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Gates Open Research speaks to Tara Shochet and Lucía Berro Pizzarossa about their Research Article. The study explores the use of self-managed abortion as a compassionate and accessible family planning and reproductive healthcare option.

First, let’s meet the authors

Tara Shochet is Director at Gynuity Health Projects, with a primary focus on medication abortion, and clinical and service delivery research.

Gynuity Health Projects is dedicated to ensuring every individual has access to safe and effective reproductive and maternal healthcare. It aims to develop scientific, clinical, and programmatic evidence in reproductive and maternal health, and advocates for its use on the ground.

Lucía Berro Pizzarossa is a post-doctoral fellow at O’Neill Institute for National and Global Health Law and a member of Women Help Women. Her research focuses on self-managed abortion as an emergent model of feminist care and the intersections of the law, health, and social movements in abortion.

Women Help Women is an international activist non-profit organization working on access to abortion. Coordinated by feminist activists, trained counselors, medical professionals, and researchers based across four continents, the organization focuses on supporting self-managed abortion, especially in places where abortion is restricted by laws, stigma, and lack of access.

How did this research project come to fruition?

The digital era is transforming the realm of reproductive care as people worldwide seek alternatives for safe and supported abortion trajectories.

For years, an increasing number of individuals sought medication abortion drugs through the internet. However, while several internet-based organizations had formed to address this demand, little was known about the breadth of de-medicalized online abortion care.

In this collaboration between Women Help Women and Gynuity Health Projects, researchers and grassroots activists partnered to explore the emerging landscape of self-managed abortion with support over the internet.

The partnership aimed to answer some key questions including:

• How many people needed this service?
• Which countries did they come from?
• What were their experiences navigating digital means for abortion access?

By combining our expertise and insights, the team sought to provide the global health community with a comprehensive understanding of the demand for self-managed abortion with online support.

Moreover, we sought to refine and enhance Women Help Women’s service delivery practices, ensuring that women receive the care and support they deserve.

Why was it important to include researchers and grassroots activists in this project?

The Women Help Women and Gynuity collaboration underscored the importance of bridging the gap between researchers and grassroots organizations.

In the realm of reproductive care, feminist activists such as Women Help Women have long been pioneers, experimenting with using telematic means to empower people even before telemedicine was integrated into mainstream healthcare systems. This model’s ever-changing and adaptable nature holds a host of learning opportunities.

By documenting and studying the innovative practices initiated by activists on the ground, we can unlock valuable insights that will contribute to advancing safe and supported abortion trajectories worldwide.

What did the research entail?

We conducted a retrospective analysis of Women Help Women’s data over a one-year period. We looked at who contacted the service, how the process was navigated, the outcomes, and people’s satisfaction with the support received.

The data we used came from two different sources:

• the consultation form
• follow-up questionnaires that each person was asked to complete

For those who did not complete the follow-up form, we also analyzed email communications between them and the Women Help Women counselors to identify outcome data.

We also engaged a multidisciplinary team of authors, including social scientists, medical doctors, and lawyers, whose diverse backgrounds enriched the data analysis.

What key findings came from the research?

The findings revealed compelling insights into the motivations, experiences, and outcomes of those seeking abortion care through this community-supported approach.

Our analysis included over 3,000 people from 30 countries. We found that the most common reasons for seeking abortion care were to avoid or postpone childbearing, financial problems, or issues around work or schooling.

Almost all service users reported that they were no longer pregnant after using the service. We also learned that most people who accessed abortion in this model reported feeling relieved and/or resolved after the abortion.

Most individuals also reported being satisfied with the abortion process and the information and support they received from the counselors at Women Help Women.

The study’s overarching message is clear. Self-managed abortion can be a safe and effective process when accompanied by community support, even without medical supervision. By documenting the experiences of thousands of individuals, this research further dispels the myths and misconceptions surrounding self-managed abortion, highlighting its viability as a compassionate and accessible reproductive healthcare option.

It reinforces the need for comprehensive, non-judgmental support networks, such as Women Help Women and similar initiatives, to enable safer and more supported abortion trajectories.

What impact do you hope this research will have?

We know that abortion continues to be a very complex matter. The hope is that this research will contribute to a shift in the public perception and understanding of self-managed abortion, showcasing it as a safe and effective option that can be undertaken with the support of trained counselors.

By demonstrating the positive outcomes and satisfaction reported by individuals who accessed abortion through initiatives like Women Help Women, the research aims to challenge the stigma surrounding self-managed abortion and advocate for greater accessibility to safe abortion methods.

In the academic and field-related context, this research provides valuable insights into the effectiveness of self-managed abortion models and the impact of community support initiatives. It adds to the body of knowledge surrounding abortion access and contributes to the ongoing academic discourse on reproductive health and rights.

The findings can be utilized by researchers, healthcare providers, policymakers, and advocates to inform their work and develop evidence-based strategies that prioritize safe and accessible abortion care.

The research also highlights the crucial role that feminist initiatives like Women Help Women play in supporting individuals’ abortion trajectories, emphasizing the importance of community-based support networks in reproductive care.

Did you face any challenges throughout your project?

Conducting research in the field of medication abortion care comes with its unique set of challenges.

One such hurdle is the issue of follow-up completion, as individuals often choose to discontinue communications after completing their abortion process.

While this may pose difficulties from a research perspective, it is not clinically problematic, as it usually signifies that individuals no longer require counselor support.

However, an innovative approach utilizing email conversations has allowed researchers to obtain compliance and outcome data from individuals who did not complete the follow-up form, providing valuable insights into the medication abortion experience.

Why did you choose to publish your work with Gates Open Research?

We chose to publish our work with Gates Open Research for two main reasons: transparency and immediate open access.

By publishing in an open-access platform, we aimed to make our research findings freely available to a broad audience, without any financial or technical barriers.

This ensures that individuals, organizations, and communities who might benefit the most from our research can access it quickly and without restrictions.

What’s next for this area of study?

As society progresses and embraces advancements in human rights standards and evidence in reproductive care, the landscape of abortion care is also evolving.

The shift towards self-managed and remote abortion care is gaining momentum, driven by factors such as technological advancements, changing attitudes towards reproductive autonomy, and the renewed energies of activists on the ground.

By conducting research and documenting the outcomes and experiences of individuals who have accessed self-managed and remote abortion care, we have built a robust body of evidence that showcases its safety, effectiveness, and positive impact on individuals’ lives.

International Conference on Family Planning Gateway

This article was published as part of the dedicated Gateway for International Conference on Family Planning delegates, where presenters can publish ICFP-related findings on Gates Open Research at no cost to themselves, regardless of Gates funding.

This is part of the Gates Foundation’s commitment to supporting the dissemination of cutting-edge family planning and reproductive health research to achieve gender equality goals worldwide.

Read the full Research Article today to dive deeper into the study and findings, and discover the latest research published in the ICFP Gateway.

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