May 17, 2022
In this issue, read about published research on the outcomes and safety of history-based screening for medication abortion as well as new research on an approach to medication abortion provision without real-time interactions between client and clinician, a retrospective review on misoprostol alone for medication abortion by mail, and the feasibility of introducing a new screening tool for preeclampsia. Find out also about our current speaking engagements.
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Outcomes and Safety of History-Based Screening for Medication Abortion |
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A study published in JAMA Internal Medicine provides evidence to show screening for medication abortion based on medical history alone is highly effective and low risk, with medications dispensed either in-person or by mail. Our findings show that the effectiveness rate (95%) is comparable to studies with pre-abortion screening using ultrasound and the major adverse event rate (0.5%) is rare. This study by ANSIRH, Gynuity and others included nearly 3,800 racially and ethnically diverse people who between February 2020 and January 2021 had obtained from 14 U.S. facilities offering in-person and online care a medication abortion without an ultrasound or pelvic exam.
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Gynuity Launches MA-ASAP Study in Minnesota (Colorado Coming Soon)
Gynuity, together with two Planned Parenthood affiliates, has launched a new pilot-study to evaluate the feasibility, safety, and acceptability of a model of care that enables assessment of medication abortion eligibility and follow-up without real-time interactions between client and clinician. Open to people in Minnesota (Colorado coming soon) who are early in their pregnancies and at least 18 years old, individuals wanting an abortion with pills initiate the process by completing an online questionnaire available via the study website www.ma-asap.org.
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Retrospective Review on Misoprostol Alone for Medication Abortion by Mail
To provide more evidence about the safety and efficacy of misoprostol alone regimens, Gynuity is conducting a retrospective review of data from about 900 patients who received misoprostol alone for medication abortion by mail from a clinic in the U.S. during the COVID-19 pandemic. We will compare abortion outcomes of these patients to outcomes of patients who received mifepristone and misoprostol at the same clinic. We expect to have results later this year.
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Pilot Study on the Feasibility of Introducing a New Screening Tool for Preeclampsia in Healthcare Facilities in Ethiopia and Uganda
Gynuity has teamed up with academic institutions in the U.S., Ethiopia, and Uganda to understand the feasibility of introducing the Congo Red Test (CRT), a simple urine point-of-care test for early identification of preeclampsia, in healthcare facilities in Ethiopia and Uganda. If successful, this pilot project led by the University of Illinois, Chicago could result in the clinical uptake of the CRT diagnostic device in routine antenatal care services and serve as a model for adoption in other countries where the burden of disease is great.
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Upcoming Webinar, May 18 - Letrozole: Alternative Combination Regimen for Medication Abortion. Challenges and Opportunities in Latin America |
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The newly updated WHO guideline on abortion care suggests for the first time a combination regimen of letrozole plus misoprostol as an alternative method of early medication abortion for use in settings where mifepristone is not available. During the webinar, Gynuity and Ipas will provide important insights on letrozole, including the limited evidence on its use for first trimester abortion, its availability and cost in parts of Latin America where abortion is legally permitted, and implications for abortion care. Webinar in Spanish, with no interpretation. |
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ESCRH Congress, May 26 – Free Communication: Patient Experiences Viewing Expulsions During Medication Abortion in the Later First Trimester |
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As part of the Access to Abortion session on May 26th, Gynuity will present a secondary analysis of findings from two prospective, open-label mifepristone-misoprostol studies evaluating what medication abortion users with 9- to 11-week pregnancies saw on expulsion, their feelings about what they saw, and the effect of viewing pregnancy tissue on satisfaction to inform pre-abortion messaging for users.
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National Abortion Federation (NAF) 45th Annual Meeting – Panel Session: Is Less More? A Critical Reappraisal of Medication Abortion Follow-up |
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A panel session, “Is Less More? A Critical Reappraisal of Medication Abortion Follow-up”, was selected for NAF’s 45th Annual Meeting in Florida. Panelists from Gynuity, the University of Texas at Austin, Stanford University and Vitala with the University of British Colombia engaged the audience in a facilitated discussion on follow-up methods with the notion that one size does not fit all. Attracting a large crowd, the session aimed to inspire innovative service delivery and shift collective values toward increased autonomy in medication abortion, as well as other person-centered measures of cost and convenience.
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New Peer-Reviewed Articles |
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Upadhyay, U.D., Raymond, E.G., Koenig, L.R., Coplon, L., Gold, M., Kaneshiro, B., Boraas, C.M., Winikoff, B. Outcomes and Safety of History-Based Screening for Medication Abortion: A Retrospective Multicenter Cohort Study. JAMA Intern Med; 2022 Mar 21; doi: 10.1001/jamainternmed.2022.0217. Online ahead of print.
Biggs, M.A., Ehrenreich, K., Morris, N., Blanchard, K. Bustamante, C.K., Choimorrow, S.Y., Hauser, D., Hernandez, Y.M., Kapp, N., Kromenaker, T., Moayedi, G.D., Perritt, J.B., Ralph, L., Raymond, E.G., Valladares, E.S., White, K., Grossman, D. Comprehension of an Over-the-Counter Drug Facts Label Prototype for a Mifepristone and Misoprostol Medication Abortion Product. Obstetrics & Gynecology; May 5, 2022; Volume - Issue - 10.1097/AOG.0000000000004757 doi: 10.1097/AOG.0000000000004757.
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A recently leaked draft opinion makes it clear that the Supreme Court is set to overturn 50 years of legal precedent regarding abortion in the U.S. If the Court revokes Roe v. Wade, as it is expected to do this summer, it would give states carte blanche to trigger abortion restrictions or bans that serve to increase barriers to essential health care, veto reproductive freedom, and worsen existing health inequalities.
We share a vision with others to see that all people have access to quality abortion care. We are a member of the Liberate Abortion campaign, a multi-tactical coalition of organizations that have come together to ensure abortion is available, affordable, accessible, and stigma-free for anyone who needs it across the U.S., and a partner in the Abortion On Our Own Terms campaign that aims to promote self-managed abortion.
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