Midlevel Versus Physician-provided Medical Abortion in the Second Trimester

NCT ID: NCT04181541

Last Updated: 2021-09-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

245 participants

Study Classification

INTERVENTIONAL

Study Start Date

2020-02-17

Study Completion Date

2021-03-03

Brief Summary

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The purpose of the study is to determine the safety and effectiveness of second trimester medical abortion when provided by nurse midwives compared with physicians. The study sample will be obtained from Michu Clinic, affiliated with St Paul's hospital, in Addis Ababa.

Detailed Description

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About 10% of all abortions globally take place at or after 13 weeks gestation. Women seeking second-trimester abortion services are often the most vulnerable and socially disadvantaged population.Studies show the rate of second-trimester abortion procedures remains stable over time, even in high-access locations, confirming the ongoing need for accessibility to services in rural locations with limited access to care. In Ethiopia, second-trimester abortion services are widely available in Addis Ababa, making up a high proportion of the total number of abortions occurring each year in the country; however, access to accurate and reliable data is limited.

The World Health Organization recommends that abortion can be provided at the lowest level of the healthcare system (WHO abortion guidelines). Training mid-level providers, such as midwives, nurses and other non-physician providers, to conduct second trimester aspiration abortions is proposed as a way to increase women's access to safe abortion procedures and has been highlighted by the WHO as an area in which rigorous research is needed (WHO task-sharing guidelines).

The investigators seek to conduct a comparative study of patients undergoing second trimester medical abortion provided by either physicians or nurse midwives.

Conditions

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Induced Abortion Second Trimester Abortion Medical Abortion Health Personnel

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

The investigators propose a randomized, controlled, non-inferiority study comparing management of medical abortion by either nurse midwives or physicians for women undergoing induced abortion at a gestational ages \> 13 weeks.
Primary Study Purpose

TREATMENT

Blinding Strategy

NONE

Study Groups

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Women receiving abortion care by physicians

Patients who receive second trimester medical abortion care from a physician.

Group Type ACTIVE_COMPARATOR

Provider type: Physicians

Intervention Type PROCEDURE

In this cohort, women will receive second trimester medical abortion care from physicians

Women receiving abortion care from midlevel providers

Patients who receive second trimester medical abortion care from a midlevel provider.

Group Type EXPERIMENTAL

Provider type: Midlevel Providers

Intervention Type PROCEDURE

In this cohort, women will receive second trimester medical abortion care from midlevel providers.

Interventions

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Provider type: Physicians

In this cohort, women will receive second trimester medical abortion care from physicians

Intervention Type PROCEDURE

Provider type: Midlevel Providers

In this cohort, women will receive second trimester medical abortion care from midlevel providers.

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

* Willing and able to give consent for participation
* Intrauterine pregnancy with confirmed gestational age \>13 weeks and \<20 weeks
* Presenting for induced abortion at Michu Clinic
* Speaker of Amharic or Oromo

Exclusion Criteria

* Women unable to give consent for participation
* Gestational age \<13 or \>20 weeks
* Adolescents aged less than 16 years
* Women with an allergy to or contraindications to mifepristone or misoprostol
* Women with a history of more than one previous hysterotomy
* Women seeking treatment for incomplete abortion, intrauterine fetal demise, or postabortion care
* Women with chronic hypertension or adrenal failure
* Women on chronic steroid treatment
Minimum Eligible Age

16 Years

Eligible Sex

FEMALE

Accepts Healthy Volunteers

Yes

Sponsors

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St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia

UNKNOWN

Sponsor Role collaborator

Ipas

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Nathalie Kapp, MD, MPH

Role: PRINCIPAL_INVESTIGATOR

Ipas

Locations

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St. Paul's Hospital Millennium Medical College

Addis Ababa, , Ethiopia

Site Status

Countries

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Ethiopia

Other Identifiers

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PM23/146

Identifier Type: -

Identifier Source: org_study_id

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