In an increasingly restrictive post-Roe reality, more pregnant people will need to rely on telehealth models for medication abortion and self-sourcing pills online. However, as with other expansions in access to reproductive healthcare, there is concern that young people will not be trusted to use these expanded models of care that require self-reporting of pregnancy duration. A new study in JAMA Pediatrics found that young people ages 15-19 are able to accurately self-assess the duration of their pregnancy compared to those in other age groups.
The researchers recruited people aged at least 15 years who sought medication or procedural abortion, spoke English or Spanish, and had no prior ultrasonography at one of seven geographically diverse abortion facilities in the US. Before ultrasonography, they obtained verbal informed consent and surveyed participants on demographic characteristics, reproductive history, and current pregnancy duration including first day of their last missed period (LMP), number of weeks since LMP, date they became pregnant, and number of weeks pregnant. They then compared patients self-assessment of pregnancy duration to that measured on ultrasound.
These findings show that in addition to adults, adolescents can self-assess how far along they are in pregnancy using a history-based screening. The results suggest that adolescents should have access to medication abortion through telehealth and virtual visits, which are becoming increasingly more common and typically do not require an ultrasound.
The researchers conclude:
“Adolescents had comparable accuracy in estimating pregnancy duration using self-administered survey questions vs older counterparts … these findings support expanding access to medication abortion to adolescents using history-based screening models.”
The publication, Accuracy of Self-assessment of Gestational Duration Among Adolescents Seeking Abortion Using Information in Addition to Date of Last Menstrual Period, is available in Jama Pediatrics.