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10-year evaluation of the use of self-managed abortion through telemedicine: A retrospective cohort study.
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  • Hanna Nortén,
  • Jack Wilkinson,
  • Onaedo Ilozumba ,
  • Kristina Gemzell-Danielsson,
  • Rebecca Gomperts
Hanna Nortén
Vrije Universiteit Amsterdam
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Jack Wilkinson
University of Manchester
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Onaedo Ilozumba
Vrije Universiteit Amsterdam
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Kristina Gemzell-Danielsson
Karolinska Institutet
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Rebecca Gomperts
Women on Web
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Abstract

Objective: This study aims to provide insight into the use, acceptability and outcome of a large group of women who self-managed medical abortion. Design: Retrospective cohort study. Setting: Self-managed abortion worldwide. Population/Sample: 30344 women who completed the follow up from of the telemedical abortion service Women on Web from January 2009 till January 2020. Methods: Analyses of the evaluation forms, binary logistic regressions were performed to test the association between year and outcomes for the total sample. Main outcome measures: Demographic information including age, economic situation, country of living,knowledge about abortion pills and acceptability. Rate of complete abortions, surgical interventions, ongoing pregnancies, blood transfusions per year. Results: 30344 women from 183 different countries completed the follow-up evaluation. In total 26076 women reported taking the medical abortion pills, of which 1.5% reported an ongoing pregnancy, 10.2% a surgical intervention, and 0.6% a blood transfusion. 99% found it to be an acceptable method. 35% found it difficult to make a donation for the service and 8.5% received the service for free. 59.2% reported that they knew about medical abortion before finding Women on Web. We found a significant increase in complete abortions in 2019 (OR= 1.92; 95% CI: 1.59 – 2.31), and decrease in surgical interventions (OR= 0.49; 95%CI: 0.40 – 0.60) compared to 2009. Conclusion: The findings of the outcomes of the 26076 self-managed abortions in this study are in line with previous research , suggesting medical abortion through telemedicine is safe, effective and highly acceptable to women.

Peer review status:UNDER REVIEW

11 Sep 2020Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
14 Sep 2020Assigned to Editor
14 Sep 2020Submission Checks Completed
17 Sep 2020Reviewer(s) Assigned