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 TJayaweera, Ika A Kristianingrum, Zara Khan, Inna Hudaya

InternationalJournal of Gynecology & Obstetrics2019(Dec 13). DOI: 10.1002/ijgo.13086. (Not open access)


Objective – To investigate the impact of a smartphone application (app) providinginformation and support for medication abortion (MA) on the primary outcomes of’feelings of support’ and ‘preparedness’ among clients of Samsara, asafe-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 seekinginformation on MA for pregnancies ≤13weeks gestation were randomized toreceive either an app with abortion information, or standard of care(high-quality comprehensive and empathic counseling on pregnancy options).Participants completed a questionnaire 24days after enrollment; Fisherexact tests and risk differences were used to assess differences inself-reported feelings of preparedness and support throughout the process ofself-managed MA.

Results – No differences in feelings of support orpreparedness were detected between participants in the app arm versus thestandard of care arm.

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