Given the overall safety profile and increasing availability of medical pregnancy termination drugs, we asked: would the mifepristone–misoprostol regimen for medical termination at ≤10 weeks of gestation meet US Food and Drug Administration regulatory criteria for over-the-counter (OTC) approval, and if not, what are the present research gaps?
Research has not kept abreast of women’s self-use of medical abortion, leaving many gaps in the scientific literature regarding the ideal conditions for safe and effective use. In December 2016, a group of 20 global abortion researchers convened following the Africa Regional Conference on Abortion to discuss current and future research on medical abortion self-use. This article lays out their list of identified research gaps and methodologic considerations in addressing them—challenges that are intended to inform both ongoing and future research.
The objective of this research was to explore the context of abortion stigma in Ghana and Zambia through qualitative research, and develop a quantitative instrument to measure stigmatizing attitudes and beliefs about abortion. Focus group discussions were conducted in both countries, and a Stigmatizing Attitudes, Beliefs, and Actions scale was created. It captures three important dimensions of abortion stigma: negative stereotypes about men and women who are associated with abortion, discrimination/exclusion of women who have abortions, and fear of contagion as a result of coming into contact with a woman who has had an abortion. It provides a validated tool for measuring stigmatizing attitudes and beliefs about abortion in Ghana and Zambia and has the potential to be applicable in other country settings.
Governments, advocates, providers, policymakers and other stakeholders who want to fully support women’s rights to access abortion across the globe must address quality of care, in addition to efforts to change abortion laws, train providers and expand service provision. Documenting and working to improve the quality of abortion care is necessary in order to improve service delivery and health outcomes, expand access to safe abortion especially in legally restricted settings, and to ensure the human right to the highest attainable standard of health, as outlined by the WHO.
We sought to determine if female community health volunteers (FCHVs) and literate women in Nepal can accurately determine success of medical abortion (MA) using an 8-question symptom checklist. Women’s and FCHVs’ assessments were compared to experienced abortion providers using standard of care. Women’s self-assessment of MA success agreed with abortion providers’ determinations 85% of the time. Agreement between FCHVs and providers was 82%. We concluded that use of a checklist to determine MA success is a promising strategy. However, further refinement of such a tool, particularly for low-literacy settings, is needed before widespread use.
