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  • Why women choose at-home abortion via teleconsultation in France: drivers of telemedicine abortion during and beyond the COVID-19 pandemic

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Original research
Why women choose at-home abortion via teleconsultation in France: drivers of telemedicine abortion during and beyond the COVID-19 pandemic
  1. Hazal Atay1,2,3,
  2. Helene Perivier4,
  3. Kristina Gemzell-Danielsson5,
  4. Jean Guilleminot6,
  5. Danielle Hassoun7,
  6. Judith Hottois8,
  7. Rebecca Gomperts2,
  8. Emmanuelle Levrier3
  1. 1 Sciences Po Paris, CEVIPOF – Centre for Political Research, Paris, France
  2. 2 Women on Web International Foundation, Toronto, Ontario, Canada
  3. 3 Sciences Po Paris, LIEPP – The Laboratory for Interdisciplinary Evaluation of Public Policy, Paris, France
  4. 4 Sciences Po Paris, OFCE – French Economic Observatory, Paris, France
  5. 5 Karolinska Institutet, Stockholm, Sweden
  6. 6 Assistance Publique – Hôpitaux de Paris, Paris, France
  7. 7 Medical Doctor, Paris, France
  8. 8 Medical Doctor, Strasbourg, France
  1. Correspondence to Hazal Atay, Political Science, Sciences Po, Paris, France; hazal.atay{at}sciencespo.fr

Abstract

Objectives In an attempt to understand the demand and main drivers of telemedicine abortion, we analysed the requests that Women on Web (WoW), an online telemedicine abortion service operating worldwide, received from France throughout 2020.

Methods We conducted a parallel, convergent, mixed-methods study among 809 consultations received from France at WoW between 1 January and 31 December 2020. We performed a cross-sectional study of data obtained from the WoW consultation survey and a manifest content analysis of anonymised email correspondence of 140 women consulting with the WoW helpdesk from France.

Findings We found that women encounter macro-level, individual-level and provider-level constraints while trying to access abortion in France. The preferences and needs over secrecy (n=356, 46.2%), privacy (n=295, 38.3%) and comfort (n=269, 34.9%) are among the most frequent reasons for women from France to choose telemedicine abortion through WoW. The COVID-19 pandemic seems to be an important driver for resorting to telemedicine (n=236, 30.6%). The lockdowns had a significant impact on the number of consultations received at WoW from France, increasing from 60 in March to 128 in April during the first lockdown and from 54 in October to 80 in November during the second lockdown.

Conclusions The demand for at-home medical abortion via teleconsultation increased in France during the lockdowns. However, drivers of telemedicine abortion are multidimensional and go beyond the conditions unique to the pandemic.

  • abortion
  • induced
  • health services accessibility
  • reproductive medicine

Data availability statement

All original data are available upon reasonable request to the researchers.

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

https://doi.org/10.1136/bmjsrh-2021-201176

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    Data availability statement

    All original data are available upon reasonable request to the researchers.

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    Footnotes

    • Twitter @hazalatay7

    • Contributors HA conceived the original research question. HA and EL performed both the quantitative analysis and the qualitative analysis. HP and KGD supervised the study analysis. HA wrote the article manuscript. All authors participated in the discussion of the results and approved the final version of the manuscript.

    • Funding This research was funded by a public grant overseen by the French National Research Agency (ANR) as part of the “Investissements d’Avenir” programme LIEPP (ANR-11-LABX-0091, ANR-11-IDEX-0005-02) and the Université de Paris IdEx (ANR-18-IDEX-0001).

    • Competing interests Coauthors RG and HA work for or are affiliated with Women on Web.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.