But in 2005, authorities reported the deaths of five North American women from an otherwise rare bacterial infection -- Clostridium sordellii -- within a week of taking mifepristone.
In 2006, Planned Parenthood substituted buccal misoprostol for vaginal misoprostol along with either antibiotics or screening and treatment for chlamydia, a sexually transmitted bacteria.
The following year, the organization started requiring antibiotics for all medical abortions. Antibiotics have been shown to reduce infection rates after an abortion by 42 percent, the report said.
The authors reviewed the rate of serious infections after medical abortions in more than 227,000 women, comparing the risk in women to whom misoprostol was given vaginally (up to March 2006) with those who received buccal administration in concert with antibiotics.
The rate of serious infections dropped 73 percent from 0.93 per 1,000 abortions before introduction of buccal administration along with antibiotics or STD screening to 0.25 per 1,000 abortions after the switch, the researchers found. Adding antibiotics to the protocol dropped the rate of serious infections a further 76 percent.
The findings in this paper essentially validate Planned Parenthood's recent changes, Fjerstad said.
"Unless there was compelling evidence to the contrary, we just don't see any reason to make a change," she said.
Wendy Wright is executive vice president of Concerned Women for America, an organization that opposes abortion.
"This study shows that the RU-486 [mifepristone] and misoprostol regimen can still cause serious complications to patients," Wright said. "While taking misoprostol orally rather than vaginally may reduce the risk, it does not eliminate consequences."
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