E. AUBENY, FIAPAC, Hôpital Broussais, 96 rue

Didot. 75014 Paris

MEDICAL ABORTION WITH MIFEPRISTONE AT HOME?

The present medical abortion

method until 49 days of amenorrhea (D.A.) is Day 1: mifepristone 600 mg taken

at the abortion centre, with the patient going home immediately afterwards; Day

3: misoprostol 400 µg taken orally, followed by medical supervision for 3 hours

in the center; Day 10-15: check-up visit. The 3-hour medical supervision on Day

3 in the center was imposed by French health authorities when medical abortion

first began because of three fears: fear of side effects of the prostaglandin,

fear of heavy bleeding at the time of expulsion of the egg, and fear that women

would not psychologically be able to tolerate being alone at the time of

expulsion. Data from ten years of French practice, 3 years of American practice

and numerous studies performed abroad (Tunisia, Vietnam) in which medical

abortions are carried out at home provide evidence that these fears are not

justified on the medical level and that medical abortions until 49 D.A. can

safely be carried out at home from a psychological point of view. A recent

French study confirms that women who choose medical abortion tolerate it very

well. It seems therefore appropriate to adapt the guidelines for medical

abortion in light of this new information and to allow patients who choose so

to take misoprostol orally at home.