July 21, 2011 — Allowing women to obtain medication abortion services via telemedicine is equally effective and acceptable to patients as receiving the drugs during a face-to-face office visit, according to a study published in the journal Obstetrics and Gynecology, MSNBC reports.
The report is among the first to study the effects of telemedicine abortion, which conservative lawmakers have increasingly targeted through legislation banning the practice. The research — led by Daniel Grossman, an assistant clinical professor of obstetrics and gynecology at the University of California-San Francisco and a senior associate at the research organization Ibis Reproductive Health — followed 578 women in Iowa who sought medication abortion services at Planned Parenthood clinics. According to Grossman, 223 of the patients elected to have the procedure via telemedicine and 226 chose face-to-face office visits.
Planned Parenthood of the Heartland has offered abortion services through telemedicine since 2008, allowing women living in rural areas without abortion providers to obtain abortion care early in pregnancy, MSNBC reports (Carroll, MSNBC, 7/20). Through the program, a woman seeking abortion care receives an ultrasound and examination from a nurse and then consults with a physician via the Internet on a private computer. If the physician determines that the patient is an appropriate candidate for medication abortion, he or she dispenses the medication remotely by pressing a button that opens a container with the drugs at the patient’s location (Women’s Health Policy Report, 5/24).
Many states stipulate that only physicians can provide medication abortion care and that they must counsel women before administering the pills. A few states allow nurse practitioners and other mid-level health care providers to dispense the medication, while at least five states recently enacted bans against using telemedicine for abortion services.
According to the study, medication abortion successfully terminated pregnancy in 99% of telemedicine patients and 97% of patients who received in-person care. There was no significant difference in complications between the two groups. Telemedicine patients were more likely to report satisfaction with their care, though 25% of telemedicine patients said after the procedure that they would have preferred being in the same room as the doctor.
Using telemedicine to provide abortion care has prompted objections from antiabortion-rights advocates, who claim the practice endangers women’s health. However, medical ethicist Arthur Caplan said this opposition has more to do with a desire to limit abortion access than with actual concern for women’s safety. “Clearly we don’t have enough primary care providers,” he said, adding, “One way to solve this is through telemedicine. We don’t want to be attacking that, we probably want to be celebrating it” (MSNBC, 7/20).