Objectives In most European countries, patients seeking medication abortion during the COVID-19 pandemic are still required to attend healthcare settings in person. We assessed whether demand for self-managed medication abortion provided by online telemedicine increased following the emergence of COVID-19. Methods We examined 3915 requests for self-managed abortion to online telemedicine service Women on Web (WoW) between 1 January 2019 and 1 June 2020. We used regression discontinuity to compare request rates in eight European countries before and after they implemented lockdown measures to slow COVID-19 transmission. We examined the prevalence of COVID-19 infection, the degree of government-provided economic support, the severity of lockdown travel restrictions and the medication abortion service provision model in countries with and without significant changes in requests. Results Five countries showed significant increases in requests to WoW, ranging from 28% in Northern Ireland (97 requests vs 75.8 expected requests, p=0.001) to 139% in Portugal (34 requests vs 14.2 expected requests, p<0.001). Two countries showed no significant change in requests, and one country, Great Britain, showed an 88% decrease in requests (1 request vs 8.1 expected requests, p<0.001). Among countries with significant increases in requests, abortion services are provided mainly in person in hospitals or abortion is unavailable and international travel was prohibited during lockdown. By contrast, Great Britain implemented a fully remote no-test telemedicine service. Conclusion These marked changes in requests for self-managed medication abortion during the COVID-19 pandemic demonstrate demand for remote models of care, which could be fulfilled by expanding access to medication abortion by telemedicine. No additional data are available. All authors, external and internal, had full access to all of the data (including statistical reports and tables) in the study and can take responsibility for the integrity of the data and the accuracy of the data analysis.

中文翻译：

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COVID-19 大流行期间八个欧洲国家对自我管理的在线远程医疗堕胎的需求：回归不连续性分析

目标 在大多数欧洲国家，在 COVID-19 大流行期间寻求药物流产的患者仍然需要亲自到医疗机构就诊。我们评估了在 COVID-19 出现后对在线远程医疗提供的自我管理药物流产的需求是否增加。方法 我们检查了 2019 年 1 月 1 日至 2020 年 6 月 1 日期间向在线远程医疗服务 Women on Web (WoW) 提出的 3915 项自我管理堕胎请求。我们使用回归不连续性来比较八个欧洲国家在实施锁定措施以减缓速度之前和之后的请求率2019冠状病毒病传播。我们检查了 COVID-19 感染的流行率、政府提供的经济支持的程度、在请求发生重大变化和没有发生重大变化的国家中，锁定旅行限制的严重程度和药物流产服务提供模式。结果 五个国家/地区对 WoW 的请求显着增加，从北爱尔兰的 28%（97 个请求 vs 75.8 个预期请求，p=0.001）到葡萄牙的 139%（34 个请求 vs 14.2 个预期请求，p<0.001）。两个国家/地区的请求没有显着变化，一个国家/地区英国的请求减少了 88%（1 个请求 vs 8.1 个预期请求，p<0.001）。在请求显着增加的国家中，堕胎服务主要是在医院亲自提供，或者无法进行堕胎，并且在封锁期间禁止国际旅行。相比之下，英国实施了完全远程的免测试远程医疗服务。结论 在 COVID-19 大流行期间自我管理药物流产请求的这些显着变化表明对远程护理模式的需求，这可以通过远程医疗扩大药物流产的访问来实现。没有额外的数据可用。所有外部和内部作者都可以完全访问研究中的所有数据（包括统计报告和表格），并对数据的完整性和数据分析的准确性负责。