Future direction of abortion technology.

Reliable statistical data indicate that even today abortion is widely used in the regulation of human reproduction, irrespective of whether it is well or badly tolerated. Medical responsibility therefore dictates that abortions should be made as safe as possible in order to safeguard the health of women who cannot avoid abortion. The most advanced development in abortion technology is medical abortion. At present, the best available method is the combination of an antiprogesterone (RU-486) and a low dose of prostaglandin, either in an injection (sulprostone) or in a vaginal pessary (gemeprost). The currently employed treatment schedules are still not optimal. The treatment lasts for at least 48 or 72 hours and close follow-up is needed to assess whether the treatment has been successful or not. The side-effects, however, are negligible, and the medical method is free from the complications of the surgical methods and those of anaesthesia. The high efficacy (95% complete abortion rate at a gestational age up to eight weeks) restricts the risk of surgery and anaesthesia to the 5% failures. Further research is required to develop a more appropriate treatment schedule, preferably a single-shot treatment. At the same time, the prevention of misuse of the medical methods must be guaranteed to achieve a better acceptance of these safe abortion methods by society. For the time being, medical supervision and follow-up seems to be mandatory, and a 'do-it-yourself' home method providing complete privacy must be regarded as unsafe and medically unacceptable.