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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:ACCEPTED

11 Sep 2020Submitted to BJOG: An International Journal of Obstetrics and Gynaecology
14 Sep 2020Submission Checks Completed
14 Sep 2020Assigned to Editor
17 Sep 2020Reviewer(s) Assigned
07 Oct 2020Review(s) Completed, Editorial Evaluation Pending
26 Oct 2020Editorial Decision: Revise Major
16 Nov 20201st Revision Received
18 Nov 2020Submission Checks Completed
18 Nov 2020Assigned to Editor
22 Nov 2020Reviewer(s) Assigned
05 Dec 2020Review(s) Completed, Editorial Evaluation Pending
07 Dec 2020Editorial Decision: Revise Minor
17 Dec 20202nd Revision Received
17 Dec 2020Submission Checks Completed
17 Dec 2020Assigned to Editor
23 Dec 2020Reviewer(s) Assigned
07 Jan 2021Review(s) Completed, Editorial Evaluation Pending
27 Jan 2021Editorial Decision: Revise Minor
05 Feb 20213rd Revision Received
05 Feb 2021Submission Checks Completed
05 Feb 2021Assigned to Editor
15 Feb 2021Review(s) Completed, Editorial Evaluation Pending
02 Mar 2021Editorial Decision: Accept