Telehealth abortions? New study provides ‘roadmap’ for women’s health services online

SEATTLE — The U.S. Supreme Court overturning Roe v. Wade has dramatically upended abortion care services nationwide. Some Americans now have to cross state lines if they wish to end a pregnancy, with over a dozen states installing “trigger bans” after the end of Roe. With some women turning to the Internet for abortion-inducing pills, a new study is offering a “roadmap” for doctors to offer “telehealth abortion services” for pregnant patients.

Researchers from the University of Washington School of Medicine assessed services provided by family medicine clinicians in a number of settings, including family planning clinics, online medical services, and primary care practices — both within and outside of multi-specialty healthcare systems.

Researchers found similar operational procedures for remote medication abortion services at these practices, with all of them following five basic steps for care provision. These steps include patient engagement, care consultations, payment, medication dispensing, and follow-up communication.

Dr. Emily Godfrey, the study’s senior author and a family medicine physician with the University of Washington Medicine health care system, says most abortion pills — a combination of mifepristone and misoprostol — are given out by independent reproductive health clinics. With many states restricting abortion access since the overturning of Roe v. Wade, this study provides “a roadmap for primary care and OB-GYN clinicians to rapidly initiate telemedicine abortion for patients, where the law allows,” explains Dr. Godfrey in a university release.

Demand for telehealth continues to rise during the pandemic era

For their study, researchers interviewed 21 doctors or clinical staff in various states in November and December of 2020 — before the Supreme Court overturned Roe. The participants were mostly family physicians or family nurse practitioners from 15 sites.

The study notes that when patients and providers communicated via email, text, or an electronic medical record portal, it took two to three minutes of the clinician’s time. Initiating a video call between a patient and clinician took 10 to 30 minutes. Afterwards, patients received their medications through the mail, delivered by the United States Postal Service.

The study’s findings have contributed to the Access, Delivered Provider Toolkit, which is a guide for providers looking to initiate their own telehealth abortion services.

“Next steps for the group include understanding patients’ experience with Telehealth medication abortion services — specifically patient perceptions of these service models and how Telehealth abortion may improve access to care for those traditionally marginalized by health care systems,” the study authors add.

Dr. Godfrey has conducted previous studies on medicated abortion, including two in 2021 that evaluated demand and aftercare for patients. Those studies revealed that clinics that mailed abortion pills to patients during the pandemic experienced high demand for telehealth abortion care.

Abortion medications currently account for over half of the abortions in the United States. A recent study discovered that online searches for abortion pills reached record highs following the court’s ruling.

The study is published in the journal The Annals of Family Medicine.

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