University Ottawa, Ottawa, Canada; Macquarie University, Sydney, Australia.
University Ottawa, Ottawa, Canada.
Contraception. 2020 Jul;102(1):61-65. doi: 10.1016/j.contraception.2020.04.007. Epub 2020 Apr 16.
The gold standard of medication abortion, mifepristone and misoprostol, became available in Canada in 2017 as a combination pack under the trade name Mifegymiso®. We aimed to document people's experiences deciding to use and accessing medication abortion and generate insights for how information and services could be improved.
We conducted semi-structured, in-depth interviews with 64 people who had used the mifepristone/misoprostol regimen to induce an abortion in seven different Canadian provinces. We used ATLAS.ti to manage our data, which we analyzed for content and themes using inductive and deductive techniques.
The overwhelming majority of participants reflected positively on their experience with mifepristone/misoprostol for early abortion. Most people reported that medication abortion offered increased autonomy, privacy, and convenience compared with instrumentation procedures and especially liked being able to have the abortion in a comfortable and familiar environment. The small number of participants who reflected more negatively on their experiences generally did not feel well informed about what to expect. Several participants reported that the media served as a key information source for finding and accessing services.
Although our sample of Canadian abortion patients appear to be highly satisfied with the mifepristone and misoprostol regimen, there are several avenues by which medication abortion care could be improved. Providing more detailed information about pain management and the products of conception and lifting up the voices and stories of those who have used mifepristone and misoprostol could help patients manage expectations and would likely be welcomed.
Changes to the Mifegymiso® product monograph since its introduction seem to have addressed a number of barriers described by early users of mifepristone and misoprostol. Continued engagement with clinicians to ensure that the process is not overly medicalized appears warranted.
米非司酮和米索前列醇是药物流产的金标准，2017 年在加拿大以商品名 Mifegymiso®组合包装上市。我们旨在记录人们决定使用和获得药物流产的经验，并为如何改进信息和服务提供见解。
我们在加拿大七个不同省份对 64 名使用米非司酮/米索前列醇方案进行药物流产的人进行了半结构式深入访谈。我们使用 ATLAS.ti 来管理我们的数据，我们使用归纳和演绎技术对数据进行内容和主题分析。
绝大多数参与者对他们使用米非司酮/米索前列醇进行早期流产的经验评价很高。大多数人报告说，与器械程序相比，药物流产提供了更大的自主权、隐私和便利性，他们特别喜欢能够在舒适和熟悉的环境中进行流产。少数对自己的经历评价较低的参与者通常对自己的预期没有得到很好的了解。一些参与者报告说，媒体是寻找和获得服务的主要信息来源。
尽管我们的加拿大堕胎患者样本似乎对米非司酮和米索前列醇方案非常满意，但药物流产护理仍有几个方面可以改进。提供更多关于疼痛管理和妊娠产物的详细信息，并引用那些使用过米非司酮和米索前列醇的人的声音和故事，可以帮助患者管理预期，这可能会受到欢迎。
自 Mifegymiso®上市以来，对其产品说明书的修改似乎解决了米非司酮和米索前列醇早期使用者描述的一些障碍。继续与临床医生合作，确保该过程不过度医学化，似乎是合理的。
