Feasibility, efficacy, safety, and acceptability of mifepristone–misoprostol for medical abortion in the Democratic People's Republic of Korea

Abstract 

Objective

To examine the feasibility, efficacy, safety, and acceptability of medical abortion among rural and urban women up to 56days of pregnancy in the Democratic People's Republic of Korea.

Method

A total of 199 women (rural n=95, urban n=104) recruited from 2 rural and 2 urban reproductive health clinics received 200mg of oral mifepristone followed 2days later by 400μg of sublingual misoprostol. The women's abortion status and satisfaction level were determined 2weeks later.

Results

Overall complete abortion occurred in 96.0% of the women; there was no statistically significant difference between the groups (rural 95.8%, 95% confidence interval [CI], 89.6–98.8; urban 96.2%, 95% CI, 90.4–98.9). The 2 groups reported similar adverse effects. In total, 90.5% of rural and 88.5% of urban participants were satisfied or very satisfied with the method.

Conclusion

The high efficacy and acceptability of medical abortion among rural and urban women suggest that medical abortion is a safe alternative to surgical abortion and can be scaled up to other reproductive health clinics in both rural and urban areas of the Democratic People's Republic of Korea, provided that there is appropriate training and supervision.

Keywords: Low-resource setting, Medical abortion, Mifepristone, Misoprostol, North Korea