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Choosing medical or surgical terminations of pregnancy in the first trimester: What is the difference?


  • Both authors meet the requirements for authorship. There are no potential conflicts of interest.

: Dr Felicity Goodyear-Smith, Department of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences, The University of Auckland, PB 92019 Auckland, New Zealand. Email:


Background: Women seeking termination of pregnancy in Auckland, New Zealand can chose between medical and surgical options up to eight weeks gestation.

Aims: To assess demographic differences or changes over time between proportions of women choosing medical or surgical abortions at a single centre and determine whether changing the mifepristone–misoprostol interval from two to one day impacted on outcomes.

Methods: Retrospective audit of two consecutive years (December 2005–November 2006 and December 2006–November 2007) of first-trimester surgical and medical terminations where the mifepristone-misoprostol interval was reduced from two to one day between years. Analysis using descriptive statistics and assessment of probability of observed differences between groups.

Results: A total of 1495 terminations were performed in 2005–2006 and 1588 in 2006–2007. No significant difference (P = 0.4) of eligible women choosing medical (21% and 23%) or surgical abortion between years. Ethnicity, age and residency status did not influence choice. Medical termination of pregnancy was more likely in women who were without previous children (P = 0.009), pregnancies (P = 0.02) or terminations (P = 0.04). Medical termination was similarly effective within six hours with either two- or one-day intervals.

Conclusions: Both medical and surgical first-trimester abortions are safe and effective. It is optimal to be able to offer women choice. Reducing the medical interval to one day does not increase adverse outcomes.