Pills in the Post: Analysis of Australia‐Based Requests to the Online Abortion Service Women on Web

INTRODUCTION: Medication abortion has transformed accessibility of abortion services. Telemedicine models-including asynchronous services where a clinician reviews a person's information without a live consultation-enable access to abortion care outside in-person health settings. This study analyzes the frequency, distribution, and motivations of Australia-based requests to Women on Web (WoW), an online referral platform that facilitates access to abortion pills and their self-management with a physician-supported email-based support team. METHODS: We analyzed anonymized consultation forms submitted to WoW by people in Australia between 2015 and 2023. We summarized descriptive statistics on individuals' ages and location by state and remoteness. We classified reasons for contacting WoW (recorded from 2018 onwards) thematically and analyzed associations between these themes. RESULTS: Over 8 years, WoW received 1573 requests from Australia-based abortion-seekers. Most requests included multiple reasons for accessing WoW's service, but cost, privacy, and preference for home-based care were the most frequently selected. When thematically analyzed, empowerment and consumer-centered care were the dominant themes, regardless of the person's age or location, alongside barriers to accessing local abortion care through Australia's formal health care system, including through including telemedicine. CONCLUSION: The small demand for care from WoW suggests that provision within the formal healthcare system is inaccessible to some, and that some abortion-seekers prefer models of care-such as asynchronous, clinician-reviewed telemedicine-with reduced medical oversight. Attention to how abortion is made available, including deregulating pills by post alongside public service provision, is needed to guarantee autonomy, freedom, and sexual and reproductive health and rights for all Australians.