Women’s preference for medical or surgical
method of termination of pregnancy at 9–12 weeks
of gestation
Dewart, H1; Johnstone, A2; Cameron, S2
1 Royal Infirmary of Edinburgh, UK; 2 Chalmers Sexual and
Reproductive Health Service, UK
Background and methods: Medical termination of pregnancy
(TOP) at less than 9 weeks of gestation and in the second
trimester, using mifepristone and misoprostol is well established
in Scotland. Although there is good evidence to support the
efficacy, safety and acceptability of medical TOP in the late first
trimester (9–12 weeks), it is not widely available. The TOP service
in Edinburgh, Scotland, UK currently offers only a surgical
method at this gestation band. A survey of women presenting to
this service at 9–12 weeks of gestation was conducted to
determine whether these women would choose a medical method
if this were available.
Results: Questionnaires were completed by a convenience sample
of 77 women over 5 months, representing 49% of all women at
this gestation during the study period. Women were of mean age
24.7 years (range 15–42). Most women (n = 51; 66%) stated that
they would choose a medical TOP if able to do so and a further
10 (13%) were unsure about preference of method. Most women
(n = 43; 56%) stated that they would still choose the medical
method, if they had to travel to another hospital (40 km away) to
have this. The commonest responses (out of 46 given) for
preferring a medical method was a perception that it was safer
(37%), easier (30%) and less invasive (28%).
Discussion and conclusions: Most women in our survey at 9–
12 weeks of gestation would in theory choose a medical method
of TOP, if this were available. Consideration should now be given
to offering this method to women as an alternative to surgery.