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New study shows medication abortion via telemedicine is as safe as in-person provision

Nov 09 2017

In a landmark study of seven years of patient data, researchers at the University of California San Francisco (UCSF) showed that medical abortion provided by telemedicine is just as safe as when women are in the same room as the doctor.

The study looked at data from Iowa patients who received a medical abortion either via telemedicine or in person from 2008 to 2015, including any reports of serious complications, including visits to the emergency department where treatment was given. Of the nearly 20,000 patients studied, only 49 complications were reported, and there was no difference in the complication rate between women who had an in-person visit and those who received the service via telemedicine.

Women who receive abortion via telemedicine undergo the same evaluation as those with an in-person visit, including having an ultrasound, which was viewed remotely by the doctor. The doctor meets with the patient by secure videoconference, and if she was eligible, the doctor remotely dispensed the medications. Women returned to the clinic about one week later to confirm that the abortion was successful.

Eighteen states in USA have banned the use of telemedicine to provide abortion, raising alleged concerns about safety. In 2008, Planned Parenthood of the Heartland in Iowa began offering medication abortion at health centres without a physician on site in order to improve access to abortion for those living in areas with few or no abortion providers. The Iowa Board of Medicine imposed a regulation in 2013 that prohibited telemedicine medication abortions. Planned Parenthood filed a legal challenge to the ban, and in 2015, the Iowa Supreme Court issued a unanimous ruling blocking the regulation and allowing telemedicine abortion care to continue.

Medical abortion has become increasingly popular since it was approved in USA in 2000, and it now accounts for almost half of eligible abortions. The regimen, which is used up to 10 weeks of pregnancy, involves taking mifepristone, followed by misoprostol, usually 24 to 48 hours later. Women’s experience with medical abortion is similar to that of a spontaneous miscarriage.

The study was published online in Obstetrics & Gynecology, the official journal of the American College of Obstetricians and Gynecologists.

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