What happens when medical abortion services give women the option of taking mifepristone home? E. Chong, L. Frye, J. Castle, G. Dean, L. Kuehl, B. Winikoff Gynuity Health Projects Introduction: Most medical abortion protocols require women to ingest mifepristone in the health center. Allowing women to take mifepristone at home affords greater flexibility and autonomy. We assessed the acceptability and feasibility of home use of mifepristone. Method: Women presenting to six Planned Parenthood centers for medical abortion were given the choice to take mifepristone in the center or at home. Participants were asked to return for follow-up 1–2 weeks later and were asked about acceptability, adherence and lost productivity. Providers were asked about acceptability of home use for each patient. Results: Of 400 participants recruited, 127 (32%) chose to take mifepristone at home. Home users were significantly more likely than center users to be doing paid work and were older. Home users primarily appreciated the scheduling flexibility; center users preferred starting the process immedi- ately. Seventy-eight percent of home users took mifepristone within 2 days of their initial visit, and none took mifepristone after 63 days of gestation. Among those who worked, went to school or were responsible for dependent care, mean days missed due to the abortion were not significantly different between groups. However, home users were more likely than center users to have missed no days of work (50% vs. 29%, p=.04). Should they need another abortion, 99% of home users would take mifepristone at home again. Providers would recommend home use in the future for 95% of home users and 84% of center users. Offering the home option did not create an extra burden on center staff; follow-up visits, unscheduled visits, uterine aspiration and calls were similar for both groups. Conclusion: Many women are interested in taking mifepristone at home, and even more might be interested if they were aware of the option before appointment scheduling. Home use was safe and acceptable to women and providers in our study, and women should be offered this choice. http://dx.doi.org/10.1016/j.contraception.2015.02.024 Uptake of long-acting reversible contraception among young women choosing medical versus surgical abortion E.S. Munroe, C.H. Ma, P.S. Lyman, M.L. Gilliam, M.T. Quinn, A.K. Whitaker University of Chicago Introduction: Long-acting reversible contraception (LARC) cannot typically be provided until patients return for follow-up after medical abortion. The effect of this delay on LARC uptake has not been studied. This analysis compares LARC uptake among young women choosing medical versus surgical abortion. Method: We performed a secondary analysis using data from a randomized controlled trial (RCT) of pre-abortion contraception counseling among women aged 15–29 years. Exclusion criteria were abortion for medical or fetal indications or sexual assault. Medical abortions were offered to patients less than 64 days gestation. For this analysis, we included all participants, regardless of medical abortion eligibility. Choice of abortion procedure type was independent of study participation. Participants were contacted at 3-month post-abortion. We performed bivariate analysis using Fisher's exact test and t test. Results: Sixty women participated in the RCT. Most were African American (78%), single non-cohabitating (78%) and earning less than US$30,000 annually (75%). Of the 37 participants eligible for medical abortion, 23 (62%) chose that option. Age was the only demographic factor that differed between women choosing medical versus surgical abortions (mean age: 24.5 vs. 21.7 years, pb.01). Women having medical and surgical procedures were equally likely to intend to use LARC after contraception counseling (65% vs. 65%, p= 1.0). Among participants having medical abortions, 65% attended the required follow-up. Women receiving medical abortions were less likely to initiate LARC within 1 month (30% vs. 60%, p=.04). At 3 months, 35% and 52% of women receiving medical and surgical abortions, respectively, reported LARC use (p=.3). Among only those 37 participants eligible for medical abortion, 30% and 64% of women receiving medical and surgical abortions, respectively, initiated LARC within 1 month (p=.09). Conclusion: Despite similar intentions to use LARC, women having medical abortions were less likely to receive LARC within 1 month. Failure to follow-up after medical abortion may present a barrier to post-abortal LARC uptake. http://dx.doi.org/10.1016/j.contraception.2015.02.025 Medical abortion outcomes following quickstart of contraceptive implants E.G. Raymond, M.A. Weaver, Y.L. Tan, K.S. Louie, M. Bousiéguez, P. Sanhueza, C. Kaplan, S. Sonalkar, A.B. Goldberg, K.R. Culwell, L. Memmel, R. Jamshidi Gynuity Health Projects Introduction: Providing contraceptive implants to medical abortion patients concurrently with the mifepristone could help reduce future pregnancy risk, but if the progestin in the implant competed with the mifepristone, the chance of abortion failure could increase. We designed this randomized trial to assess the effects of co-administration of etonogestrel implants and mifepristone on medical abortion outcome and 6-month pregnancy rate. Method: We enrolled women in Mexico and the USA who requested abortion with mifepristone and misoprostol and desired etonogestrel implants for post-abortion contraception. We randomly assigned each woman to receive implants either on the day of mifepristone ingestion (quickstart group) or after the abortion was complete (afterstart group). We collected data within the first month and at 4 and 7 months after enrollment. Results: Of 476 women enrolled, including 425 in Mexico and 51 in the USA, we allocated 236 to the quickstart group and 240 to the afterstart group. In the quickstart and afterstart groups, respectively, 9 (3.8%) and 9 (3.8%) had surgery to complete the abortion, a difference of 0.06% (90%CI - 3.1%, 3.2%), which excluded our pre-specified non-inferiority margin of 5 percentage points. In the quickstart and afterstart groups, respectively, 12 (5.1%) and 17 (7.1%) received extra abortifacient medication; 211 (89.4%) and 209 (87.1%) required no additional treatment; and 4 (1.7%) and 5 (2.1%) were lost to follow-up. We found no evidence of a difference between groups in unscheduled clinical visits, mean abortion-related pain, days of bleeding or serious adverse events. Women in the quickstart group were more satisfied with their group assignment. Data on subsequent pregnancies are not yet available. Conclusion: Concurrent administration of etonogestrel implants with mifepristone did not decrease medical abortion success or cause other adverse clinical consequences and was preferred by women. This option should be routinely offered to patients. http://dx.doi.org/10.1016/j.contraception.2015.02.026 429 Abstracts / Contraception 91 (2015) 426–429