Telehealth medication abortion is safe and effective, study shows

O medical abortion done via telehealth consultation is as safe and effective as that done in a clinical consultation (in person), points out a study published last week in Nature Medicine magazine .

Medical abortion is the most common form of abortion in the United States and consists of a method in which someone interrupt a pregnancy by taking pills, without having to undergo surgery .

The research assessed that, with rare exceptions, telehealth guaranteed the safety and effectiveness of medical abortions in consultations via text messages and also via video calls.

Of the people who participated in the study, the majority preferred assistance via text messages.

The study analyzed records of 6,034 medication abortions performed via telehealth between April 2021 and January 2022 at three virtual clinics operating in 20 states and the District of Columbia.

Of the 6,034 abortions in the study, 99.8% were not followed by serious adverse events.

“In total, 0.25% of patients suffered a serious adverse event related to abortion; 0.16% were treated for an ectopic pregnancy and 1.3% of miscarriages were referred to the emergency room,” the study says.

The effectiveness and safety of medication abortion provided through video and text consultations were similar to numbers from other medication abortion studies involving in-person care.

As with in-person appointments, patients who opt for telehealth are not required to undergo any tests or physical exams.

Instead, a healthcare worker decides whether to prescribe the abortion medication based on the patient's medical history.

The study also showed that medical abortion was highly effective, as 97.7% of participants had a complete abortion after taking the pills, without the need for any further intervention.

Among those whose abortion was not initially complete, 0.56% took more medication to complete the procedure; 1.4% required a surgical procedure; and 0.94% had a confirmed or suspected continued pregnancy.

Results were similar for patients regardless of race, ethnicity or age.

“Telehealth medication abortion is effective, safe, and comparable to published rates of in-person medication abortion care,” researchers at the University of California, San Francisco concluded.

The new study is helpful in reinforcing that the practice is safe and effective, said Dr. Pratima Gupta, an abortion provider in San Diego who was not involved in the new research.

“It's great to have research data to support what we already knew about the safety of medication abortion,” she said.

Telehealth options meet patients' needs, she said, and that may be more important than ever with more states restricting abortion access since the U.S. Supreme Court overturned Roe v. Wade. Wade in 2022.

“I think it’s really wonderful that we can meet patients where they are. So whatever your preferred method of communication, be it text messaging, phone messaging, video messaging, we can meet your needs with accessibility,” said Gupta. “And it gives them the privacy they need to control their lives.”

In the US, telehealth services have offered medication abortion care at some level since 2008, but this option has become much more widely used during the Covid-19 pandemic.

In 2021, the US Food and Drug Administration (FDA) said it would no longer require in-person appointments for medications to be prescribed.

This has paved the way for more virtual appointments in states where abortion and telehealth for abortion are not prohibited.

Medical abortion is aimed at those who are up to ten weeks after the start of their last menstrual period.

The method is not recommended for people with certain health problems and who have had an ectopic pregnancy (with a fertilized egg implanted outside the uterus).