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Women’s experiences of self-administration of misoprostol at home as part of early medical abortion: a qualitative evaluation
  1. Jeni Harden1,
  2. Julie Ancian2,
  3. Sharon Cameron3,4,
  4. Nicola Boydell5
  1. 1Usher Institute, The University of Edinburgh, Edinburgh, UK
  2. 2Cermes3-IRIS, EHESS, Paris, France
  3. 3Chalmers Sexual and Reproductive Health Centre, NHS Lothian, Edinburgh, UK
  4. 4University of Edinburgh Division of Health Sciences, Edinburgh, UK
  5. 5University of Edinburgh Centre for Population Health Sciences, Edinburgh, UK
  1. Correspondence to Dr Jeni Harden, Usher Institute, The University of Edinburgh, Edinburgh EH8 9AG, UK; jeni.harden{at}ed.ac.uk

Abstract

Background Between 2017 and 2019, legislation was introduced in the UK that approved the home as a place for self-administration of misoprostol for early medical abortion. While research has shown that early medical abortion at home is as safe as in a clinical setting, women’s experiences in the UK in the light of this change have not yet been investigated. This qualitative research explored the experiences of women in one region of Scotland, UK who accessed early medical abortion with home self-administration of misoprostol.

Methods Qualitative interviews were conducted with 20 women who had recently undergone early medical abortion (≤69 days' gestation) with home self-administration of misoprostol. The data were analysed thematically using an approach informed by the Framework analytic approach.

Results Women appreciated the flexibility that home administration of misoprostol offered, including the opportunity to control the timing of the abortion. This was particularly important for women who sought not to disclose the abortion to others. Most women valued being in the comfort and privacy of the home when preparing for self-administration, although a small number highlighted some concerns about being at home. Most women reported that self-administration of misoprostol was straightforward; however, some expressed concerns around assessing whether their experiences were ‘normal’.

Conclusions Women welcomed the opportunity for home self-administration of misoprostol. To further improve women’s early medical abortion experience we suggest that the legislation be amended so that women can self-administer in an appropriate non-clinical setting, not just their home.

  • abortion, induced
  • health services research
  • qualitative research
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Footnotes

  • Twitter @jeniharden, @j_ancian

  • Contributors The original idea and overall study design were conceived by JH, STC and NB. JA collected the qualitative data. JH prepared the initial manuscript, with edits by NB, JA and STC. All authors jointly approved the version to be published and are accountable for the accuracy and integrity of the work.

  • Funding The study was funded by the NHS Lothian Sexual Health and Blood Borne Virus Programme Fund.

  • Competing interests None declared.

  • 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.

  • Patient consent for publication Not required.

  • Ethics approval The study was reviewed and granted ethical approval by the Usher Research Ethics Group, University of Edinburgh (Application 1864; 14 January 2019).

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

  • Data availability statement No data are available. Consent was not obtained from study participants.

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