{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T15:26:26Z","timestamp":1767108386670,"version":"3.44.0"},"reference-count":23,"publisher":"BMJ","issue":"4","license":[{"start":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T00:00:00Z","timestamp":1635120000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/bmj.com\/coronavirus\/usage"}],"funder":[{"DOI":"10.13039\/501100004359","name":"Swedish Research Council","doi-asserted-by":"crossref","award":["2017-00932"],"award-info":[{"award-number":["2017-00932"]}],"id":[{"id":"10.13039\/501100004359","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004047","name":"Karolinska Institutet","doi-asserted-by":"publisher","award":["non-applicable"],"award-info":[{"award-number":["non-applicable"]}],"id":[{"id":"10.13039\/501100004047","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Region Stockholm","award":["combined residency and PhD training programme"],"award-info":[{"award-number":["combined residency and PhD training programme"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Sex Reprod Health"],"accepted":{"date-parts":[[2021,10,6]]},"published-print":{"date-parts":[[2022,10]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Induced abortion is legal in Italy but with restrictions. The online abortion provider Women on Web (WoW) serves as an alternative way to access abortion. The COVID-19 pandemic has affected sexual and reproductive health worldwide. Italy was one of the first countries hit by the pandemic and imposed strict lockdown measures. We aimed to understand why women requested WoW abortion in Italy and how this was affected by the pandemic.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We conducted an observational study analysing requests made to WoW before and during the pandemic. We analysed 778 requests for medical abortion from Italy between 1 March 2019 to 30 November 2020 and compared the characteristics of requests submitted before and during the pandemic. We also performed subgroup analysis on teenagers and COVID-19-specific requests.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There was an increase in requests during the COVID-19 pandemic compared with the previous year (12% in the first 9 months). The most common reasons for requesting a telemedicine abortion through WoW were privacy-related (40.9%); however, this shifted to COVID-19-specific (50.3%) reasons during the pandemic. Requests from teenagers (n=61) were more frequently made at later gestational stages (p=0.003), had a higher prevalence of rape (p=0.003) as the cause of unwanted pregnancies, and exhibited less access to healthcare services compared with adult women.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>There was an increase in total demand for self-managed abortion during the pandemic and reasons for requesting an abortion changed, shifting from privacy-related to COVID-19-specific reasons. This study also highlighted the uniquely vulnerable situation of teenagers with unwanted pregnancies seeking self-managed abortion.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjsrh-2021-201281","type":"journal-article","created":{"date-parts":[[2021,10,25]],"date-time":"2021-10-25T13:26:17Z","timestamp":1635168377000},"page":"252-258","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":11,"title":["Telemedicine as an alternative way to access abortion in Italy and characteristics of requests during the COVID-19 pandemic"],"prefix":"10.1136","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0548-3374","authenticated-orcid":false,"given":"Karin","family":"Brandell","sequence":"first","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Karolinska Institutet, Stockholm, Sweden"},{"name":"Sodertalje Hospital, Sodertalje, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hannah","family":"Vanbenschoten","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Bioengineering, University of Washington, Seattle, Washington, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mirella","family":"Parachini","sequence":"additional","affiliation":[{"name":"AMICA (Associazione Medici Italiani Contraccezione e Aborto), Rome, Italy"},{"name":"International Federation of Abortion and Contraception Professionals, Vienna, Austria"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Gomperts","sequence":"additional","affiliation":[{"name":"Women on Web, Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Gemzell-Danielsson","sequence":"additional","affiliation":[{"name":"Department of Women\u2019s and Children\u2019s Health, Karolinska Institutet, Stockholm, Sweden"},{"name":"Gynecology and Reproductive Medicine, Karolinska Universitetssjukhuset, Stockholm, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,10,25]]},"reference":[{"key":"2025090510552157000_48.4.252.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjsrh-2020-200709"},{"key":"2025090510552157000_48.4.252.2","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1007\/s13365-020-00900-w","article-title":"COVID-19: update of the Italian situation","volume":"26","author":"Prezioso","year":"2020","journal-title":"J Neurovirol"},{"key":"2025090510552157000_48.4.252.3","unstructured":"Md S . Relazione del Ministro DELLA salute dulla attuazione DELLA Legge contenente norme per La tutela sociale DELLA maternit E per l'interruzione volontaria di gravidanza (Legge 194\/78), 2018. https:\/\/www.salute.gov.it\/imgs\/C_17_pubblicazioni_2924_allegato.pdf"},{"key":"2025090510552157000_48.4.252.4","doi-asserted-by":"crossref","first-page":"272","DOI":"10.3109\/13625187.2014.990089","article-title":"Conscientious objection and waiting time for voluntary abortion in Italy","volume":"20","author":"Bo","year":"2015","journal-title":"Eur J Contracept Reprod Health Care"},{"key":"2025090510552157000_48.4.252.5","doi-asserted-by":"publisher","DOI":"10.1136\/medethics-2013-101656"},{"key":"2025090510552157000_48.4.252.6","unstructured":"Md S . OGGETTO: Aggiornamento delle \u201cLinee di indirizzo sulla interruzione volontaria di gravidanza con mifepristone e prostaglandine\u201d, 2020. 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