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• W3084237053 abstract "Abstract Introduction In April 2019 the abortion telemedicine service Women on Web (WoW) opened their helpdesk to Germany and saw a progressive rise in consultations. Our aim was to understand the motivations, and perceived barriers to access, for women who choose telemedicine abortion outside the formal health sector in Germany. Methods We conducted a parallel convergent mixed-methods study among 1090 women in Germany, who requested medical abortion through WoW between January 1 st and December 31 st , 2019. We performed a cross-sectional study of data contained in online consultations and a content analysis of 108 email texts. Analysis was done until saturation; results were merged, and triangulation was used to validate results. Results Frequent reported reasons for choosing telemedicine abortion in the consultation forms were “I need to keep the abortion a secret from my partner or family” (48%) and “I would rather keep my abortion private” (48%). The content analysis developed two main themes and seven subsidiary categories: 1) internal motivations for seeking telemedicine abortion encompassing i) autonomy, ii) perception of external threat, iii) shame and stigma, and 2) external barriers to formal abortion care, encompassing: (iv) financial stress, v) logistic barriers to access vi) provider attitudes, and vii) vulnerability of foreigners). The findings in the quantitative and qualitative analysis were consistent. Conclusion Women in Germany who choose telemedicine abortion outside the formal health sector do so both from a place of empowerment and a place of disempowerment. Numerous barriers to abortion access exist in the formal sector which are of special relevance to vulnerable groups such as adolescents and undocumented immigrants. Key message points When Women on Web, an abortion telemedicine service operating outside the formal health care sector, opened in Germany in April 2019, 1205 women consulted the service in the first nine months. Women who choose telemedicine abortion do so both from a position of empowerment, for reasons of autonomy, and from a position of disempowerment and lack of autonomy. Numerous barriers to abortion access, as permitted by German law exist in the formal health sector, which may most impact vulnerable groups such as adolescents, women with low financial means, and undocumented immigrants." @default.
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• W3084237053 date "2020-09-09" @default.
• W3084237053 modified "2023-09-23" @default.
• W3084237053 title "Why women choose abortion through telemedicine outside the formal health sector in Germany? A mixed-methods study" @default.
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• W3084237053 doi "https://doi.org/10.1101/2020.09.08.20190249" @default.
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