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No-test medication abortion screening criteria may disproportionately exclude some marginalized groups from telehealth abortion care

New research reveals disparities in the populations who would screen eligible for medication abortion when applying no-test screening criteria, in particular young people and people experiencing food and housing insecurity.

Findings: Self-Managed Abortions and Medical Mistrust and Mistreatment

Out of 1,386 eligible individuals who consented and had complete clinician data, 21.1% (306/1,386) were ineligible with testing, 71.5% (n=991/1,386) were ineligible using no-test criteria and 51.4% (n=713/1,386) screened ineligible using no-test criteria yet eligible with testing, also known as false positives.
Ineligibility using no-test criteria was significantly greater among people ages 15-19 and experiencing food or housing insecurity.
Moderate/severe pelvic pain was the most common (614/1,386) patient-reported reason for ineligibility and reported significantly more by people ages 15-19, who were nulliparous and experienced food or housing insecurity.

Implications: How Does No-Test Medication Abortion Impact Accessibility?

This study considers how no-test medication abortion screening criteria may inadvertently exclude patients who might be eligible for medication abortion. The findings emphasize that conservative no-test screening approaches limit patient access to abortion care, potentially exacerbating inequities.  Future questions are left to be explored, including further examination of no-test screening criteria to ensure that people eligible for medication abortion are able to safely access needed care. This may help researchers better understand why certain groups are more likely to be found ineligible and would ensure that all patients have access to safe and effective reproductive health options.

“Ensuring equitable access to abortion care requires that all people have access to a range of safe and effective options, including no-test and in-person abortion care in order to best meet people’s healthcare needs.”

The article, No-Test Screening Protocols May Disproportionately Exclude Structurally Oppressed Communities Who Could Benefit from Accessing Medication Abortion, is available in Health Equity.

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