A research agenda for moving early medical pregnancy termination over the counter

Kapp, Nathalie; Grossman, Daniel; Jackson, Emily; Castleman, Laura; Brahmi, Dalia

doi:10.1111/1471-0528.14646

Cited by 24 publications

(17 citation statements)

References 34 publications

(57 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Some women may prefer full medical supervision and support, while others may prefer an autonomous process; still others may prefer something in between. The diversity of reasons we found for seeking to self‐manage supports prior work advocating for abortion medications to be available over the counter in pharmacies and through a variety of clinical telemedicine models . We hope that they also inspire creative thinking about how providers and public health practitioners can design and implement new models that ensure safe, supported and accessible abortion care for all.…”

Section: Resultsmentioning

confidence: 52%

“…Moreover, not all who encounter such barriers are able to overcome them. Indeed, two medications to be available over the counter in pharmacies 34 and through a variety of clinical telemedicine models. 35,36 We hope that they also inspire creative thinking about how providers and public health practitioners can design and implement new models that ensure safe, supported and accessible abortion care for all.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Motivations and Experiences of People Seeking Medication Abortion Online in the United States

Aiken

Broussard

Johnson

et al. 2018

Perspect Sexual Reproductive

View full text Add to dashboard Cite

show abstract

Section: Resultsmentioning

confidence: 52%

Section: Discussionmentioning

confidence: 99%

Motivations and Experiences of People Seeking Medication Abortion Online in the United States

Aiken

Broussard

Johnson

et al. 2018

Perspect Sexual Reproductive

View full text Add to dashboard Cite

show abstract

“…In 2014, nearly one third (31%) of nonhospital abortions were performed with medications [1]. While MA meets most of the Food and Drug Administration criteria for over-the-counter (OTC) approval, including its low toxicity, low potential for abuse and nonaddictiveness [2], access to the method remains restricted. In the United States, women are required to obtain mifepristone in a medical facility such as a doctor's office, clinic or hospital, even though they are allowed to take it at home [3,4].…”

Section: Introductionmentioning

confidence: 99%

“…Increasingly, women in the United States are obtaining MA through nontraditional routes including online or through telemedicine services, particularly where access is difficult [2,15,16]. Those who self-manage their abortions outside of the formal health care setting presumably do so because they prefer its privacy and convenience and/or face barriers accessing care [17][18][19][20].…”

Section: Introductionmentioning

confidence: 99%

Support for and interest in alternative models of medication abortion provision among a national probability sample of U.S. women

et al. 2019

View full text Add to dashboard Cite

The objective was to assess women's personal interest in and support for three alternative models of medication abortion (MA) provision. Study design: Using an online survey of a U.S. national, probability-based representative sample of women ages 18-49, we gauged personal interest in and general support for three alternative models for accessing abortion pills: (1) in advance from a doctor for future use, (2) over-the-counter (OTC) from a drugstore and (3) online without a prescription. We conducted multivariable analyses to identify characteristics associated with support for these provision models. Results: Fifty percent (n=7022) of eligible women invited completed the survey. Nearly half (49%) supported and 30% were personally interested in one or more of the three access models; 44% supported advance provision, 37% supported OTC access, and 29% supported online access. Common advantages reported for advance provision, OTC and online access included privacy (49%, 29% and 46%, respectively), convenience (38%, 44% and 38%) and being able to end the pregnancy earlier (48%, 40% and 29%). Common disadvantages included concern that women might take the pills incorrectly (55%, 53% and 57%), not seeing a clinician before the abortion (52%, 54% and 53%) and safety (42%, 43% and 60%). History of abortion and experiencing barriers accessing reproductive health services were associated with greater support for the alternative models. Conclusion: Women are interested in and support alternative models of MA provision, in particular, advance provision. However, they also reported concerns about incorrect pill use and not seeing a clinician beforehand. Implications: Offering women more choices in how they access medication abortion, including options where they can safely self-manage their own care, has the potential to expand access to care.

show abstract

“… 7 , 8 Aside being approved for clinical use for over a decade, it is also recommended for use by the World Health Organization (WHO) and other key global reproductive health bodies. 9 , 10 …”

Section: Introductionmentioning

confidence: 99%

Medical abortions among university students in Ghana: implications for reproductive health education and management

Appiah-Agyekum¹

2018

IJWH

View full text Add to dashboard Cite

PurposeIn Ghana, unsafe abortion is a major cause of maternal mortality. Even though pharmaceutical drugs seem to be a key means of unsafe abortion, a paucity of evidence exists on the issue among adolescents, students, and other groups at risk. This study therefore explores the abortion experiences of Ghanaian university students with particular reference to pharmaceutical drugs to fill the knowledge gap and enrich the evidence base for reproductive health education, policies, and interventions on abortions among students.Patients and methodsUndergraduate students from the University of Ghana were randomly selected and interviewed. The interviews was recorded, transcribed, and analyzed thematically using the framework analysis.ResultsStudents were aware of safe medical abortion services but were reluctant to use them because of cost, stigma, and proximity. Generally, medical abortions were more likely to be self-induced among students with misoprostol-based drugs administered orally or vaginally. However, students also used various over-the-counter drugs, contraceptives, and prescription drugs singly, in series, or in combinations to induce abortion. Yet students had relatively little knowledge on the inherent risks and long-term implications of unsafe medical abortions and were more likely to have repeat abortions through unsafe medical methods.ConclusionStudents’ knowledge and awareness of safe medical abortion avenues have not influenced their propensity to use them because of stigma, cost, and other factors. Rather, several methods of unsafe medical abortions are used increasingly with dire long-term effects on students. Serious knowledge gaps exist among students on the methods and risks of medical abortion. Consequently, there is an urgent need to revise current abortion management approaches and redirect attention toward reducing stigma and financial and social costs of safe abortion services, and increasing the proactive engagement, counseling, and management of medical abortions among students.

show abstract

A research agenda for moving early medical pregnancy termination over the counter

Cited by 24 publications

References 34 publications

Motivations and Experiences of People Seeking Medication Abortion Online in the United States

Motivations and Experiences of People Seeking Medication Abortion Online in the United States

Support for and interest in alternative models of medication abortion provision among a national probability sample of U.S. women

Medical abortions among university students in Ghana: implications for reproductive health education and management

Contact Info

Product

Resources

About