The 130th Annual Meeting of APHA

Abstract #48665

Jennifer Blum, MPH¹, Selma Hajri, MD², Hela Chelli, MD³, Ben Mansour Farouk, MD⁴, Nabiha Guedanna, MD⁴, Arielle Lutwick⁵, and Beverly Winikoff, MD, MPH¹. (1) Population Council, One Dag Hammarskjold Plaza, New York, NY 10017, 212 339 0614, jblum@popcouncil.org, (2) Private Physician, 1 rue de la mosque, La Marsa, Tunisa, Tunisia, (3) Centre de materniteet de Neonatalogie de Tunis, La Rabta, Service "A", Tunis, Tunisia, (4) Office National de la Famille et de la Population, Rue de L'Evacuation, Bardo 2000, Tunisia, (5) University of Chicago, 5220 S Kimbark Ave. Apt 1, Chicago, IL 60615

We will present results from a multi-site study of 380 Tunisian women using medical abortion. This study is the first attempt to offer medical abortion services to women outside of the capital, Tunis, and included sites in Sousse and Sfax. In the study, all consenting women presenting with a gestation less than 56 days LMP were offered a simplified medical abortion regimen consisting of a 200 mg mifepristone on day one and 400 mcg oral misoprostol on day 3 (at home or at the clinic). Clinical data were collected at the study sites and women were asked to record their experiences outside of the clinic in a diary card. Preliminary results show that approximately 95% of women (Home users: 97.4%, Clinic users: 93.4%) had a successful abortion using this regimen. When we asked why they selected medical abortion, women reported a preference for a method that was non-surgical (18.4%) and did not require use of anesthesia (15.7%). Home use of misoprostol was extremely popular, with the majority of women (approx. 65%) choosing to administer their misoprostol at home. Women indicated that home administration is desirable because it offers greater confidentiality (19.3%), is easier (14.3%) and requires less time and money for additional clinic visits (11.1%). The Tunisian women in this study expressed a high degree of satisfaction with their medical abortion. Mifepristone was approved for use in Tunisia in November 2000. To date, mifepristone is not available for use in the country. We hope that the results from this study will provide further evidence to support its introduction.

Learning Objectives:

• 1)Name reasons why home use medical abortion regimens are feasible for use in less-developed countries like Tunisia, 2)Learn how success rates can improve as provider's gain experience with the method

Keywords: Abortion, Reproductive Health

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: The Population Council holds the U.S. rights to mifepristone.
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.