The Lancet Global Health: New study shows self-managed abortion with medication is safe and no less effective than clinician-managed medication abortion in a clinical setting

CAMBRIDGE, Mass., Nov. 18, 2021 /PRNewswire/ --

SAFE Study Highlights:

• Self-managed abortion (SMA) with medications is very safe and effective:
• 93.8% of those who used the mifepristone + misoprostol regimen had a complete abortion without surgical intervention.
• 98.8% of those who used the misoprostol-alone regimen had a complete abortion without surgical intervention.
• SMA with medication is no less effective than clinician-managed medication abortion in a clinical setting, for pregnancies <9 weeks duration.
• No deaths or major adverse events took place among SAFE study participants.

Today, the Studying Accompaniment Model Feasibility and Effectiveness (SAFE) study was published in The Lancet Global Health. Safe abortion advocates at Colectiva Feminista La Revuelta de Neuquén (Argentina), GIWYN (Nigeria), and in Southeast Asia, together with researchers at Ibis Reproductive Health (South Africa and USA), designed and implemented the SAFE study.

The SAFE study, the first study of its kind, recruited over 1,000 people who contacted a safe abortion accompaniment group in Argentina or Nigeria, followed them for approximately one month, and measured outcomes on their self-managed abortion experiences, with abortion completion without surgical intervention as the primary outcome.

Self-managed medication abortion involves the use of one of two medication regimens to end a pregnancy without clinical supervision recommended by the World Health Organization (WHO). The WHO-recommended medication regimens of mifepristone in combination with misoprostol, or misoprostol alone, are established safe and effective methods of terminating pregnancy in clinical settings. A self-managed abortion with accompaniment involves non-clinically trained abortion counselors who provide evidence-based information about the use of medication abortion, as well as compassionate emotional (and sometimes physical support), throughout an individual's self-managed medication abortion process. Abortion accompaniment is provided over the phone, through secure digital messaging platforms, and/or in person.

"There is a misconception that self-managed abortion may somehow be unsafe, or less effective than clinician-managed medication abortion—this is simply untrue. The SAFE study definitively demonstrates that self-managed medication abortion is no less effective than clinician-managed medication abortion using both mifepristone + misoprostol as well as misoprostol alone," said Heidi Moseson, PhD, Senior Research Scientist at Ibis Reproductive Health and lead author of the SAFE study. "The greatest risks today for people self-managing their abortions are legal, such as criminalization and arrest, not medical. These data support the fact that governments, professional bodies, and clinicians should remove legal and procedural barriers to self-managed abortion."

The SAFE study reinforces an existing body of evidence that, with accurate information, people can safely and effectively use medications to terminate a pregnancy outside of a clinical setting. These findings provide evidence for the demedicalization of early abortion care, and support the importance of continued access to remote models for medication abortion—including telemedicine—that have been implemented in several countries as a result of the COVID-19 pandemic. Results from this study also suggest that SMA with support from accompaniment support can be a core strategy for expanding access to safe, effective abortion care.

About Ibis Reproductive Health:

Ibis Reproductive Health is a global nonprofit driving change through bold, rigorous research and principled partnerships that advance sexual and reproductive autonomy, choices, and health worldwide. When research is undertaken in partnership with the communities most impacted, we can effectively use data to catalyze change and shift power. We focus on increasing access to quality abortion care, transforming access to abortion and contraception through technology and service innovations, and expanding comprehensive sexual and reproductive health information and services. Ibis works with partners in more than 30 countries on six continents. 

Colectiva Feminista La Revuelta de Neuquén:

For the past 20 years, activists with La Revuelta have focused on providing information and accompanying people who decide to abort, so that they can do so safely, and with care. La Revuelta is part of a network of more than 60 accompaniment collectives throughout Argentina.

About GIWYN:

Generation Initiative for Women and Youth Network (GIWYN) is a nonprofit based in Lagos, Nigeria. GIWYN is founded on the principle that every woman and youth has the right to the highest standard of living, safe reproductive choices, high quality health care, and an enabling environment that promotes their fundamental human, reproductive and sexual health rights. GIWYN leads grassroots-driven change through the provision of SRHR information, empowerment activities, and advocacy.

SOURCE Ibis Reproductive Health