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Abstract
Background Changes in legislation due to COVID-19 led to the introduction of telemedicine for early medical abortion (EMA) at home in Scotland. The opportunity to provide contraception at presentation may be more limited with this model of care. We compared contraceptive use immediately post-abortion with 3–6 months later to determine if contraceptive needs were being met.
Methods We contacted 579 women by telephone call or text message who agreed to be involved in a service evaluation of telemedicine EMA in NHS Lothian at 3–6 months post-abortion. A research nurse administered a questionnaire on the women's current contraception use. The research nurses also offered women support in switching or initiating contraception via the abortion service if desired.
Results The response rate to the contact was 57% (331/579). Under a third of the women (30%, 98/331) were using the progestogen-only pill (POP) at 3–6 month follow-up, a significant decrease (p<0.00) compared with 65% (215/331) who were provided with POP at the time of abortion. Thirty-nine women (12%) were provided with contraception through this telephone contact, leading to a significant increase in the proportion using subdermal implants, the progestogen injectable or intrauterine contraception.
Conclusions This study shows that there was a decrease in the use of the POP 3–6 months after telemedicine EMA during the COVID-19 pandemic. Telephone contact at 3–6 months to facilitate obtaining contraception may be a promising strategy to improve access to effective methods with this model of abortion care.
- Abortion, Therapeutic
- Contraceptive Agents, Female
- Contraceptive Devices, Female
- contraception behavior
- COVID-19
- Mifepristone
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
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- Abortion, Therapeutic
- Contraceptive Agents, Female
- Contraceptive Devices, Female
- contraception behavior
- COVID-19
- Mifepristone
Data availability statement
All data relevant to the study are included in the article or uploaded as supplementary information.
Footnotes
Twitter @doctorjjrw
Contributors SC, JRW and MV designed the study, analysed the data and drafted the initial manuscript. JJRW is the guarantor.
Funding The study was conducted by staff at the MRC Centre for Reproductive Health, which is supported by grant MR/N022556/1.
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.
Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.