Background & Rationale
There are two methods of following up after an early medical abortion (EMA) to make sure you are no longer pregnant: blood test and urine test. Both methods are safe and effective, and each has pros and cons. In Aotearoa New Zealand, some abortion services use a blood test up to 1 week after the abortion, and others use a home urine pregnancy test 3 weeks after.
The aim of this project is to find out which method is easier and more acceptable to women and health practitioners, and which is more cost-effective.
We think that a self-assessment follow up method after EMA (including a urine pregnancy test) will result in more complete follow up, and will be as safe and effective at detecting continuing pregnancy as comparative blood tests. Answering this important research question will result in a strong recommendation in the NZ abortion clinical guideline, less variation in practice between abortion clinics and achievement of health equity.
Your Participation
If you consent to participate, you will be randomly allocated to one of two follow-up methods; you have a 50/50 chance of being in one group or the other. Up to this point, the abortion process will be the same for every wāhine in the study. After you are allocated to a group, you will find out which method of follow-up you will receive and this cannot be changed during the study unless your health practitioner thinks you need to.
If this sounds like something you are wiling to support, please read the information sheet for further details.
Blood test follow up group:
First blood test done at the start of the EMA
Second blood test done 7 days later at your nearest lab, using a form provided by health practitioner at start of EMA
Health practitioner will contact you after the second test to explain the results.
If the second test is not done, there will be two reminders by phone, text message or email.
Urine test follow up group (self-assessment):
At your EMA appointment, you will receive a low sensitivity urine pregnancy test to take home (sent via courier if participating via telehealth) with instructions.
Test performed 3 weeks after the EMA; instructions provided on how to interpret results and what to do if the test is positive or negative.
As part of a holistic approach, the research nurse will touch base with you weekly to help support you and your whānau to manage the process.
At four weeks after the EMA, the health practitioner will contact you to ask the results of your test. If you have not yet done the test, there will be two reminders by phone, text message or email.
After your EMA:
For all participants, a questionnaire about your experience will be completed at 4 – 6 weeks after the EMA and at 12 months after the EMA. You can choose to do them electronically online, by telephone with the research team, or on paper to be returned by post.
All communication from the research team will be confidential and carried out via your preferred method (email, phone call, or text message).