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The Journal of the American Board of Family Medicine 23 (4): 509-513 (2010)
DOI: 10.3122/jabfm.2010.04.090229
© 2010 American Board of Family Medicine
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Original Research

Medical Abortion: Outcomes in a Family Medicine Setting

Linda Prine, MD, Caitlin Shannon, JD, MPH, Ginger Gillespie, MD, William A. Crowden, Jennifer Fortin, MPH, Michelle Howe, PA-C and Ilana Dzuba, MHS

Institute for Family Health (LP, GG), New York, NY
Gynuity Health Projects (CS, ID), New York, NY
Planned Parenthood of Waco, TX (WAC)
Planned Parenthood League of Massachusetts, Boston (JF)
Family Planning Associates Medical Group, Chicago, IL (MH)

Correspondence: Corresponding author: Linda Prine, MD, 16 East 16th St, New York, NY 10011 (E-mail: lindaprine{at}earthlink.net)

Purpose: To compare outcomes of early medical abortion with mifepristone and misoprostol in a family medicine setting and specialized reproductive health clinics.

Methods: This study used data collected from a prospective, open-label, randomized trial of oral versus buccal misoprostol efficacy. A secondary analysis was performed, evaluating efficacy, acceptability, and interventions after medication at the family medicine site compared with the 6 specialized reproductive health sites.

Results: Comparing data from patients in the family medicine setting (n = 116) to specialized reproductive health sites (n = 731) revealed no difference in overall efficacy (95.7% vs 93.4%; P = .351). The family medicine site used a second dose of misoprostol more frequently than the other sites (6.9% vs 2.5%; P = .018). In addition, uterine aspiration after medical abortion at the family medicine site was not used for "medically necessary" reasons whereas reproductive health clinics used it 2.6% of the time (marginally significant; P = .094). Patient satisfaction at family medicine sites was comparable to the other sites (91.2% vs 92.0%; P = .792).

Conclusion: Medical abortion has similar efficacy and patient satisfaction when offered in a family medicine practice or at a reproductive health specialty clinic. These findings should reassure family physicians that medical abortion can be offered safely in their practices.

Key Words: Practice-based Research • PBRN • Abortion • Misoprostol • Family Medicine


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