"On my own time": A qualitative exploration of patient experiences receiving asynchronous medication abortion care in the United States, 2022-2023.

OBJECTIVES

This study aimed to explore patient experience and support needs in receiving asynchronous medication abortion care without a real-time provider visit.

STUDY

DESIGN

We conducted semistructured interviews with individuals who received asynchronous medication abortion care through the Medication Abortion-Autonomous Self-Assessment Project study from May 2022 through February 2023. We asked participants about their decision-making, needs, and experiences with this method of medication abortion. We transcribed, coded, and analyzed the interviews. We identified major themes related to patient experience with asynchronous medication abortion care and synthesized suggestions for improving this care modality.

RESULTS

We interviewed 18 individuals from August to October 2023 who received an asynchronous medication abortion through the Medication Abortion-Autonomous Self-Assessment Project study in either Minnesota or Colorado. Asynchronous medication abortion care offered patients psychosocial control, flexibility and convenience, autonomy, privacy, and the ability to avoid unnecessary medical contact. The majority of participants stated they would use this method again if needed and would recommend it to a friend. Participants found asynchronous medication abortion care to be acceptable, and many provided suggestions on how to improve this service, including offering synchronous contacts with providers in case of emergency, an optional synchronous follow-up contact, and more support for and information around the medication abortion experience generally.

CONCLUSIONS

Asynchronous medication abortion care was a highly acceptable alternative to real-time and in-person medication abortion care and allowed participants to avoid unnecessary contact with clinical providers. Participants expressed the need for more patient education about medication abortion and optional follow-up with clinical providers.

IMPLICATIONS: Asynchronous medication abortion care can lower barriers to abortion access for patients while increasing clinic and provider capacity for in-person care. Expansion of asynchronous medication abortion care services, especially in shield law states, and adequate insurance coverage for asynchronous care services can facilitate access to timely care.