Background: New strategies are needed to help people overcome barriers to abortion and achieve greater reproductive autonomy. Demedicalized models for medication abortion care have the potential to greatly expand access to abortion, particularly for those most affected by distance and cost barriers. Methods: The study is a patient-centered, clinically supported, prospective observational study among people ...Read more >

Background: Current regulations restrict access to medication abortion and contribute to the perception that women cannot safely take medication abortion pills (mifepristone and misoprostol) on their own without clinician supervision. However, these drugs meet many of the Food and Drug Administration (FDA) criteria for being available over the counter (OTC). Medication abortion is safe, has ...Read more >

Background: While mifepristone has the potential to expand abortion access in the US through integration into primary care, initial expectations for provision by family physicians have not been realized. Research indicates that physician motivation to provide medication abortion is an important factor in overcoming logistical and organizational barriers to abortion provision. Methods: For this project, ...Read more >

Background: A rapid increase in legislation restricting access to clinical abortion services in the US has sparked renewed interest in self-managed abortion as a response to clinic access barriers. At the same time, rising interest in self-care and the role of the internet as a go-to source of goods and services raises the possibility that ...Read more >

Background: Mifepristone did not “revolutionize” access to abortion in the ways originally anticipated. However, in the 17 years since its approval it has changed the face of abortion care, potentially in ways that have increased access. In 2014, nearly-one third of abortions were early medication procedures, and 26% of clinic facilities provided only early medication ...Read more >

Background: The Mifeprex® Risk Evaluation and Mitigation Strategy (REMS) requires that the drug be dispensed only in a clinic, office, or hospital, despite the lack of evidence that this improves safety. In a recent survey of obstetrician-gynecologists (Ob-Gyns), we found that only 14% provided medication abortion, but an additional 15% said they would provide it ...Read more >

Background: While medication abortion has the potential to expand abortion access, barriers persist. One such barrier may be locating a provider. Research has shown that individuals commonly use the internet to self-refer for abortion services. However, we have previously shown that the quality of information available online for abortion self-referral is low, and it is ...Read more >

Background: Current approaches to pain management are inadequate for both aspiration and medication abortion. Our recent placebo controlled trial found that an easily taught auricular acupuncture protocol led to much lower maximum pain during aspiration abortion compared to usual care (median scores 39.5 versus 71 on a 100-point Visual Analog Scale). The intervention also substantially ...Read more >

Background: There is global consensus that there is benefit to providing Rh immune globulin in the third trimester to prevent immune sensitization and consequent pregnancy complications, however, evidence to guide management of Rh-negative women in the first trimester bleeding is lacking. Our preliminary data indicate that women undergoing abortion in the first trimester are exposed ...Read more >

Background: This project will build upon existing training resources to develop and pilot a free, online, training resource titled “Medication Abortion in Primary Care.” This training will be designed to meet the needs of general Internists, and other primary care providers who may not be comfortable performing intrauterine procedures. By providing clinicians a continuing medical ...Read more >