Impact of the introduction of new medical methods on therapeutic abortions at the Royal Infirmary of Edinburgh

Objective To assess the impact of the introduction of new medical methods on the provision of therapeutic abortions at the Royal Infirmary Edinburgh. Design A review of the total number of abortions performed by medical and surgical means between 1989 and 1995 (inclusive); a prospective survey of the terminations of pregnancy (less than or equal to 9 weeks of gestation) performed over the six-month period of January to June 1994; and a questionnaire of the reasons why women chose a particular method. Setting Large teaching hospital in Scotland. Subjects One thousand and seven women seeking early pregnancy termination between January and June 1994. Main outcome measures Proportion of pregnancies terminated by medical means; comparison of complete abortion rate, incidence of complications and morbidity following both medical and surgical methods (less than or equal to 9 weeks of gestation); reasons for preference of the method of abortion. Results Since 1991 there has been a progressive increase in the number of medical abortions performed at the Royal Infirmary of Edinburgh, and by 1994 the majority of women (57%) seeking abortion at less than or equal to 9 weeks chose a medical method. Women who chose medical abortion had more years at full-time education and were less likely to smoke (P < 0.04). Both medical and surgical methods were highly effective (> 96% complete abortion) with a low incidence of complications and morbidity. However, women who had chosen the medical method were less likely to receive antibiotics for suspected endometritis than their surgical counterparts (chi(2), P = 0.0001). Conclusions If this trend towards medical methods in Edinburgh is repeated elsewhere, it will inevitably have an impact on gynaecological services by releasing staff and operating time for other purposes.