English summary: Abortion at under 12 weeks of gestation – are national guidelines followed?

Background

Finnish guidelines for abortion were created in 2001 and updated in September 2007. The guidelines contain detailed instructions for medical and surgical abortions but in reality it has been seen that, nationally, clinical practices vary considerably. The aim of this study was to examine how personnel treating women who undergo induced abortion at under 12 weeks of gestation are being instructed and how well the national guidelines are implemented.

Methods

During the year 2008 instructions for personnel treating women undergoing abortion at under 12 weeks of gestation were gathered from all hospitals and health care centres that carry out abortions in Finland. The information contained in these instructions was analysed and compared to the national guidelines.

Results

The instructions for personnel were of variable quality and partly inadequate. The most significant differences involved the timelimits for medical abortion, the dosing of misoprostol and performance of the check-up examination. Instructions about the use of contraception varied and only little attention was given to the patient’s need for mental and social support.

Conclusions

Despite the national guidelines for induced abortion clinical practices vary substantially. National model instructions would probably unify clinical practices and make them more cost-effective. Based on this study, model instructions for personnel and patients have been created and they will be included in the next update of national guidelines for abortion.