Workshop: Does

the method of abortion affect acceptability?

Alenka Pretnar- Darovec

The workshop involved lively discussion by colleagues

from the United Kingdom, Austria, Belgium, France, the Netherlands, Slovenia

and also a Hungarian rapporteur.

The question was addressed not only from the women’s

point of view but also from the doctors’.

In all the countries represented the abortion pill

(mifepristone and misoprostol) is available. Differences appeared with regards

to who is involved in performing the abortion. If a woman chooses the abortion

pill, in France, England or Belgium, it is possible to offer them privacy by

taking it at home. In England general practitioners and also nurses can be

involved in helping women with their decision.

The most common abortion technique in all countries,

is vacuum aspiration up to 12 weeks gestation. Women tend to choose it because

of tradition. In Slovenia, where an acceptability study was conducted in

co-operation with WHO, women wanted as short a procedure as possible – (that is

menstrual regulation or vacuum aspiration under general anaesthesia).

Differences were found amongst nulligravidas where they were afraid of a

surgical procedure and choose medical abortion.

In the second trimester in these European countries

abortion is performed with mifepristone and prostaglandin- vaginally or orally.

Only in Slovenia is it done with intra-amniotic prostaglandin.

Participants mostly agreed that medical abortion is

more painful and takes more time than a surgical one. Although painkillers were

prescribed, women mainly choose general anaesthetic and vacuum aspiration in

most cases.

In conclusion factors influencing acceptability are

gestational age, options in specific countries, age and parity of women,

travelling distance and the price of the


Never the less pain during medical abortion is also a

very important factor when compared with the option of anaesthetic during a

surgical abortion.

Last but not least increasing knowledge, not only

women’s, but also of medical staff will help in discussing abortion, which not

only provides more options, but also empowers women.

So the “take home message” is that the abortion pill,

as a future abortion at home must be better known. We suggest encouraging

information provision in all forms of media.

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