Researchers from over a dozen organizations and institutions find the potential for self-assessment tools to empower individuals in managing their reproductive health
San Francisco, CA - A study published in the American Journal of Obstetrics and Gynecology found that individuals can accurately determine their eligibility for medication abortion using self-reported health history. This research supports the use of self-screening and telehealth for medication abortion care, which are becoming increasingly important as access to in-person care faces growing restrictions. The study also suggests that medication abortion could be appropriate for over-the-counter (OTC) sale in the future.
Findings reveal that the vast majority of people truly ineligible for medication abortion correctly identified themselves as ineligible in self-screening (92.2%). Many more participants exercised an over-abundance of caution, self-screening as ineligible when a clinician later determined they were in fact eligible for medication abortion (48.5%). Frequent and incorrect self-screening as ineligible could prevent people from accessing care, especially in settings where facility-based abortion care is no longer available.
The study highlights the potential for self-assessment tools to empower individuals in managing their reproductive health, particularly in settings where traditional clinical evaluations are less accessible. The findings also suggest a need for more specific self-screening questions to assess the risk of ectopic pregnancy, and to ensure access to as many eligible people as possible.
"The evidence is clear: patients can safely and effectively assess on their own whether they are eligible for medication abortion, tending to err on the side of caution,” said Lauren Ralph, PhD, MPH, Associate Professor, Advancing New Standards in Reproductive Health, UCSF. “Given the strong safety profile of these pills, this study provides additional evidence supporting over-the-counter access to mifepristone and misoprostol," adds Daniel Grossman, MD, Director of Advancing New Standards in Reproductive Health, UCSF.
“This study confirms what we already know—people seeking abortion are highly capable of assessing their own eligibility for medication abortion. With an impressive 92.2% sensitivity rate at identifying people ineligible for medication abortion, these findings underscore the safety and reliability of self-screening models,” said Ghazaleh Moayedi, DO, MPH, Founder and President of Pegasus Health Justice Center. “As we work to expand access to medication abortion, we must trust people to make informed decisions about their care and remove unnecessary barriers that stand in their way. Medication abortion is safe and should be available over-the-counter.”
"These findings absolutely reaffirm what I have witnessed throughout my decades as an obstetrician-gynecologist: the patients I care for are fully capable of making informed and autonomous decisions about their lives and this includes accurately self-screening for medication abortion eligibility. The over-medicalization and unnecessary restriction of abortion care is not based in medicine and science but, instead, ideology. Every person should have access to the care they need without barriers, restrictions or stigma,” said Jamila B. Perritt, MD MPH FACOG, President and CEO of Physicians for Reproductive Health. “This research further underscores the safety and effectiveness of medication abortion and highlights the importance of ensuring access to trusted, evidence-based care.
This study, conducted across nine abortion facilities in multiple states, examined the accuracy of self-assessed eligibility for medication abortion. 1,386 participants aged 15 and older, who spoke English or Spanish and were seeking medication or procedural abortion with no prior ultrasound at the facility, completed a self-assessment based on their medical history. Their responses were then compared to clinician assessments using diagnostic accuracy measures, providing critical insights into the accuracy of self-screening for medication abortion.
This study was led by Advancing New Standards in Reproductive Health (ANSIRH) at the University of California, San Francisco in collaboration with Access Reproductive Justice, Advocates for Youth, California Latinas for Reproductive Justice, Emory College of Nursing, Ibis Reproductive Health, International Planned Parenthood Federation, Pegasus Health Justice Center, Physicians for Reproductive Health, Red River Women’s Clinic, Resound Research for Reproductive Health, University of Arizona College of Medicine Phoenix, University of Arizona College of Medicine Tucson, and University of Washington.
For more information or to get in touch with our experts, contact:
Virali Modi-Parekh
Strategic Communications Director
(415) 353-4784
[email protected]