[Ambulatory medical abortion performed in a family planning center]

In France, since 2001, medical abortion can be performed in ambulatory conditions, provided an agreement is signed with a hospital serving as referral for complications or failures of the method. This study, reports on the experience of a family planning center (NGO MFPF, Mouvement français de planning familial) in partnership with Delafontaine Hospital in Saint-Denis. In 2004, the MFPF has managed 161 cases of ambulatory medical abortion using a protocol of 200mg of mifepristone on day 1 and 400 to 800 microg of misoprostol on day 3, with possibility for the women to stay at home or go to the hospital for the expulsion. The average age of the women was 24 years and the proportion of young and vulnerable women quite high. The rate of success, defined as the absence or surgical intervention, approached 94.5% and only one case of severe complication was reported, massive hemorrhage 40 days after the initial intake of misoprostol. 75% of women chose to stay home. Acceptance of the method was very good with minimal request for more consultations than the three visits proposed in the protocol. The quality of the follow-up was high with 82% of women attending the medical check, with no difference being observed with regard to age, obstetrical history or socio-economic groups. Ambulatory medical abortion was successful and safe even among vulnerable women. NGOs with multidisciplinary staff involving counsellors, nurses and doctors can offer high quality preparation and follow-up.