Reynolds-Wright John Joseph, Cameron Sharon T
Centre for Reproductive Health, Institute for Regeneration and Repair, The University of Edinburgh, Edinburgh, UK
Chalmers Centre for Sexual and Reproductive Health, NHS Lothian, Edinburgh, UK.
BMJ Sex Reprod Health. 2025 Jan 6;51(1):51-53. doi: 10.1136/bmjsrh-2024-202391.
Most abortions in Scotland are conducted at home before 12 weeks' gestation using telemedicine. The volume of information given at a pre-abortion consultation may feel overwhelming and contraception may not be prioritised. Telemedicine limits immediate provision of some methods. Pathways to improve access to post-abortion contraception (PAC) are needed.
We piloted a PAC 'text-and-call' service for patients having telemedicine abortion in Edinburgh. Those agreeing to contact were sent a text message 4-6 weeks later. The message offered a follow-up telephone call with a nurse to discuss contraception. An online decision aid was used to support method selection where needed. Rapid access to the chosen method was arranged.
During the period February-April 2022, 672 patients accessed abortion care, of whom 427 (64%) agreed to post-abortion text message contact. Most (354/427, 83%) did not respond or declined further contact, and 73/427 (17%) requested a follow-up call.Two participants did not respond to the follow-up call. Most (63/73, 86%) knew what method they wanted prior to the call. Just over half of these patients (34/73, 54%) changed to a higher-effectiveness method than they were currently using and the remainder obtained further supplies of their existing method. Eight participants had not selected a method prior to the call and received structured counselling; five chose long-acting reversible contraception (LARC) but only one subsequently initiated this.
This PAC service was taken up by a small proportion of patients but supported a sizeable minority to connect to further contraceptive supplies, half of whom accessed more effective methods.
在苏格兰，大多数堕胎手术是在妊娠12周前通过远程医疗在家中进行的。堕胎前咨询时提供的信息量可能会让人应接不暇，避孕措施可能未被列为优先事项。远程医疗限制了某些避孕方法的即时提供。因此需要改善堕胎后避孕（PAC）服务获取途径。
我们在爱丁堡为接受远程医疗堕胎的患者试点了一项PAC“短信和电话”服务。同意联系的患者在4 - 6周后会收到一条短信。该短信提供与护士进行后续电话沟通以讨论避孕措施的机会。必要时使用在线决策辅助工具来支持避孕方法的选择。并安排快速获取所选避孕方法。
在2022年2月至4月期间，672名患者接受了堕胎护理，其中427名（64%）同意接受堕胎后短信联系。大多数（354/427，83%）没有回复或拒绝进一步联系，73/427（17%）要求进行后续电话沟通。两名参与者未回复后续电话。大多数（63/73，86%）在电话沟通前就知道自己想要的避孕方法。这些患者中略超过一半（34/73，54%）更换为比他们当前使用的更有效的避孕方法，其余患者则获得了其现有避孕方法的更多供应。八名参与者在电话沟通前未选择避孕方法，接受了结构化咨询；五人选择了长效可逆避孕法（LARC），但只有一人随后开始使用。
这项PAC服务只有一小部分患者使用，但为相当一部分少数群体提供了支持，使他们能够获得更多的避孕用品，其中一半人采用了更有效的避孕方法。
