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Objectives
To examine the acceptability of self-managed medication abortion using misoprostol-alone
acquired from an online or local pharmacy in the US.
Methods
Between November and December 2021, we conducted 32 semi-structured in-depth interviews
with individuals who used misoprostol-alone to self-manage an abortion in June 2020.
We recruited participants from Aid Access, an online telemedicine organization that
provided self-managed abortion assistance and prescriptions for misoprostol from a
local or online pharmacy for eligible people in all 50 states. Interviews were transcribed
and thematically coded to assess individual satisfaction with acquiring and using
misoprostol.
Results
Participants were initially hesitant to trust Aid Access, but having a pharmacy prescription
sent by a physician legitimized the service. From internet searches and previous abortion
experiences, participants had extensive knowledge of misoprostol's efficacy and utility.
Participants who used the in-person pharmacy pick-up model had both confidence in
the familiarity of the process and concerns about intrusive questioning from the pharmacist.
Although rare, some did experience pharmacist pushback or refusal. Participants who
used the online pharmacy model were concerned about shipping times but had positive
and informative interactions with the pharmacists. Across both models, participants
desired more extensive options for emotional support.
Conclusions
Participants had high levels of knowledge about misoprostol and familiarity with the
pharmacy as a healthcare institution. Despite some unmet emotional needs and negative
encounters with pharmacists, overall, this process was acceptable to participants
and has the potential to expand medication abortion access in the restrictive policy
landscape of the US.
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Copyright
© 2022 Published by Elsevier Inc.
