Trial assesses new method of abortion follow-up

A trial is under way to compare lab tests versus at-home pregnancy tests following early medical abortions to see which method has greater success at ensuring women know the abortion has worked.

Currently, lab tests are the most common method, one the next day and a second one week later. However, across all Aotearoa New Zealand’s abortion clinics, another Waipapa Taumata Rau, University of Auckland study found 20 percent of women were either not getting the follow-up tests done or not able to be contacted with the results.

“It's such an important piece of follow-up to know that the termination has worked and you're not pregnant because we know, for one or two percent of people, it won't work and they will still be pregnant,” says lead researcher Associate Professor Michelle Wise, Deputy Head of the University’s Department of Obstetrics and Gynaecology.

“If they don't do the follow-up test, or they do the test and don't find out the results of the test, and end up still pregnant, they're not going to find out till potentially weeks or months later. And that can be devastating.”

The Health Research Council has granted the research project $1.2 million over the upcoming three years to compare follow-up with the current lab-test method versus at-home pregnancy tests.

An early medical abortion takes place before ten weeks and the woman takes two types of medication to induce the termination. They can have the abortion in her own home and avoid surgery.

The new method of follow-up, which is more commonly used in other countries, involves a urine pregnancy test, which is either positive or negative.

“If it's positive three weeks later, then she might still be pregnant and she then needs to go back to the abortion service,” Dr Wise says.

“But if it's negative, and most of them will be negative, then she knows she's not pregnant and she just gets on with her life.

The new method means the woman has more autonomy and doesn’t need to travel to a lab.

The method has just started being used in New Zealand in 2023.

“Once we know the results of this study, if it's shown to be safe and effective, which we expect it to be, then it would enable all the services around New Zealand to use that method of follow-up,” Dr Wise says.

Anybody having an early medical abortion is eligible for the study.