The acceptability of medical abortion in China, Cuba and India

In a comparative study of the acceptability of medical abortion and surgical abortion among women in developing countries, patients at clinics in China, Cuba and India were allowed to choose between a surgical procedure and a medical regimen of mifepristone and misoprostol. The most common reasons women cited for choosing medical abortion were their desire to avoid surgery and general anesthesia; the reasons they mentioned most frequently for choosing surgical abortion were speed, simplicity and effectiveness. The failure rate for medical abortion varied from 5% in India to 16% in Cuba, while that for surgical abortion ranged from 0% in India to 4% in Cuba. Although side effects were more frequently reported by women who chose medical abortion, the majority of women at all sites were either satisfied or highly satisfied with their abortion experience, regardless of method (medical, 84-95%; surgical, 94-100%). At every site, medical abortion clients were significantly more likely than surgical clients to report being highly satisfied (China, 43% vs. 23%; Cuba, 59% vs. 39%; India, 69% vs. 54%), but also were more likely to report not being satisfied (China, 6% vs. 4%; Cuba, 17% vs. 7%; India, 5% vs. 0%). In China and India, women who had a medical abortion were significantly more likely than those who had a surgical abortion to say they would choose the same method again.