester abortion. Changing the medical induction regimen from misoprostol alone to the mifepristone-misoprostol regimen will likely shorten the duration of the procedure, allowing for more women to be served in public sector facilities.
In 2013 we began an observational study of the mifepristone regimen for second-trimester abortion (13-20 weeks gestation) in Western Cape Province, South Africa. We recruited 207 women requesting legal termination of pregnancy in the second trimester. We will use data from our previous research examining the misoprostol-alone regimen to make important comparisons in the effectiveness and safety of the two medical induction regimens for second-trimester abortion. Analysis is underway.