A roadmap for research on self-managed abortion in the United States

A roadmap for research on self-managed abortion in the United States
(Posted August 29 2018)

Advancing New Standards in Reproductive Health (ANSIRH), Gynuity Health Projects, and Ibis Reproductive Health. A roadmap for research on self-managed abortion in the United States. August 2018.

Media coverage and research data show a growing awareness of the option to self-manage (or self-induce or self-source) abortion outside of the formal health care system; we are learning more about people’s experiences with self-managed abortion, and how often people choose this option in the United States. Recent evidence indicates between one and seven percent of abortion patients (see below) have taken or done something to try to end their current pregnancy. In addition, in 2015, there were more than 700,000 Google searches using terms related to self-induced abortion in the United States. The reasons women attempt to self-manage an abortion are varied, but they are often related to barriers accessing clinic-based care, as well as a preference for self-care.

Continued: https://ibisreproductivehealth.org/publications/roadmap-research-self-managed-abortion-united-states

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Telemedicine Could Help Fill the Gaps in America’s Abortion Care

Telemedicine Could Help Fill the Gaps in America's Abortion Care

Author: Garnet Henderson
Aug 7, 2018

Imagine a woman in Lubbock, Texas, who just found out that she's pregnant. She wants an abortion, but Lubbock is one of 27 abortion deserts in the US: The nearest clinic is 308 miles away in Fort Worth, forcing her to take time off from work, pay for travel, and likely arrange childcare to get there. She’s less than 10 weeks along, so she’s a candidate for medication abortion—which could, theoretically, be completed in the privacy of her home. But Texas requires that the FDA protocol for medication abortion be followed to the letter. She’ll have to return to the clinic within one to two weeks for a follow-up visit, despite evidence that an in-person follow-up is unnecessary.

What if, instead, she could video chat with a doctor, pick up a prescription from her regular pharmacy, and manage her own abortion with on-call medical support—a telemedicine abortion?

Continued: https://www.wired.com/story/telemedicine-could-help-fill-the-gaps-in-americas-abortion-care/

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USA – How technology could preserve abortion rights

How technology could preserve abortion rights
Telemedicine prescriptions could undercut state abortion restrictions.


Abortion rights advocates are exploring how technology might preserve or even expand women’s access to abortion if the Supreme Court scales back Roe v. Wade.

A nonprofit group is testing whether it's safe to let women take abortion pills in their own homes after taking screening tests and consulting with a doctor on their phones or computers. Because the study is part of an FDA clinical trial, the group isn’t bound by current rules requiring the drugs be administered in a doctor’s office or clinic.

Continued: https://www.politico.com/story/2018/07/29/abortion-rights-technology-telemedicine-prescriptions-693328

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U.S.: Abortion Via Telemedicine Is Totally Safe, Study Says

Abortion Via Telemedicine Is Totally Safe, Study Says
States are cracking down on telemedicine abortions, but research argues it's as safe as going to a doctor.

Sept 8, 2017
Catherine Pearson, Women & Parents Senior Reporter, HuffPost

A new study is challenging the premise of laws across the country prohibiting abortions administered through telemedicine.

Nineteen states require a clinician to be present when a woman takes medicine to end her pregnancy in order to keep her safe.

But the new, multi-year study has found that medication abortions are just as safe when they are done with a clinician overseeing them remotely as they are in the physical presence of a doctor.

Continued at source: Huffington Post: http://www.huffingtonpost.ca/entry/abortion-via-telemedicine-is-totally-safe_us_59b2af99e4b0dfaafcf79bee

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How much do abortions cost across Australia? – explainer

How much do abortions cost across Australia? – explainer

In some areas women can pay as much as $800 for a first trimester termination. Guardian Australia looks at how prohibitive expenses interact with legal restrictions to limit access

Anna Livsey
Tuesday 22 August 2017

Campaigns for easier access to abortion in Australia have largely focused on changes to the law but in a speech last week the Labor deputy leader, Tanya Plibersek, highlighted another crucial factor: cost.

“For many women abortions are unaffordable and unattainable,” she said. “The legal right to access a termination isn’t much use to a homeless teenager when the upfront cost of an abortion is more than $500.”

Continued at source: The Guardian: https://www.theguardian.com/news/datablog/2017/aug/22/how-much-do-abortions-cost-across-australia-explainer

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Online Abortion Service Women on Web: a vital alternative

Online Abortion Service Women on Web: a vital alternative

May 17th, 2017
A new scientific study published today in the BMJ shows that telemedical abortions are highly effective.

The study was conducted by researchers from the University of Texas in Austin, Princeton University and the University of Edinburgh. They looked at the data of 1,000 women in Ireland and Northern Ireland who used the service of Women on Web. Women on Web is an online service of telemedicine initiated ten years ago by Women on Waves. Women living in countries where access to safe abortions is restricted can use it to access information and be referred to a medical doctor to receive a medical abortion.
For more information about Women on Web: +31624195506 or info@womenonwaves.org

Press release by BMJ:

Online abortion service offers vital alternative to unsafe methods to end pregnancy

Results support growing calls for reform of highly restrictive abortion laws

Early medical abortion using online telemedicine offers a highly effective alternative to unsafe methods to end a pregnancy for women in countries where access to safe abortion is restricted, finds a study published by The BMJ today.
The findings, based on reports from women living in the Republic of Ireland and Northern Ireland where abortion laws are among the most restrictive in the world, show that rates of adverse events are low and that women are able to identify potentially serious complications and seek medical attention when advised.
The results provide the best safety evidence to date for self sourced medical abortion through telemedicine - and have important implications for millions of women worldwide, say the researchers.
About a quarter of the world's population lives in countries with highly restrictive abortion laws. Globally, each year an estimated 43,000 women die as a result of lack of access to safe legal abortion services through their countries' formal healthcare systems. Millions more have complications.
Yet little is known about the safety and effectiveness of medical abortion provided through online clinics.
So a team of international researchers led by Abigail Aiken at the University of Texas, analysed self reported outcome data submitted to a telemedicine clinic by 1,000 women four weeks after receiving and using the drugs mifepristone and misoprostol to end an early pregnancy.
Almost 95% reported successfully ending their pregnancy. Seven women (0.7%) reported receiving a blood transfusion and 26 (2.6%) reported receiving antibiotics. No deaths were reported.
Ninety three women (9.3%) reported experiencing any symptom for which they were advised to seek medical attention and, of these 87 (95%) sought attention.
None of the five women who did not seek medical attention reported experiencing an adverse outcome.
The researchers highlight some study limitations that could have introduced bias and say their results might not be generalisable to all settings. However, key strengths include the large sample size and high follow-up rate.
"For the millions of women worldwide living in areas where access to abortion is restricted, the findings show the vital role played by self sourced medical abortion in providing an option with high effectiveness rates and few reported adverse outcomes," they conclude.
In a linked editorial, researchers in Canada say, while findings from self reported data must always be treated with some degree of caution, these "reassuring study data support growing calls for reform."
They point out that repeal of legal restrictions "would support the safest and most equitable abortion care for women in Irish jurisdictions.
Until then, for the first time in history, women of all social classes in a legally restricted yet high resource setting have equitable access to a reasonable alternative: medical abortion guided by physicians through telemedicine," they conclude.
Note to Editors:
Journal: The BMJ

For more information, please contact:

Abigail R A Aiken, LBJ School of Public Affairs, University of Texas at Austin, TX, USA - Research

Email: araa2@utexas.edu

Wendy V Norman, Associate Professor, University of British Columbia, Vancouver, BC, Canada - Editorial

Email: wendy.norman@ubc.ca


Source: Women on Waves: https://www.womenonwaves.org/en/page/6985/online-abortion-service-women-on-web--a-vital-alternative

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Research finds 95% success from abortion pills bought online

Research finds 95% success from abortion pills bought online
British Medical Journal publishes findings suggesting abortion pills are safe alternative

May 16, 2017
Kitty Holland

Abortion pills bought online can be a safe “alternative” to travelling for abortion or unsafe abortion, research published in the British Medical Journal finds.

The study, based on self-reported outcome data from 1,000 women in the Republic and Northern Ireland, finds 95 per cent of those who obtained abortion pills online successfully terminated their pregnancies.

Just under 10 per cent sought medical attention.

Continued at source: Irish Times: https://www.irishtimes.com/news/social-affairs/research-finds-95-success-from-abortion-pills-bought-online-1.3085526

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Abortion by telemedicine: an equitable option for Irish women

Abortion by telemedicine: an equitable option for Irish women

BMJ 2017; 357 doi: https://doi.org/10.1136/bmj.j2237. Cite this as: BMJ 2017;357:j2237
Published 16 May 2017
Wendy V Norman, associate professor, Bernard M Dickens, professor emeritus of health law and policy

Reassuring study data support growing calls for reform

Women’s need for abortion is no less in countries where abortion is legally restricted. Globally, a quarter of all pregnancies end in abortion, with higher rates in countries with severe legal restrictions than in countries offering safe legal abortion.1 In 1969 the United Nations affirmed the rights of parents to determine the number and spacing of their children.2 Half a century later a key component of this right is not equitably accessible.

Continued at source: BMJ: http://www.bmj.com/content/357/bmj.j2237

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Abortion pills accessed online are as safe, effective as clinics: study

Abortion pills accessed online are as safe, effective as clinics: study
Telemedicine may be option in countries where service is restricted, researchers suggest

CBC News Posted: May 16, 2017

Medical abortions done at home using pills and an online telemedicine service appear to be just as safe and effective as those done at legal clinics, a new study has found. And it's an approach that the Canadian health-care system may be able to learn from, the author of an accompanying editorial says.

To conduct the study, researchers analyzed the outcomes of 1,023 women in Ireland and Northern Ireland who sought medical abortion services through Women on Web, a non-profit organization that provides access to medications used to induce abortion, between 2010 and 2012. Outcomes were known for 1,000 of those women, and nearly all the women were less than nine weeks into their pregnancy.

Continued at source: CBC: http://www.cbc.ca/news/health/medical-abortion-telemedicine-1.4118688

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Australia: Over-the-phone abortion service safe and effective, review finds

Over-the-phone abortion service safe and effective, review finds

Kate Aubusson
5 Apr 2017

An over-the-phone abortion service has been providing Australian women with a safe and effective way of terminating pregnancies, a preliminary review has found.

The Tabbot Foundation gave more than 1800 women access to medical abortions without the need for a face-to-face doctor consultation over 18 months.

Its founders say the service allows women to avoid the potential for stigma and judgment harboured by some healthcare professionals and anti-abortion protesters at family planning clinics.

Continued at source: Cowra Guardian: http://www.cowraguardian.com.au/story/4578615/over-the-phone-abortion-service-safe-and-effective-review-finds/?cs=7

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