Making the case for supported self-managed medical abortion as an option for the future
Bibliographic record
Abstract
The use of misoprostol at home to induce abortion began in Brazil in the 1980s and spread rapidly to many parts of the globe. The combination of mifepristone plus misoprostol with safe and effective dosages and regimens rapidly became available through clinical provision and was included on the World Health Organization (WHO) complementary essential medicines list in 2005. In 2018, it was moved to the WHO core list of essential medicines and approved for self-managed abortion (SMA) at home up to 12 weeks’ gestation, based on substantial evidence of efficacy, safety and acceptability in legally permitted settings.1 Telemedicine counselling and long-distance provision of medical abortion pills for home use in legally restricted settings was begun in 2007 by Women on Web, a safe abortion hotline initiated by a feminist doctor. Access was greatly expanded when a second international hotline, Women Help Women, was launched in 2014. Telemedicine to counsel women and arrange SMA at home has been shown to be safe and acceptable in a systematic review of provision by both Women on Web and medical practitioners in the USA, Canada and Australia.2 A recent systematic scoping review on SMAfound that telemedicine and SMA with abortion pills has high levels of effectiveness.3 The positive outcomes experienced by women(2), were with physician-supervised self-managed abortion where women had access to information and support via telemedicine during the abortion process. This article focuses on the issue of support with respect to the acceptability of telemedicine and SMA. We examine these issues …
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.016 | 0.055 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.006 | 0.016 |
| Scholarly communication | 0.012 | 0.025 |
| Open science | 0.004 | 0.010 |
| Research integrity | 0.034 | 0.053 |
| Insufficient payload (model declined to judge) | 0.024 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".