Mifepristone abortion in minors

Approximately one-third of pregnant teenagers in the U.S. choose abortion. This prospective study evaluated whether medical abortion with mifepristone and misoprostol is physically and emotionally acceptable in adolescents. Adolescents 14- to 17-years-old, with pregnancies < or =56 days gestation, and seeking abortion services with parental consent from at least one parent were enrolled. Mifepristone (200 mg) was administered, followed 2 days later by 800 microg of misoprostol administered vaginally. Follow-up visit occurred on Day 4-8 to confirm abortion completion. Questionnaires regarding acceptability of the procedure as well as emotional coping were administered at the initial visit, at the follow-up visit, and by phone at 4 weeks postabortion. All 28 adolescents had complete medical abortions without complications or surgical intervention, and five minors did not require misoprostol. At the Day 4-8 follow-up visit, 75% of teens found the procedure acceptable, and that increased to 96% by the 4-week visit. Although 57% reported stress and 43% reported fear initially, by 4 weeks postabortion only 21% of the teens reported stress, and 8% were still experiencing fear. In addition, the minors' satisfaction with their abortion decision increased from 43% to 79% by 4 weeks postabortion. Medical abortion with mifepristone and misoprostol was highly effective and well tolerated, physically and emotionally, by adolescents in our sample. A larger clinical trial is needed to generalize these findings to other adolescent populations seeking medical abortion services.