{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T07:13:59Z","timestamp":1761808439528,"version":"3.40.5"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T00:00:00Z","timestamp":1616025600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100006393","name":"Universidad de Granada","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006393","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Unsafe abortion is the cause of a substantial number of maternal mortalities and morbidities globally, but specifically in low\u2010 and middle\u2010income countries. Medical abortion methods provided by non\u2010physicians may be a way to reduce the burden of unsafe abortions. Currently, only one systematic review comparing non\u2010physicians with physicians for medical abortion exists. However, the review does not have any setting restrictions and newer evidence has since been published. Therefore, this review aims to evaluate the effectiveness, acceptability, and safety of first\u2010trimester abortion managed by non\u2010physicians compared with physicians in low\u2010 and middle\u2010income countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Material and methods<\/jats:title><jats:p>The databases PubMed, Cochrane Library, Global Health Library, and EMBASE were searched using a structured search strategy. Further, the trial registries clinicaltrials.gov and The International Clinical Trial Registry Platform were searched for published and unpublished trials. Randomized controlled trials comparing provision of medical abortion by non\u2010physicians with that by physicians in low\u2010 or middle\u2010income countries were included. Risk of bias was assessed using the Cochrane Risk of Bias tool. Trials that reported effect estimates on the effectiveness of medical methods on complete abortion were included in the meta\u2010analysis. The protocol was prospectively registered in the PROSPERO database, ID: CRD42020176811.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Six papers from four different randomized controlled trials with a total of 4021 participants were included. Two of the four included trials were assessed to have overall low risk of bias. Four papers had outcome data on complete abortion and were included in the meta\u2010analyses. Medical management of first\u2010trimester abortion and medical treatment of incomplete abortion were found to be equally effective when provided by a non\u2010physician as when provided by a physician (risk ratio 1.00; 95% CI 0.99\u20101.01). Further, the treatment was equally safe, and women were equally satisfied when a non\u2010physician provided the treatment compared with a physician.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Provision of medical abortion or medical treatment for incomplete abortion in the first trimester is equally effective, safe, and acceptable when provided by non\u2010physicians compared with physicians in low\u2010 and middle\u2010income countries. We recommend that the task of providing medical abortion and medical treatment for incomplete abortion in low\u2010 and middle\u2010income countries should be shared with non\u2010physicians.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.14134","type":"journal-article","created":{"date-parts":[[2021,3,16]],"date-time":"2021-03-16T20:16:00Z","timestamp":1615925760000},"page":"718-726","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Medical management of induced and incomplete first\u2010trimester abortion by non\u2010physicians in low\u2010 and middle\u2010income countries: A systematic review and meta\u2010analysis of randomized controlled trials"],"prefix":"10.1111","volume":"100","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0226-2883","authenticated-orcid":false,"given":"Marianne Bogen","family":"Kristiansen","sequence":"first","affiliation":[{"name":"University of Southern Denmark Odense 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