The Green Room: A Podcast from Obstetrics & Gynecology Editors’ Picks for August 2023
Jul 17, 2023
Heidi Moseson, a researcher currently in Bali, joins Dr. Jason Wright and Dr. John Fischer to dive into critical findings on self-managed abortions. Moseson discusses how individuals often navigate these procedures with limited medical support and highlights disparities in access across countries. They also touch on the implications of maternal age on health outcomes, revealing rising rates of severe maternal morbidity. The conversation further examines the importance of HPV screening in transfeminine individuals post-gender-affirming surgeries, raising awareness of potential cancer risks.
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Real-World Self-Managed Abortion Study
- Heidi Moseson described recruiting people who self-managed medication abortion using mifepristone plus misoprostol or misoprostol alone and followed them for about a month.
- The subanalysis focused on 264 people who started at 9–22 weeks gestation from the larger SAFE study of ~1,300 participants.
High Effectiveness Even After 9 Weeks
- The effectiveness of self-managed medication abortion at ≥9 weeks was high, with about 89% completing with pills alone.
- There was a slightly higher proportion of procedural evacuation than earlier gestations but overall effectiveness remained strong.
Care-Seeking Often For Confirmation
- About 23.5% of participants sought medical care, largely for confirmation rather than complications.
- Many pursued ultrasounds mainly to confirm completion, not because of adverse events.