Sexual and reproductive health

Expanding access to medical abortion: Perspectives of women and providers in developing countries


The use of medications and herbs with presumed medicinal properties to induce abortion is documented throughout recorded history [1]. However, the advent of safe and effective regimens for medical abortion (MA), also sometimes termed medication abortion or nonsurgical abortion, is more recent. Clinical trials of mifepristone alone for early abortion began in 1982 and reported complete abortion rates of less than 80%. It was soon discovered that the rates could be improved to nearly 100% if a prostaglandin analogue was administered 24–48 hours after mifepristone...

Medical abortion is one of the most significant developments in the field of reproductive health, both in countries where abortion is permitted on broad grounds or on request and in others where it is highly restricted. Where abortion is permitted and MA has been approved, MA provides a safe, effective, and noninvasive alternative to surgical abortion and is highly acceptable to women whether it was induced by misoprostol only or by the combined regimen [5–7]...

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[1] Joffe C. Abortion and medicine: a sociopolitical history. In: Paul M, Lichtenberg S, Borgatta L, Grimes DA, Stubblefield PG, Mitchell D, et al, editors. Management of Unintended and Abnormal Pregnancy: Comprehensive Abortion Care. Oxford, UK: Wiley-Blackwell; 2009. p. 1–9.

[5] Winikoff B, Sivin I, Coyaji KJ, Cabezas E, Xiao B, Gu S, et al. Safety, efficacy, and acceptability of medical abortion in China, Cuba, and India: a comparative trial of mifepristone-misoprostol versus surgical abortion. Am J Obstet Gynecol 1997;176(2): 431–7.

[7] Blanchard K, Winikoff B, Ellerston C. Misoprostol used alone for the termination of early pregnancy: a review of evidence. Contraception 1999;59(4):209–17.


Improving maternal health by preventing unsafe abortion