{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T16:58:45Z","timestamp":1775667525250,"version":"3.50.1"},"reference-count":25,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2019,7,21]]},"published-print":{"date-parts":[[2019,10]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>In October 2017, Scotland legalised the home use of misoprostol for the purpose of early medical abortion (EMA). Women up to 9+6 weeks\u2019 gestation can now self-administer the drug at home, 24\u201348\u2009hours after receiving mifepristone in the clinic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To evaluate the impact of this change on the uptake and success rate of EMA, and on the provision of effective contraception on discharge.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A prospective observational study was conducted to compare the outcomes of two cohorts of women in the 6 months before and 6 months after the introduction of home administration of misoprostol. The main outcome measures were uptake of EMA, success of EMA and provision of long-acting reversible contraception (LARC) to women undergoing EMA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There was a statistically significant increase in the uptake of EMA from 698\/1075 (64.9%) women in the first study period to 823\/1146 (71.8%) in the second study period. There was no statistically significant difference in the success rate of EMA: 99.3% and 98.9% in clinic and home misoprostol cohorts, respectively. There was also no statistically significant difference in the proportion of women provided with LARC: 37.7% and 33.7% in clinic and home misoprostol cohorts, respectively.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Self-administration of misoprostol at home increased uptake of EMA, with no effect on the high success rate that was previously seen with clinic administration of misoprostol. In addition, the reduced number of visits associated with home use of misoprostol has not affected the provision of effective contraception to women.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2018-200278","type":"journal-article","created":{"date-parts":[[2019,8,17]],"date-time":"2019-08-17T17:25:18Z","timestamp":1566062718000},"page":"296-301","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":15,"title":["Impact of self-administration of misoprostol for early medical abortion: a prospective observational cohort study"],"prefix":"10.1136","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0044-5635","authenticated-orcid":false,"given":"Rebecca Elizabeth","family":"Finch","sequence":"first","affiliation":[{"name":"University of Edinburgh, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kevin","family":"McGeechan","sequence":"additional","affiliation":[{"name":"School of Public Health, Faculty of Medicine, The University of Sydney, Sydney, New South Wales, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Johnstone","sequence":"additional","affiliation":[{"name":"Dean Terrace Centre, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Cameron","sequence":"additional","affiliation":[{"name":"Department of Sexual and Reproductive Health, NHS Lothian, Edinburgh, UK"},{"name":"University of Edinburgh Division of Health Sciences, Edinburgh, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,8,17]]},"reference":[{"key":"2025090512065968000_45.4.296.1","unstructured":"Information Services Division (ISD) Scotland, NHS National Services Scotland . Termination of pregnancy statistics: year ending, 2017. Available: http:\/\/www.isdscotland.org\/Health-Topics\/Sexual- Health\/Abortions\/ [Accessed 29 October 2018]."},{"key":"2025090512065968000_45.4.296.2","unstructured":"Department of Health . Abortion statistics, England and Wales, 2017. Available: https:\/\/www.gov.uk\/government\/statistics\/abortion-statistics-for-england-and-wales-2017 [Accessed 29 Oct 2018]."},{"key":"2025090512065968000_45.4.296.3","unstructured":"Socialstyrelsen. Statistik om aborter , 2017. Available: https:\/\/www.socialstyrelsen.se\/publikationer2018\/2018- 5-17\/Sidor\/default.aspx [Accessed 26 Oct 2018]."},{"key":"2025090512065968000_45.4.296.4","unstructured":"Guttmacher Institute . Induced abortion in the United States, 2018. Available: https:\/\/www.guttmacher.org\/fact-sheet\/induced-abortion-united-states [Accessed 26 Oct 2018]."},{"key":"2025090512065968000_45.4.296.5","unstructured":"Royal College of Obstetricians and Gynaecologists . 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Chief Medical Officer Directorate. Abortion - Improvement to existing services - Approval for Misoprostol to be taken at home. Available: https:\/\/www.sehd.scot.nhs.uk\/cmo\/CMO(2017)14.pdf [Accessed 21 Nov 2018]."},{"key":"2025090512065968000_45.4.296.11","doi-asserted-by":"publisher","DOI":"10.1046\/j.1471-0528.2002.02156.x"},{"key":"2025090512065968000_45.4.296.12","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2004.06.005"},{"key":"2025090512065968000_45.4.296.13","doi-asserted-by":"publisher","DOI":"10.1080\/13625180500284581"},{"key":"2025090512065968000_45.4.296.14","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deq037"},{"key":"2025090512065968000_45.4.296.15","unstructured":"World Health Organisation . Safe abortion: technical and policy guidance for health systems. 2nd ed. Geneva, Switzerland: World Health Organisation, 2012."},{"key":"2025090512065968000_45.4.296.16","unstructured":"Scottish Courts and Tribunals. SPUC-v-Scottish Ministers , 2018. 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