Objectives: This study investigates using mobile text systems to support women through medical abortion, for self-assessment of abortion completion, and to reinforce family planning messages. This initiative will assess whether mobile phones can be used to reduce the requirement for follow-up visits as is the current standard of care. Materials: This RCT will recruit 460 women seeking medical abortion in the Western Cape, South Africa. Methods: All women receive standard abortion care with mifepristone and home administration of misoprostol and return to the clinic to assess completion. Consenting women are randomised to “standard of care” (SOC) or “SOC plus mobile” intervention study arm. The intervention group are SMSd over 3 weeks coaching them through the abortion process. They are encouraged to selfassess abortion completion through a questionnaire via their mobile phone. Lastly they are given access to comprehensive family planning information via their phones. Interviews are conducted at both clinic visits and at 1 month post abortion. Comparisons are tested using Chi2 or Fisher exact tests for proportions and T-tests for continuous variables. Significance is tested at the 0.05 level. Results: Early results for 131 women showed no significant differences between study arms at baseline for age, education, gestational age, socioeconomic status and anxiety or depression. At exit, intervention women had experienced less stress associated with their abortion (P = 0.042) and were better prepared for the bleeding they experienced (P = 0.001). All recommended the SMSs as a support method for women undergoing same-stage abortion. 85% of intervention women tried the self-assessment and of these, 78% reached an endpoint. Pilot results at 1 month post abortion showed 88% of women were using family planning - in most cases DMPA although the IUD was a method of choice in some younger women. Conclusions: Support SMSs are effective for women undergoing abortion. Final results will assess the feasibility of reducing the need for the follow-up visit when safe to do so according to selfassessment of completion. Where this is the case, uptake of postabortion family planning needs to be promoted and self-efficacy encouraged with respect to continuation of effective usage.
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