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Notes: Objective To describe and compare health outcomes two years after medical abortion or vacuum aspiration in women recruited into a patient preference trial during 1990 to 1991.Design Women recruited to the original, partially randomised study were contacted for assessment using a structured interview.Setting Grampian region of Scotland, UK.Participants One hundred and forty women who had participated in a partially randomised study of first trimester abortion two years previously.Intervention Vacuum aspiration or medical abortion using mifepristone and gemeprost.Main outcome measures Long-term general, reproductive and psychological health; acceptability of procedure; perceived value of choice of method of termination.Results There were no significant differences between women who had undergone medical abortion or vacuum aspiration two years previously in general, reproductive or psychological health. Almost all women placed a high value on the provision of choice of method of termination. There was a significant difference in perception of long term procedure acceptability among women who had been randomised to a method of termination.Conclusions Women should have the opportunity to choose the method of termination. This opportunity will result in high levels of acceptability, particularly at gestations under 50 days of amenorrhoea.

Notes: Objectives 1. To produce a list of evidence-based criteria for good quality care relating to female laparoscopic sterilisation. 2. To assess the level of agreement with each criterion among gynaecologists in Scotland. 3. To obtain an overview of current sterilisation practice for comparison with the agreed criteria.Design 1. Agreement with criteria assessed by questionnaire survey; 2. Overview of current practice obtained by questionnaire survey and by casenote review.Setting Scotland.Sample 1. Questionnaire survey: all 132 consultant gynaecologists in NHS practice. 2. casenote review: 988 consecutive women sterilised in 12 representative hospitals.Results The response rate to the questionnaire survey was 94%. A list of 15 evidence-based criteria was produced, covering patient selection, information and counselling, techniques of tubal occlusion and timing of sterilisation. All 15 suggested criteria gained an overall balance of support among responding gynaecologists. Similar impressions of current practice were gained from the questionnaire survey and from the casenote review. Aspects of practice which measured up well to the agreed criteria included: only 6% of women sterilised were younger than 25 years of age; over 85% of casenotes included clear documentation that women had been counselled regarding failure rate and intended permanency; 88% of sterilisations were performed, or directly supervised by, a gynaecologist of consultant or senior registrar status; and only 2% of sterilisations were undertaken in combination with induced abortion. Aspects of practice which compared poorly with the agreed criteria, and for which recommendations for change have been made, included: only 22% of casenotes mentioned that the option of vasectomy had been discussed; only 30% of gynaecologists indicated that they provide locally produced information leaflets as an adjunct to counselling; four methods of tubal occlusion (including unipolar diathermy) were in use; and there were wide variations among hospitals in the use of day-case care, ranging from 19% to 99%.Conclusions A list of criteria for good quality care in relation to sterilisation has been validated by agreement among Scottish gynaecologists. Current practice (as assessed by questionnaire survey and casenote review) has been compared with the criteria and some recommendations for change in practice have been made. Following dissemination of these results and recommendations, re-audit will be undertaken in order to identify any changes.