CONTEXT: Abortion induced by drugs is now a viable alternative to surgically induced abortion for U. S. women. Women's willingness to use these new methods of medical abortion hinges on the extent to which they prove acceptable, however. METHODS: Among 304 women participating in a clinical trial of medical abortion, 186 received a methotrexate-induced abortion and 118 were offered the option of a medical abortion but chose a surgical procedure instead. Study participants completed self-administered questionnaires before the abortion and again at a follow-up visit. RESULTS: Women in the medical and surgical abortion groups did not differ significantly with regard to demographic and other background characteristics: Their mean age was about 27, more than two-thirds were white, and three-quarters were unmarried and worked either part-time or full-time. However, women's ratings of seven attributes of abortion methods were significant predictors of choosing a medical abortion: Women were more likely to choose medical abortion if they placed greater importance on a method that was nonsurgical, one that resembled a miscarriage or one that could take place at home (odds ratios, 2.0-3.3). Conversely, women were less likely to choose medical abortion if they valued methods that were quick, that did not involve painful cramping or seeing blood or blood clots and that needed a doctor or nurse to be present (odds ratios, 0.3-0.5). Compared with those who had a surgical abortion, women who had a methotrexate-induced abortion expected more bleeding (mean scores, 3.5 vs. 3. 1) and reported more pain (3.4 vs. 2.9), heavier bleeding (3.4 vs. 2.5) and bleeding of longer duration (3.3 vs. 2.6). The overwhelming majority of women in the medical and surgical abortion groups reported that they were either very or somewhat satisfied with their abortion method (81% and 82%, respectively), would recommend it to others (82% and 78%) and would choose the method again (89% and 93%). CONCLUSIONS: Factors affecting the choice of abortion method appear to be numerous and complex. Providers need to be sensitive to differences in women's values and life circumstances when counseling them about an abortion method. In particular, providers should incorporate into their counseling sessions what women need to know about the characteristics of abortion methods and help women to identify what is the best option for them.
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机译：背景：对于美国女性而言，药物人工流产现在已成为手术人工流产的可行替代方案。然而，妇女是否愿意使用这些新的药物流产方法取决于它们在多大程度上可以接受。方法：在参加药物流产临床试验的304名妇女中，有186名接受了甲氨蝶呤引起的流产，有118名妇女选择了药物流产，但选择了手术方法。研究参与者在流产之前以及随后的随访中完成了自我管理的问卷调查。结果：药物和手术流产组中的妇女在人口统计学和其他背景特征方面无显着差异：她们的平均年龄约为27岁，三分之二是白人，四分之三的人未婚且兼职或全职。但是，妇女对堕胎方法的七个属性的评级是选择药物流产的重要预测指标：如果妇女更加重视非手术方法（类似于流产或可能发生的一种方法），则她们更有可能选择药物流产。在家（赔率比率为2.0-3.3）。相反，如果妇女评价快速，不痛苦的抽筋，不见血液或血凝块的方法，而需要医生或护士在场的话，她们选择药物流产的可能性就较小（比率为0.3-0.5）。与进行人工流产的女性相比，接受甲氨蝶呤人工流产的女性预计会有更多的出血（平均分：3.5 vs. 3. 1），并报告更多的疼痛（3.4 vs. 2.9），出血量更大（3.4 vs. 2.5）和持续时间更长的出血（3.3比2.6）。药物和手术流产组中绝大多数妇女报告说，她们对自己的流产方法非常满意（分别为81％和82％），会推荐给其他人（82％和78％）并选择再次使用该方法（分别为89％和93％）。结论：影响堕胎方法选择的因素似乎众多而复杂。提供者在向他们咨询堕胎方法时，必须对妇女价值观和生活条件的差异敏感。特别是，提供者应在其咨询会议中纳入妇女需要了解的有关堕胎方法特点的信息，并帮助妇女确定最适合她们的选择。
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