Missing mifepristone at tribal health facilities serving native Americans

Glaser, Katherine; Whitehair, Jennifer

doi:10.1016/j.contraception.2021.03.027

Cited by 3 publications

(1 citation statement)

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“…However, for women, transgender men, and gender non‐binary pregnancy capable individuals living in states where abortion is now banned, restricted, or where telehealth provision of medication abortion is not legal, they have limited access to the combined mifepristone and misoprostol regimen 24 . It is also difficult to acquire mifepristone in rural settings and from tribal health facilities 25 and the high price of mifepristone (compared to misoprostol) poses an additional barrier. Overall, following the Dobbs decision, these barriers to accessing mifepristone will likely be exacerbated, and many abortion seekers will need to travel to other states for access to the combined mifepristone and misoprostol regimen.…”

Section: Discussionmentioning

confidence: 99%

Safety and effectiveness of self‐managed abortion using misoprostol alone acquired from an online telemedicine service in the United States

Johnson

Michels-Gualtieri

Gomperts³

et al. 2023

Perspect Sexual Reproductive

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Objectives To evaluate self‐reported outcomes and serious adverse events following self‐managed medication abortion using misoprostol alone provided from an online service. Study Design We conducted a retrospective record review of self‐managed abortion outcomes using misoprostol obtained from Aid Access, an online telemedicine organization serving United States (US) residents, between June 1, 2020, and June 30, 2020. The main outcomes were the proportion of people who reported ending their pregnancy without instrumentation intervention and the proportion who received treatment for serious adverse events. Results During the study period, 1016 people received prescriptions for misoprostol. We obtained follow‐up information for 610 (60%) of whom 568 confirmed use of the medication and 42 confirmed non‐use. When taking the medication, 96% were at or less than 10 weeks' gestation and 4% were more than 10 weeks. Overall, 88% (95% CI: 84.6–90.2) reported successfully ending their pregnancy without instrumentation intervention. Of the 568 who took the misoprostol, 12 (2%) reported experiencing one or more serious adverse events and 20 (4%) reported experiencing a symptom of a potential complication. Conclusions Self‐managed medication abortion using misoprostol provided by an online telemedicine service has a high rate of effectiveness and a low rate of serious adverse events. Outcomes compare favorably to other service delivery models using a similar regimen. As mifepristone continues to be over‐regulated and the 2022 US Supreme Court ruling allows states to severely restrict access to in‐clinic abortion care, this regimen is a promising option for self‐managed abortion in the US.

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Section: Discussionmentioning

confidence: 99%