Efficacy and acceptability of a mifepristone-misoprostol combined regimen for early induced abortion among women in Mexico City.

OBJECTIVE: To evaluate the experience of women receiving mifepristone-misoprostol for early induced abortion in public sector facilities in the Federal District of Mexico City. METHODS: An open-label prospective study was conducted with 1000 pregnant women who sought induced abortion with a pregnancy of up to 63days of gestation, as measured from the date of their last menstrual period. The study was conducted in three public sector healthcare facilities: two secondary level hospitals and one primary care clinic. Women ingested 200mg mifepristone on day 1, followed by 800µg buccal misoprostol 24hours later, and they returned for follow-up on day 8. The primary outcome was complete abortion without recourse to surgical intervention. RESULTS: A total of 971 women received mifepristone-misoprostol and were included in the analysis for efficacy of treatment. The overall efficacy of the combined medical abortion regimen studied was 97.3% (n=945); the success rate did not vary significantly by gestational age (95.9%-100%; P=0.449). Most women (n=922, 95.0%) had a successful induced abortion with only one dose of misoprostol. CONCLUSION: The combined mifepristone and buccal misoprostol regimen was found to be highly effective and acceptable among Mexican women. www.ClinicalTrials.gov: NCT00386282.

Public opinion on abortion in Mexico City after the landmark reform.

This article presents findings from three opinion surveys conducted among representative samples of Mexico City residents: the first one immediately prior to the groundbreaking legalization of first-trimester abortion in April 2007, and one and two years after the reform. Bivariate and multivariate analyses were performed to assess changes in opinion concerning abortion and correlates of favorable opinion following reform. In 2009 a clear majority (74 percent) of respondents were in support of the Mexico City law allowing for elective first-trimester abortion, compared with 63 percent in 2008 and 38 percent in 2007. A significant increase in support for extending the law to the rest of Mexico was found: from 51 percent in 2007 to 70 percent in 2008 and 83 percent in 2009. In 2008 the significant independent correlates of support for the Mexico City law were education, infrequent religious service attendance, sex (being male), and political party affiliation; in 2009 they were education beyond high school, infrequent religious service attendance, and ever having been married.

Experiences and opinions of health-care professionals regarding legal abortion in Mexico City: a qualitative study.

This study examines the experiences and opinions of health-care professionals after the legalization of abortion in Mexico City in 2007. Sixty-four semistructured interviews were conducted between 1 December 2007 and 16 July 2008 with staff affiliated with abortion programs in 12 hospitals and 1 health center, including obstetricians/gynecologists, nurses, social workers, key decisionmakers at the Ministry of Health, and others. Findings suggest that program implementation was difficult because of the lack of personnel, space, and resources; a great number of conscientious objectors; and the enormous influx of women seeking services, which resulted in a work overload for participating professionals. The professionals interviewed indicate that the program improved significantly over time. They generally agree that legal abortion should be offered, despite serious concerns about repeat abortions. They recommend improving family planning campaigns and post-procedure contraceptive use, and they encourage the opening of primary health-care facilities dedicated to providing abortion services.