Assessment of Abortion Methods, Management, and Patient Satisfaction Among Women Seeking Safe Abortion Services in a...

Unsafe abortion is a major contributor to maternal mortality in low- and middle-income countries. Despite the legalization of abortion and expanded access to services in Nepal, data on abortion practices and patient satisfaction remain limited.

This study aimed to assess abortion methods, their management, and patient satisfaction among women seeking safe abortion services at a tertiary care hospital in Kathmandu, Nepal.

A hospital-based cross-sectional study.

The study was conducted from December 2023 to May 2024 among 285 women aged ⩾18 years with gestational age of up to 12 weeks. Data were collected through face-to-face interviews and clinical records, followed by 7-day post-abortion assessment via in-person visits or phone calls. Pearson's chi-square test and binary logistic regression were performed at a 5% level of significance to identify factor associated with patient satisfaction.

Among 285 women, 76.8% underwent medical abortion with oral mifepristone followed by misoprostol via sublingual, buccal, or vaginal routes, while 23.2% received surgical abortion through vacuum aspiration after misoprostol pre-treatment and local anesthesia. Discharge medications commonly included analgesics (paracetamol and ibuprofen) and antibiotics (ciprofloxacin, and metronidazole). Post-abortion contraceptive uptake was 79.3%, with implants (28.8%) and condoms (28.4%) being the most chosen methods. Overall, 50.2% of women reported satisfaction with the abortion services received. Logistic regression analysis showed that higher education (AOR: 5.63; 95% CI: 2.40-13.16), extended family structure (AOR: 7.25; 95% CI: 3.11-16.91), and no history of live birth (AOR: 4.20; 95% CI: 1.48-11.93) were significantly associated with higher satisfaction, while age ⩾35 years was negatively associated (AOR: 0.52; 95% CI: 0.28-0.95).

Medical abortion was the preferred method, and overall management was aligned with WHO guidelines. However, patient satisfaction was moderate. Improving infrastructure, ensuring privacy, reducing waiting times, enhancing post-abortion counseling, and providing tailored health education with regular service evaluations are needed to improve the quality of abortion care and patient satisfaction.