Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Dec;33(1):2500828.
doi: 10.1080/26410397.2025.2500828. Epub 2025 Jun 4.

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

Mary Achieng Ouma  1 , Anita Alaze  1 , Kenneth Juma  2 , Hazal Atay  3 , Rebecca Gomperts  4 , Céline Miani  5
Affiliations

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

Mary Achieng Ouma et al. Sex Reprod Health Matters. 2025 Dec.

Abstract
in English, French, Spanish

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.

Au Kenya, l’accès à l’avortement est restreint par la loi et autorisé dans un ensemble limité de cas. Les prestataires de services de télé-avortement, comme Women on Web (WoW), assurent des soins d’avortement sûrs et efficaces en dehors du secteur de la santé formel. Cette étude explore les caractéristiques et les motivations des personnes au Kenya qui ont effectué une consultation en ligne sur le site de WoW entre 2013 et 2019. Nous avons utilisé des données anonymisées fournies par WoW pour décrire les caractéristiques des participantes (n = 857) et leurs motivations pour accéder à la consultation en ligne de WoW (n = 449, car ces informations n’étaient disponibles que pour les personnes ayant rempli le questionnaire à partir de décembre 2017). L’âge médian des participantes était de 23 ans; 65.0% n’avaient pas d’enfants et 80,9% n’avaient jamais avorté. Les grossesses étaient dues à un échec de la contraception (43.6%) ou à son absence (49.0%), ou encore à un viol (6.0%). Les raisons les plus fréquemment invoquées pour accéder à la consultation en ligne étaient les restrictions juridiques et le coût de l’avortement. Ces raisons ont été sélectionnées par près de la moitié des participantes (respectivement 235 et 222/449). Venait ensuite le souhait de garder l’avortement privé ou secret, motif sélectionné par 34.5% et 26.0% des participantes. Parmi les raisons formulées de manière plus positive, le confort chez soi arrivait en tête (23.6%), suivi de la volonté de prendre en charge son avortement (20.7%) et l’idée qu’avorter par le biais de WoW donnait plus d'autonomie (17.4%). Les personnes voulant avorter qui ont recours aux services de télé-avortement le font généralement suite à un échec de la contraception ou une absence de méthode contraceptive et pour avoir accès à un avortement sûr, éviter la stigmatisation et protéger leur vie privée. L’expansion des services de télé-avortement, au sein ou en dehors des services de santé formels, pourrait renforcer l’autonomie et la capacité d’action des personnes souhaitant avorter au Kenya.

En Kenia, el acceso al aborto es restringido por las leyes y permitido bajo condiciones limitadas. Los prestadores de servicios de teleaborto, como Women on Web (WoW), proporcionan servicios de aborto seguros y eficaces fuera del sector salud formal. Este estudio explora las características y motivaciones de personas en Kenia que realizaron una consulta digital en el sitio web de WoW en 2013–2019. Utilizamos datos anonimizados proporcionados por WoW para describir las características de las participantes (n = 857) y sus motivaciones para acceder a la consulta digital de WoW (n = 449, dado que esta información estaba disponible solo para aquéllas que contestaron el cuestionario de diciembre de 2017). La edad media de las participantes era de 23; el 65.0% no tenía hijos y el 80.9% no había tenido un aborto anterior. Los embarazos fueron causados por la falla (43.6%) o ausencia de un método anticonceptivo (49.0%), o por violación (6.0%). Las razones relatadas con mayor frecuencia para acceder a la consulta digital fueron restricciones jurídicas y costos de aborto, ambas seleccionadas por aproximadamente la mitad de las participantes (respectivamente 235 y 222/449). La tercera razón más frecuente fue el deseo de mantener el aborto privado o en secreto, que fue seleccionada por el 34.5% y el 26.0% de las participantes. Entre las razones planteadas de manera más positiva, la primera fue la comodidad en el hogar (23.6%), seguida de querer hacerse cargo del aborto por sí misma (20.7%) y considerar empoderador tener un aborto por medio de WoW (17.4%). Las personas que buscan un aborto por medio de servicios de teleaborto generalmente lo hacen después de la falla o ausencia de anticoncepción y para obtener acceso a abortos seguros, evitar estigma y conservar su privacidad. La ampliación de los servicios de teleaborto, dentro o fuera de los servicios de salud formales, podría fortalecer la autonomía y agencia de las personas que buscan un aborto en Kenia.

Keywords: Kenya; Women on Web; abortion stigma; medical abortion; self-managed abortion; telehealth.

Plain language summary

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.

PubMed Disclaimer

Conflict of interest statement

HA is affiliated with the non-governmental organisation Women on Web that provided the data for this manuscript. RG is the funder of Women on Web.

Figures

Figure 1.
Figure 1.
Teleconsultation participants flow chart
Figure 2.
Figure 2.
Motivations for accessing the WoW online consultation, Kenya, 2017–2019 (n = 449). Note: The exact question reads “What are the main reasons why you are requesting an abortion through Women on Web?” Answers are pre-specified options that women can select. The question is optional, which explains the missing data (n = 18). Multiple responses are allowed, and respondents tended to give multiple answers, so that the total response exceeds the number of respondents (n = 449).
See this image and copyright information in PMC

References

    1. Juma K, Ouedraogo R, Mwoka M, et al. . Protocol for a scoping review of research on abortion in sub-Saharan Africa. PLoS One. 2021;16(7):e0254818. doi:10.1371/journal.pone.0254818 - DOI - PMC - PubMed
    1. The Constitution of Kenya 2010 . 2010.
    1. Ipas . Kenya restores standards and guidelines for comprehensive reproductive health, including abortion. Ipas Newsletter. 2019.
    1. In Op-ed, the Center’s Evelyne Opondo Calls on Kenya to Stop the Harassment of Women and Girls Seeking Abortion Care. The Kenyan government must align its penal code with the 2010 Constitution. [Internet]. 2022 Available from: https://reproductiverights.org/op-ed-kenya-abortion-harassment-women-girls/.
    1. Mohamed SF, Izugbara C, Moore AM, et al. . The estimated incidence of induced abortion in Kenya: a cross-sectional study. BMC Pregnancy Childbirth. 2015;15(1):185. doi:10.1186/s12884-015-0621-1 - DOI - PMC - PubMed

LinkOut - more resources