Telemedicine for medication abortion could greatly improve accessibility to rural women and expand abortion accessibility to an additional 3.5 million reproductive-aged women, according to recent research.1
“While it’s been around for a bit of time, I do think the onset of the COVID pandemic, and now with Dobbs, we’ve seen a surge in interest in telehealth abortion and greater recognition of the benefits of the telehealth delivery system,” says Terri-Ann Thompson, PhD, a senior research scientist with Ibis Reproductive Health in Cambridge, MA. “We’ve been doing work with medication abortion for about a decade, and primarily we looked at models that originated with clinics.”
Before the pandemic, the only people with access to medication abortion through telehealth were enrolled in research. The pandemic shifted a lot of healthcare to telemedicine direct-to-patient services. It became possible to help people access medication abortion through telehealth services. Now, telemedicine abortion services are available in states where this is legal. Both ways of administering medication abortion pills are equally safe and effective, Thompson notes.
Now, more women are accessing medication abortion through online platforms, such as AidAccess.org, which saw a huge increase in demand after Texas passed its six-week abortion ban in 2021.
“As researchers, we’re still actively collecting data,” Thompson says. “That trend [of increased online access] has continued in the post-Dobbs era.”
Online Sources Are Growing
The share of medication abortions provided through online sources is growing, as is the share of medication abortions provided by online pharmacies. These pharmacies play an important role, especially in states with broad laws protecting abortion rights.
“They have become a big part of the story, once we saw direct-to-patient healthcare,” Thompson says.
Thompson and colleagues did not address underground abortion pills, such as those brought from Mexico into the United States, although others are looking at studying this activity. They also are studying the influx of pills from people running grassroots organizations to help provide access to medication abortion.
State abortion bans are causing a seismic shift in how women obtain abortion care in the United States. What has been a more concentrated, grounded system that is based on clinic care is now shifting to online platforms without brick-and-mortar clinics and to grassroots organizations and self-managed abortions.
“We’re looking at a system that is more dispersed than it was before. How do you, as a clinician, make sense of that, both for your patients and for yourself?” Thompson asks.
REFERENCE
- Seymour JW, Thompson T-A, Milechin D, et al. Potential impact of telemedicine for medication abortion policy and programming changes on abortion accessibility in the United States. Am J Public Health 2022;112:1202-1211.
Telemedicine for medication abortion could greatly improve accessibility to rural women and expand abortion accessibility to an additional 3.5 million reproductive-aged women, according to recent research.
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