A new study is the first to evaluate how telemedicine can help vulnerable women access safe medical abortions.
The World Health Organization (WHO) states that 25 million unsafe abortions are performed yearly and as a result, up to 47,000 women and girls die. Individuals seek non-medical abortions for many reasons including a lack of resources, the stigma surrounding abortion and restrictive abortion laws. For example, in South Africa, it is estimated that approximately half of all abortions are performed outside of the general healthcare system, risking the safety of women in need of care.
“As far as we know, our study is the first randomised clinical trial to evaluate telemedicine, meaning care at a distance, in abortion. This method can potentially reduce the number of unsafe abortions, something that is particularly important and relevant in times when the right to abortion is under threat”, said Margit Endler, a researcher at the Department of Women’s and Children’s Health at Karolinska Institutet and consultant at the Department of Obstetrics and Gynaecology at Södersjukhuset (Stockholm South General Hospital).
Studying women seeking medical abortions
The study from Karolinska Institutet involved 900 women from four clinics in Cape Town, South Africa, who were at or before nine weeks gestation and who were seeking care for a medical abortion.
Half of the women received standard care with an in-person consultation, an ultrasound, and then had a medical abortion initiated by an oral tablet at the clinic. The other half received treatment through telemedicine, where women will fill out an online form, receive information and instructions for the medical abortion procedure via text, and took both abortion medications at home. The only in-person component was a uterine examination as a safety precaution.
Most women preferred telemedicine
The researchers compared the rate of successful medical abortion, continuing pregnancy, adverse events, and satisfaction with the treatment. They discovered that women completing an abortion through telemedicine understood the instructions well and achieved the same treatment results as the women receiving standard in-person care whilst maintaining similar levels of safety.
“What was interesting was that the majority of women in both groups expressed that they preferred the telemedicine option. This care model can be particularly important in resource-poor areas where there is a lack of healthcare infrastructure or restrictive abortion laws. For example, women can be examined at a clinic that does not have access to ultrasound and then receive guidance for the abortion remotely”, said Margit Endler.
The researchers are exploring a new study in Africa that will evaluate if women deemed a low risk of complications can go without a physical visit to the clinic completely.
