10-year evaluation of the use of self-managed abortion through
telemedicine: A retrospective cohort study.
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.