November 24, 2020
Greetings from New York where we are winding down an unsettling year full of challenges but looking ahead to the New Year with hope. Our team continues to juggle pandemic work-life balance, embracing flexibility and new ways of working. This year-end newsletter highlights our advances despite the COVID-19 crisis and shares next steps in our work to enhance people-centered reproductive and maternal health care through research and strategic partnerships.
Cheers to a year ahead full of positive change and scientific advances!
Warm wishes,
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Beverly Winikoff
President
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Medical Abortion via Telemedicine Reaches Individuals in 28 Mexican States |
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Building on more than a dozen years of research and training in Mexico to increase access to medical abortion, Gynuity and colleagues now focus on models of telemedicine for medical abortion service delivery. We now have early results of a pilot study conducted in private sector health services. The project mailed 118 packages with medication and instructions for use of a combined mifepristone-misoprostol regimen for use through 10 weeks’ gestation to individuals in 28 Mexican states (see map). Abortion outcomes align with reported rates of efficacy and safety for in-person care using the same regimen: 96% of procedures were successful with medication alone, and no serious complications were reported. Aspiration occurred for one ongoing pregnancy and for two incomplete abortions. Three participants reported visits to an outside clinical provider resulting in ultrasound and reassurance. Overall satisfaction with TeleAborto was very high, as was the likelihood that users of the service would recommend it to a friend.
We increased the sample to continue to offer the service and collect information about user and provider experiences. We will now expand the network of providers offering TeleAborto and begin outreach to increase awareness of the service among organizations that serve survivors of rape and sexual violence, migrants, and advocates for reproductive rights and justice in Mexico. For more information go to www.TeleAborto.org, our new TeleAborto Social Media Kit, or contact TeleAborto@gynuity.org.
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A Toolkit to Simplify Contraceptive Access for People Using Medical Abortion
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Gynuity’s One Visit: A toolkit for medical abortion providers is the product of a pilot project with two family planning clinics. The toolkit provides resources for providers and health care systems to introduce service delivery that allows people choosing medical abortion the option to receive an implant or injectable contraceptive at the same time as mifepristone. Simplifying medical abortion protocols and contraceptive access promises to make both options more convenient, available and acceptable. See the toolkit here.
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Missed Period Pills Offer Another Option for People Seeking to Disrupt Pregnancy |
Gynuity has recently published a study of mifepristone and misoprostol for treatment of delayed menses without prior pregnancy confirmation, otherwise known as “missed period pills.” Used in this way, the pills would still terminate a pregnancy if one were present, but people using the method could do so without knowing if they had been pregnant. The main aim of our study was to explore potential interest in missed period pills in the United States. We conducted the study in two states: one in the northeast with no major abortion restrictions; and one in the midwest with multiple major abortion restrictions. We enrolled 678 people across nine health centers and found interest was greatest (70%) among those who would be unhappy if pregnant. Key reasons for interest were to prevent, avoid or terminate pregnancy; and psychological or emotional benefits, including management of abortion stigma. Reasons for non-interest included concerns about safety or side effects, desire to be pregnant or have a baby, and not wanting to abort or hurt a fetus/baby. Our findings suggest that some people do not desire pregnancy confirmation before taking medications that might disrupt a pregnancy. As a result, if missed period pills were an option in the United States, demand might be substantial and wide-ranging across demographic groups. In light of these findings, an important next step is to assess the feasibility, acceptability and use of an actual missed period pills service. “Exploring Potential Interest in Missed Period Pills in two US States: Contraception 2020 Sep 9;S0010-7824(20)30337-1. doi: 10.1016/j.contraception.2020.08.014. Online ahead of print.”
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Misoprostol or Oxytocin for Labor Induction Study |
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Gynuity and colleagues at the University of Liverpool, All India Institute of Medicine, Nagpur; Government Medical College, Nagpur and Daga Women’s Hospital are conducting a trial exploring whether continuing oral misoprostol is superior to the standard protocol of switching to intravenous oxytocin after labour induction with oral misoprostol for hypertensive disease. The primary outcome is the rate of caesarean birth, but the study will also consider satisfaction and cost. |
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Guidance for Providers Offering Misoprostol-Alone for Abortion Amidst COVID-19 now available in Arabic! |
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In case you missed it, this timely resource created with numerous collaborators --
CEDES, Médecins Sans Frontières, ASAP, CLACAI, REDAAS and Women Help Women, is now available in Arabic. It offers providers guidance on safe medical abortion during the COVID-19 pandemic. The resource reviews the steps of providing misoprostol medical abortion regimens and makes evidence-based recommendations for limiting contact and reducing in-person visits.
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Save the Date! December 3, 8 and 10, 2020
¡RESERVE LA FECHA! el 3, 8 y 10 de diciembre, 2020
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Task sharing medical abortion care and medications for uterine evacuation: Course for health care professionals
Tareas compartidas para la atención del aborto con medicamentos y sus otros usos para evacuación uterina: Curso para prestadores clínicos y auxiliares
Gynuity is offering a three-part online training in Spanish for a broad range of health care providers on task-sharing and medical abortion care. The course follows a multi-year initiative in Mexico to share the evidence base for task-sharing in maternal and reproductive health, reaching over 5,000 health care providers. Please helps us spread the word to colleagues in Mexico and Latin America about this live webinar.
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Please consider supporting Gynuity for Giving Tuesday! |
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