Gynuity Marks International Safe Abortion Day

September 28th is an annual day of action in support of access to safe and legal abortion. What began as a regional campaign for the decriminalization of abortion in Latin America over 30 years ago has since turned into a global event. It also happens to be an important date in the U.S. reproductive health calendar. Twenty-one years ago the Food and Drug Administration (FDA) approved mifepristone, a technology that changed the face of abortion. Gynuity has always sought to contribute to the availability of abortion with pills in every way. We take a dim view of a new Texas law that came into effect this month restricting abortion access. Today, we spotlight a small but varied sample of our recent efforts to further strengthen access to safe abortion care.

Published Research

Expanding Access to De-Medicalized Abortion Care Through Telemedicine

We published a summary of the expansion of the TelAbortion study in the U.S. during the COVID-19 pandemic and share evidence to date on its safety, efficacy, and acceptability. Outcomes are comparable to in-clinic care, and medical abortion provision using telemedicine and mail is highly effective. This paper was the primary source cited in the U.S. Food and Drug Administration’s (FDA) decision to suspend the in-person mifepristone dispensing requirements for the duration of the pandemic. The FDA is now reviewing the restrictions currently placed on mifepristone.

In case you missed it. This summer, Contraception ran a special issue dedicated to the mifepristone REMS – an unnecessary and overly burdensome FDA regulation that places constraints on where, and by whom, mifepristone can be dispensed. Co-guest edited by Dr. Elizabeth Raymond, a Gynuity staff member, the issue assembles over 20 commentaries and original research articles that can be used by advocates seeking to put evidence into the hands of decision-makers.

Omitting Ultrasound Before Medical Abortion Provision by Telemedicine and Mail

A study conducted by Gynuity and partners exploring the omission of pre-abortion ultrasound before provision of telemedicine medical abortion does not appear to compromise safety or result in more ongoing pregnancies. Compared with individuals who had a pre-abortion ultrasound, people who did not receive such tests were more likely to have unplanned clinical encounters or incomplete abortions, perhaps because they had less contact with a provider. However, both groups had similar and very low rates of ongoing pregnancy and hospitalization or blood transfusion. Abortion-seekers who do not have an ultrasound may be more likely to seek post-treatment care and have procedural interventions.

Resources

Checklist: Minimum Requirements for Medical Abortion Package Inserts

Together with the International Planned Parenthood Federation, we developed a checklist outlining the minimum requirements for high-quality medical abortion package inserts. Our previous analysis of package inserts from 20 countries revealed numerous inaccuracies and inconsistencies, including inadequate storage instructions and outdated gestational age limits and regimens. A searchable database of quality medical abortion products is available here.

Reference Guide: Supporting Adoption of Task Sharing in Medical Abortion Care in Mexico

We worked with a team of clinical and midwifery professionals in Mexico to design a virtual training for clinicians and reproductive health program managers on medical abortion care. The four-module, six-hour course was delivered twice to over 500 health professionals from Mexico and a dozen Latin American countries. We developed for course participants a reference guide, which lists national laws and clinical guidelines as well as international recommendations and published papers to support use by midwives and mid-level providers of mifepristone and misoprostol for abortion care and uterine evacuation. We plan to translate the training content into other languages (currently only available in Spanish) and adapt it as a self-paced online course.  A watershed moment. Earlier this month, Mexico’s Supreme Court ruled that a Coahuila state law criminalizing abortion was unconstitutional. We celebrate this decision, which helps pave the way for decriminalizing abortion in other states. Ever since Mexico City legalized abortion in 2007, Gynuity has worked with the public and private sector in Mexico to expand and streamline abortion care, including through telemedicine medical abortion.

Podcast

Furthering the Evidence for Later First Trimester Medical Abortion Regimens

In this podcast, Ilana Dzuba, a Gynuity staff member, chats with the media editor of Contraception about a multi-country study evaluating the success of medical abortion regimens in the later first trimester of pregnancy. We continue to build on this research, exploring further the evidence for the most effective medical abortion regimen at 11 and 12 weeks.

Additional Resources

For a deeper dive into our work on medical abortion, visit the Resources section of our website.

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