Takeaway
- Self-assessment at home for completed medical abortion is safe and effective and has many benefits.
Why this matters
- Medical abortion is often elected for its privacy and accessibility, but follow-up visits can be burdensome, especially for women with limited financial resources.
- Home self-assessment may shorten waiting and travel times, prevent missed school or work, improve confidentiality, and save medical resources.
Key results
- No difference in effectiveness was seen between self-assessment and clinic follow-up (risk ratio [RR], 1.00; 95% CI, 0.99-1.01).
- No differences seen between groups for need of follow-up surgery, hemorrhage, fever, infections, or ongoing pregnancy.
- Acceptability was greater for self-assessment compared with in-clinic follow-up (81.91% vs 48.35%).
Study design
- Systematic review and meta-analysis.
- 4 randomised controlled clinical trials (n=5493 participants) included in final analysis.
- Participants undergoing medical abortion at home were identified.
- The intervention was a self-assessment of abortion outcome done by home urine pregnancy test combined with a follow-up home visit or telephone call to confirm termination of pregnancy.
- Self-assessment at home was compared with traditional in-person clinic follow-up visit.
- The primary outcome was successful complete abortion.
- Funding: None.
Limitations
- Small number of studies met inclusion criteria.
References
References
