INDONESIA – Effect of a smartphone intervention on self-managed medication abortion experiences among safe abortion hotline clients: a randomized, controlled trial

by Caitlin Gerdts, Ruvani T Jayaweera, Ika A Kristianingrum, Zara Khan, Inna Hudaya

International Journal of Gynecology & Obstetrics 2019(Dec 13). DOI: 10.1002/ijgo.13086. (Not open access)


Objective – To investigate the impact of a smartphone application (app) providing information and support for medication abortion (MA) on the primary outcomes of ‘feelings of support’ and ‘preparedness’ among clients of Samsara, a safe-abortion hotline in Indonesia.

Methods – In a parallel-arm, non-clinical, randomized controlled trial, women (ages ≥15) who contacted Samsara between February 2017- July 2018 seeking information on MA for pregnancies ≤13 weeks gestation were randomized to receive either an app with abortion information, or standard of care (high-quality comprehensive and empathic counseling on pregnancy options). Participants completed a questionnaire 24 days after enrollment; Fisher exact tests and risk differences were used to assess differences in self-reported feelings of preparedness and support throughout the process of self-managed MA.

Results – No differences in feelings of support or preparedness were detected between participants in the app arm versus the standard of care arm.

Conclusion – This study represents the first-ever randomized, controlled trial (and prospective study) among those who contacted a safe abortion hotline for information about and support for self-managed abortion. Levels of preparedness, confidence, and feelings of support were all extremely high among both control and intervention arms – indicative of the high quality, evidence-based information, comprehensive, and supportive abortion counseling that safe abortion hotline clients receive.