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Study Shows that Guided Self-Managed Abortion via TeleAborto is Safe, Acceptable & Feasible in Mexico

A study published in Contraception provides evidence to show that guided self-managed abortion is safe, acceptable and feasible in Mexico when supportive health care is provided from a distance and abortion pills are mailed.

Data for this analysis by Gynuity Health Projects and partners were collected between April 2019 and August 2021 through our ongoing direct-to-patient medication abortion telemedicine service, referred to as TeleAborto, at three private clinics in Mexico City and with one non-clinician community provider in Campeche.

Study sites sent packages containing abortion medication (mifepristone and misoprostol tablets), painkillers and an instruction guide to individuals who were determined eligible for the procedure after they had undergone a screening consultation and received standard abortion counselling by phone or videoconference. Individuals deemed ineligible were offered other service alternatives. Pre-abortion tests, such as ultrasound, were done at facilities local to the participants and the results were evaluated by the site requesting them. Follow-up contact via phone call or messaging was scheduled seven to 14 days after shipment of the package to ascertain abortion outcome and the need for additional care.

Key Findings

  • Collectively, the sites conducted screenings with 581 people to assess eligibility for the service, scheduled 393 counselling sessions via telemedicine, and shipped 378 packages by courier to people across all 32 Mexican states.
  • All packages were successfully delivered.
  • Abortion outcome was determined for 9 in ten (87%) study participants. The overwhelming majority (93%) among these reported successfully ending their pregnancies with the medications provided and without additional intervention.
  • No deaths were reported. One person was hospitalized and received a blood transfusion as well as dilation and curettage, a procedure that is still standard in many hospitals in Mexico.
  • Study participants reported high satisfaction overall, citing convenience followed by privacy as the most-valued aspects of the service.
  • The sample reflects a broad geographical reach in Mexico. It is notable that 42% of study participants reported distances of 500km or more from their chosen study site, which could translate to at least four hours of bus travel each way.

The findings from this original investigation add to the mounting evidence globally in support of self-managed abortion via telemedicine, a model which the World Health Organization recommends where appropriate. These findings are timely, adding to the promising landscape for abortion access and rights in Mexico. A growing number of Mexican states are lifting legal restrictions on abortion since last year’s decision by the country’s Supreme Court, which declared it unconstitutional for Coahuila state to criminalize women for having an abortion.

Additional private and public sector providers have joined TeleAborto and will help support efforts to close the access gap by reaching more vulnerable and remote populations across Mexico.

M. Peña et al., Telemedicine for medical abortion service provision in Mexico: A safety, feasibility, and acceptability study, Contraception, https://doi.org/10.1016/j.contraception.2022.06.009

With thanks to our study partners—Gineclinic, Centro de Atención Integral a la Pareja, Medieg, RedMyH, Planned Parenthood Global, CENETEC—and the individuals who consented to take part in this study.