A text message intervention for self-assessment of complications after medical abortion in Colombia: A pilot RCT

Background: For most women, a follow-up visit after medical abortion is medically unnecessary. This pilot RCT aims to establish the safety and feasibility of text-message (SMS) follow-up versus standard of care (in-person follow-up visit 15 days post procedure) after medical abortion at a clinic in Bogota, Colombia.  

Methods: Women in both intervention and control groups received wanted medical abortions according to clinic protocol.  Over the two weeks following, women in the intervention group received 5 text messages containing clinical information and supportive messaging. Eleven days following the procedure, women in the intervention arm were asked to respond to a simple set of self-assessment questions via text message.  Women whose self-assessment indicated a need for follow-up were requested to return to the clinic as soon as possible.

Results: A total of 173 women between the ages of 18-49 were enrolled in the study (intervention: n=77; control: n=96).   The proportion of women returning to the clinic to be seen for side-effects or mild complications before the scheduled follow-up visit was the same across study groups (4.7%).  In both study groups,  92% of women were satisfied with their abortion and follow-up care, the large majority of women in both study groups would recommend the process to a friend (intervention: 86%, control 89%), and 84% of the intervention group believed that SMS follow-up would help someone like them through the medical abortion process.

Conclusions: SMS follow-up after medical abortion appears to be a safe and feasible method of follow-up for medical abortion care.