{
  "abstract": "Background Access to post-abortion contraception (PAC) is critical for reducing unintended pregnancies and supporting reproductive decision-making. Patients often face challenges in identifying, accessing and initiating their preferred contraceptive methods post-abortion. This may be particularly so with telemedicine models of care with absence of in-person appointments, and reduced opportunities to provide some contraceptive methods. This qualitative service evaluation explored patients' perspectives on PAC consultations and decision-making to inform future PAC service models in the era of telemedicine.Methods Qualitative interviews with 15 patients who had telemedicine medical abortion at home up to 12 weeks’ gestation. Data were analysed using reflexive thematic analysis.Results Contraceptive discussions during pre-abortion consultations were valued for supporting informed choices about future contraceptive use. Decision-making was influenced by previous contraception experiences, emotional state at the time of abortion and concerns about contraceptive ‘failure’. Some preferred non-hormonal methods due to past negative experiences with hormonal contraceptives. However, limited information about 'natural' contraceptive methods and concerns about discussing these with healthcare professionals were described. Barriers to accessing preferred methods, particularly long-acting reversible contraception (LARC), included reduced availability of appointments and caring responsibilities. Fast-tracked appointments for LARC fitting post-abortion were valued. The need for flexible PAC consultations and access after abortion, for example, remote consultations complemented by personalised interactions with sexual and reproductive health experts, was emphasised.Conclusion The findings highlight the need for flexible and more accessible PAC service models in the era of telemedicine care to ensure timely access to preferred contraceptive methods.",
  "authors": [
    {
      "affiliations": [
        "Usher Institute, Centre for Biomedicine, Self and Society, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK"
      ],
      "name": "Nicola Boydell"
    },
    {
      "affiliations": [
        "Science, Technology and Innovation Studies, School of Social and Political Science, The University of Edinburgh, Edinburgh, UK"
      ],
      "name": "Sophie Buijsen"
    },
    {
      "affiliations": [
        "Institute for Repair and Regeneration, Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK",
        "Chalmers Centre, NHS Lothian, Edinburgh, UK"
      ],
      "name": "John Joseph Reynolds-Wright"
    },
    {
      "affiliations": [
        "Institute for Repair and Regeneration, Centre for Reproductive Health, The University of Edinburgh, Edinburgh, UK",
        "Chalmers Centre, NHS Lothian, Edinburgh, UK"
      ],
      "name": "Sharon T Cameron"
    },
    {
      "affiliations": [
        "Usher Institute, Centre for Population Health Sciences, College of Medicine and Veterinary Medicine, The University of Edinburgh, Edinburgh, UK"
      ],
      "name": "Jeni Harden"
    }
  ],
  "title": "Abortion patients’ perspectives on enhancing a telemedicine model of post-abortion contraception: a qualitative study",
  "uid": "c1a2b562-6afc-5a12-80ff-434cc1462d7a"
}