- A new study finds that telemedicine is an effective and safe way to administer an abortion via medication.
- Many Americans live far from a clinic where an abortion is available.
- Multiple states have passed laws that severely curtail access to abortion or effectively outlaw abortion entirely.
For the first time since Roe vs. Wade was decided, there are multiple states in the United States where it soon may be almost impossible to legally obtain an abortion.
Earlier this year, a handful of states cracked down on abortion access, passing bills that prohibit abortions after six weeks.
And just this week, the Trump administration announced that federally funded family planning clinics — many of which are affiliated with Planned Parenthood — can no longer refer women for abortions.
As restrictions on abortion care tighten across multiple fronts, many women have come to rely on accessing abortion medications via telemedicine.
Telemedicine has been particularly beneficial for those with limited access to abortions, as it allows women to receive care sooner and at a healthcare center closer to where they live.
Still, despite the fact that telemedicine abortions have been proven to be incredibly safe and effective, several states continue to prohibit them or have passed laws to restrict them due to claims they may be unsafe.
Now, new research further supports the fact that telemedicine abortions are just as safe as the standard provision of medication abortions.
Medication abortions provided via telemedicine essentially have the same health outcomes as medication abortions provided in a clinic or medical setting, according to the study, which published in the journal Obstetrics & Gynecology early July.
A medication abortion is when pills are given to a patient in order to end a pregnancy. The medications — mifepristone and misoprostol— used via telemedicine are the same pills used with in-office visits.
They must be taken within the first 10 weeks of gestation. They’re extremely safe and rarely cause severe complications.
The first drug, mifepristone, is a progesterone receptor blocker and causes the pregnancy to separate from the uterine lining. The second drug, misoprostol, causes the cervix to open and the uterus to contract, which expels the pregnancy.
“Both this study and another larger one from Iowa found that serious complications are very rare and no more likely to occur with telemedicine compared with an in-person visit. There is no medical reason that justifies banning telemedicine provision of medication abortion,” the study’s co-author Dr. Daniel Grossman, a professor in the department of obstetrics, gynecology, and reproductive sciences at the University of California, San Francisco, told Healthline.
To evaluate telemedicine abortions, researchers with Ibis Reproductive Health in Cambridge, Massachusetts, and Advancing New Standards in Reproductive Health, a group at the University of California, San Francisco, analyzed health records from 5,952 women who received a medication abortion — 738 who got an abortion through telemedicine services, and 5,214 through standard, on-site procedures.
The women were treated at 26 health centers in four states — Alaska, Idaho, Nevada, and Washington — between April 2017 and March 2018.
All women received on-site ultrasound scans, lab testing, and counseling sessions.
The patients who received a standard abortion met with a clinician in person. Those who received the abortion medications via telemedicine spoke with a clinician via a secure videoconference platform at a participating health center. They then took a portion of the medications in view of the clinician on-screen.
The researchers then looked at the prevalence of both minor and major adverse events with both groups.
The team found that there were no notable differences between the group who received the medication via telehealth and the group that underwent a standard medication abortion.
Rates of adverse effects — such as an ectopic pregnancy or blood transfusions — were very low in both groups, according to the study.
In the United States, there are 27 cities that have a population of at least 100,000 people that are considered to be “abortion deserts.” These areas are more than 100 miles from the closest abortion provider.
On top of that, up to 90 percent of counties in the United States don’t have an abortion provider, leaving hundreds of thousands of women with extremely limited access to abortion care.
For many of these women, telehealth may be their best bet if they’re seeking to end a pregnancy.
There are two ways in which women can obtain telemedicine abortions.
First, rather than drive hundreds of miles to the closest abortion provider, pregnant women can visit a nearby health center. There, they meet with on-site staff and speak to a clinician who prescribes the pills virtually via a video conference.
Another telehealth organization, TelAbortion, provides medical abortions directly to women in their own homes.
With TelAbortion, an abortion provider conducts an online video evaluation. The patient then obtains all the required tests at nearby radiology and lab facilities, and the pills are then mailed to the patient’s home.
“Telemedicine for abortion, when done in a safe setting and proper screening, can be safe, highly effective, and a way for patients who otherwise don’t have access to medical care, or can’t get access due to state limitations, to terminate pregnancies safely,” says Dr. Tristan Emily Bickman, a board-certified OB-GYN and co-author of the book “Whoa, Baby!”
Of course, not everyone will qualify for a medication abortion.
“There are definitely some patients who will not qualify for a telemedicine abortion — for example, if it is determined that the patient may have an ectopic pregnancy,” Grossman said.
A patient may not know she has an at-risk condition until she gets evaluated, which is why it’s so crucial for telemedicine patients to undergo routine testing at a nearby health facility.
Seeing as telemedicine abortions are just as safe as standard medication abortions, many health experts hope to increase access to them in the future.
Seventeen states currently prohibit clinicians from dispensing the abortion medications remotely, Bickman said.
Lifting these restrictions could significantly expand medication abortion access to new and underserved communities, according to the Guttmacher Institute.
With telemedicine abortion, more women can get the same high-quality care, and safety as standard medication abortions.
As states tighten access to abortions across the United States, more women are turning to telemedicine abortions. While 17 states prohibit clinicians from prescribing abortion pills remotely over concerns it may be unsafe, research has shown that telemedicine abortions are very safe and effective. Now, new evidence shows that telemedicine abortions lead to the same outcomes as standard medication abortions conducted by an on-site clinician.