TY - JOUR T1 - Making the case for supported self-managed medical abortion as an option for the future JF - BMJ Sexual & Reproductive Health JO - BMJ Sex Reprod Health DO - 10.1136/bmjsrh-2021-201181 SP - bmjsrh-2021-201181 AU - Lesley Hoggart AU - Marge Berer Y1 - 2021/06/22 UR - http://jfprhc.bmj.com/content/early/2021/06/22/bmjsrh-2021-201181.abstract N2 - The use of misoprostol at home to induce abortion began in Brazil in the 1980s and spread rapidly to many parts of the globe. The combination of mifepristone plus misoprostol with safe and effective dosages and regimens rapidly became available through clinical provision and was included on the World Health Organization (WHO) complementary essential medicines list in 2005. In 2018, it was moved to the WHO core list of essential medicines and approved for self-managed abortion (SMA) at home up to 12 weeks’ gestation, based on substantial evidence of efficacy, safety and acceptability in legally permitted settings.1Telemedicine counselling and long-distance provision of medical abortion pills for home use in legally restricted settings was begun in 2007 by Women on Web, a safe abortion hotline initiated by a feminist doctor. Access was greatly expanded when a second international hotline, Women Help Women, was launched in 2014. Telemedicine to counsel women and arrange SMA at home has been shown to be safe and acceptable in a systematic review of provision by both Women on Web and medical practitioners in the USA, Canada and Australia.2 A recent systematic scoping review on SMAfound that telemedicine and SMA with abortion pills has high levels of effectiveness.3 The positive outcomes experienced by women(2), were with physician-supervised self-managed abortion where women had access to information and support via telemedicine during the abortion process. This article focuses on the issue of support with respect to the acceptability of telemedicine and SMA. We examine these issues … ER -