Can Screening for Medication Abortion be Safely Done by a Computer? 

Providing medication abortion based only on the responses from a programmed self-administered questionnaire is likely to be effective, safe, efficient, and acceptable, according to the findings from a pilot study conducted by Gynuity in close partnership with Planned Parenthood affiliates in Colorado and Minnesota. For this study, individuals wanting to manage their own abortion reviewed an informational website about medication abortion and filled out a linked questionnaire programmed to produce a conclusion regarding their eligibility that they then submitted online for review by a physician. After ruling out the need for a real-time clinical consultation or ultrasound, the abortion medications together with painkillers, anti-nausea pills, a pregnancy test and instruction guide were mailed or collected in person. Read a more detailed summary of the study and key findings, including information on abortion outcome, adverse events, and satisfaction.

Raymond, E.G., Frye, L.J., Tocce, K., Gingras, S., Almquist, A., Firstenberg, A., Ortega, C., Blumenthal, P.D., Winikoff, B., Boraas, C. Evaluation of a “Smart” Screening Tool for Asynchronous Assessment of Medication Abortion Eligibility: A Pilot Study Contraception; Nov 2023; doi:10.1016/j.contraception.2023.110340

Exploring Research Participants' Experiences and Satisfaction with Childbirth 

With partners, we published a paper reporting on a new way for researchers to understand what is important to women undergoing induction of labor for hypertension in pregnancy. The mixed-methods Participant Generated Experience and Satisfaction (PaGES) tool asks research participants to state freely what is important before and after birth, and then asks them to rate the importance of each statement and describe their satisfaction with it after delivery. In this way, it captures both qualitative and quantitative insights on their priorities. Incorporated into the MOLI (Misoprostol vs. Oxytocin for Labor Induction) trial conducted in three government hospitals in central India, a pilot study assessed the feasibility and acceptability of this tool. Interviews with patients showed that they valued the opportunity to be consulted during childbirth. 

Symon, A., Lightly, K., Howard, R., Mundle, S., Faragher, B., Hanley, M., Durocher, J., Winikoff, B., Weeks, A. Introducing the Participant-Generated Experience and Satisfaction (PaGES) Index: A Novel, Longitudinal Mixed-Methods Evaluation Tool BMC Med Res Methodol; Sep 2023; doi:10.1186/s12874-023-02016-1

Enrollment is set to begin for a study evaluating the feasibility of remote provision of medication abortion services via private providers in Ecuador using a misoprostol-only regimen for abortion through 12 weeks’ pregnancy. In contrast to other places where Gynuity has conducted research on telemedicine medication abortion, mifepristone is not available in Ecuador and, while a recent decision to include the drug on the national list of basic medicines is positive, a registered mifepristone product is not expected to come onto the market soon. The knowledge gained as a result of our study should be useful for other settings where mifepristone is not currently available. 

To ensure the most vulnerable populations are meaningfully integrated into the self-care movement, the IAWG Self-Care Task Team, International Rescue Committee, and Self-Care Trailblazer Group co-created a Global Call to Action for Sexual and Reproductive Health Self-Care in Humanitarian and Fragile Settings, and have collated their first global progress tracker update. It features updates from self-care research, implementation and advocacy projects, including a completed introductory study by Gynuity and Women Health & Family Planning that helped inform a policy decision to incorporate telemedicine medication abortion into national abortion guidelines in Ukraine. 

More than 300 leading reproductive health researchers have put their names to an amicus brief filed in the U.S. Supreme Court regarding a case concerning mifepristone, a highly effective and safe medication that has been available in the U.S. since 2000 and is most commonly known for its use in combination with misoprostol to cause abortion. The group, which includes researchers from Gynuity, shares a significant interest in evidence-based reproductive health and has published extensively on the topic of medication abortion. Arguing in favor of the reversal of a lower court decision that would limit access to mifepristone nationwide, the brief cites published studies that support the U.S. Food and Drug Administration’s decisions to expand the drug’s conditions of use in recent years. The Court will hear combined oral argument on March 26 in Food and Drug Administration v. Alliance for Hippocratic Medicine and Danco Laboratories v. Alliance for Hippocratic Medicine.