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Efficacy of self-administration of medication abortion for first trimester of pregnancy in Ethiopia: A multicenter prospective cohort study

Abel Gedefaw(1), Getasew Bayu(2), Misganaw Worku(3), Mamush Agonafir(4), Sintayehu Amare(5), Dejene Hailu(6), Abraham Fessehaye Sium(7),


(1) Senior Managing Editor, African Journal of Reproductive Health (ADepartment of Obstetrics and Gynecology, Hawassa University College of Medicine and Health Sciences, Hawassa, EthiopiaJRH)
(2) Senior Managing Editor, African Journal of Reproductive Health (ADepartment of Obstetrics and Gynecology, Hawassa University College of Medicine and Health Sciences, Hawassa, EthiopiaJRH)
(3) Senior Managing Editor, African Journal of Reproductive Health (ADepartment of Obstetrics and Gynecology, Hawassa University College of Medicine and Health Sciences, Hawassa, EthiopiaJRH)
(4) Family guidance association, Hawassa branch Hawassa, Ethiopia
(5) Hawassa Universitycomprehensive specialized hospital, Hawassa, Ethiopia
(6) School of public Health, Hawassa University, Hawassa, Ethiopia
(7) Department of Obstetrics and Gynecology, St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia
Corresponding Author

Abstract


Medical abortion with mifepristone and misoprostol, or misoprostol alone, can be safely administered in clinics or self-managed at home up to nine weeks of gestation. We conducted a prospective multi-center cohort study among women and girls seeking pregnancy termination at six purposively selected healthcare facilities or medication abortion dispensers in Hawassa City, Southern Ethiopia, from March 16, 2024, to January 15, 2025. We grouped the participants in two cohorts: self-administration of medication abortion (exposure group) and health-personnel provided medication abortion care (control group). Data were collected using the Kobo Toolbox tool and analyzed with SPSS version 26. A total of 554 participants (341 participants in the exposure group and 213 participants were in the control group) were included in the final analysis. Effectiveness was measured as the proportion of women who had successful medication abortion without further requirement of addition procedure to complete the abortion. We found self-administration of medication abortion at ≤12 weeks as effective as health-personnel provided medical abortion. After controlling for gestational age, medication abortion regimen, and parity self-administration of medication abortion was as effective as health-personnel provided medication abortion (AOR= 1.13, 95% CI: 1.07–1.20). Write a conclusive statement.

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