Self-managed medication abortion outcomes: results from a prospective study

• Published in: Reproductive Health 2020
• Main Authors: Moseson, Heidi, Jayaweera, Ruvani, Raifman, Sarah, Keefe-Oates, Brianna, Filippa, Sofia, Motana, Relebohile, Egwuatu, Ijeoma, Grosso, Belén, Kristianingrum, Ika, Nmezi, Sybil, Zurbriggen, Ruth, Gerdts, Caitlin
• Format: Text Resource
• Language: English
• Subjects: Abortion
• DOI: 10.21203/rs.3.rs-31998/v2

Background: To evaluate the feasibility of conducting a prospective study to measure self-managed medication abortion outcomes, and to collect preliminary data on safety and effectiveness of self-managed medication abortion, we recruited callers to accompaniment groups (volunteer networks that provide counselling through the out-of-clinic medication abortion process by trained counselors over the phone or in-person). Methods: In 2019, we enrolled callers to three abortion accompaniment groups in three countries into a prospective study on the safety and effectiveness of self-managed medication abortion with accompaniment support. Participants completed up to five interview-administered questionnaires from baseline through six-weeks after taking the pills. Primary outcomes included: (1) the number of participants enrolled in a 30-day period, (2) the proportion that had a complete abortion; and (3) the proportion who experienced any warning signs of potential or actual complications. Results: Over the 30-day recruitment period, we enrolled 227 participants (95% of those invited), and retained 204 participants (90%) for at least one study follow-up visit. At the one-week follow-up, two participants (1%) reported a miscarriage prior to taking the pills, and 202 participants (89% of those enrolled and 99% of those who participated in the one-week survey) had obtained and taken the medications. Three weeks after taking the medications, 192 (95%) participants reported feeling that their abortion was complete. Three (1.5%) received a surgical intervention, two (1%) received antibiotics, and five (3%) other medications. Participants did not report any major adverse events. Conclusion: These results establish the feasibility of conducting prospective studies of self-managed medication abortion in legally restrictive settings. Further, the high effectiveness of self-managed medication abortion with accompaniment support reported here is consistent with high levels of effectiveness reported in prior studies. Trial Registration: ISRCTN95769543