A new day for accessing abortion in the first weeks of pregnancy arrived with the abortion pill. It took the procedure out of a clinic and allowed the patient, after lab tests and sonogram, to have one in-person visit with a medical professional, and then go home, take a pill and have the abortion at home. (This is called a medical abortion). Now even that one in-person visit may not be necessary, replaced by a teleconference with a medical professional. Especially in states with restrictive abortion laws and very few clinics – or none – TelAbortion could mean the difference between life and death – safe abortion or life-threatening illegal procedures.
Choices Women’s Medical Center participated in the study organized by Gynuity Health Project. Esther Prigue, LCSW, and Administrator and Head of Counseling at Choices was part of the TelAbortion Project Team. The manuscript announcing the study results has been accepted for publication by Contraception Magazine.
Upon publication, we will send our readers a link to the entire manuscript. For now, here is a brief description of the study and Abstract.
TelAbortion: evaluation of a direct to patient telemedicine abortion service in the United States.
Some of our key findings and conclusions include:
Medical abortion (medication abortion) can be safely and effectively provided using direct-to-patient telemedicine, which allows patients to obtain the service via videoconference and mail without an in-person visit with an abortion provider.
The TelAbortion service is highly acceptable to patients and can increase access to abortion for people who have difficulty going in person to an abortion clinic.
The U.S. Food and Drug Administration, as well as individual states, should lift legal and regulatory restrictions on abortion so that this service can be provided throughout the entire United States.
Abstract
Objectives
To evaluate the safety, feasibility, and acceptability of a direct-to-patient telemedicine service that enabled people to obtain medical abortion (medication abortion) without visiting an abortion provider in person.
Study design
We offered the service in five states. Each participant had a videoconference with a study clinician and had pre-treatment laboratory tests and ultrasound at facilities of her choice. If the participant was eligible for medical abortion (medication abortion), the clinician sent a package containing mifepristone, misoprostol, and instructions to her by mail. After taking the medications, the participant obtained follow-up tests and had a follow-up consultation with the clinician by telephone or videoconference to evaluate abortion completeness. The analysis was descriptive.
Results
Over 32 months, we conducted 433 study screenings and shipped 248 packages. The median interval between screening and mailing was 7 days (91st percentile 17 days), and no participant took the mifepristone at ≫71 days of gestation. We ascertained abortion outcomes of 190/248 package recipients (77%): 177/190 (93%) had complete abortion without a procedure. Of the 217/248 package recipients who provided meaningful follow-up data (88%), one was hospitalized for postoperative seizure and another for excessive bleeding, and 27 had other unscheduled clinical encounters, 12 of which resulted in no treatment. A total of 159/248 participants who received packages (64%) completed satisfaction questionnaires at study exit; all were satisfied with the service.
Conclusions
This direct-to-patient telemedicine abortion service was safe, effective, efficient, and satisfactory. The model has the potential to increase abortion access by enhancing the reach of providers and by offering people a new option for obtaining care conveniently and privately.
Implications
Provision of medical abortion (medication abortion) by direct-to-patient telemedicine and mail has the potential to increase abortion access by increasing the reach of providers and by offering people the option of obtaining abortion care without an in-person visit to an abortion provider.
