SELF-MANAGED, BUT NOT ALONE: THE HEALTHCARE NEEDS OF SELF-MANAGED MEDICATION ABORTION USERS

Objectives

Post-Dobbs v Jackson Women’s Health Organization, self-managed medication abortion (SMMA) is increasingly common in the US (Aiken et al 2024). This analysis assesses whether, and why, SMMA users seek medical attention post-SMMA. It also explores how user demographics and abortion policy environment influence treatment-seeking post-SMMA.

Methods

From July 2023-February 2024, we surveyed SMMA users in Florida, Indiana, and Louisiana about their abortion experiences and treatment-seeking behaviors. An additional round of data will be collected from May-August 2024. We recruited respondents through seven SMMA providers; analyses will also incorporate Aid Access client follow-up data. We examine three dimensions of post-SMMA care: (1) any post-abortion care, (2) care for symptoms requiring medical attention or additional abortive interventions and (3) adverse events requiring treatment. We assess treatment-seeking by user demographics via multivariate regression; we also compare treatment-seeking before and after abortion bans in Indiana and Florida relative to Louisiana, where abortion policy was static throughout the study.

Results

Data from 2023 fielding (n=154) indicate high SMMA efficacy (95%) and infrequent complications. 39% of respondents sought medical attention post-SMMA—85% to verify their pregnancy had ended. Black individuals, and parents, were significantly more likely to seek treatment than others. Final findings will incorporate data from Aid Access, May-August 2024 survey data, and estimates of the impact of abortion bans on treatment-seeking.

Conclusions

A sizeable proportion of users sought treatment after SMMA, despite high efficacy and low rates of complications. Policymakers, advocates, and providers should ensure that SMMA users can safely access desired medical attention, regardless of state policy environment.