Results
Abortion pills were provided to 81683 women between 2009-2019. A total of 30344 (37.2%) women from 183 different countries completed the follow-up evaluation between January 2009 and December 2019, of which 26076 (85.6%) reported that they used the abortion pills and were included for main data analysis. 3780 (12.4%) women did not use the abortion pills, and 488 (1.6%) evaluations were completely unanswered. Reasons for not completing the medical abortion included: deciding to continue the pregnancy (n=737), having a spontaneous miscarriage meanwhile (n=1839), deciding to use another method meanwhile (n=1040), realising they were not pregnant (n=39), having issues with customs (n=121) and having an ectopic pregnancy (n=4). Missing data was relatively low, ranging from 0.5 - 0.7 % and was deleted from the subsequent regression analysis.
(Table 1. Overview of study population.)
A summary of the main outcome measures is presented in Table 2. Ongoing pregnancy was reported by 404 (1.5 %) women while 22926 (87.9%) reported a complete abortion. The overall rate of blood transfusion was 0.6 % (n=155). As a proxy of economic situation, we found that 9175 (35%) who made a donation for the service reported that it was difficult to find the money . In 8.5% of cases (n=2223) the service was fully donated. Just over half of the women reported prior knowledge of medical abortion. 96.6% (n=25178) found medical abortion to be an appropriate method for them, and 99% (25186) found it to be acceptable of having the medical abortion at home with WoW support. 96.1% (n=25071) would recommend WoW services to other women in a similar situation.
(Table 2. Frequency table of use and outcome of medical abortion.)
Results from logistic regression analysis are summarised in Table 3. Year of treatment was significantly associated with all outcomes, except for knowledge about medical abortion. Models were adjusted for age, which had an OR and CI close or equal to 1, indicating no association for each outcome. Overall, the chance of having a complete abortion increased with year, OR 1.92 (95% CI: 1.59 – 2.31) 2019 versus 2009. The risk of having surgical intervention significantly decreased from 2012 onwards, with an OR of  0.49 (95% CI: 0.40 – 0.60) in 2019 versus 2009.
(Table 3. Changes in the use and outcome of medical abortions between 2009-2019.)