Original research article| Volume 94, ISSUE 2, P137-142, August 2016

Download started.


Exploring Canadian women's knowledge of and interest in mifepristone: results from a national qualitative study with abortion patients



      Although Canada decriminalized abortion in 1988, significant disparities in access to services and an uneven geographic distribution of providers persists. Health Canada registered mifepristone, the gold standard of medication abortion, in July 2015. Our study explored Canadian women's knowledge of, interest in, and perspectives on mifepristone prior to registration.


      From November 2012 through July 2015 we conducted in-depth interviews with 174 Anglophone and Francophone women from Alberta, Manitoba, New Brunswick, Ontario, and Quebec about their abortion experiences and their opinions about medication abortion. We purposively recruited participants from different age cohorts and different regions within each study province to explore a range of perspectives. We analyzed these interviews for content and themes related to mifepristone using both deductive and inductive analytic techniques.


      The overwhelming majority of participants had no knowledge of mifepristone at the time of the interview. However, after providing a brief description of an evidence-based mifepristone/misoprostol regimen, more than half of the participants reported that they would have considered this method had it been available at the time of their abortion and most would have been comfortable receiving medication abortion care from a family physician or nurse practitioner. Most women supported the approval of mifepristone and felt Canadian women would benefit from having more options for early pregnancy termination.


      Although knowledge of mifepristone among recent abortion patients was low, considerable interest in medication abortion exists. Expanding awareness-raising efforts and supporting the approval of evidence-based regimens and provision of mifepristone appears warranted.


      The approval and introduction of mifepristone for early abortion in Canada promises to increase options and access. Creating tailored and culturally and contextually resonant messages about mifepristone is of high priority. Promoting evidence-based protocols and the inclusion of a full range of qualified professionals in service provision is also warranted.


      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Contraception
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Newbold K.
        • Willinsky J.
        Providing family planning and reproductive healthcare to Canadian immigrants: perceptions of healthcare providers.
        Cult Health Sex. 2009; 11: 369-382
        • Sethna C.
        • Doull M.
        Far from home? A pilot study tracking women's journeys to a Canadian abortion clinic.
        J Obstet Gynaecol Can. 2007; 27: 640-647
        • Wiebe E.
        • Najafi R.
        • Soheil N.
        • Kaman A.
        Muslim women having abortions in Canada: attitudes, beliefs, and experiences.
        Can Fam Physician. 2011; 57: e134-e138
        • Wiebe E.
        • Sandhu S.
        Access to abortion: what women want from abortion services.
        J Obstet Gynaecol Can. 2008; 30: 327-331
        • Norman W.
        Induced abortion in Canada 1974-2005: trends over the first generation with legal access.
        Contraception. 2012; 85: 185-191
        • Shaw J.
        Reality check. A close look at accessing abortion services in Canadian hospitals.
        Can Choice. 2006;
        • Downie J.
        • Nassar C.
        Barriers to access to abortion through a legal lens.
        Health Law J. 2007; 15: 143-173
        • Erdman J.
        • Grenon A.
        • Harrison-Wilson L.
        Medication abortion in Canada: a right-to-health perspective.
        Am J Public Health. 2008; 98: 1764-1769
        • Kaposy C.
        The public funding of abortion in Canada: going beyond the concept of medical necessity.
        Med Health Care Philos. 2009; 12: 301-311
        • Kaposy C.
        Improving abortion access in Canada.
        Health Care Anal. 2010; 18: 17-34
        • Farid C.
        Access to abortion in Ontario: from Morgentaler 1988 to the savings and restructuring act.
        Health Law J. 1997; 5: 119-145
        • World Health Organization (WHO)
        Safe abortion: technical and policy guidance for health systems.
        2nd ed. WHO, Geneva2012
        • Winikoff B.
        • Sheldon W.
        Use of medicines changing the face of abortion.
        Int Perspect Sex Reprod Health. 2012; 38: 164-166
        • Cleland K.
        • Smith N.
        Aligning mifepristone regulation with evidence: driving policy change using 15 years of excellent safety data.
        Contraception. 2015; 92: 171-181
        • Foster A.
        • Jackson B.
        • LaRoche K.
        • Simmonds K.
        • Taylor D.
        From qualified physician to licensed health care professional: the time has come to change mifepristone's label.
        Contraception. 2015; 92: 200-202
        • Limacher J.
        • Daniel I.
        • Isaacksz S.
        • Payne G.
        • Dunn S.
        • Coyte P.
        • et al.
        Early abortion in Ontario: options and costs.
        J Obstet Gynaecol Can. 2006; 28: 142-148
        • Dunn S.
        • Cook R.
        Medical abortion in Canada: behind the times.
        Can Med Assoc J. 2014; 186: 13-14
        • Health Canada
        Regulatory decision summary: MIFEGYMISO.
        ([Cited 2015 Dec 16. Available from:])
      1. Deniz N. Lincoln Y. The sage handbook of qualitative research. 3rd ed. Sage Publications, Thousand Oaks, CA2005
      2. RU-486 abortion pill approved by Health Canada.
        CBC News: Health, 2015 ([cited 2015 Dec 16. Available from:])
        • Bygdeman M.
        • Gemzell K.
        • Marions L.
        Medical termination of early pregnancy: the Swedish experience.
        JAMWA. 2000; 35: S195-S196
        • Clark S.
        • Ellertson C.
        • Winikoff B.
        Is medical abortion acceptable to all American women: the impact of sociodemographic characteristics on the acceptability of mifepristone-misoprostol abortion.
        JAMWA. 2000; 35: S177-S182
        • Jones R.
        • Henshaw S.
        Mifepristone for early medical abortion: experiences in France, Great Britain and Sweden.
        Perspect Sex Reprod Health. 2002; 34: 154-161
        • Alam A.
        • Bracken H.
        • Johnston H.
        • Raghavan S.
        • Islam N.
        • Winikoff B.
        • et al.
        Acceptability and feasibility of mifepristone-misoprostol for menstrual regulation in Bangladesh.
        Int Perspect Sex Reprod Health. 2013; 39: 79-87
        • Peña M.
        • Dzuba I.
        • Smith P.S.
        • Mendoza L.J.
        • Bousiéguez M.
        • Martínez M.
        • et al.
        Efficacy and acceptability of a mifepristone-misoprostol combined regimen for early induced abortion among women in Mexico City.
        Int J Gynaecol Obstet. 2014; 127: 82-85
        • National Abortion Federation [Internet]
        Educational resources.
        ([Cited 2015 Dec 16, Available from:])