Online access to abortion medications: a review of utilization and clinical outcomes
Margit Endler1, Amanda Cleeve2, Kristina Gemzell-Danielsson2
1Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Tomtebodavägen 18b, 171 77 Stockholm, Sweden; Department of Public Health, and Women's Health Research Unit, University of Cape Town, Falmouth Road, 7950 Cape Town, South Africa.
Abstract:
We performed a search in PubMed and Web of Science on the self-use of abortion medication after online access. Studies published between January 1, 1995, and March 31, 2019, were considered. We included studies of online services that were (i) led by healthcare staff (n = 14), (ii) led by non-healthcare staff (n = 4), and (iii) providing noninteractive access (n = 17). Our outcomes were utilization (frequency and demand for services), acceptability for women, safety, and success rate. Key findings: Women are increasingly using the Internet to access abortion medication. Available services are of varying quality. Women accessing noninteractive services report feelings of distress related to the lack of medical guidance, and the demand for interactive guidance through the abortion process is high. Women using services led by healthcare staff report high rates of satisfaction and similar rates of clinical outcomes as those of in-person abortion care.
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