Exploring the Role of At-home Semi-Quantitative Pregnancy Tests for Medical Abortion Follow-up

• Percent of women who felt confident in using the test and would be willing to use it in place of clinic-based follow up in the future [ Time Frame: 18 months ] [ Designated as safety issue: No ]
• The proportion of times the provider believes that each participant correctly read her test result [ Time Frame: 18 months ] [ Designated as safety issue: No ]
• Percent of providers who were comfortable with the urine pregnancy test determining whether women need to return or not for clinic-based follow-up [ Time Frame: 18 months ] [ Designated as safety issue: No ]
• The proportion of times that the semi-quantitative test correctly identifies all on going pregnancies [ Time Frame: 18 months ] [ Designated as safety issue: No ]

This study will examine the feasibility, acceptability and usability of a semi-quantitative urine pregnancy test (dBest One Step hCG Panel Test Kit) for at-home follow-up after early medical abortion using mifepristone+misoprostol. The study seeks to:

1. Assess the feasibility of using this test in lieu of standard one-week clinic-based follow up for determination of complete abortion status as part of normal service delivery. In Mexico, follow up will be in two weeks, as is standard care in that .
2. To determine if women using this test at home understand how to use it and can correctly interpret the results; is it practical.
3. Assess women's and provider's acceptability of using at-home pregnancy tests in lieu of clinic-based follow up for confirmation of complete medical abortion in the future.

Women presenting to clinic seeking medical abortion

Inclusion Criteria:

• Women age greater than or equal to 18 years
• Gestational age less than or equal to 63 days by last menstrual period (LMP), ultrasound or clinical assessment
• Agrees to return for follow-up visit and willing to provide an address and/or telephone number for purposes of follow-up
• Able to consent to study participation.

Inclusion Criteria for Mexico:

• Gestational age <_ 70 days from LMP
• Eligible for mifepristone- misoprostol medical abortion according to clinic guidelines
• Willing to follow instructions of the provider regarding use of the at-home pregnancy test
• Agrees to provide test results by phone to study coordinator on morning of schedule follow-up visit
• Willing to provide an address and/or telephone number for purposes of follow-up
• Agrees to return for standard follow-up visit
• Wishes to participate in the study
• Having easy access to a telephone and transportation
• Able to consent to study participation

Exclusion Criteria:

• Women less than 18 years of age
• Women not eligible for medical abortion services
• Women unable to provide contact information
• Women unable to sign the consent form

Exclusion Criteria for Mexico:

• Women not eligible for medical abortion services
• Women unable to provide contact information
• Women unable to sign the consent form

• Stanford University
• Secretaría de Salud del Distrito Federal
• Office National de la Famille et de la Population, Tunisia
• Maternité de la Rabta, Tunisia
• Clinique du Parc, Tunisia