Effectiveness and Acceptability of Medical Abortion Provided Through Telemedicine

Grossman, Daniel; Grindlay, Kate; Buchacker, Todd; Lane, Kathleen; Blanchard, Kelly

doi:10.1097/aog.0b013e318224d110

Cited by 132 publications

(169 citation statements)

References 18 publications

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“…24 Notably, it is growing more common for abortion pills to be supplied via telemedicine and evidence suggests that this can offer an effective provision model. 15,16,25,26 Official Irish advice regarding abortion pills tends towards blanket statements about the dangers of sourcing any pharmaceuticals online or using the pills "without medical supervision". 27,40 Irish media also carry frequent reports drawing attention to purported dangers of home use of pills (see, for example 28 ).…”

Section: Home Use Of Abortion Pills In Irelandmentioning

confidence: 99%

“…The privacy offered by internet provision may thus be twoedged. 25 A member of the WoW helpdesk staff explained that "[w]omen feel much more free to tell us what is happening, to discuss the real situation, to say things that they would never tell their own doctor' before immediately going on to note that she also worried about women feeling isolated and having no support, explaining: '[w]e get many e-mails saying that you're the only one who knows, I can't tell anyone" (Maaike, WoW, interview). The Director of WHW expressed the same ambivalence:…”

Section: Home Use Of Abortion Pills In Irelandmentioning

confidence: 99%

“…29 Women are also advised that pills "are designed to be used in abortion clinics", notwithstanding the many studies establishing the safety of home use. 20,25 Further, a claim that the pills "may not work if you are … pregnant with twins", is not backed by evidence, with the one small study that exists showing no difference in failure rate, bleeding or pain when pills are used in singleton and twin pregnancies. 43 …”

Section: Official Responses To Home Usementioning

confidence: 99%

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How can a state control swallowing? The home use of abortion pills in Ireland

Sheldon

2016

Reproductive Health Matters

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Evidence suggests that there is widespread home use of abortion pills in Ireland and that ending a pregnancy in this way is potentially safer than the alternatives available to many women. This paper argues that there is a strong case for women with unwanted pregnancies to be offered truthful and objective information regarding the use of abortion pills by trusted local professionals and, further, that this is possible within existing law. A move in this direction would not, however, negate the need for legal reform to address the fundamental moral incoherence of a law that treats women who terminate pregnancies within Ireland as criminals but those who travel to access services overseas as victims in need of support. In support of these arguments, the paper draws on both library research and a small number of interviews with government officials, service providers and activists.

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Section: Home Use Of Abortion Pills In Irelandmentioning

confidence: 99%

Section: Home Use Of Abortion Pills In Irelandmentioning

confidence: 99%

Section: Official Responses To Home Usementioning

confidence: 99%

See 1 more Smart Citation

How can a state control swallowing? The home use of abortion pills in Ireland

Sheldon

2016

Reproductive Health Matters

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“…With these tools, the majority of women could manage their abortion at home on their own. With this objective in mind, providers and researchers have explored ways to simplify medical abortion follow-up with serial human chorionic gonadotropin (hCG) testing, high-and low-sensitivity pregnancy tests, and telephone or other virtual follow-up [3][4][5][6][7].…”

Section: Introductionmentioning

confidence: 99%

“…Previous research has documented change in hCG level after medical abortion [6,[8][9][10]. Since 2005, Planned Parenthood Federation of America has waived the follow-up visit if it poses undue hardships owing to distances from abortion facilities or other reasons, and women manage their followup with serial hCG testing [11].…”

Section: Introductionmentioning

confidence: 99%

Simplified medical abortion using a semi-quantitative pregnancy test for home-based follow-up

Lynd

Blum

Ngoc³

et al. 2013

International Journal of Gynecology & Obstetrics

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Objective: To simplify follow-up after medical abortion by examining whether women could use a semiquantitative pregnancy test at home to screen for ongoing pregnancy. Methods: Three hundred women seeking medical abortion at a tertiary hospital in Vietnam participated in the study. Participants used a semiquantitative pregnancy test at the hospital to estimate baseline human chorionic gonadotropin (hCG) levels and administered another test at home 2 weeks later for comparison. Women interpreted the test result at home and then returned to hospital for follow-up care. At this visit, self-assessment was verified. To assess further the feasibility of the test as a follow-up tool in service delivery, 200 additional women completed a user comprehension survey. Results: The tests identified all 11 ongoing pregnancies among study participants (100% sensitivity; 89.7% specificity). Women reported that the test was easy to use (255/292 [87.3%]) and that provider instructions helped them to use the test (291/292 [99.7%]). Conclusion: Semi-quantitative pregnancy tests offer high sensitivity and negative predictive value. If user instructions can be further simplified, the tests could be used in lieu of transvaginal ultrasound and/or serum hCG at clinic-based follow-up or by women themselves for home-based follow-up. Clinical trials.gov: NCT01150279

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