Over-the-counter oral contraceptive use among women in Mexico: results from a national survey

Telemedicine for medical abortion service provision in Mexico: A safety, feasibility, and acceptability study

OBJECTIVE

We aimed to obtain evidence about the safety, acceptability, and feasibility of a direct-to-patient telemedicine medical abortion service in Mexico's private health sector.

STUDY DESIGN

A prospective observational one-group study to evaluate a telemedicine abortion service, referred to as TeleAborto, was conducted at three private clinics and one non-clinician community-based provider. Information about the study was provided by phone, websites, and social media. Abortion seekers were screened for eligibility and underwent any pre-abortion tests requested by the study site at services close to home. Eligible participants received packages with abortion medication, analgesics, and instructions and a remote follow-up contact was scheduled for 7-14 days later. Primary outcomes include abortion outcome, management of adverse events, acceptability, and feasibility measures such as package reception and follow-up contact, and challenges to get pre- and post-abortion tests.

RESULTS

We conducted 581 screenings and sent 378 study packages, all successfully received, reaching abortion seekers in all 32 states. All participants took medications before 70 days gestational age as per study protocol. Abortion outcome was determined for 87% participants (330/378); 93% (306/330) had a successful abortion without intervention and 18 with intervention; six individuals decided to continue the pregnancy. Participants reported high satisfaction with TeleAborto, citing convenience as their most valued aspect (85%; 264/311).

CONCLUSIONS

This study showed that guided self-management telemedicine abortion is safe, acceptable, and feasible in Mexico. The model has the potential to close the access gap for indigenous and rural populations, particularly those that rely on public sector services.

Bayesian spatial modelling of contraception effects on fertility in Mexican municipalities in 2020

The prevalence and use of contraceptive methods is an essential element to explain the behaviour of fertility and population growth. The objective of this study was to analyse the spatial correlation between the use of contraceptive methods in women of childbearing age and fertility levels observed in Mexico's municipalities in 2020. Data on contraceptive use are from the National Survey of Demographic Dynamics (ENADID) 2018, while fertility rates were estimated from vital statistics and population census data. Three Bayesian spatial models including fixed effects, random effects and spatial effects were employed. The models were estimated using the integral nested Laplace approximation (INLA) package available in the R language. The results reveal the existence of important regional inequalities associated with the use and prevalence of contraceptive methods, which generate marked differences in observed levels of fertility between municipalities.