Women's preferences for general or local anesthesia for pain during first trimester surgical abortion in India.

Women in India are rarely given a choice about their pain management methods for first trimester abortions. To investigate women's preferences and perceptions of pain, we allowed 100 women in Mumbai to choose between local and general anesthesia (60% selected general, while 40% elected local anesthesia). Using visual analog scales ranging from 1 to 7, women characterized their pain several times during their abortion visits. Local anesthesia clients reported more pain during (2.3 local vs. 1.0 general) and immediately after (1.9 vs. 1.0) the procedure. By three hours post-procedure, none of the women in either group reported any pain. General anesthesia clients reported that having no pain (95%) or anxiety (38%) were the best features, while local anesthesia clients liked being ambulatory (26%), avoiding side effects (26%), and feeling awake (21%). Though women in both groups were satisfied, local anesthesia clients were more likely to recommend it to friends (95% vs. 85%). Given these advantages, our study suggests that some women willingly accept additional pain incurred by exchanging local for general anesthesia.

Mifepristone-misoprostol abortion: a trial in rural and urban Maharashtra, India.

As several important policy questions remain regarding the use of medical abortion in developing countries, we investigated the safety, efficacy, and acceptability of mifepristone-misoprostol abortion in the outpatient family planning departments of two urban hospitals and one rural hospital in India. Nine-hundred women (with gestations of < or =63 days in the urban sites and < or =56 days in the rural site) received 600 mg mifepristone followed 48 h later by 400 microg oral misoprostol in the clinic. Four point four percent or fewer urban women and 1.0% rural women were lost to follow-up. Perfect and typical-use failure rates were low at all sites. While rural women reported fewer side effects at all sites, the vast majority of women were satisfied with their medical abortions. Medical abortion can be offered safely, effectively, and acceptably in the outpatient family planning departments of urban and rural hospitals in India.