December 9, 2010 — Although most women seeking medical abortions receive an ultrasound, a recent study suggests that this step is not medically necessary and could serve as a barrier to the procedure, Reuters reports. Medical abortion, which involves taking a dose of the drug mifepristone followed by misoprostol, can be performed in the U.S. within nine weeks of a woman’s last menstrual period. The drugs are about 97% effective. While there are no official guidelines that women should first receive ultrasounds, the practice is common because it is the most precise way to determine how long a woman has been pregnant.
The study — published in the British Journal of Obstetrics and Gynecology — explored whether a woman’s estimate of her last menstrual period and a physical exam would be adequate to determine her eligibility for a medical abortion early in pregnancy. For the study, Gynuity Health Projects researchers examined data on 4,484 women seeking medical abortions at one of 10 family planning clinics, including eight operated by Planned Parenthood. The women provided the date of their last period and received a physical exam and an ultrasound.
The study found that based on the reported date of the last period and a physical exams alone, a medical abortion would have been performed beyond nine weeks for only 1.6% of the women, all of whom but one were within the 11th week of their last period. Studies show that medical abortion is still effective with no increased risk of complications at 11 weeks.
Lead researcher Hillary Bracken of Gynuity said the study’s findings suggest that abortion providers and physicians who do not have ultrasound equipment can still “feel safe” in offering medical abortion. She added that this could also expand access to medical abortion in rural areas of the U.S. and developing countries, where ultrasounds are not available.
Eliminating ultrasounds before medical abortions also could reduce cost barriers. According to Planned Parenthood, ultrasounds in the U.S. range from $350 to $650 or more depending on what tests or exams are performed (Norton, Reuters, 12/8).