Setting and participants

Women will be recruited from sites where safe and legal medical abortion services are well-established in diverse and regionally representative low resource countries. Specifically, the Paropkar Maternity and Women’s Hospital in Kathmandu, Nepal, Job Tabane Hospital in Rustenburg, South Africa, and the National Hospital of Obstetrics and Gynecology in Hanoi, Vietnam, are hosting this study.

All participants will be administered mifepristone in clinic to initiate the medical abortion and will be instructed to use misoprostol and the study medicines at home according to standard practice. In Nepal and Vietnam, women also have the option to use misoprostol (and for the purposes of this trial, the study medicines) under supervision in the clinic until the time of expulsion; typically, a minority of women undergoing medical abortion at these sites choose to complete the medical abortion in clinic.

Women ages 18 years and older seeking medical abortion up to 63 days’ gestation at these sites, who report a willingness to participate in the study, are fluent in the language of site, possess sufficient literacy to adhere to study instructions and complete home self-assessments, and agree to be contacted by telephone are eligible for participation. Women will be excluded if any pregnancy abnormalities (e.g. multiple gestation, molar, ectopic, or non-viable pregnancy) or allergies/contraindications to use of mifepristone and misoprostol or any of the study medications are detected. Additionally, women who report no access to a time-keeping device or an inability to return to the study site with no option for telephone contact will be excluded.