Study: Experiences with medication abortion differed before and during the COVID-19 pandemic

While the COVID-19 pandemic impacted access to contraceptives, little is known about the specific amount of influence the pandemic had, especially on medication abortion access.

To better assess what exact impact the pandemic had on medication abortion, researchers from the Keck School of Medicine of the University of Southern California used Reddit to observe self-reported experiences and questions about medication abortion before and during the pandemic. Their data was presented as an abstract at the 2022 American College of Obstetricians & Gynecologists' Annual Clinical & Scientific Meeting held in San Diego, California from May 6-8.¹

Using keywords (eg, “abortion pill,” “misoprostol”), researchers discovered posts about medication abortion in 7 subreddits (eg, r/Askwomen, r/abortion). The searches were divided into 2 time periods: pre-pandemic (September-November 2019) and during pandemic (April-June 2020). Searches were also filtered for questions about or experiences with medication abortion.

Posts were examined via inductive and iterative coding to differentiate salient themes. Additionally, the prevalence of themes was assessed during and before the pandemic using chi-square tests, and researchers obtained institutional review board approval.

Results of the study demonstrated a 134% increase in medication abortion-related posts during the pandemic (70 posts prior vs 164 posts during). Six common themes were identified including sharing anxieties (34%), geographic barriers (22%), privacy/secrecy surrounding abortion (21%), post-abortion relief (19%), concerns about pain/bleeding (18%), and medication seeking (12%).

Also, during the pandemic, 54 (24%) posts mentioned COVID-19 as an obstacle and more posts voiced concerns regarding efficacy during vs prior to COVID-19 (17% vs 3%, P =.05).

The authors did note they did not detect a statistically significant change in stating self-managed abortion (23% vs 27%), teleabortion (9% vs 16%), or clinic abortion (46% vs.32%) in posts before vs during the COVID-19 pandemic. Nine posts (7%) specified interest in medication abortion above 11 weeks.

“Individuals share abortion experiences and seek support and advice on Reddit,” the authors concluded. “Nearly a quarter of posts reported COVID-19 being a barrier to abortion access. However, concerns about abortion access, emotions surrounding abortion, and advice-seeking were prevalent across time periods.”

Reference

1. Reissner H, Ponzio MR, Nagatani-Short L, Hurtado A, Nguyen B. Medication abortion experiences before and during the COVID-19 pandemic: A content analysis of online Reddit posts [A19]. Presented at: 2022 American College of Obstetrics and Gynecology Annual Clinical & Scientific Meeting; May 6 to May 8, 2022.