Evidence map›Paper›PMID 39832976›Full record

ArticleBMJ open2025

Seeking abortion medications online: experiences from a mystery client study in Colombia.

Daniel Arango Arango, Alice F Cartwright, Ava Braccia, Ann Moore, Maria M Vivas

Abstract read
In one paragraph

Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Daniel Arango ArangoFundación Oriéntame, Bogotá, Colombia.
Alice F CartwrightGuttmacher Institute, New York, New York, USA acartwright@guttmacher.org.ORCID http://orcid.org/0000-0002-1557-8062
Ava BracciaGuttmacher Institute, New York, New York, USA.
Ann MooreGuttmacher Institute, New York, New York, USA.ORCID http://orcid.org/0000-0002-6914-1974
Maria M VivasFundación Oriéntame, Bogotá, Colombia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesWhile Colombians gained broad legal access to abortion in 2022, people still lack knowledge about its availability and face variable quality of care at health facilities. This study sought to understand whether online sellers provide the instructions and medication dosages necessary for effective medication abortions.

designThe study design involved mystery clients contacting sellers identified across websites and social media platforms (Facebook, Instagram, and TikTok) to purchase abortion pills. Unique sellers were contacted with two profiles (first and second trimester pregnancy gestational ages). Mystery clients documented information received on physical effects, complications and how to take the pills from the sellers in a predesigned survey in SurveyCTO.

settingThe study was conducted in Colombia from July to September 2023. We documented and described sellers' conversations with mystery clients and pills received. We identified 161 sellers across platforms, which resulted in 65 unique sellers after deduplication. We attempted to contact each unique seller twice.

resultsAlmost all sellers screened for gestational age using last menstrual period. Bleeding (84.6%) and cramping (66.7%) were the physical effects most commonly mentioned to mystery clients, although pain was mentioned to second trimester clients more often than first (40.5% vs 22.0%). Less than 17% of sellers highlighted possible complications that could require medical attention. Almost 90% of purchases were received (88.9%). All contained manufacturer-branded misoprostol and 77.5% were undamaged aluminium blister packages. While 82.6% of first trimester clients were instructed to take an initial misoprostol dosage in line with Colombia's Ministry of Health guidelines, all second trimester clients were told to take a dosage exceeding the recommended amount. Although most sellers provided appropriate information on administration routes for the pills, sellers also provided contradictory and unnecessary instructions.

conclusionOnline sellers of abortion pills may persist even as legal abortion becomes more widely available in Colombia. While misoprostol was received from many of these sellers, they did not provide sufficient information about potential complications or accurate dosing instructions to second trimester clients. Accurate medication abortion information specific to Colombia should be made more accessible so that people can more easily navigate the new care landscape.

Indexed as

Abortifacient AgentsAbortifacient Agents, NonsteroidalAbortion, InducedAdultColombiaFemaleHumansInternetMisoprostolPregnancyYoung AdultAbortifacient AgentsAbortifacient Agents, NonsteroidalMisoprostolhealth servicesLatin Americapublic healthreproductive medicineself-managementsocial media

Identifiers

PMID39832976
PMCPMC11752010

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.