Design and development of AbortionCareTXT, a text message programme for individuals undergoing medication abortion

Abstract Background In Canada, medication abortion accounts for approximately 30% of the 100 000 annual abortions. Despite the advantages of privacy and autonomy, many individuals report feeling unprepared and uninformed about the medication abortion process. Mobile health (mHealth) tools offer a promising avenue for delivering discreet evidence-based support, yet remain underused in abortion care. This study aimed to develop and refine AbortionCareTXT, a text message-based programme providing timely evidence-based information and emotional support for individuals undergoing medication abortion in Canada. Methods Guided by user-centred intervention development principles, four rounds of semi-structured interviews were conducted with abortion providers and pregnancy-capable people. Participants reviewed and provided feedback on message content, tone, timing and usability, which informed revisions to the programme. Results Twelve abortion providers and 13 pregnancy-capable people (46.2% with abortion experience) participated. Key modifications across all rounds included simplified language, added reassurance and enhanced privacy and symptom guidance. The final programme consists of 28 messages delivered over 6 weeks, covering information, support, frequently asked questions, emergency care and reminder content aligned with the usual clinical course. Conclusion The results suggest that a structured text-based intervention may be acceptable to both pregnancy-capable people and abortion providers and can address information, emotional and practical needs. AbortionCareTXT may enhance users’ sense of being informed and enhance the patient experience. Future research will evaluate the programme’s feasibility and real-world impact.