{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T12:46:08Z","timestamp":1790513168109,"version":"4.1.0"},"reference-count":24,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,2,4]],"date-time":"2021-02-04T00:00:00Z","timestamp":1612396800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000265","name":"Medical Research Council","doi-asserted-by":"publisher","award":["MR\/N022556\/1"],"award-info":[{"award-number":["MR\/N022556\/1"]}],"id":[{"id":"10.13039\/501100000265","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Edinburgh Family Planning Trust"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2021,1,5]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In response to the COVID-19 pandemic, legislation and guidance were introduced in Scotland permitting medical abortion at home by telemedicine for pregnancies at less than 12 weeks\u2019 gestation. Women had a telephone consultation with a clinician. Routine ultrasound was not performed. Medications and a low-sensitivity pregnancy test to confirm success of treatment were collected by or delivered to the woman, with telephone support provided as needed.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A prospective cohort study of 663 women choosing medical abortion at home via the NHS Lothian telemedicine abortion service between 1 April and 9 July 2020. Interviewer-administered questionnaires were completed 4 and 14 days following treatment. Regional hospital databases were reviewed to verify abortion outcomes and complications within 6\u2009weeks. Outcome measures included efficacy, complications and acceptability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Almost all (642\/663, 98.2%) the women were under 10 weeks\u2019 gestation. For 522\/663 (78.7%) women, gestation was determined using last menstrual period alone. Some 650\/663 (98%) women had a complete abortion, 5 (0.8%) an ongoing pregnancy and 4 (0.6%) an incomplete abortion. No one was treated inadvertently beyond 12 weeks\u2019 gestation, but one woman was never pregnant. One woman who had a pre-abortion ultrasound was later managed as a caesarean scar ectopic. There were two cases of haemorrhage and no severe infections. Some 123 (18.5%) women sought advice by telephone for a concern related to the abortion and 56 (8.4%) then attended a clinic for review. Most (628, 95%) women rated their care as very or somewhat acceptable.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This model of telemedicine abortion without routine ultrasound is safe, and has high efficacy and high acceptability among women.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2020-200976","type":"journal-article","created":{"date-parts":[[2021,2,5]],"date-time":"2021-02-05T04:08:42Z","timestamp":1612498122000},"page":"246-251","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":85,"title":["Telemedicine medical abortion at home under 12 weeks\u2019 gestation: a prospective observational cohort study during the COVID-19 pandemic"],"prefix":"10.1136","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6597-1666","authenticated-orcid":false,"given":"John Joseph","family":"Reynolds-Wright","sequence":"first","affiliation":[{"name":"Queen's Medical Research Institute, University of Edinburgh MRC Centre for Reproductive Health, Edinburgh, UK"},{"name":"NHS Lothian, Chalmers Centre, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Johnstone","sequence":"additional","affiliation":[{"name":"Queen's Medical Research Institute, University of Edinburgh MRC Centre for Reproductive Health, Edinburgh, UK"},{"name":"NHS Lothian, Chalmers Centre, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"McCabe","sequence":"additional","affiliation":[{"name":"Queen's Medical Research Institute, University of Edinburgh MRC Centre for Reproductive Health, Edinburgh, UK"},{"name":"NHS Lothian, Chalmers Centre, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Evans","sequence":"additional","affiliation":[{"name":"Edinburgh Clinical Research Facility, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1168-2276","authenticated-orcid":false,"given":"Sharon","family":"Cameron","sequence":"additional","affiliation":[{"name":"Queen's Medical Research Institute, University of Edinburgh MRC Centre for Reproductive Health, Edinburgh, UK"},{"name":"NHS Lothian, Chalmers Centre, Edinburgh, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,2,4]]},"reference":[{"key":"2025090510062319000_47.4.246.1","unstructured":"Royal College of Obstetricians and Gynaecologists . The care of women requesting induced abortion (Evidence-based clinical guideline number 7), 2011. Available: https:\/\/www.rcog.org.uk\/globalassets\/documents\/guidelines\/abortion-guideline_web_1.pdf [Accessed 4 Jun 2020]."},{"key":"2025090510062319000_47.4.246.2","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1136\/bmjsrh-2019-200568","article-title":"Women's experiences of self-referral to an abortion service: qualitative study","volume":"47","author":"Low","year":"2021","journal-title":"BMJ Sex Reprod Health"},{"key":"2025090510062319000_47.4.246.3","unstructured":"National Institute for Health and Care Excellence (NICE) . Abortion care (NG140), 2019. Available: https:\/\/www.nice.org.uk\/guidance\/NG140 [Accessed 4 Jun 2020]."},{"key":"2025090510062319000_47.4.246.4","unstructured":"Chief Medical Officer for Scotland . Abortion \u2013 Covid-19 \u2013 approval for mifepristone to be taken at home and other contingency measures, 2020. Available: https:\/\/www.sehd.scot.nhs.uk\/cmo\/CMO%282020%2909.pdf"},{"key":"2025090510062319000_47.4.246.5","unstructured":"Royal College of Obstetricians and Gynaecologists . Coronavirus (COVID-19) infection and abortion care, 2020. Available: https:\/\/www.rcog.org.uk\/en\/guidelines-research-services\/guidelines\/coronavirus-abortion\/ [Accessed 30 Dec 2020]."},{"key":"2025090510062319000_47.4.246.6","unstructured":"Public Health Scotland . Termination of pregnancy statistics year ending 2019, 2020. Available: https:\/\/beta.isdscotland.org\/find-publications-and-data\/population-health\/sexual-health\/termination-of-pregnancy-statistics\/ [Accessed 4 Jun 2020]."},{"key":"2025090510062319000_47.4.246.7","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.15684"},{"key":"2025090510062319000_47.4.246.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1471-0528.2008.01787.x"},{"key":"2025090510062319000_47.4.246.9","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2011"},{"key":"2025090510062319000_47.4.246.10","doi-asserted-by":"publisher","DOI":"10.1097\/AOG.0000000000002212"},{"key":"2025090510062319000_47.4.246.11","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1111\/ajo.12800","article-title":"A direct-to-patient telemedicine abortion service in Australia: retrospective analysis of the first 18 months","volume":"58","author":"Hyland","year":"2018","journal-title":"Aust N Z J Obstet Gynaecol"},{"key":"2025090510062319000_47.4.246.12","doi-asserted-by":"crossref","first-page":"1611","DOI":"10.1111\/aogs.13944","article-title":"Information on early medical abortion for women using an audiovisual animation vs face\u2010to\u2010face consultation: a consortium randomized and quasi\u2010randomized trial","volume":"99","author":"Reynolds\u2010Wright","year":"2020","journal-title":"Acta Obstet Gynecol Scand"},{"key":"2025090510062319000_47.4.246.13","unstructured":"Faculty of Sexual & Reproductive Healthcare (FSRH) . Advice for women seeking contraception, abortion and other sexual and reproductive healthcare during the COVID-19 epidemic, 2020. Available: https:\/\/www.fsrh.org\/how-to-access-contraception-coronavirus\/ [Accessed 30 Dec 2020]."},{"key":"2025090510062319000_47.4.246.14","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2018-200278"},{"key":"2025090510062319000_47.4.246.15","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2017-101868"},{"key":"2025090510062319000_47.4.246.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2016.04.013"},{"key":"2025090510062319000_47.4.246.17","doi-asserted-by":"publisher","DOI":"10.1016\/j.contraception.2014.09.009"},{"key":"2025090510062319000_47.4.246.18","article-title":"Utility of a routine ultrasound for detection of ectopic pregnancies among women requesting abortion: a retrospective review","author":"Duncan","year":"2020","journal-title":"BMJ Sex Reprod Health"},{"key":"2025090510062319000_47.4.246.19","doi-asserted-by":"publisher","DOI":"10.1111\/1471-0528.12982"},{"key":"2025090510062319000_47.4.246.20","unstructured":"World Health Organization (WHO) . Expanding health worker roles for safe abortion in the first trimester of pregnancy. Available: https:\/\/www.who.int\/reproductivehealth\/publications\/unsafe_abortion\/health-worker-roles-safe-abortion-1st-trimester-summary\/en\/ [Accessed 30 Dec 2020]."},{"key":"2025090510062319000_47.4.246.21","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1016\/j.contraception.2017.11.005","article-title":"Simplified medical abortion screening: a demonstration project","volume":"97","author":"Raymond","year":"2018","journal-title":"Contraception"},{"key":"2025090510062319000_47.4.246.22","unstructured":"Faculty of Sexual & Reproductive Healthcare (FSRH) . Contraception after pregnancy, 2017. Available: https:\/\/www.fsrh.org\/standards-and-guidance\/documents\/contraception-after-pregnancy-executive-summary-document\/ [Accessed 4 Jun 2020]."},{"key":"2025090510062319000_47.4.246.23","doi-asserted-by":"publisher","DOI":"10.1136\/jfprhc-2011-100166"},{"key":"2025090510062319000_47.4.246.24","unstructured":"Scottish Government . Scottish Index of Multiple Deprivation (SIMD), 2020. Available: www.simd.scot [Accessed 30 Dec 2020]."}],"container-title":["BMJ Sexual &amp; Reproductive Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjsrh-2020-200976","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T17:07:39Z","timestamp":1757092059000},"score":1,"resource":{"primary":{"URL":"https:\/\/jfprhc.bmj.com\/lookup\/doi\/10.1136\/bmjsrh-2020-200976"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,2,4]]},"references-count":24,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2021,10,12]]},"published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1136\/bmjsrh-2020-200976"],"URL":"https:\/\/doi.org\/10.1136\/bmjsrh-2020-200976","relation":{},"ISSN":["2515-1991","2515-2009"],"issn-type":[{"value":"2515-1991","type":"print"},{"value":"2515-2009","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,2,4]]}}}