Perspectives on Abortion Services, the Pre-Abortion Visit, and Telemedicine Abortion: A Qualitative Study in Sweden.

Context: According to Swedish law, abortion treatment should be carried out at an approved healthcare facility. All persons seeking medication abortions are obliged to attend an in-person visit, which includes a gynecological examination, an ultrasound scan, and administration of mifepristone at a hospital/clinic. However, some countries have implemented telemedicine abortion services without the requirement of in-person visits during and after the COVID-19 pandemic. The aim of this study is to (1) describe abortion seekers' experience of currently available abortion care; (2) explore abortion seekers' suggestions for improving medication abortion care; and (3) explore abortion seekers' views on an abortion care model that omits an in-person appointment and examination.

Methods: We interviewed 20 participants who sought early medication abortion at Sahlgrenska University Hospital, Gothenburg, Sweden, from March to April 2023. Systematic text-condensation of qualitative semi-structured interviews was used to explore abortion seekers' experience of the pre-abortion visit, including the gynecological and ultrasound examinations, thoughts about abortion care services, and telemedicine abortion.

Results: Three main findings emerged (1) The participants found it easy to contact the abortion clinic, but experienced undesired waiting time (2) Most participants appreciated the gynecological examination, but some found it distressing and uncomfortable (3) Participants considered telemedicine and taking mifepristone at home to be a good option in addition to in-person abortion care.

Conclusion: Offering both telemedicine and in-person consultations enhances abortion seekers' autonomy, reduces delays, and minimizes stress in abortion care.