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Self-managed medication abortion in South Korea: A retrospective records review of the uptake of medication abortion through online telemedicine prior to decriminalization

      Abstract

      Objectives

      To examine the uptake of medication abortion through online telemedicine in South Korea prior to decriminalization of abortion beginning in 2019.

      Study design

      We conducted a descriptive cross-sectional analysis of medication abortion consultations submitted to Women on Web, an online telemedicine service, from South Korea between 2013 and 2019.

      Results

      The uptake of medication abortion through Women on Web increased every year between 2013 and 2019, adding up to 12,115 consultations across 7 years. The median age was 25 and the median gestational age was 37 days. Individuals reported financial constraints (66.2%) as the most common reason for wanting an abortion. This was followed by not wanting a child at this point (64.7%) and wanting to finish school (34.6%).

      Conclusions

      This study illustrates the uptake of medication abortions via Women on Web between 2013 and 2019, prior to decriminalization of abortion in South Korea.

      Implications

      This study attests to the use of online telemedicine for medication abortion, despite the legal restrictions prior to decriminalization of abortion in South Korea.

      Keywords

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      References

      1. Criminal Act. Global abortion policies database. https://abortion-policies.srhr.org/documents/countries/01-Republic-of-Korea-Criminal-Act.pdf (accessed December 22, 2021).

      2. Mother and Child Act. Global abortion policies database. https://abortion-policies.srhr.org/documents/countries/02-Republic-of-South-Korea-Mother-and-Child-Health-Act.pdf (accessed December 22, 2021).

      3. The Constitutional Court of Korea. Case on the crimes of abortion. Global Abortion Policies Database. https://abortion-policies.srhr.org/documents/countries/06-Republic-of-Korea-Constitutional-Court-Decision-2019.pdf (accessed December 22, 2021).

        • Eun-ji B.
        Historic ruling sparks debate over abortion pills.
        Korea Times, 2019 (accessed December 20, 2021)
        • Hyo-jin L.
        ‘Abortion consultation’ included in health insurance.
        Korea Times, 2021 (accessed December 20, 2021)
        • Arin K.
        Not illegal, but not legal: the murky landscape of abortion in South Korea.
        The Korea Herald, 2022 (accessed September 26, 2022)
        • Woo-hyun S
        Hyundai pharm seeks approval for abortion pill.
        The Korea Herald, 2021 (accessed December 22, 2021)
        • World Health Organization
        Unsafe abortion: the preventable pandemic.
        Lancet. 2006; 4 (Accessed on December 20, 2021)
        • Bernabé-Ortiz A
        • White PJ
        • Carcamo CP
        • Hughes JP
        • Gonzales MA
        • Garcia PJ
        • et al.
        Clandestine induced abortion: prevalence, incidence and risk factors among women in a Latin American country.
        CMAJ. 2009; 180 ([published correction appears in CMAJ. 2009 Mar 3;180:5:541]): 298-304https://doi.org/10.1503/cmaj.071399
        • Ahn H.S.
        • Seol H.J.
        • Lim J.E.
        • Hong S.H.
        • Lee S.Y.
        • Park M.I.
        • et al.
        Estimates of induced abortion in South Korea: health facilities survey.
        J Obstet Gynaecol Res. 2012; 38: 324-328https://doi.org/10.1111/j.1447-0756.2011.01701.x
      4. Korea Institute for Health and Social Affairs. Survey on induced abortion. https://www.korea.kr/archive/expDocView.do?docId=38663; 2018 (accessed December 22, 2021).

        • Jiyeon L.
        Illegal abortion, South Korea's open secret.
        Reuters, 2008 (accessed December 22, 2021)
        • Jae-Woo I
        South Korean women look to Dutch non-profit for terminating unwanted pregnancies.
        Hankyoreh, 2018 (accessed December 22, 2021)
        • Pizzarossa LB
        • Nandagiri R.
        Self-managed abortion: a constellation of actors, a cacophony of laws?.
        Sex Reprod Health Matters. 2021; 29: 1https://doi.org/10.1080/26410397.2021.1899764
        • Assis MP
        • Erdman JN.
        Abortion rights beyond the medico-legal paradigm.
        Glob Public Health. 2021; https://doi.org/10.1080/17441692.2021.1971278
        • Endler M
        • Lavelanet AF
        • Cleeve A
        • Ganatra B
        • Gomperts R
        • Gemzell-Danielsson K.
        Telemedicine for medication abortion: a systematic review.
        BJOG. 2019; 126: 1094-1102https://doi.org/10.1111/1471-0528.15684
        • Porter Erlank C
        • Lord J
        • Church K.
        Acceptability of no-test medication abortion provided via telemedicine during Covid-19: analysis of patient-reported outcomes.
        BMJ Sex Reprod Health. 2021; 47: 261-268https://doi.org/10.1136/bmjsrh-2020-200954
        • Kohn JE
        • Snow JL
        • Grossman D
        • Thompson TA
        • Seymour JW
        • Simons HR.
        Introduction of telemedicine for medication abortion: changes in service delivery patterns in two U.S. states.
        Contraception. 2021; 103: 151-156https://doi.org/10.1016/j.contraception.2020.12.005
        • Gomperts RJ
        • van der Vleuten K
        • Jelinska K
        • da Costa CV
        • Gemzell-Danielsson K
        • Kleiverda G.
        Provision of medication abortion using telemedicine in Brazil.
        Contraception. 2014; 89: 129-133https://doi.org/10.1016/j.contraception.2013.11.005
      5. Women on Web. Press release: Women on Web telemedicine abortion service turns 15, https://www.womenonweb.org/en/page/20954/press-release-women-on-web-telemedicine-abortion-service-turns-15; 2020 (accessed September 26, 2022).

      6. Women on Web. Who we are? https://www.womenonweb.org/en/page/521/who-we-are (accessed September 26, 2022).

      7. Women on Web. I need an abortion, https://www.womenonweb.org/en/i-need-an-abortion (accessed September 26, 2022).

      8. Ministerio de Sanidad. Datos Estadísticos, https://www.sanidad.gob.es/profesionales/saludPublica/prevPromocion/embarazo/tablas_figuras.htm#Tabla%202 (accessed November 21, 2022).

      9. Ined. Avortements, https://www.ined.fr/fr/tout-savoir-population/chiffres/france/avortements-contraception/avortements/ (accessed November 21, 2022).

        • Kim D.
        Study on the measures for strengthening the efficacy for safe abortion.
        Sexual and reproductive health and rights forum. Korea Women's Development Institute, 2021 (accessed December 22, 2021)
      10. National Institute for Health and Care Excellence (NICE). Abortion care, NG140. https://www.nice.org.uk/guidance/ng140; 2019 (Accessed December 22, 2021).

      11. World Health Organization. WHO recommendations on self-care interventions: self-management of medication abortion. https://apps.who.int/iris/bitstream/handle/10665/332334/WHO-SRH-20.11-eng.pdf?ua=1; 2020 (accessed April 12, 2021).

      12. World Health Organization. Abortion care guideline 2022. https://srhr.org/abortioncare/; 2022 (accessed September 26, 2022).

      13. Women on Web. Google core update: impact on women on web and abortion access, https://www.womenonweb.org/en/page/20103/google-core-update-impact-on-women-on-web-and-abortion-access (accessed September 27, 2022).