THURSDAY, March 31 (HealthDay News) -- Medical abortions by midlevel providers (MLPs), up to nine weeks gestation, are as safe and effective as those provided by doctors, according to a study published online March 31 in The Lancet.
Ina K. Warriner, Ph.D., from the World Health Organization in Geneva, and colleagues assessed whether medical abortions provided by MLPs less than nine weeks (63 days) into pregnancy was as safe and effective as those provided by doctors for women living less than a 90-minute journey from a clinic in Nepal. Women received 200 mg oral mifepristone followed by 800 µg vaginal misoprostol two days after the procedure and were followed up after 10 to 14 days. Complete abortion without manual vacuum aspiration within 30 days of treatment was the main end point in 514 women randomly assigned to a doctor and 518 women assigned to an MLP.
The investigators found that 97.3 percent of the women in the MLP cohort and 96.1 percent of women in the physician cohort had a complete abortion. One percent of women in the doctor cohort had a failed abortion. The MLP cohort had no failed abortions, and the remaining abortions in both groups were incomplete. No serious complications were observed in either group. The risk difference of 1.24 percent for complete abortion between the two groups fell between a predetermined margin of equivalence (−5 to 5 percent).
"Nurses and auxiliary nurse midwives could have an important role in making life-saving abortion methods accessible to women living in remote areas of developing countries," the authors write.
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