Original research article Assessment of significant factors affecting acceptability of home administration of misoprostol for medical abortion ☆ Helena Kopp Kallner a, ⁎ , Christian Fiala b , Kristina Gemzell-Danielsson a a Division of Obstetrics and Gynaecology, Department of Woman and Child Health, Karolinska Institutet/Karolinska University Hospital, 171 77 Stockholm, Sweden b Gynmed Clinic, Maria Hilfergürtel 37, 1150 Vienna, Austria Received 12 July 2011; revised 7 August 2011; accepted 15 August 2011 Abstract Background: Knowledge on factors affecting acceptability of medical abortion with mifepristone followed by home administration of misoprostol is scarce. The objective of this study was therefore to assess factors affecting acceptability and experience of home use of misoprostol for medical abortion up to 63 days' gestation. Study Design: Prospective observational study with acceptability assessed through questionnaires. Factors affecting acceptability were analyzed using multivariate logistic regression. Results: A total of 395 women were included. Independent factors for acceptability were having a partner/friend present and having a positive low-sensitivity urine hCG at follow-up, although most of these patients had successful abortions. Age, gestational length and requirement of extra pain medication did not affect acceptability. Conclusion: Home administration of misoprostol is highly acceptable. Increasing the number of complete abortions should be a focus of future research. Women should be encouraged to have a partner/friend present during home administration of misoprostol. © 2012 Elsevier Inc. All rights reserved. Keywords: Mifepristone; Misoprostol; Home administration; Medical abortion; Termination of pregnancy; Acceptability 1. Introduction Medical abortion using the anti-progesterone mifepris- tone and a prostaglandin analogue was first approved in France, UK and Sweden in 1988, 1991 and 1992, respectively. The combined regimen of mifepristone fol- lowed 36–48 h later by the prostaglandin E 1 analogue misoprostol is now well established for gestations up to 63 days with studies reporting high efficacy and good patient acceptability [1–3]. When mifepristone was approved for medical abortion in the USA in 2000, home administration of misoprostol became the standard protocol. More recently, home self-administration of misoprostol has also become an option in some European countries where women are still free to choose to have the abortion in the clinic. It has been shown that gestational length influences acceptability of medical abortion with clinic administration of misoprostol negatively, whereas a previous childbirth has a positive influence [4]. Furthermore, analgesia use in women undergoing medical abortion up to 63 days of gestation in a clinic setting increased with longer gestational age, younger age and in nulliparous women [5]. Previous studies have shown high acceptability of home use of misoprostol in various European settings [6–8], but so far no studies have evaluated specific factors of importance for acceptability of home administration of misoprostol when women still have a free choice of self- or clinic administration. The aim of this study was to assess the influence on acceptability of age, gestational length, reproductive history, extra analgesia requirements, feeling calm and safe, having a partner/friend present and the outcome of treatment among women choosing home administration of misoprostol in medical abortion up to 63 days of gestation in a setting where clinic use remains an option for women. Contraception 85 (2012) 394 – 397 ☆ The study was supported by grants from the Swedish Research Council, FAS, Karolinska Institutet and the County of Stockholm City/Karolinska Institutet (ALF). ⁎ Corresponding author. Tel.: +46 70 4402070. E-mail address: Helena.Kopp-kallner@ds.se (H. Kopp Kallner). 0010-7824/$ – see front matter © 2012 Elsevier Inc. All rights reserved. doi:10.1016/j.contraception.2011.08.009