Caitlin Gerdts

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    Objectives: Existing data suggest that European women from countries with relatively liberal abortion laws travel to other European countries for abortion care, yet, few studies have described this unique experience. Methods: We analysed preliminary data from a five-year mixed method study conducted in the UK and the Netherlands. We examined characteristics of women travelling for abortion services from France, Italy, Germany, and other EU countries. We present results from 127 self-administered surveys collected in the UK (n=41) and in the Netherlands (n=86). From our data we identify main barriers to abortion care, estimate the costs incurred, and describe delays women experienced in the process. We contextualize these findings using data from in-depth interviews. Results will be updated based on the most up-to-date data. Results: Patients incurred large out-of-pocket costs. Only 5% of respondents in the Netherlands and 2.5% in the UK had the costs of the abortion procedure fully or partially covered by insurance and all clients incurred additional travel costs. The majority of participants were in their second trimester of pregnancy. On average, clients had considered an abortion over a month before their scheduled procedure, and almost all wanted to access abortion earlier in their pregnancy, but were delayed because they did not know they were pregnant and/or there were no abortion services near their residence. The main barriers to abortion services included surpassing the gestational age limit in their country of residence or not meeting the legal requirements. On average, clients travelled 3-6 hours to access services in the UK and the Netherlands. Conclusion: Women throughout Europe experience legal, social, and procedural barriers to abortion services in their countries of residence that cause them to have to travel for abortion services abroad. Women incur high costs in travelling for abortion services and in many cases are delayed in accessing wanted abortion services

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    Smartphone applications (apps) have been shown to increase health knowledge and agency, and to improve medication adherence and health outcomes. Given increasing restrictions on access to abortion and reproductive health services in the US and around the globe, new technologies that expand access to information about and support for comprehensive sexual and reproductive health issues, including abortion, are needed. 
    In partnership with safe abortion hotlines, abortion clinics, reproductive justice organizations, and advocate colleagues, Ibis Reproductive Health has conducted formative research examining user needs and preferences for such a smartphone app in Indonesia, Mexico, and the U.S.  Formative work has demonstrated that smartphone apps are desirable across a range of contexts, and apps that provides comprehensive SRH information, including information on abortion, delivered through a supportive and secure platform, are needed. Users want an app that can be tailored to their current reproductive health realities and can be modified to meet changing needs throughout their reproductive lives. We will additionally share preliminary findings from a randomized control trial conducted in partnership with Samsara, a safe abortion hotline in Indonesia, to evaluate feasibility and acceptability of a smartphone app that provides information and support for women self-managing medication abortion.