Examining service delivery patterns before and after implementation of a direct-to-patient telehealth service providing medication abortion in Australia.

In August 2016, MSI Australia (MSIA) brought to scale a direct-to-patient telehealth medication abortion service. We used MSIA's patient management systems from January 2015 to December 2018 to assess changes in the proportion of abortion patients obtaining care after 13 weeks' gestation, proportion of abortion patients obtaining medication abortion versus procedural abortion and proportion of abortion patients from regional and remote versus metropolitan areas. The proportions of abortion patients obtaining care before 13 weeks' gestational duration and those from regional and remote residents did not change between the pre- and post-periods.

Experiences with and unmet needs for medication abortion support: A qualitative study with US abortion support providers.

Introduction: Quality abortion care must be person-centered. Although academic literature has focused on full-spectrum and abortion doulas supporting instrumentation abortion (also referred to as procedural abortion) clients, clients undergoing medication abortion remain understudied and may have unique needs. We aimed to understand United States (US) abortion support providers' perceptions of medication abortion clients' support needs by exploring which needs they address, which needs remain unmet, and how remote support provision might help address client needs.

Interest in and Support for Alternative Models of Medication Abortion Provision Among Patients Seeking Abortion in the United States.

Introduction: Medication abortion is safe and effective, but restrictions still limit patients from accessing this method. Alternative models of medication abortion provision, namely advance provision, over-the-counter (OTC), and online, could help improve access to care for some, although there is limited evidence about abortion patients' interest in these models.

Methods: Between 2017 and 2019, we administered a cross-sectional survey to abortion patients at 45 clinics across 15 U.

Sampling strategies among studies of barriers to abortion in the United States: A scoping review of abortion access research.

Objectives: Understanding barriers to abortion care is particularly important post-Dobbs. However, many abortion access studies recruit from abortion-providing facilities, which overlook individuals who do not present for clinic-based care. To our knowledge, no studies have reviewed research recruitment strategies in the literature or considered how they might affect our knowledge of abortion barriers.

What attributes of abortion care affect people's decision-making? Results from a discrete choice experiment.

Objectives: We aimed to measure both stated and experimentally "revealed" abortion provision preferences among US people with capacity for pregnancy.

Study Design: In July 2022, we recruited US residents assigned female sex at birth and aged 18 to 55 years using Prolific, an online survey hosting platform. We asked participants what first-trimester abortion method and delivery model they would prefer.

Emotional, informational, and decision-making support needs among people seeking abortion in the US: perspectives from All-Options Talkline callers.

People seeking abortion may need or want emotional or informational support before, during, and after their abortion. Feeling supported and affirmed contributes to perceptions of quality care. The All-Options Talkline offers free, telephone-based, peer counselling to callers anywhere in the United States.

Patient and provider experiences using a site-to-site telehealth model for medication abortion.

Background: In the site-to-site telehealth for medication abortion model, patients visit a health center to meet with a remote clinician using telehealth technology. This model is safe, effective, and acceptable to patients and providers. The objective of this study was to document the experiences of patients and providers using telehealth for medication abortion in Planned Parenthood health centers across different geographical contexts in the United States.

Improving our estimates: assessing misclassification of abortion accessibility in the United States.

Purpose: Quantify the misclassification of abortion accessibility resulting from calculations based on block groups, census tracts, ZCTAs, or counties versus census blocks.

Methods: We included 850 facilities from the 2018 ANSIRH Facility Database and Planned Parenthood website. Accessibility was the proportions of 18-44 year-old women living within a 30-, 60-, and 90-minute drive from an abortion-providing facility.

Potential Impact of Telemedicine for Medication Abortion Policy and Programming Changes on Abortion Accessibility in the United States.

To quantify the impact of telemedicine for medication abortion (TMAB) expansion or ban removal on abortion accessibility. We included 1091 facilities from the 2018 Advancing New Standards in Reproductive Health facility database and Planned Parenthood Web site, among which 241 did not offer abortion as sites for TMAB expansion. Accessibility was defined as the proportion of reproductive-aged women living within a 30-, 60-, or 90-minute drive time from an abortion-providing facility.

Effectiveness and safety of a direct-to-patient telehealth service providing medication abortion targeted at rural and remote populations: Cross-sectional findings from Marie Stopes Australia.

Objectives: We assessed the safety and effectiveness of direct-to-patient telehealth provision of medication abortion in Australia.

Study Design: We included all medication abortions (January 2017-December 2018) from Marie Stopes Australia's patient management and adverse event reporting systems. We defined effectiveness as whether the patient had a continuing pregnancy, incomplete abortion, and/or subsequent vacuum aspiration or procedural abortion and safety as whether the patient experienced any adverse event.

"It just seemed like a perfect storm": A multi-methods feasibility study on the use of Facebook, Google Ads, and Reddit to collect data on abortion-seeking experiences from people who considered but did not obtain abortion care in the United States.

Most studies of abortion access have recruited participants from abortion clinics, thereby missing people for whom barriers to care were insurmountable. Consequently, research may underestimate the nature and scope of barriers that exist. We aimed to recruit participants who had considered, but failed to obtain, an abortion using three online platforms, and to evaluate the feasibility of collecting data on their abortion-seeking experiences in a multi-modal online study.

General practitioner knowledge of and engagement with telehealth-at-home medical abortion provision.

In Australia, there are many barriers to abortion, particularly for women living in regional, rural and remote areas. Telehealth provision of medical abortion is safe, effective and acceptable to patients and providers. In 2015, Marie Stopes Australia (MSA) launched an at-home telehealth model for medical abortion to which GPs could refer.

An observational study of patient experiences with a direct-to-patient telehealth abortion model in Australia.

Background: While abortion care is widely legal in Australia, access to care is often poor. Many Australians must travel long distances or interstate to access abortion care, while others face stigma when seeking care. Telehealth-at-home medical abortion is a potential solution to these challenges.

Comparison of Facebook, Google Ads, and Reddit for the Recruitment of People Who Considered but Did Not Obtain Abortion Care in the United States: Cross-sectional Survey.

Background: In the United States, abortion access is restricted by numerous logistical, financial, social, and policy barriers. Most studies on abortion-seeking experiences in the United States have recruited participants from abortion clinics. However, clinic-based recruitment strategies fail to capture the experiences of people who consider an abortion but do not make it to an abortion clinic.

Introduction of telemedicine for medication abortion: Changes in service delivery patterns in two U.S. states.

Objective(s): Telemedicine for medication abortion (teleMAB) is safe and effective, yet little is known about how its introduction affects service delivery. We assessed changes in service delivery patterns 1 year after introducing teleMAB at Planned Parenthood in 2 U.S.

Pregnancy and Abortion: Experiences and Attitudes of Deployed U.S. Servicewomen.

Introduction: More U.S. servicewomen than civilian women experience unintended pregnancies, which can impact their health, well-being, and careers.

At-home telemedicine for medical abortion in Australia: a qualitative study of patient experiences and recommendations.

Introduction: This study aimed to explore patient experiences obtaining a medical abortion using an at-home telemedicine service operated by Marie Stopes Australia.

Methods: From July to October 2017, we conducted semistructured in-depth telephone interviews with a convenience sample of medical abortion patients from Marie Stopes Australia. We analysed interview data for themes relating to patient experiences prior to service initiation, during an at-home telemedicine medical abortion visit, and after completing the medical abortion.

Contraceptive use and access among deployed US servicewomen: findings from an online survey.

Background/introduction: This study aimed to survey US servicewomen on their contraceptive access and use during deployment.

Methods: Between June 2016 and July 2017, we conducted a cross-sectional online survey among a convenience sample of current and former members of the US Military, National Guard and Reserves who had a deployment ending in 2010 or later. Participants were asked open-ended and closed-ended questions about their demographics and contraceptive use and access before and during their last deployment.

Abortion Need among U.S. Servicewomen: Evidence from an Internet Service.

Introduction: U.S. servicewomen have high rates of unintended pregnancy, but federal policy prohibits abortion provision at military treatment facilities and military insurance coverage of abortion, except in cases of rape, incest, or a life-endangering pregnancy.

Medication Abortion Provided Through Telemedicine in Four U.S. States.

Objective: To assess outcomes of medication abortion provided through telemedicine compared with standard medication abortion at Planned Parenthood health centers in four U.S. states.

Facilitators and Barriers to Contraceptive Use Among U.S. Servicewomen Who Had an Abortion.

Introduction: Despite evidence that the unintended pregnancy rate is higher among U.S. servicewomen than the general population and that servicewomen may face barriers to contraceptive use, there is little research about contraceptive access and use experiences of non-deployed active duty servicewomen.

Abortion Knowledge and Experiences Among U.S. Servicewomen: A Qualitative Study.

Context: U.S. servicewomen have a higher rate of unintended pregnancy than civilian women, yet the military does not provide or cover abortion, except in limited circumstances.

The Role of Community Health Centers in Reducing Racial Disparities in Spatial Access to Primary Care.

Introduction: Racial minorities are more likely to live in primary care shortage areas. We sought to understand community health centers' (CHCs) role in reducing disparities.

Methods: We surveyed all primary care practices in an urban area, identified low access areas, and examined how CHCs influence spatial accessibility.