One in three females in Canada will undergo an abortion during their lifetime. Some people experience stigma, shame and physical symptoms after an abortion, underscoring the importance of post-procedure care. Most clinics will schedule a follow-up visit post-procedure along with oral instructions and printed resources. However, most abortion services in Canada are only available in urban centres, creating barriers to follow-up care for those who travel from rural and remote communities. The complication rate post-abortion is less than 1%, suggesting that follow-up visits may not be needed, and that people can self-manage post-procedure care with appropriate information. Using an innovative approach, post-procedure resources can be compiled into a digital health intervention, which can provide additional support and reassurance through an email service.
Dr. Roopan Gill and her team at the Women’s Health Research Institute created a website and email system for post-abortion follow up care, MyPostCare, as part of her fellowship research at the University of British Columbia and BC Women’s Hospital + Health Centre. The website includes four sections: 1) post-procedure care information; 2) an interactive contraception explorer tool; 3) an interactive emotional wellbeing tool; and 4) sexual health resources. Users can also sign up to receive check-in emails at defined points in their post-procedure recovery journey, which direct them to relevant sections on the website. MyPostCare.ca was developed using user-centred design where end-users were involved at every stage of the process to ensure the website meets their needs and preferences. Individuals who had experienced an abortion informed the content and design, took part in user testing, and participated in a pilot study to assess if MyPostCare was a feasible and acceptable way to support self-management of their follow-up care. Participants who lived in a variety of locations across British Columbia were recruited from three abortion clinics in the Vancouver Lower Mainland. For user-testing of MyPostCare.ca, participants were recruited through social media from across Canada.
Qualitative and quantitative results from the formative phase and the pilot trial revealed that individuals wanted to receive information and post-abortion support via email and on their mobile devices. Trial participants found the intervention was feasible and acceptable for follow-up care. Some individuals reported that emails were timed perfectly, and in some cases prevented unnecessary visits to their doctor or the emergency room. The MyPostCare team at the Women’s Health Research Institute is working to expand the availability of this service, and has recently made a call to abortion providers across Canada to contribute to local resources which will be integrated into website. Dr Gill has also been working with the World Health Organization to develop global safe abortion guidelines for self-managed medical abortion. Digital health can play an important role in continuing the momentum towards self-managed abortion care globally.
For More Information
Gill R, Ogilvie G, Norman WV, Fitzsimmons B, Maher C, Renner R. Feasibility and Acceptability of a Mobile Technology Intervention to Support Postabortion Care in British Columbia: Phase I. J Med Internet Res. 2019 May 29;21(5):e13387.https://www.jmir.org/2019/5/e13387/