{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T20:56:44Z","timestamp":1793307404760,"version":"4.5.0"},"reference-count":25,"publisher":"BMJ","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Fam Plann Reprod Health Care"],"accepted":{"date-parts":[[2007,12,12]]},"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:sec>\n                  <jats:title>Background and methodology<\/jats:title>\n                  <jats:p>South Africa's Choice on Termination of Pregnancy Act of 1996 provides for safe termination of pregnancy (TOP) in designated facilities in the public and private health sectors. In 2001, mifepristone-misoprostol medical abortion was approved for TOP up to 56 days, but this method is not yet available in the public sector. Information on the operational requirements for integrating mifepristone-misoprostol medical abortion into South Africa's public sector safe abortion services is required to guide policy decisions. This study trained health workers to provide medical abortion to 290 women attending three TOP sites. Prospective data were collected to ascertain women's experience of the method, pregnancy outcome, women's and provider's acceptability of the method, and the operational requirements for providing medical abortion.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Twenty-nine (10%) women were lost to follow-up; 261 (90%) women had a confirmed abortion outcome, of whom 93% had a complete abortion. Given the option, the vast majority of women opted to use misoprostol at home. No serious side effects were reported; pain (66%), and heavy bleeding (67%) were the most common side effects. Most (96%) women were very satisfied with the experience. Health providers were satisfied with providing medical abortion and recommended its introduction to complement existing surgical TOP services.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Discussion and conclusion<\/jats:title>\n                  <jats:p>This study demonstrates that integration of medical abortion into public sector services is feasible. The results of this study will guide policy decisions about integrating medical abortion into South Africa's public sector safe abortion services, within the context of the existing enabling legislative framework.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1783\/147118908784734846","type":"journal-article","created":{"date-parts":[[2008,6,23]],"date-time":"2008-06-23T21:07:12Z","timestamp":1214255232000},"page":"159-164","source":"Crossref","is-referenced-by-count":24,"title":["Integrating medical abortion into safe abortion services: experience from three pilot sites in South Africa"],"prefix":"10.1136","volume":"34","author":[{"given":"Mary","family":"Kawonga","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly","family":"Blanchard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diane","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Cullingworth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kim","family":"Dickson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"von Mollendorf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beverly","family":"Winikoff","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2008,7,1]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/S0010-7824(99)00115-8","article-title":"The efficacy of medical abortion: a meta-analysis","volume":"61","author":"Kahn, J.G.; Becker, B.J.; MacIsaa, L.; Amory, J.K.; Neuhaus, J.; Olkin, I.","year":"2000","unstructured":"Kahn JG, Becker BJ, MacIsaa L, Amory JK, Neuhaus J, Olkin I, et al. The efficacy of medical abortion: a meta-analysis. Contraception 2000; 61: 29\u201340.","journal-title":"Contraception"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1509","DOI":"10.1056\/NEJM199305273282101","article-title":"Early termination of pregnancy with mifepristone (RU 486) and the orally active prostaglandin misoprostol","volume":"328","author":"Peyron, R.; Aub\u00e9ny, E.; Targosz, V.; Silvestre, L.; Renault, M.; Elkik, F.","year":"1993","unstructured":"Peyron R, Aub\u00e9ny E, Targosz V, Silvestre L, Renault M, Elkik F, et al. Early termination of pregnancy with mifepristone (RU 486) and the orally active prostaglandin misoprostol. 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Obstet Gynecol 1997; 89: 790\u2013796.","journal-title":"Obstet Gynecol"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1241","DOI":"10.1056\/NEJM199804303381801","article-title":"Early pregnancy termination with mifepristone and misoprostol in the United States","volume":"338","author":"Spitz, I.M.; Bardin, C.W.; Benton, L.; Robbins, A.","year":"1998","unstructured":"Spitz IM, Bardin CW, Benton L, Robbins A. Early pregnancy termination with mifepristone and misoprostol in the United States. N Engl J Med 1998; 338: 1241\u20131247.","journal-title":"N Engl J Med"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1016\/S0002-9378(97)70511-8","article-title":"and acceptability of medical abortion in China, Cuba and India: a comparative trial of mifepristone-misoprostol versus surgical abortion","volume":"176","author":"Winikoff, B.; Sivin, I.; Coyaji, K.J.; Cabezas, E.; Xiao, B.; Gu, S.","year":"1997","unstructured":"Winikoff B, Sivin I, Coyaji KJ, Cabezas E, Xiao B, Gu S, et al. Safety, efficacy, and acceptability of medical abortion in China, Cuba and India: a comparative trial of mifepristone-misoprostol versus surgical abortion. 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Can women in less-developed countries use a simplified medical abortion regimen? Lancet 2001; 357(9266): 1402\u20131405.","journal-title":"Lancet"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1111\/j.1471-0528.2000.tb13273.x","article-title":"Task Force on Post-Ovulatory Methods of Fertility Regulation. Comparison of two doses of mifepristone in combination with misoprostol for early medical abortion: a randomised trial","volume":"107","author":"World Health Organization","year":"2000","unstructured":"World Health Organization Task Force on Post-Ovulatory Methods of Fertility Regulation. Comparison of two doses of mifepristone in combination with misoprostol for early medical abortion: a randomised trial. Br J Obstet Gynaecol 2000; 107: 524\u2013530.","journal-title":"Br J Obstet Gynaecol"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/S0010-7824(98)00150-4","article-title":"and vaginal misoprostol for abortion","volume":"59","author":"Schaff, E.A.; Eisinger, S.H.; Stadalius, L.S.; Franks, P.; Gore, B.Z.; Poppema, S.","year":"1999","unstructured":"Schaff EA, Eisinger SH, Stadalius LS, Franks P, Gore BZ, Poppema S. Low-dose mifepristone 200 mg and vaginal misoprostol for abortion. Contraception 1999; 59: 1\u20136.","journal-title":"Contraception"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"401","DOI":"10.1016\/j.contraception.2004.05.005","article-title":"Results and lessons learned from a small medical abortion clinical study in Turkey","volume":"70","author":"Akin, A.; Blum, J.; Ozalp, S.; Ondero_lu, L.; Kirca, U.; Bilgili, N.","year":"2004","unstructured":"Akin A, Blum J, Ozalp S, Ondero_lu L, Kirca U, Bilgili N, et al. Results and lessons learned from a small medical abortion clinical study in Turkey. Contraception 2004; 70: 401\u2013406.","journal-title":"Contraception"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1016\/j.contraception.2004.06.012","article-title":"Expanding medical abortion in Tunisia: women\u2019s experiences from a multi-site expansion study","volume":"70","author":"Hajri, S.; Blum, J.; Gueddana, N.; Saadi, H.; Maazoun, L.; Ch\u00e9lli, H.","year":"2004","unstructured":"Hajri S, Blum J, Gueddana N, Saadi H, Maazoun L, Ch\u00e9lli H, et al. Expanding medical abortion in Tunisia: women\u2019s experiences from a multi-site expansion study. Contraception 2004; 70: 487\u2013491.","journal-title":"Contraception"},{"key":"ref_15","article-title":"Choice on Termination of Pregnancy Act, 1996 (Act 92 of 1996)","author":"Department of Health","year":"1996","unstructured":"Department of Health. Choice on Termination of Pregnancy Act, 1996 (Act 92 of 1996). 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