***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: This was a prospect i ve study involving 205 women seeking medical abortion with gestational age ⩽ 63 days . Question naires regarding expectations , experience and satisfaction with medical abortion were self-completed at the end of the procedure . Women 's satisfaction was assessed using the visual analogue scale from 0 to 10 . Satisfaction and acceptability parameters were correlated with socio-demographic and obstetric data . The mean degree of overall satisfaction was 8.3 ( range 1 – 10 ) . Around 90 % of women would select the method again and would recommend it to a friend or relative . The degree of satisfaction showed a positive correlation with women 's age ( P < 0.001 ) and number of children ( P < 0.05 ) and a significant negative correlation with gestational age ( P < 0.005 ) . Marital status , type of financial support and acceptable pain and bleeding experience also showed a correlation with the satisfaction score . On the other h and , acceptability was correlated with husb and /partner agreement and support during the procedure and adequate counselling regarding pain and bleeding Background Despite changes to the abortion legislation in South Africa in 1996 , barriers to women accessing abortion services still exist including provider opposition to abortions and a shortage of trained and willing abortion care providers . The dearth of abortion providers undermines the availability of safe , legal abortion , and has serious implication s for women 's access to abortion services and health service planning . In South Africa , little is known about the personal and professional attitudes of individuals who are currently working in abortion service provision . Exploring the factors which determine health care providers ' involvement or disengagement in abortion services may facilitate improvement in the planning and provision of future services . Methods Qualitative research methods were used to collect data . Thirty four in-depth interviews  and one focus group discussion were conducted during 2006 and 2007 with health care providers who were involved in a range of abortion provision in the Western Cape Province , South Africa . Data were analysed using a thematic analysis approach . Results Complex patterns of service delivery were prevalent throughout many of the health care facilities , and fragmented levels of service provision operated in order to accommo date health care providers ' willingness to be involved in different aspects of abortion provision . Related to this was the need expressed by many providers for dedicated , st and -alone abortion clinics thereby creating a more supportive environment for both clients and providers . Almost all providers were concerned about the numerous difficulties women faced in seeking an abortion and their general quality of care . An overriding concern was poor pre and post abortion counselling including contraceptive counselling and provision . Conclusion This is the first known qualitative study undertaken in South Africa exploring providers ' attitudes towards abortion and adds to the body of information addressing the barriers to safe abortion services . In order to sustain a pool of abortion providers , programmes which both attract prospect i ve abortion providers , and retain existing providers , needs to be developed and financial compensation for abortion care providers needs to be considered OBJECTIVE To determine the acceptability of taking mifepristone at home for early medical abortion in the United States . STUDY DESIGN This prospect i ve , non-r and omized , open-label study at six Planned Parenthood centers gave women with pregnancies up to 63 days ' gestation seeking medical abortion the choice of taking mifepristone in the center or at home . Participants were interviewed at a follow-up visit 1 - 2 weeks after mifepristone administration to assess their experience with the option they selected . RESULTS Four-hundred women were enrolled between April 2013 and June 2014 of which 32 % ( n=128 ) chose to take mifepristone at home . Abortion success rates did not differ between home and center users ( 96 % and 97 % ) . Among home users , 82 % reported taking the  mifepristone at the time they planned with their provider and no participant took it after 63 days ' gestation . The most common reason cited for selecting home use was scheduling flexibility and significantly more home users took  misoprostol on the weekend ( 50 % vs. 36 % , p=.02 ) . Home users were more likely than center users to report missing no days of work due to the abortion ( 47 % vs. 28 % , p=.08 ) . Ninety-nine percent of home users reported that they would  take mifepristone at home again and 96 % would recommend home use to a friend . Offering this option did not increase the service delivery burden on study providers , who would recommend home use in the future for most participants . CONCLUSIONS Home use of mifepristone is a highly acceptable practice for which there is current dem and , and it should be offered as part of routine medical abortion services . IMPLICATION S Offering the option of home use of mifepristone to medical abortion patients can provide women and clinics with more flexibility while maintaining a safe , effective and acceptable service . These results provide support for telemedicine or pharmacy distribution BACKGROUND The aim of the study was to compare satisfaction with medical and surgical abortion and to identify potential confounders affecting satisfaction . METHODS 1033 women with gestational age ( GA ) < or = 63 days had either a medical ( 600 mg mifepristone followed by 1 mg gemeprost ) or a surgical abortion ( vacuum aspiration in general anaesthesia ) .  The procedure was determined either by r and omization ( n = 111 ) or by choice ( n = 922 ) . Data on satisfaction , side effects and expectations were collected from question naires 2 and 8 weeks after termination . RESULTS More women were very satisfied or satisfied after a surgical than a medical abortion both after choosing method ( 92 % vs 82 % , P < 0.0001 ) , and after r and omization ( 94 % vs 68 % , P < 0.001 ) . Satisfaction was higher after choosing a medical procedure than after r and omization to the same procedure ; 82 % and 68 % , respectively , P < 0.05 . Satisfaction with the medical procedure was inversely correlated with GA and the intensity of pain , nausea , vomiting and dizziness , while satisfaction with the surgical procedure was unaffected by these side effects . Fewer women with a failed medical than a failed surgical abortion were satisfied ( 17 % vs 62 % ) , P < 0.05 . CONCLUSIONS Satisfaction with both medical and surgical abortions is high , although higher with the surgical than the medical procedure , and higher after choosing method than after r and omization CONTEXT Annually , more than 700,000 women turn to menstrual regulation , or uterine evacuation with vacuum aspiration ; many more resort to unsafe abortion . Using pills for the evacuation of the uterus could increase women 's access to safe menstrual regulation services and reduce the high levels of abortion- and menstrual regulation- related morbidity in Bangladesh . METHODS At 10 facilities in Bangladesh , 651 consenting women who were seeking menstrual regulation services and who were 63 days or less past their last menstrual period received 200 mg of mifepristone followed 24 hours later by 800 mcg of buccal misoprostol , administered either at home or in the clinic . Prospect i ve data were collected to determine women 's experience and satisfaction with the procedure , menstrual regulation outcome , and the human and physical re sources required for providing the method . Focus group discussion s were conducted with a purposively sample d group of service providers at each site to underst and their attitudes about the introduction of menstrual regulation with medication . RESULTS The majority of women ( 93 % ) with known menstrual regulation outcomes evacuated the uterus without surgical intervention . Overall , most women ( 92 % ) were satisfied with use of pills for their menstrual regulation . Providers faced initial challenges and concerns , particularly related to the additional counseling requirements and lack of control over the final outcome , but became more confident after successful use of the medication regimen . CONCLUSIONS Mifepristone-misoprostol can be safely offered within existing menstrual regulation services in urban and periurban areas in Bangladesh and is highly acceptable to women . Providers ' initial concerns diminish with increased experience with the method BACKGROUND A sublingual misoprostol-alone regimen was used in 50 women requesting medical abortion at up to 12 weeks gestation . The efficacy and acceptability of this regimen were studied . METHODS The women were given 600 microg misoprostol sublingually every 3 h for a maximum of 5 doses . RESULTS The overall complete abortion rate was 86 % ( 95 % confidence interval : 74 - 93 ) . The mean number of doses of misoprostol required was 4.1 + /- 1.1 . There was no significant change in haemoglobin concentration and the median duration of vaginal bleeding was 15 days ( range : 7 - 56 ) . Diarrhoea , fever and chills were the most common side-effects . The acceptability of this regimen of  misoprostol  was good : 97.7 % of the women who had a complete abortion would choose this method again and 88.4 % would recommend it to others . They preferred sublingual misoprostol as it is convenient to take , avoids the painful vaginal administration and gives more privacy during the abortion process . CONCLUSION This regimen of sublingual misoprostol is an effective and acceptable method of medical abortion . R and omized controlled trials are required to compare the efficacy of various misoprostol-alone regimens of medical abortion . Pharmacokinetic studies and clinical trials are needed to find out the most appropriate dose , dosing interval and route of administration of misoprostol Please cite this paper as : Rodriguez M , Seuc A , Kapp N , von Hertzen H , Huong N , Wojdyla D , Mittal S , Arustamyan K , Shah R , the World Health Organization Research Group on Post‐Ovulatory Methods of Fertility Regulation . Acceptability of misoprostol‐only medical termination  of pregnancy compared with vacuum aspiration : an international , multicentre trial . BJOG 2012;119:817–823 OBJECTIVE To test the feasibility and acceptability of a simplified mifepristone-misoprostol regimen for early abortion in 2 tertiary teaching hospitals and 2 family planning clinics in Nepal . METHODS Consenting pregnant women ( n=400 ) with amenorrhea of 56 days or less seeking termination of pregnancy received 200 mg of oral mifepristone followed 48 hours later with 400 microg of oral misoprostol , administered either at home or at the clinic . Prospect i ve data were collected to determine the women 's experience , abortion outcome , and the operational requirements for providing the method . RESULTS Most ( 91.3 % ) of the 367 women with known outcomes had successful medical abortions . Given the option , most ( 89.7 % ) women elected to administer the misoprostol at home . CONCLUSION A simplified medical abortion protocol , including home administration of misoprostol , can be successfully integrated into clinical services in Nepal , where abortion services were recently legalized OBJECTIVE To evaluate the need for and outcome of  self-administered medical abortion  with mifepristone and misoprostol  in Brazil , provided through Women on Web , a global telemedicine abortion service . STUDY DESIGN A retrospective case review of women from Brazil who contacted Women on Web in 2011 . Information from the online consultation , follow-up question naire and emails were used to analyze data including demographics , gestational age , outcome of the medical abortion and symptoms that lead to surgical interventions . RESULTS The Women on Web website had 109779 unique visitors from Brazil , 2104 women contacted the helpdesk by email . Of the 1401 women who completed the online consultation , 602 women continued their request for a medical abortion . Of the 370 women who used the medicines , 307 women gave follow-up information about the outcome of the medical abortion . Of these , 207 ( 67.4 % ) women were 9 weeks or less pregnant , 71 ( 23.1 % ) were 10 , 11 or 12 weeks pregnant , and 29 ( 9.5 % ) women were 13 weeks or more pregnant . There was a significant difference in surgical intervention rates after the medical abortion ( 19.3 % at < 9 weeks , 15.5 % at 11 - 12 weeks and 44.8 % at > 13 weeks , p=.06 ) . However , 42.2 % of the women who had a surgical intervention had no symptoms of a complication . CONCLUSION There is large need for medical abortion in Brazil . Home use of mifepristone and misoprostol provided through telemedicine is safe and effective . However , after 13 weeks gestation , there is an increased risk of surgical intervention that may be due to the regimen used and local clinical practice s in Brazil . IMPLICATION S The current study shows that there is an unmet need for medical abortion in Brazil , a country with legal restrictions on access to safe abortion services . Telemedicine can help fulfill the need and self administration of medical abortion is safe and effective even at late first trimester abortion . Prospect i ve trials are needed to establish safety , effectiveness and acceptability of home use of medical abortion beyond 12 weeks of pregnancy OBJECTIVE To document abortion practice s and contraceptive use among women of reproductive age in an urban slum of Delhi . METHODS Data were collected as part of a cross-sectional study conducted in an urban resettlement colony in the North East District of Delhi between November 2010 and December 2011 .  Systematic r and om sampling was used to enroll 200 married women aged 15 - 49 years from each of the four blocks of the colony . Participants were interviewed and 
    Output:
    
Country-specific abortion laws , implementing protocol s , side-effects , rates of failures , and the need to verify the abortion shaped women 's preference for abortion methods .
Overall , women who preferred medical abortions did so because they perceived it as a ' natural ' and safe procedure that can be self-conducted at home , thereby reducing their dependency on the health system .
However , women face significant barriers to medical abortion care .
These include legal requirements around type of provider , site of service , need for follow-up , providers ' limited knowledge of the procedure , and preferences for surgical abortions .
Borderless internet-based services have enabled some women to circumvent these barriers .
Our review suggests that  medical abortions  are used by women either in countries where the health system is fully supportive or where the health system is completely disengaged , usually due to restricted abortion laws .
In those countries where abortions are legal but often difficult to access due to health system barriers , women tend to prefer surgical abortions