8
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: not found
      • Article: not found

      Demand for Self-Managed Medication Abortion Through an Online Telemedicine Service in the United States

      Read this article at

      ScienceOpenPublisherPMC
      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Objectives. To examine demand for abortion medications through an online telemedicine service in the United States. Methods. We examined requests from US residents to the online telemedicine abortion service Women on Web (WoW) between October 15, 2017, and August 15, 2018. We calculated the population-adjusted rate of requests by state and examined the demographics, clinical characteristics, and motivations of those seeking services, comparing those in states with hostile versus supportive abortion policy climates. Results. Over 10 months, WoW received 6022 requests from US residents; 76% from hostile states. Mississippi had the highest rate of requests (24.9 per 100 000 women of reproductive age). In both hostile and supportive states, a majority (60%) reported a combination of barriers to clinic access and preferences for self-management. Cost was the most common barrier (71% in hostile states; 63% in supportive states; P  < .001). Privacy was the most common preference (49% in both hostile and supportive states; P  = .66). Conclusions. Demand for self-managed medication abortion through online telemedicine is prevalent in the United States. There is a public health justification to make these abortions as safe, effective, and supported as possible.

          Related collections

          Most cited references22

          • Record: found
          • Abstract: found
          • Article: found
          Is Open Access

          Abortion Incidence and Service Availability In the United States, 2014

          CONTEXT National and state-level information about abortion incidence can help inform policies and programs intended to reduce levels of unintended pregnancy. METHODS In 2015–2016, all U.S. facilities known or expected to have provided abortion services in 2013 or 2014 were surveyed. Data on the number of abortions were combined with population data to estimate national and state-level abortion rates. The number of abortion-providing facilities and changes since a similar 2011 survey were also assessed. The number and type of new abortion restrictions were examined in the states that had experienced the largest proportionate changes in clinics providing abortion services. RESULTS In 2014, an estimated 926,200 abortions were performed in the United States, 12% fewer than in 2011; the 2014 abortion rate was 14.6 abortions per 1,000 women aged 15–44, representing a 14% decline over this period. The number of clinics providing abortions declined 6% between 2011 and 2014, and declines were steepest in the Midwest (22%) and the South (13%). Early medication abortions accounted for 31% of nonhospital abortions, up from 24% in 2011. Most states that experienced the largest proportionate declines in the number of clinics providing abortions had enacted one or more new restrictions during the study period, but reductions were not always associated with declines in abortion incidence. CONCLUSIONS The relationship between abortion access, as measured by the number of clinics, and abortion rates is not straightforward. Further research is needed to understand the decline in abortion incidence.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Impact of Clinic Closures on Women Obtaining Abortion Services After Implementation of a Restrictive Law in Texas.

            To evaluate the additional burdens experienced by Texas abortion patients whose nearest in-state clinic was one of more than half of facilities providing abortion that had closed after the introduction of House Bill 2 in 2013.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Using telemedicine for termination of pregnancy with mifepristone and misoprostol in settings where there is no access to safe services.

              Women on Web is a service that uses telemedicine to help women access mifepristone and misoprostol in countries with no safe care for termination of pregnancy (TOP). This study reviews the telemedicine service. After an online consultation, women with an unwanted pregnancy of up to 9 weeks are referred to a doctor. If there are no contraindications, a medical TOP is conducted by mail. After maximising the follow up from 54.8 to 77.6%, 12.6% decided not to do the TOP and 6.8% of the women who did the medical TOP at home needed a vacuum aspiration. Telemedicine can provide an alternative to unsafe TOP. Outcomes of care are in the same range as TOP provided in outpatient settings.
                Bookmark

                Author and article information

                Journal
                American Journal of Public Health
                Am J Public Health
                American Public Health Association
                0090-0036
                1541-0048
                October 17 2019
                : e1-e8
                Affiliations
                [1 ]Abigail R. A. Aiken and Dana M. Johnson are with the LBJ School of Public Affairs, University of Texas, Austin. Jennifer E. Starling and James G. Scott are with the Department of Statistics and Data Sciences, University of Texas, Austin. Alexandra van der Wal and Sascha van der Vliet are with the Faculty of Science, VU University, Amsterdam. Kathleen Broussard is with the Department of Sociology, University of Texas, Austin. Elisa Padron is with the College of Natural Sciences, University of Texas,...
                Article
                10.2105/AJPH.2019.305369
                6893344
                31622157
                628a92f2-e5ad-4bf3-9f53-304f67163a45
                © 2019
                History

                Comments

                Comment on this article