Information on the operational requirements for integrating mifepristone-misoprostol medical abortion into South Africa’s public sector safe abortion services is required to guide policy decisions. This study trained health workers to provide medical abortion to 290 women attending three TOP sites. Prospective data were collected to ascertain women’s experience of the method, pregnancy outcome, women’s and provider’s acceptability of the process, and the operational requirements for providing medical abortion.
Twenty-nine women were lost to follow-up; 261 women had a confirmed abortion outcome, of whom 93% had a complete abortion. Given the option, the vast majority of women opted to use misoprostol at home. No severe side effects were reported; pain and heavy bleeding were the most common side effects. Most women were delighted with the experience. Health providers were confident with providing medical abortion and recommended its introduction to complement existing surgical TOP services.
The study concluded that the integration of medical abortion into public sector services is feasible. The results of this study will guide policy decisions about integrating medical abortion into South Africa’s public sector safe abortion services within the context of the existing enabling legislative framework.