Safety, Efficacy and Acceptability of Mifepristone- Misoprostol Medical Abortion in Vietnam

Only two studies, however, have focused on the potential use of mifepristone and misoprostol for medical abortion in developing countries,4 and only one of these measured the method’s acceptability to clients.5 Given the potential of medical abortion to improve conditions for women in developing countries, these women’s perceptions of the method in general and of the mifepristone-misoprostol regimen in particular is critical to its acceptability. Patients’ attitudes, expectations and tolerance of side effects influence surgical intervention rates; ultimately, for the method to work successfully, women must complete the regimen and wait while the treatment takes its course. In Vietnam, the number of pregnancy terminations has risen steadily over the past 15 years and is now estimated at more than one million per year;6 since the early 1990s, the annual number of abortions has exceeded the annual number of births.7 A 1994 nationwide survey found that 13% of women have had at least one abortion.8 Moreover, in 1992, the total abortion rate was estimated as 2.5 lifetime abortions per woman, the highest in Asia and the thirdhighest in the world.9 Additionally, the surgical abortion services available in Vietnam are marked by a number of safety and quality problems.10 For example, sterilization of instruments Nguyen Thi Nhu Ngoc is vice director, Hung Vuong Hospital, Ho Chi Minh City, Vietnam; Khong Ngoc Am is retired director, Maternal and Child Health and Family Planning, Hanoi Obstetric and Gynecology Hospital, Hanoi, Vietnam; and Do Trong Hieu is chief, Maternal and Child Health Department, Ministry of Health, Hanoi. Beverly Winikoff is director, Reproductive Health; Shelley Clark is consultant; Charlotte Ellertson is program associate; and Batya Elul is staff program associate—all with the Population Council, New York. This study was funded by an anonymous donor. The authors thank Kurus Coyaji and Andrea Eschen for their assistance. Safety, Efficacy and Acceptability of MifepristoneMisoprostol Medical Abortion in Vietnam