Developing a Forward-looking Agenda and Methodologies for Research of Self-use of Medical Abortion

In December 2016, following the “Africa Regional Conference on Abortion: From Research to Policy,” a group of 20 global abortion researchers, representing nine different international organizations and universities, convened to discuss current and future research on medical abortion self-use (http://abortionresearchtopolicy.org). While recognizing the meaning of “self-use” to be evolving, we considered women's self-use of medical abortion as provision of drugs from pharmacies, drug sellers or through online services or other outlets, without a prescription from a clinician, followed by a woman's self-management of the abortion process, including care-seeking for any complications. Research has not kept abreast of women's self-use of medical abortion, leaving many gaps in the scientific literature regarding the ideal conditions for safe and effective use. Therefore, our main objectives were to assess the research gaps highlighted during the conference, identify specific challenges to conducting research on medical abortion self-use and share promising research methodologies to advance this research. Although there are overlaps with the recommended and well-researched practice of women's self-management of the abortion process at home after receiving medical abortion medicines, screening and information from a clinician [1 ], our intent was focused on the emerging practice of self-use. The challenges laid out in this document — a list of identified research gaps and methodologic considerations in addressing them — are intended to inform both ongoing and future research by the participants in this meeting; in sharing them, we hope to inform and validate not only our future work but also that of other researchers.