Prevalence estimation of self-managed abortion in Argentina: a web-based respondent-driven sampling study

BACKGROUND: Respondent-driven sampling (RDS) is a social network sampling technique used to study hidden behaviours. We used web-based RDS (webRDS) to estimate the prevalence of self-managed abortion (SMA) outside the formal healthcare system in Argentina where abortion was legalised in 2020, but access remains uneven. METHODS: A cross-sectional web survey (February-May 2024) among individuals aged 16-49 years, ever pregnant, and residing in Argentina. Our primary outcome was the proportion of SMA occurring outside the formal healthcare system. Estimates were generated using the RDS II estimator. RESULTS: Seven recruitment chains generated 2437 participants (mean of 19.8 recruitment waves, the longest being 51). We filtered for suspected repeat and ineligible participation and generated RDS estimates for the remaining 1340 participants. The estimated personal network size was 4.9; participants knew an average of 2.7 peers with abortion experience. An estimated 17.1% reported ≥1 abortion, ever in life. Among these, an estimated 20.7% (95% CI 14.2 to 28.0) reported an SMA outside the formal healthcare system; 65.3% before and 24.7% after the legal reform. An estimated 42.2% completed the SMA alone. Reported advantages included autonomy in timing and setting, and support person choice. Disadvantages included concerns about pill quality and uncertainties around the process. CONCLUSIONS: A substantial proportion of women in Argentina with abortion experience have had an SMA outside the formal healthcare system, including post-legalisation. Our findings highlight the need to better address the preferences and needs of those facing unintended pregnancy and the potential of webRDS to study SMA.