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Could routine pregnancy self-testing facilitate earlier recognition of unintended pregnancy? A feasibility study among South African women
  1. Deborah Constant1,
  2. Sofia Lopes1,
  3. Daniel Grossman2
  1. 1Women’s Health Research Unit, School of Public Health & Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
  2. 2Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, Oakland, California, USA
  1. Correspondence to Dr Deborah Constant, Women’s Health Research Unit, School of Public Health & Family Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, 7925, Western Cape, South Africa; Deborah.Constant{at}uct.ac.za

Abstract

Introduction We explored whether routine pregnancy self-testing is feasible and acceptable to women at risk of late recognition of pregnancy as a strategy to facilitate early entry into either antenatal or abortion care.

Methods A feasibility study among South African sexually active women not desiring pregnancy within 1 year, and not using long-acting or injectable contraceptives. At recruitment, we provided five free urine pregnancy tests for self-testing on the first day of each of the next 3 months. We sent monthly text reminders to use the tests with requests for no-cost text replies. Our main outcome was the proportion of participants self-testing within 5 days of the text reminder over three consecutive months. Other outcomes were ease of use of tests, preference for self-testing versus clinic testing, acceptability of routine self-testing (all binary responses followed by open response options) and response to text messages (four-point Likert scale).

Results We followed up 71/76 (93%) participants. Two confirmed new pregnancies at the first scheduled test and completed exit interviews, and 64/69 (93%) self-reported completing all three monthly tests. Self-testing was easy to do (66/71, 93%); advantages were convenience (21/71, 30%) and privacy (18/71, 25%), while the main disadvantage was no nurse present to advise (17/71, 24%). Most would recommend monthly testing (70/71, 99%). Text reminders were generally not bothersome (57/71, 80%); 35/69 (51%) participants replied with test results over all three months.

Conclusion Providing free pregnancy tests to women at risk of late recognition of pregnancy is feasible to strengthen early confirmation of pregnancy status.

  • health services accessibility
  • patient participation
  • reproductive behavior

Data availability statement

Deidentified participant data is available from the corresponding author upon reasonable request. Reuse is permissible following the authors' agreement to the proposed study protocol. (ORCID ID: 0000-0002-7176-9963)

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Data availability statement

Deidentified participant data is available from the corresponding author upon reasonable request. Reuse is permissible following the authors' agreement to the proposed study protocol. (ORCID ID: 0000-0002-7176-9963)

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Footnotes

  • Twitter @DrDGrossman

  • Contributors DC and DG were involved in the study design, and drafting and finalising the manuscript. DC conducted the study and did the analysis. SL managed the data, assisted with analysis, and reviewed the final manuscript.

  • Funding The study was funded by The Regents of the University of California (UCSF0108651).

  • 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.

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

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