Project educates Kazakhstani women on monitoring medical abortion outcomes

The dBest multilevel pregnancy test (MLPT) is available in Kazakhstan for purchase, until recently, most providers and women were unaware that it could be used to monitor medical abortion outcomes. With support from a special safe abortion-themed round of the Innovation Fund, Gynuity developed and tested written instructions and a short instructional video for women and providers on the use of MLPTs for medical abortion follow-up in Russian Kazakh. Gynuity partnered with the local IPPF affiliate, Kazakhstan Association for Sexual and Reproductive Health (KMPA), and other advocates to inform providers, representatives of the Ministry of Health, and other policymakers about the MLPT and these new resources. Current in-country efforts focus on the registration of an MLPT for sale in pharmacies, which will increase access to this novel technology.

Medical abortion providers routinely require women to return one or two weeks after taking abortifacient drugs to confirm pregnancy termination. Ultrasound, pelvic examination, or serum pregnancy tests are costly and may be inconvenient, particularly for women who live far away or have competing commitments, and they must be performed by specially trained personnel.

Multilevel pregnancy tests (MLPT) are able to measure the approximate concentration of human chorionic gonadotropin (hCG) in urine. If performed before and after the woman takes the abortifacient drugs, a decline in hCG concentration is interpreted to indicate that no ongoing pregnancy exists, whereas a stable or rising concentration indicates need for further evaluation. MLPTs provide rapid results and are generally less expensive than an ultrasound or a blood test that detect the level of pregnancy hormone. Moreover, MLPTs can detect continuing pregnancy after administration of medical abortion drugs much earlier than regular pregnancy tests, and they can be used by women on their own at home.