Feasibility and Acceptability of At-Home Routine Pregnancy Testing in the United States: A Pilot Study

We aimed to investigate the acceptability of regular self-testing among people with increased risk for delayed pregnancy recognition when provided with free at-home pregnancy tests and to explore the feasibility of this intervention among a larger sample.

In 2019-2020, we recruited participants across the United States by using flyers posted online and in community settings and abortion clinics. We purposively sampled people with pregnancy capacity who were 18 to 24 years old, had irregular menses, or had a recent second-trimester abortion. Participants were mailed pregnancy tests and instructions. Participants received text message reminders to test monthly over a 3-month period and were asked to text back results. Participants also completed online surveys at baseline, after 1 month, and after 3 months. A purposive subsample of participants was selected to participate in semi-structured interviews. Interviews were analyzed using thematic analysis of interview guide topics and emergent themes.

61 participants were enrolled. Fifty-four participants (90%) responded to the text reminders and 52 (85%) reported testing in all 3 months. Fifty-eight (95%) said tests were easy to use, 59 (97%) said the results were clear, and all participants found it convenient to text their results. Fourteen participants completed qualitative interviews. All described continuing to test after the study and indicated high acceptability for text reminders. Interviewees described convenience and cost as primary benefits for preferring at-home pregnancy testing.

Regular self-testing and texting results is feasible and acceptable to participants provided with free at-home urine pregnancy tests. These results can inform future studies designed to investigate the effect of regular self-testing on timing of pregnancy detection to facilitate early entry to prenatal care or early abortion.