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| Sara Gomez/Ipas |
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By studying medical abortion care at 300 health centers around the country, Planned Parenthood has identified ways to improve abortion care and reduce already low rates of post-abortion infection. The finding was published July 9 in The New England Journal of Medicine. Mary Fjerstad, nurse practitioner and senior clinical advisor for the Ipas Medical Abortion Initiative, was the primary author of the research during her previous position at the Planned Parenthood Federation of America (PPFA). Other investigators included James Trussell (Princeton University), Irving Sivin (the Population Council), E. Steve Lichtenberg (Northwestern University Feinberg School of Medicine) and Vanessa Cullins (PPFA).
“Our goal was to make a safe procedure even safer,” said Fjerstad. “We found that providing medical abortion with a nonvaginal route of misoprostol led to a statistically significant drop in the rate of serious infections. Providing antibiotics with the medical abortion led to a further drop in the infection rate.”
But the study’s findings extended beyond improving medical abortion protocols, Fjerstad continued. “I think the most important thing to be learned from this research is that a large institution or entity — such as a country where the health system is introducing medical abortion — can use the classic quality improvement cycle to improve outcomes. By identifying areas that need improvement, making a change and continuing to track their data, they can assess whether the change does indeed result in better care.”
The study generated national media attention, including stories in The New York Times and the San Francisco Chronicle, excerpted below.
Change cuts infections linked to abortion pill
Erin Allday, Chronicle Staff Writer
Thursday, July 9, 2009
A simple change in the technique used to deliver the abortion pill reduced the number of serious infections attributed to the drug by more than half, and dropped infection rates to nearly zero when antibiotics were introduced, according to a study released today.
The results were a welcome relief to abortion providers, who fought for years to get federal approval of the pill in the United States and had faced renewed criticism of the drug after dozens of severe infections were reported and seven women died.
"Our aim was to make a safe procedure even safer," said Mary Fjerstad, lead author of the study, who helped develop Planned Parenthood's strategy for delivering the pill. She left Planned Parenthood earlier this year to work with Ipas, a nonprofit abortion rights group.
Abortion Pill Study Suggests Way to Limit Infection
By DENISE GRADY
July 8, 2009
A large study of the pills used to induce abortion has found that infections are rare but can be made even less common if the pills are taken by mouth instead of vaginally, and with antibiotics.
But it is not clear whether the findings will change medical practice. Abortion providers and other experts had different reactions to the study. Most agreed that it was reasonable to change to the oral route, but some hesitated at routinely prescribing antibiotics, which can have side effects, for a procedure with a very low infection rate.
For more information, contact media@ipas.org