# Telehealth abortion services via Women on Web in Kenya (2013–2019): a descriptive analysis of the characteristics and motivations of the care seekers

## TL;DR

This study describes Kenyan individuals who used Women on Web for teleabortion, highlighting their motivations and the challenges they faced due to legal restrictions and costs.

## Contribution

The study provides new insights into the characteristics and motivations of teleabortion users in Kenya, emphasizing the role of privacy and legal barriers.

## Key findings

- Most participants were young, had no children, and had not had a previous abortion.
- The main reasons for using teleabortion were legal restrictions and high costs of abortion.
- Privacy and home comfort were also significant motivators for accessing teleabortion services.

## Abstract

In Kenya, access to abortion is legally restricted and allowed under a limited set of conditions. Teleabortion service providers, such as Women on Web (WoW), provide safe and effective abortion care outside the formal health sector. This study explores the characteristics and motivations of individuals in Kenya who completed an online consultation on the WoW website in 2013–2019. We used anonymised data provided by WoW to describe participants’ characteristics (n = 857) and their motivations for accessing the WoW online consultation (n = 449, since this information was only available for those who filled out the questionnaire from December 2017). Participants’ median age was 23; 65.0% did not have children, and 80.9% had not had a previous abortion. Pregnancies were caused by failure (43.6%) or absence of contraceptive method (49.0%), or rape (6.0%). The most frequently reported reasons for accessing the online consultation were legal restrictions and abortion costs. Those were selected by about half the participants (respectively 235 and 222/449). Next came the wish to keep the abortion private or secret, which was selected by 34.5% and 26.0% of participants. Among more positively framed reasons, home comfort came first (23.6%), followed by wanting to deal with the abortion oneself (20.7%) and finding an abortion through WoW empowering (17.4%). Abortion-seekers turning to teleabortion services usually do so following failing or absent contraception and to get access to safe abortions, avoid stigma, and keep their privacy. Expansion of teleabortion services, within or outside formal healthcare services, could strengthen abortion-seekers’ autonomy and agency in Kenya.

In Kenya, access to abortion is legally restricted and allowed under a limited set of conditions. Teleabortion service providers, such as Women on Web (WoW), provide safe and effective abortion care outside the formal health sector: following an online consultation, they may provide abortion pills to persons experiencing an unwanted pregnancy. This study explores the characteristics of the individuals in Kenya who completed an online consultation on the WoW website in 2013–2019, as well as the reason why they decided to access the WoW website. We analysed anonymised data provided by WoW. Participants were, on average, 23 years old, 2/3 did not have children, and 80.9% did not have a previous abortion. Pregnancies were caused by failure (43.6%) or absence of contraceptive method (49.6%), or rape (6.0%). The most frequently reported reasons for accessing the online consultation were legal restrictions and abortion costs. About half the participants selected those. Next came the wish to keep the abortion private or secret, which was selected by, respectively, 34.5% and 26.0% of participants. Among more positively framed reasons, home comfort came first (23.6%), followed by wanting to take care of one’s abortion (20.7%) and finding an abortion through WoW empowering (17.4%). Abortion-seekers turning to teleabortion services usually do so following failing or absent contraception and with the intention of getting access to safe abortions, avoiding stigma, and keeping their privacy. Expansion of teleabortion services, within or outside formal healthcare services, could strengthen abortion-seekers’ autonomy and agency in Kenya.